{"reporting_entity_name": "Molina-Healthcare-of-Texas", "reporting_entity_type": "health insurance issuer", "last_updated_on": "2026-10-29", "version": "2.0.0", "out_of_network": [{"name": "Laboratory - Hematology", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0305", "description": "Laboratory", "allowed_amounts": [{"tin": {"type": "ein", "value": "751837454"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 170.114, "npi": [1447250253]}, {"billed_charge": 206.81, "npi": [1447250253]}, {"billed_charge": 132.7718, "npi": [1447250253]}, {"billed_charge": 146.11, "npi": [1447250253]}, {"billed_charge": 169.5544, "npi": [1447250253]}, {"billed_charge": 168.8108, "npi": [1447250253]}, {"billed_charge": 172.3667, "npi": [1447250253]}, {"billed_charge": 126.6067, "npi": [1447250253]}, {"billed_charge": 110.87, "npi": [1447250253]}, {"billed_charge": 160.8629, "npi": [1447250253]}, {"billed_charge": 342.42, "npi": [1447250253]}, {"billed_charge": 221.623, "npi": [1447250253]}, {"billed_charge": 170.9588, "npi": [1447250253]}, {"billed_charge": 130.574, "npi": [1447250253]}, {"billed_charge": 131.628, "npi": [1447250253]}, {"billed_charge": 219.0694, "npi": [1447250253]}, {"billed_charge": 170.2567, "npi": [1447250253]}, {"billed_charge": 146.2243, "npi": [1447250253]}, {"billed_charge": 153.9117, "npi": [1447250253]}, {"billed_charge": 163.57, "npi": [1447250253]}, {"billed_charge": 140.91, "npi": [1447250253]}, {"billed_charge": 161.1033, "npi": [1447250253]}, {"billed_charge": 166.1, "npi": [1447250253]}, {"billed_charge": 153.3914, "npi": [1447250253]}, {"billed_charge": 178.342, "npi": [1447250253]}, {"billed_charge": 248.29, "npi": [1447250253]}, {"billed_charge": 135.2233, "npi": [1447250253]}, {"billed_charge": 155.9836, "npi": [1447250253]}, {"billed_charge": 149.84, "npi": [1447250253]}, {"billed_charge": 183.63, "npi": [1447250253]}, {"billed_charge": 154.558, "npi": [1447250253]}, {"billed_charge": 245.6, "npi": [1447250253]}, {"billed_charge": 166.735, "npi": [1447250253]}, {"billed_charge": 93.56, "npi": [1447250253]}, {"billed_charge": 321.65, "npi": [1447250253]}, {"billed_charge": 106.26, "npi": [1447250253]}, {"billed_charge": 149.7757, "npi": [1447250253]}, {"billed_charge": 166.8086, "npi": [1447250253]}, {"billed_charge": 176.591, "npi": [1447250253]}, {"billed_charge": 166.838, "npi": [1447250253]}, {"billed_charge": 147.223, "npi": [1447250253]}, {"billed_charge": 158.2875, "npi": [1447250253]}, {"billed_charge": 134.7988, "npi": [1447250253]}, {"billed_charge": 161.8763, "npi": [1447250253]}, {"billed_charge": 190.096, "npi": [1447250253]}, {"billed_charge": 177.3588, "npi": [1447250253]}, {"billed_charge": 163.356, "npi": [1447250253]}, {"billed_charge": 180.5582, "npi": [1447250253]}]}]}]}, {"name": "Emergency Room - General", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0450", "description": "Emergency Room", "allowed_amounts": [{"tin": {"type": "ein", "value": "752678857"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 103.5, "npi": [1417980202]}, {"billed_charge": 333.25, "npi": [1417980202]}, {"billed_charge": 106.75, "npi": [1417980202]}, {"billed_charge": 779.25, "npi": [1417980202]}, {"billed_charge": 683.75, "npi": [1417980202]}, {"billed_charge": 2758.25, "npi": [1417980202]}, {"billed_charge": 254.75, "npi": [1417980202]}]}, {"allowed_amount": 396.31, "billing_code_modifier": [""], "providers": [{"billed_charge": 1042.5, "npi": [1417980202]}]}, {"allowed_amount": 3797.35, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 2758.25, "npi": [1417980202]}]}, {"allowed_amount": 122.42, "billing_code_modifier": [""], "providers": [{"billed_charge": 332.25, "npi": [1417980202]}]}, {"allowed_amount": 605.81, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 1521.25, "npi": [1417980202]}]}, {"allowed_amount": 222.92, "billing_code_modifier": [""], "providers": [{"billed_charge": 537.75, "npi": [1417980202]}]}]}]}, {"name": "Laboratory - General", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0300", "description": "Laboratory", "allowed_amounts": [{"tin": {"type": "ein", "value": "751037591"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 142.7467, "npi": [1124305065]}, {"billed_charge": 113.672, "npi": [1124305065]}, {"billed_charge": 195.8088, "npi": [1124305065]}, {"billed_charge": 40.0, "npi": [1124305065]}, {"billed_charge": 47.75, "npi": [1124305065]}, {"billed_charge": 392.86, "npi": [1124305065]}, {"billed_charge": 97.0514, "npi": [1124305065]}, {"billed_charge": 162.1408, "npi": [1124305065]}, {"billed_charge": 96.8885, "npi": [1124305065]}]}]}]}, {"name": "Laboratory - Chemistry", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0301", "description": "Laboratory", "allowed_amounts": [{"tin": {"type": "ein", "value": "412101361"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 214.55, "npi": [1609855139]}, {"billed_charge": 285.79, "npi": [1609855139]}, {"billed_charge": 153.91, "npi": [1609855139]}, {"billed_charge": 190.6607, "npi": [1609855139]}, {"billed_charge": 311.0461, "npi": [1609855139]}, {"billed_charge": 185.85, "npi": [1609855139]}, {"billed_charge": 104.78, "npi": [1609855139]}, {"billed_charge": 249.74, "npi": [1609855139]}, {"billed_charge": 190.6236, "npi": [1609855139]}, {"billed_charge": 407.22, "npi": [1609855139]}]}, {"allowed_amount": 20.62, "billing_code_modifier": [""], "providers": [{"billed_charge": 328.07, "npi": [1609855139]}]}]}]}, {"name": "SBSQ HOSPITAL IP/OBS CARE HIGH MDM 50 MINUTES", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "99233", "description": "SBSQ HOSPITAL IP/OBS CARE HIGH MDM 50 MINUTES", "allowed_amounts": [{"tin": {"type": "ein", "value": "271463889"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 108.8, "billing_code_modifier": [""], "providers": [{"billed_charge": 351.0, "npi": [1912096694]}]}]}]}, {"name": "Pharmacy - Extension of 25X - Drug Requiring Detailed Coding", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0636", "description": "Pharmacy - Extension of 25x", "allowed_amounts": [{"tin": {"type": "ein", "value": "752678857"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.49, "billing_code_modifier": [""], "providers": [{"billed_charge": 10.0, "npi": [1417980202]}]}, {"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 50.0, "npi": [1417980202]}, {"billed_charge": 2.1531, "npi": [1417980202]}, {"billed_charge": 2.5, "npi": [1417980202]}, {"billed_charge": 6.25, "npi": [1417980202]}, {"billed_charge": 11.3125, "npi": [1417980202]}, {"billed_charge": 5.0, "npi": [1417980202]}, {"billed_charge": 3.25, "npi": [1417980202]}, {"billed_charge": 12.5, "npi": [1417980202]}, {"billed_charge": 2.5331, "npi": [1417980202]}]}, {"allowed_amount": 0.49, "billing_code_modifier": ["JW"], "providers": [{"billed_charge": 10.0, "npi": [1417980202]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["JZ"], "providers": [{"billed_charge": 0.8295, "npi": [1417980202]}, {"billed_charge": 16.33, "npi": [1417980202]}, {"billed_charge": 0.4568, "npi": [1417980202]}]}]}]}, {"name": "Laboratory - Chemistry", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0301", "description": "Laboratory", "allowed_amounts": [{"tin": {"type": "ein", "value": "752770738"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 335.75, "npi": [1770514077]}, {"billed_charge": 463.25, "npi": [1770514077]}, {"billed_charge": 324.5, "npi": [1770514077]}, {"billed_charge": 328.75, "npi": [1770514077]}, {"billed_charge": 153.5, "npi": [1770514077]}, {"billed_charge": 210.75, "npi": [1770514077]}, {"billed_charge": 231.0, "npi": [1770514077]}, {"billed_charge": 679.25, "npi": [1770514077]}, {"billed_charge": 565.0, "npi": [1770514077]}, {"billed_charge": 334.25, "npi": [1770514077]}, {"billed_charge": 229.25, "npi": [1770514077]}, {"billed_charge": 561.75, "npi": [1770514077]}, {"billed_charge": 278.25, "npi": [1770514077]}, {"billed_charge": 348.5, "npi": [1770514077]}, {"billed_charge": 449.8611, "npi": [1770514077]}, {"billed_charge": 222.25, "npi": [1770514077]}, {"billed_charge": 257.75, "npi": [1770514077]}, {"billed_charge": 671.0, "npi": [1770514077]}, {"billed_charge": 161.0, "npi": [1770514077]}, {"billed_charge": 225.75, "npi": [1770514077]}, {"billed_charge": 340.0, "npi": [1770514077]}, {"billed_charge": 385.0938, "npi": [1770514077]}, {"billed_charge": 308.0, "npi": [1770514077]}, {"billed_charge": 364.4435, "npi": [1770514077]}, {"billed_charge": 442.5, "npi": [1770514077]}]}, {"allowed_amount": 20.62, "billing_code_modifier": [""], "providers": [{"billed_charge": 679.25, "npi": [1770514077]}]}, {"allowed_amount": 15.31, "billing_code_modifier": [""], "providers": [{"billed_charge": 679.25, "npi": [1770514077]}]}]}]}, {"name": "Other Imaging Services - Ultrasound", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0402", "description": "Other Imaging Services", "allowed_amounts": [{"tin": {"type": "ein", "value": "751837454"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 151.54, "billing_code_modifier": [""], "providers": [{"billed_charge": 1049.03, "npi": [1447250253]}, {"billed_charge": 1072.02, "npi": [1447250253]}, {"billed_charge": 1101.64, "npi": [1447250253]}, {"billed_charge": 1269.06, "npi": [1447250253]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["U6"], "providers": [{"billed_charge": 765.0, "npi": [1447250253]}]}, {"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 1049.03, "npi": [1447250253]}, {"billed_charge": 527.09, "npi": [1447250253]}, {"billed_charge": 765.0, "npi": [1447250253]}, {"billed_charge": 945.11, "npi": [1447250253]}, {"billed_charge": 1053.25, "npi": [1447250253]}, {"billed_charge": 1515.29, "npi": [1447250253]}, {"billed_charge": 1101.64, "npi": [1447250253]}, {"billed_charge": 1269.06, "npi": [1447250253]}, {"billed_charge": 1020.91, "npi": [1447250253]}, {"billed_charge": 1152.88, "npi": [1447250253]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["LT"], "providers": [{"billed_charge": 610.83, "npi": [1447250253]}]}, {"allowed_amount": 151.54, "billing_code_modifier": ["U6"], "providers": [{"billed_charge": 1152.88, "npi": [1447250253]}]}]}]}, {"name": "Emergency Room - General", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0450", "description": "Emergency Room", "allowed_amounts": [{"tin": {"type": "ein", "value": "202848116"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 308.31, "billing_code_modifier": [""], "providers": [{"billed_charge": 333.25, "npi": [1629138029]}, {"billed_charge": 779.25, "npi": [1629138029]}]}, {"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 882.0625, "npi": [1629138029]}, {"billed_charge": 2758.25, "npi": [1629138029]}, {"billed_charge": 542.5, "npi": [1629138029]}, {"billed_charge": 333.25, "npi": [1629138029]}, {"billed_charge": 652.6667, "npi": [1629138029]}]}, {"allowed_amount": 67.875, "billing_code_modifier": [""], "providers": [{"billed_charge": 333.25, "npi": [1629138029]}]}, {"allowed_amount": 222.56, "billing_code_modifier": [""], "providers": [{"billed_charge": 537.75, "npi": [1629138029]}]}, {"allowed_amount": 67.87, "billing_code_modifier": [""], "providers": [{"billed_charge": 333.25, "npi": [1629138029]}, {"billed_charge": 103.5, "npi": [1629138029]}]}, {"allowed_amount": 395.66, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 1042.5, "npi": [1629138029]}]}, {"allowed_amount": 395.66, "billing_code_modifier": [""], "providers": [{"billed_charge": 1042.5, "npi": [1629138029]}]}, {"allowed_amount": 863.2, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 2758.25, "npi": [1629138029]}]}, {"allowed_amount": 308.31, "billing_code_modifier": ["59"], "providers": [{"billed_charge": 333.25, "npi": [1629138029]}, {"billed_charge": 779.25, "npi": [1629138029]}]}, {"allowed_amount": 122.22, "billing_code_modifier": [""], "providers": [{"billed_charge": 332.25, "npi": [1629138029]}]}, {"allowed_amount": 67.87, "billing_code_modifier": ["59"], "providers": [{"billed_charge": 333.25, "npi": [1629138029]}]}, {"allowed_amount": 604.81, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 1521.25, "npi": [1629138029]}]}]}]}, {"name": "Laboratory - Urology", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0307", "description": "Laboratory", "allowed_amounts": [{"tin": {"type": "ein", "value": "756001743"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 187.0, "npi": [1336172105]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["59"], "providers": [{"billed_charge": 187.0, "npi": [1336172105]}]}]}]}, {"name": "RADIOLOGIC EXAM CHEST SINGLE VIEW", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "71045", "description": "RADIOLOGIC EXAM CHEST SINGLE VIEW", "allowed_amounts": [{"tin": {"type": "ein", "value": "751286819"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 10.02, "billing_code_modifier": ["2676"], "providers": [{"billed_charge": 36.0, "npi": [1689623464]}]}, {"allowed_amount": 10.02, "billing_code_modifier": ["2677"], "providers": [{"billed_charge": 36.0, "npi": [1689623464]}]}, {"allowed_amount": 10.02, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 36.0, "npi": [1689623464]}]}]}]}, {"name": "Pharmacy - General", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0250", "description": "Pharmacy (also see 063x, an extension of 025x)", "allowed_amounts": [{"tin": {"type": "ein", "value": "751047527"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 27.0743, "npi": [1396779948]}, {"billed_charge": 14.6819, "npi": [1396779948]}, {"billed_charge": 1.99, "npi": [1396779948]}, {"billed_charge": 9.91, "npi": [1396779948]}, {"billed_charge": 1.2567, "npi": [1396779948]}, {"billed_charge": 2.0, "npi": [1396779948]}, {"billed_charge": 1.51, "npi": [1396779948]}, {"billed_charge": 0.75, "npi": [1396779948]}, {"billed_charge": 0.882, "npi": [1396779948]}, {"billed_charge": 65.4075, "npi": [1396779948]}, {"billed_charge": 50.0, "npi": [1396779948]}, {"billed_charge": 1.3333, "npi": [1396779948]}, {"billed_charge": 13.834, "npi": [1396779948]}, {"billed_charge": 6.3276, "npi": [1396779948]}, {"billed_charge": 6.4744, "npi": [1396779948]}, {"billed_charge": 1.65, "npi": [1396779948]}, {"billed_charge": 1.01, "npi": [1396779948]}, {"billed_charge": 2.275, "npi": [1396779948]}, {"billed_charge": 3.1406, "npi": [1396779948]}, {"billed_charge": 29.7325, "npi": [1396779948]}, {"billed_charge": 1.4, "npi": [1396779948]}, {"billed_charge": 3.55, "npi": [1396779948]}, {"billed_charge": 2.9207, "npi": [1396779948]}, {"billed_charge": 47.8143, "npi": [1396779948]}, {"billed_charge": 6.9464, "npi": [1396779948]}, {"billed_charge": 4.565, "npi": [1396779948]}, {"billed_charge": 3.3112, "npi": [1396779948]}, {"billed_charge": 2.525, "npi": [1396779948]}, {"billed_charge": 20.86, "npi": [1396779948]}, {"billed_charge": 1.0385, "npi": [1396779948]}, {"billed_charge": 2.5, "npi": [1396779948]}, {"billed_charge": 0.25, "npi": [1396779948]}, {"billed_charge": 0.5, "npi": [1396779948]}, {"billed_charge": 1.135, "npi": [1396779948]}, {"billed_charge": 1.1367, "npi": [1396779948]}, {"billed_charge": 13.7658, "npi": [1396779948]}, {"billed_charge": 1.0, "npi": [1396779948]}]}]}]}, {"name": "Emergency Room - General", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0450", "description": "Emergency Room", "allowed_amounts": [{"tin": {"type": "ein", "value": "260194016"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 308.31, "billing_code_modifier": [""], "providers": [{"billed_charge": 524.33, "npi": [1205018439]}, {"billed_charge": 902.11, "npi": [1205018439]}]}, {"allowed_amount": 222.56, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 782.31, "npi": [1205018439]}]}, {"allowed_amount": 308.31, "billing_code_modifier": ["XS"], "providers": [{"billed_charge": 902.11, "npi": [1205018439]}]}, {"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 524.33, "npi": [1205018439]}, {"billed_charge": 317.78, "npi": [1205018439]}, {"billed_charge": 2202.0, "npi": [1205018439]}, {"billed_charge": 361.12, "npi": [1205018439]}, {"billed_charge": 321.2, "npi": [1205018439]}, {"billed_charge": 321.05, "npi": [1205018439]}, {"billed_charge": 1598.6867, "npi": [1205018439]}, {"billed_charge": 1468.57, "npi": [1205018439]}, {"billed_charge": 1109.848, "npi": [1205018439]}, {"billed_charge": 1346.995, "npi": [1205018439]}]}, {"allowed_amount": 67.875, "billing_code_modifier": [""], "providers": [{"billed_charge": 317.78, "npi": [1205018439]}, {"billed_charge": 330.56, "npi": [1205018439]}, {"billed_charge": 392.06, "npi": [1205018439]}]}, {"allowed_amount": 604.81, "billing_code_modifier": [""], "providers": [{"billed_charge": 2122.8, "npi": [1205018439]}]}, {"allowed_amount": 222.56, "billing_code_modifier": [""], "providers": [{"billed_charge": 782.31, "npi": [1205018439]}]}, {"allowed_amount": 122.22, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 478.23, "npi": [1205018439]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["XU"], "providers": [{"billed_charge": 524.33, "npi": [1205018439]}, {"billed_charge": 392.06, "npi": [1205018439]}, {"billed_charge": 2308.84, "npi": [1205018439]}]}, {"allowed_amount": 3791.1, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 4233.71, "npi": [1205018439]}, {"billed_charge": 3879.67, "npi": [1205018439]}]}, {"allowed_amount": 67.87, "billing_code_modifier": [""], "providers": [{"billed_charge": 317.78, "npi": [1205018439]}, {"billed_charge": 392.06, "npi": [1205018439]}]}, {"allowed_amount": 67.8733, "billing_code_modifier": [""], "providers": [{"billed_charge": 392.06, "npi": [1205018439]}]}, {"allowed_amount": 395.66, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 1283.4, "npi": [1205018439]}, {"billed_charge": 1334.74, "npi": [1205018439]}]}, {"allowed_amount": 395.66, "billing_code_modifier": [""], "providers": [{"billed_charge": 1283.4, "npi": [1205018439]}, {"billed_charge": 1334.74, "npi": [1205018439]}]}, {"allowed_amount": 308.31, "billing_code_modifier": ["XU"], "providers": [{"billed_charge": 524.33, "npi": [1205018439]}, {"billed_charge": 814.34, "npi": [1205018439]}, {"billed_charge": 902.11, "npi": [1205018439]}]}, {"allowed_amount": 863.2, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 3879.67, "npi": [1205018439]}]}, {"allowed_amount": 122.22, "billing_code_modifier": [""], "providers": [{"billed_charge": 478.23, "npi": [1205018439]}]}, {"allowed_amount": 1197.29, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 4233.71, "npi": [1205018439]}]}, {"allowed_amount": 604.81, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 2122.8, "npi": [1205018439]}, {"billed_charge": 2444.0, "npi": [1205018439]}]}]}]}, {"name": "Radiology - Diagnostic - General", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0320", "description": "Radiology - Diagnostic", "allowed_amounts": [{"tin": {"type": "ein", "value": "752770738"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 644.75, "npi": [1770514077]}, {"billed_charge": 664.25, "npi": [1770514077]}, {"billed_charge": 626.125, "npi": [1770514077]}, {"billed_charge": 1044.25, "npi": [1770514077]}, {"billed_charge": 588.0, "npi": [1770514077]}]}, {"allowed_amount": 126.14, "billing_code_modifier": [""], "providers": [{"billed_charge": 792.25, "npi": [1770514077]}, {"billed_charge": 664.25, "npi": [1770514077]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["RT"], "providers": [{"billed_charge": 701.0, "npi": [1770514077]}, {"billed_charge": 599.5, "npi": [1770514077]}, {"billed_charge": 608.5, "npi": [1770514077]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["LT"], "providers": [{"billed_charge": 511.25, "npi": [1770514077]}, {"billed_charge": 870.25, "npi": [1770514077]}, {"billed_charge": 608.5, "npi": [1770514077]}, {"billed_charge": 489.25, "npi": [1770514077]}]}]}]}, {"name": "LEVEL IV SURG PATHOLOGY GROSS AND MICROSCOPIC EXAM", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "88305", "description": "LEVEL IV SURG PATHOLOGY GROSS AND MICROSCOPIC EXAM", "allowed_amounts": [{"tin": {"type": "ein", "value": "453710597"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 42.24, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 125.0, "npi": [1225423502]}]}, {"allowed_amount": 42.2414, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 125.0, "npi": [1225423502]}]}]}]}, {"name": "Pharmacy - General", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0250", "description": "Pharmacy (also see 063x, an extension of 025x)", "allowed_amounts": [{"tin": {"type": "ein", "value": "751837454"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 1.53, "npi": [1447250253]}, {"billed_charge": 2.984, "npi": [1447250253]}, {"billed_charge": 1.0802, "npi": [1447250253]}, {"billed_charge": 15.72, "npi": [1447250253]}, {"billed_charge": 1.1012, "npi": [1447250253]}, {"billed_charge": 0.105, "npi": [1447250253]}, {"billed_charge": 8.674, "npi": [1447250253]}, {"billed_charge": 12.005, "npi": [1447250253]}, {"billed_charge": 0.68, "npi": [1447250253]}, {"billed_charge": 16.6039, "npi": [1447250253]}, {"billed_charge": 6.4892, "npi": [1447250253]}, {"billed_charge": 3.0006, "npi": [1447250253]}, {"billed_charge": 0.3567, "npi": [1447250253]}, {"billed_charge": 18.12, "npi": [1447250253]}, {"billed_charge": 0.7129, "npi": [1447250253]}, {"billed_charge": 2.1677, "npi": [1447250253]}, {"billed_charge": 84.12, "npi": [1447250253]}, {"billed_charge": 1.63, "npi": [1447250253]}, {"billed_charge": 4.0143, "npi": [1447250253]}, {"billed_charge": 13.9825, "npi": [1447250253]}, {"billed_charge": 0.8756, "npi": [1447250253]}, {"billed_charge": 21.45, "npi": [1447250253]}, {"billed_charge": 8.1967, "npi": [1447250253]}, {"billed_charge": 0.7583, "npi": [1447250253]}, {"billed_charge": 0.92, "npi": [1447250253]}, {"billed_charge": 2.8625, "npi": [1447250253]}, {"billed_charge": 1.01, "npi": [1447250253]}, {"billed_charge": 3.4476, "npi": [1447250253]}, {"billed_charge": 7.795, "npi": [1447250253]}, {"billed_charge": 2.1623, "npi": [1447250253]}, {"billed_charge": 1.9175, "npi": [1447250253]}, {"billed_charge": 31.38, "npi": [1447250253]}, {"billed_charge": 0.41, "npi": [1447250253]}, {"billed_charge": 7.585, "npi": [1447250253]}, {"billed_charge": 8.0744, "npi": [1447250253]}, {"billed_charge": 15.58, "npi": [1447250253]}, {"billed_charge": 1.435, "npi": [1447250253]}, {"billed_charge": 1.048, "npi": [1447250253]}, {"billed_charge": 3.577, "npi": [1447250253]}, {"billed_charge": 0.6467, "npi": [1447250253]}, {"billed_charge": 8.9694, "npi": [1447250253]}, {"billed_charge": 10.2516, "npi": [1447250253]}, {"billed_charge": 11.2275, "npi": [1447250253]}, {"billed_charge": 1.837, "npi": [1447250253]}, {"billed_charge": 2.9281, "npi": [1447250253]}, {"billed_charge": 1.8172, "npi": [1447250253]}, {"billed_charge": 3.8688, "npi": [1447250253]}, {"billed_charge": 0.02, "npi": [1447250253]}, {"billed_charge": 2.105, "npi": [1447250253]}, {"billed_charge": 14.7486, "npi": [1447250253]}, {"billed_charge": 1.5403, "npi": [1447250253]}, {"billed_charge": 30.13, "npi": [1447250253]}, {"billed_charge": 1.35, "npi": [1447250253]}, {"billed_charge": 1.04, "npi": [1447250253]}, {"billed_charge": 27.75, "npi": [1447250253]}, {"billed_charge": 0.135, "npi": [1447250253]}, {"billed_charge": 35.71, "npi": [1447250253]}, {"billed_charge": 10.8114, "npi": [1447250253]}, {"billed_charge": 0.6616, "npi": [1447250253]}, {"billed_charge": 3.5185, "npi": [1447250253]}, {"billed_charge": 0.17, "npi": [1447250253]}, {"billed_charge": 1.0433, "npi": [1447250253]}, {"billed_charge": 0.1333, "npi": [1447250253]}, {"billed_charge": 0.37, "npi": [1447250253]}, {"billed_charge": 1.3567, "npi": [1447250253]}, {"billed_charge": 3.2135, "npi": [1447250253]}, {"billed_charge": 2.0467, "npi": [1447250253]}, {"billed_charge": 0.9627, "npi": [1447250253]}, {"billed_charge": 1.6765, "npi": [1447250253]}, {"billed_charge": 8.3383, "npi": [1447250253]}, {"billed_charge": 0.756, "npi": [1447250253]}, {"billed_charge": 9.0138, "npi": [1447250253]}, {"billed_charge": 3.2482, "npi": [1447250253]}, {"billed_charge": 1.5889, "npi": [1447250253]}, {"billed_charge": 0.0967, "npi": [1447250253]}, {"billed_charge": 1.795, "npi": [1447250253]}, {"billed_charge": 2.2821, "npi": [1447250253]}, {"billed_charge": 5.7, "npi": [1447250253]}, {"billed_charge": 0.9488, "npi": [1447250253]}, {"billed_charge": 10.01, "npi": [1447250253]}, {"billed_charge": 0.598, "npi": [1447250253]}, {"billed_charge": 0.9807, "npi": [1447250253]}, {"billed_charge": 4.966, "npi": [1447250253]}, {"billed_charge": 1.06, "npi": [1447250253]}, {"billed_charge": 8.823, "npi": [1447250253]}, {"billed_charge": 6.4217, "npi": [1447250253]}, {"billed_charge": 1.615, "npi": [1447250253]}, {"billed_charge": 10.19, "npi": [1447250253]}, {"billed_charge": 4.2409, "npi": [1447250253]}, {"billed_charge": 1.1699, "npi": [1447250253]}, {"billed_charge": 7.6383, "npi": [1447250253]}, {"billed_charge": 1.88, "npi": [1447250253]}, {"billed_charge": 26.44, "npi": [1447250253]}, {"billed_charge": 0.502, "npi": [1447250253]}, {"billed_charge": 1.1152, "npi": [1447250253]}, {"billed_charge": 0.035, "npi": [1447250253]}, {"billed_charge": 2.5225, "npi": [1447250253]}, {"billed_charge": 10.7625, "npi": [1447250253]}, {"billed_charge": 2.7426, "npi": [1447250253]}, {"billed_charge": 8.0452, "npi": [1447250253]}, {"billed_charge": 37.92, "npi": [1447250253]}, {"billed_charge": 27.8225, "npi": [1447250253]}, {"billed_charge": 1.2, "npi": [1447250253]}, {"billed_charge": 12.245, "npi": [1447250253]}, {"billed_charge": 0.075, "npi": [1447250253]}, {"billed_charge": 13.2814, "npi": [1447250253]}, {"billed_charge": 2.3, "npi": [1447250253]}, {"billed_charge": 1.714, "npi": [1447250253]}, {"billed_charge": 2.07, "npi": [1447250253]}, {"billed_charge": 8.0964, "npi": [1447250253]}, {"billed_charge": 0.1067, "npi": [1447250253]}, {"billed_charge": 0.6538, "npi": [1447250253]}, {"billed_charge": 1.6, "npi": [1447250253]}, {"billed_charge": 9.6683, "npi": [1447250253]}, {"billed_charge": 46.2533, "npi": [1447250253]}, {"billed_charge": 1.2543, "npi": [1447250253]}, {"billed_charge": 1.985, "npi": [1447250253]}, {"billed_charge": 10.0027, "npi": [1447250253]}, {"billed_charge": 1.4983, "npi": [1447250253]}, {"billed_charge": 0.285, "npi": [1447250253]}, {"billed_charge": 0.4467, "npi": [1447250253]}, {"billed_charge": 4.4138, "npi": [1447250253]}, {"billed_charge": 2.2702, "npi": [1447250253]}, {"billed_charge": 0.33, "npi": [1447250253]}, {"billed_charge": 1.525, "npi": [1447250253]}, {"billed_charge": 2.0092, "npi": [1447250253]}, {"billed_charge": 1.95, "npi": [1447250253]}, {"billed_charge": 0.07, "npi": [1447250253]}, {"billed_charge": 12.248, "npi": [1447250253]}, {"billed_charge": 0.5525, "npi": [1447250253]}, {"billed_charge": 20.34, "npi": [1447250253]}, {"billed_charge": 0.12, "npi": [1447250253]}, {"billed_charge": 4.3, "npi": [1447250253]}, {"billed_charge": 0.9333, "npi": [1447250253]}, {"billed_charge": 0.1567, "npi": [1447250253]}, {"billed_charge": 10.3544, "npi": [1447250253]}, {"billed_charge": 0.44, "npi": [1447250253]}, {"billed_charge": 1.8312, "npi": [1447250253]}, {"billed_charge": 7.3517, "npi": [1447250253]}, {"billed_charge": 3.9793, "npi": [1447250253]}, {"billed_charge": 16.91, "npi": [1447250253]}, {"billed_charge": 7.5, "npi": [1447250253]}, {"billed_charge": 5.8646, "npi": [1447250253]}, {"billed_charge": 9.1617, "npi": [1447250253]}, {"billed_charge": 2.4938, "npi": [1447250253]}, {"billed_charge": 2.7575, "npi": [1447250253]}, {"billed_charge": 11.524, "npi": [1447250253]}, {"billed_charge": 4.2, "npi": [1447250253]}, {"billed_charge": 3.03, "npi": [1447250253]}, {"billed_charge": 11.4786, "npi": [1447250253]}, {"billed_charge": 0.255, "npi": [1447250253]}, {"billed_charge": 4.1141, "npi": [1447250253]}, {"billed_charge": 2.38, "npi": [1447250253]}, {"billed_charge": 5.5064, "npi": [1447250253]}, {"billed_charge": 12.1308, "npi": [1447250253]}, {"billed_charge": 0.6667, "npi": [1447250253]}, {"billed_charge": 0.1, "npi": [1447250253]}, {"billed_charge": 4.428, "npi": [1447250253]}, {"billed_charge": 74.057, "npi": [1447250253]}, {"billed_charge": 6.3, "npi": [1447250253]}, {"billed_charge": 2.8404, "npi": [1447250253]}, {"billed_charge": 18.61, "npi": [1447250253]}, {"billed_charge": 0.8425, "npi": [1447250253]}, {"billed_charge": 5.0357, "npi": [1447250253]}, {"billed_charge": 14.35, "npi": [1447250253]}, {"billed_charge": 0.915, "npi": [1447250253]}, {"billed_charge": 0.11, "npi": [1447250253]}, {"billed_charge": 0.492, "npi": [1447250253]}, {"billed_charge": 168.24, "npi": [1447250253]}, {"billed_charge": 11.49, "npi": [1447250253]}, {"billed_charge": 4.0564, "npi": [1447250253]}, {"billed_charge": 5.9444, "npi": [1447250253]}, {"billed_charge": 1.335, "npi": [1447250253]}, {"billed_charge": 18.5867, "npi": [1447250253]}, {"billed_charge": 3.2181, "npi": [1447250253]}]}]}]}, {"name": "Emergency Room - General", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0450", "description": "Emergency Room", "allowed_amounts": [{"tin": {"type": "ein", "value": "751047527"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 308.31, "billing_code_modifier": [""], "providers": [{"billed_charge": 779.25, "npi": [1396779948]}, {"billed_charge": 333.25, "npi": [1396779948]}]}, {"allowed_amount": 222.56, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 537.75, "npi": [1396779948]}]}, {"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 1742.6667, "npi": [1396779948]}, {"billed_charge": 1141.5833, "npi": [1396779948]}, {"billed_charge": 1768.75, "npi": [1396779948]}, {"billed_charge": 775.2813, "npi": [1396779948]}, {"billed_charge": 103.5, "npi": [1396779948]}, {"billed_charge": 254.75, "npi": [1396779948]}, {"billed_charge": 542.5, "npi": [1396779948]}, {"billed_charge": 333.25, "npi": [1396779948]}, {"billed_charge": 1264.0833, "npi": [1396779948]}, {"billed_charge": 818.25, "npi": [1396779948]}, {"billed_charge": 550.2188, "npi": [1396779948]}, {"billed_charge": 2758.25, "npi": [1396779948]}, {"billed_charge": 1545.75, "npi": [1396779948]}]}, {"allowed_amount": 67.875, "billing_code_modifier": [""], "providers": [{"billed_charge": 103.5, "npi": [1396779948]}, {"billed_charge": 333.25, "npi": [1396779948]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["XS"], "providers": [{"billed_charge": 254.75, "npi": [1396779948]}]}, {"allowed_amount": 604.81, "billing_code_modifier": [""], "providers": [{"billed_charge": 1521.25, "npi": [1396779948]}]}, {"allowed_amount": 235.54, "billing_code_modifier": ["LT"], "providers": [{"billed_charge": 334.0, "npi": [1396779948]}]}, {"allowed_amount": 67.875, "billing_code_modifier": ["59"], "providers": [{"billed_charge": 103.5, "npi": [1396779948]}]}, {"allowed_amount": 222.56, "billing_code_modifier": [""], "providers": [{"billed_charge": 537.75, "npi": [1396779948]}]}, {"allowed_amount": 122.22, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 332.25, "npi": [1396779948]}]}, {"allowed_amount": 67.8733, "billing_code_modifier": ["59"], "providers": [{"billed_charge": 103.5, "npi": [1396779948]}, {"billed_charge": 333.25, "npi": [1396779948]}]}, {"allowed_amount": 3791.1, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 2758.25, "npi": [1396779948]}]}, {"allowed_amount": 589.22, "billing_code_modifier": [""], "providers": [{"billed_charge": 1408.25, "npi": [1396779948]}]}, {"allowed_amount": 67.87, "billing_code_modifier": [""], "providers": [{"billed_charge": 103.5, "npi": [1396779948]}, {"billed_charge": 333.25, "npi": [1396779948]}]}, {"allowed_amount": 290.83, "billing_code_modifier": [""], "providers": [{"billed_charge": 811.0, "npi": [1396779948]}]}, {"allowed_amount": 863.2, "billing_code_modifier": [""], "providers": [{"billed_charge": 2758.25, "npi": [1396779948]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 1521.25, "npi": [1396779948]}, {"billed_charge": 2758.25, "npi": [1396779948]}]}, {"allowed_amount": 67.8733, "billing_code_modifier": [""], "providers": [{"billed_charge": 103.5, "npi": [1396779948]}, {"billed_charge": 333.25, "npi": [1396779948]}]}, {"allowed_amount": 1347.93, "billing_code_modifier": [""], "providers": [{"billed_charge": 1768.5, "npi": [1396779948]}]}, {"allowed_amount": 395.66, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 1042.5, "npi": [1396779948]}]}, {"allowed_amount": 395.66, "billing_code_modifier": [""], "providers": [{"billed_charge": 1042.5, "npi": [1396779948]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["59"], "providers": [{"billed_charge": 779.25, "npi": [1396779948]}, {"billed_charge": 103.5, "npi": [1396779948]}, {"billed_charge": 254.75, "npi": [1396779948]}, {"billed_charge": 333.25, "npi": [1396779948]}]}, {"allowed_amount": 863.2, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 2758.25, "npi": [1396779948]}]}, {"allowed_amount": 308.31, "billing_code_modifier": ["59"], "providers": [{"billed_charge": 779.25, "npi": [1396779948]}, {"billed_charge": 333.25, "npi": [1396779948]}]}, {"allowed_amount": 122.22, "billing_code_modifier": [""], "providers": [{"billed_charge": 332.25, "npi": [1396779948]}]}, {"allowed_amount": 67.87, "billing_code_modifier": ["59"], "providers": [{"billed_charge": 333.25, "npi": [1396779948]}]}, {"allowed_amount": 604.81, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 1521.25, "npi": [1396779948]}]}, {"allowed_amount": 357.54, "billing_code_modifier": ["LT"], "providers": [{"billed_charge": 367.5, "npi": [1396779948]}]}]}]}, {"name": "Laboratory - Chemistry", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0301", "description": "Laboratory", "allowed_amounts": [{"tin": {"type": "ein", "value": "753175630"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 55.0, "npi": [1285798918]}, {"billed_charge": 33.0, "npi": [1285798918]}, {"billed_charge": 152.0, "npi": [1285798918]}, {"billed_charge": 243.5, "npi": [1285798918]}, {"billed_charge": 85.0, "npi": [1285798918]}, {"billed_charge": 105.5429, "npi": [1285798918]}, {"billed_charge": 148.0, "npi": [1285798918]}, {"billed_charge": 175.0, "npi": [1285798918]}, {"billed_charge": 44.0, "npi": [1285798918]}, {"billed_charge": 159.0, "npi": [1285798918]}, {"billed_charge": 102.0909, "npi": [1285798918]}, {"billed_charge": 91.0, "npi": [1285798918]}, {"billed_charge": 135.7931, "npi": [1285798918]}, {"billed_charge": 115.0, "npi": [1285798918]}, {"billed_charge": 138.6, "npi": [1285798918]}, {"billed_charge": 594.0, "npi": [1285798918]}, {"billed_charge": 92.0, "npi": [1285798918]}, {"billed_charge": 334.0, "npi": [1285798918]}, {"billed_charge": 338.0, "npi": [1285798918]}, {"billed_charge": 137.0, "npi": [1285798918]}, {"billed_charge": 143.0, "npi": [1285798918]}, {"billed_charge": 238.0, "npi": [1285798918]}, {"billed_charge": 127.0, "npi": [1285798918]}, {"billed_charge": 73.0, "npi": [1285798918]}, {"billed_charge": 185.25, "npi": [1285798918]}, {"billed_charge": 130.5, "npi": [1285798918]}]}, {"allowed_amount": 9.72, "billing_code_modifier": [""], "providers": [{"billed_charge": 92.0, "npi": [1285798918]}]}, {"allowed_amount": 56.93, "billing_code_modifier": [""], "providers": [{"billed_charge": 334.0, "npi": [1285798918]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["59"], "providers": [{"billed_charge": 97.0, "npi": [1285798918]}]}, {"allowed_amount": 6.87, "billing_code_modifier": [""], "providers": [{"billed_charge": 85.0, "npi": [1285798918]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["91"], "providers": [{"billed_charge": 148.0, "npi": [1285798918]}, {"billed_charge": 143.0, "npi": [1285798918]}]}, {"allowed_amount": 15.31, "billing_code_modifier": [""], "providers": [{"billed_charge": 152.0, "npi": [1285798918]}]}, {"allowed_amount": 7.28, "billing_code_modifier": [""], "providers": [{"billed_charge": 236.0, "npi": [1285798918]}]}]}]}, {"name": "Laboratory - Immunology", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0302", "description": "Laboratory", "allowed_amounts": [{"tin": {"type": "ein", "value": "753175630"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 404.0, "npi": [1285798918]}, {"billed_charge": 96.0, "npi": [1285798918]}, {"billed_charge": 234.0, "npi": [1285798918]}, {"billed_charge": 373.0, "npi": [1285798918]}, {"billed_charge": 161.0, "npi": [1285798918]}, {"billed_charge": 668.0, "npi": [1285798918]}, {"billed_charge": 578.0, "npi": [1285798918]}, {"billed_charge": 251.0, "npi": [1285798918]}, {"billed_charge": 181.0, "npi": [1285798918]}, {"billed_charge": 109.0, "npi": [1285798918]}, {"billed_charge": 153.0, "npi": [1285798918]}, {"billed_charge": 242.5, "npi": [1285798918]}, {"billed_charge": 332.0, "npi": [1285798918]}, {"billed_charge": 251.8, "npi": [1285798918]}]}, {"allowed_amount": 18.78, "billing_code_modifier": [""], "providers": [{"billed_charge": 129.0, "npi": [1285798918]}]}, {"allowed_amount": 30.17, "billing_code_modifier": [""], "providers": [{"billed_charge": 234.0, "npi": [1285798918]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["59"], "providers": [{"billed_charge": 237.0, "npi": [1285798918]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["91"], "providers": [{"billed_charge": 153.0, "npi": [1285798918]}, {"billed_charge": 332.0, "npi": [1285798918]}]}, {"allowed_amount": 38.83, "billing_code_modifier": [""], "providers": [{"billed_charge": 126.0, "npi": [1285798918]}]}]}]}, {"name": "INJECTION ACETAMINOPHEN NOT OTHERWISE SPEC 10 MG", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "J0131", "description": "INJECTION ACETAMINOPHEN NOT OTHERWISE SPEC 10 MG", "allowed_amounts": [{"tin": {"type": "ein", "value": "853503076"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 390.0, "npi": [1124623889]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["76"], "providers": [{"billed_charge": 390.0, "npi": [1124623889]}]}]}]}, {"name": "CT Scan - General", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0350", "description": "CT Scan", "allowed_amounts": [{"tin": {"type": "ein", "value": "752770738"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 320.73, "billing_code_modifier": [""], "providers": [{"billed_charge": 4150.0, "npi": [1770514077]}]}, {"allowed_amount": 622.69, "billing_code_modifier": [""], "providers": [{"billed_charge": 4150.0, "npi": [1770514077]}]}, {"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 5817.25, "npi": [1770514077]}, {"billed_charge": 6795.5, "npi": [1770514077]}]}, {"allowed_amount": 345.85, "billing_code_modifier": [""], "providers": [{"billed_charge": 5817.25, "npi": [1770514077]}]}, {"allowed_amount": 505.67, "billing_code_modifier": [""], "providers": [{"billed_charge": 6795.5, "npi": [1770514077]}]}]}]}, {"name": "Pharmacy - Extension of 25X - Drug Requiring Detailed Coding", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0636", "description": "Pharmacy - Extension of 25x", "allowed_amounts": [{"tin": {"type": "ein", "value": "751777119"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.49, "billing_code_modifier": [""], "providers": [{"billed_charge": 5.25, "npi": [1073511762]}, {"billed_charge": 1.47, "npi": [1073511762]}, {"billed_charge": 4.56, "npi": [1073511762]}]}, {"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 1.8, "npi": [1073511762]}, {"billed_charge": 0.678, "npi": [1073511762]}, {"billed_charge": 3.756, "npi": [1073511762]}, {"billed_charge": 1.4842, "npi": [1073511762]}, {"billed_charge": 1.29, "npi": [1073511762]}, {"billed_charge": 0.576, "npi": [1073511762]}, {"billed_charge": 0.72, "npi": [1073511762]}, {"billed_charge": 97.8817, "npi": [1073511762]}, {"billed_charge": 42.0, "npi": [1073511762]}, {"billed_charge": 12.52, "npi": [1073511762]}, {"billed_charge": 31.8, "npi": [1073511762]}, {"billed_charge": 276.85, "npi": [1073511762]}]}, {"allowed_amount": 0.49, "billing_code_modifier": ["JW"], "providers": [{"billed_charge": 5.25, "npi": [1073511762]}, {"billed_charge": 2.73, "npi": [1073511762]}, {"billed_charge": 4.56, "npi": [1073511762]}]}, {"allowed_amount": 0.495, "billing_code_modifier": [""], "providers": [{"billed_charge": 4.56, "npi": [1073511762]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["JZ"], "providers": [{"billed_charge": 2.82, "npi": [1073511762]}, {"billed_charge": 160.65, "npi": [1073511762]}, {"billed_charge": 2.2635, "npi": [1073511762]}, {"billed_charge": 1.67, "npi": [1073511762]}]}, {"allowed_amount": 0.495, "billing_code_modifier": ["JW"], "providers": [{"billed_charge": 4.56, "npi": [1073511762]}]}]}]}, {"name": "Pharmacy - General", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0250", "description": "Pharmacy (also see 063x, an extension of 025x)", "allowed_amounts": [{"tin": {"type": "ein", "value": "752051646"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.49, "billing_code_modifier": [""], "providers": [{"billed_charge": 20.0, "npi": [1891765178]}]}, {"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 12.0595, "npi": [1891765178]}, {"billed_charge": 0.875, "npi": [1891765178]}, {"billed_charge": 38.75, "npi": [1891765178]}, {"billed_charge": 2.0, "npi": [1891765178]}, {"billed_charge": 0.75, "npi": [1891765178]}, {"billed_charge": 13.5, "npi": [1891765178]}, {"billed_charge": 10.0, "npi": [1891765178]}, {"billed_charge": 1.2344, "npi": [1891765178]}, {"billed_charge": 23.0, "npi": [1891765178]}, {"billed_charge": 9.6, "npi": [1891765178]}, {"billed_charge": 32.25, "npi": [1891765178]}, {"billed_charge": 3.75, "npi": [1891765178]}, {"billed_charge": 56.75, "npi": [1891765178]}, {"billed_charge": 141.75, "npi": [1891765178]}, {"billed_charge": 1.2325, "npi": [1891765178]}, {"billed_charge": 25.75, "npi": [1891765178]}, {"billed_charge": 27.5, "npi": [1891765178]}, {"billed_charge": 2.6154, "npi": [1891765178]}, {"billed_charge": 4.0, "npi": [1891765178]}, {"billed_charge": 5.0, "npi": [1891765178]}, {"billed_charge": 48.25, "npi": [1891765178]}, {"billed_charge": 9.3125, "npi": [1891765178]}, {"billed_charge": 37.75, "npi": [1891765178]}, {"billed_charge": 2.25, "npi": [1891765178]}, {"billed_charge": 28.125, "npi": [1891765178]}, {"billed_charge": 9.5833, "npi": [1891765178]}, {"billed_charge": 583.25, "npi": [1891765178]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["U8"], "providers": [{"billed_charge": 109.25, "npi": [1891765178]}]}, {"allowed_amount": 2.043, "billing_code_modifier": ["JZ"], "providers": [{"billed_charge": 14.2775, "npi": [1891765178]}]}]}]}, {"name": "Laboratory - Hematology", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0305", "description": "Laboratory", "allowed_amounts": [{"tin": {"type": "ein", "value": "751748586"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 206.5, "npi": [1508899204]}, {"billed_charge": 233.5, "npi": [1508899204]}, {"billed_charge": 208.75, "npi": [1508899204]}, {"billed_charge": 706.5, "npi": [1508899204]}, {"billed_charge": 226.5, "npi": [1508899204]}, {"billed_charge": 145.75, "npi": [1508899204]}]}]}]}, {"name": "Laboratory - Urology", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0307", "description": "Laboratory", "allowed_amounts": [{"tin": {"type": "ein", "value": "751837454"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 129.78, "npi": [1447250253]}, {"billed_charge": 83.58, "npi": [1447250253]}, {"billed_charge": 162.16, "npi": [1447250253]}]}]}]}, {"name": "Laboratory - Chemistry", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0301", "description": "Laboratory", "allowed_amounts": [{"tin": {"type": "ein", "value": "824052186"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 306.86, "npi": [1801826839]}, {"billed_charge": 152.18, "npi": [1801826839]}, {"billed_charge": 285.79, "npi": [1801826839]}, {"billed_charge": 459.04, "npi": [1801826839]}, {"billed_charge": 243.23, "npi": [1801826839]}, {"billed_charge": 185.85, "npi": [1801826839]}, {"billed_charge": 153.91, "npi": [1801826839]}, {"billed_charge": 117.24, "npi": [1801826839]}, {"billed_charge": 249.74, "npi": [1801826839]}, {"billed_charge": 104.78, "npi": [1801826839]}, {"billed_charge": 56.6, "npi": [1801826839]}, {"billed_charge": 217.7, "npi": [1801826839]}, {"billed_charge": 229.02, "npi": [1801826839]}, {"billed_charge": 273.89, "npi": [1801826839]}, {"billed_charge": 407.22, "npi": [1801826839]}, {"billed_charge": 147.19, "npi": [1801826839]}]}]}]}, {"name": "IAAD IA SEVERE AQT RESPIR SYND CORONAVIRUS", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "87426", "description": "IAAD IA SEVERE AQT RESPIR SYND CORONAVIRUS", "allowed_amounts": [{"tin": {"type": "ein", "value": "853503076"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": ["QW"], "providers": [{"billed_charge": 988.56, "npi": [1124623889]}]}]}]}, {"name": "MEDICATION TRAINING AND SUPPORT PER 15 MINUTES", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "H0034", "description": "MEDICATION TRAINING AND SUPPORT PER 15 MINUTES", "allowed_amounts": [{"tin": {"type": "ein", "value": "851283674"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 4.5, "billing_code_modifier": ["HQ"], "providers": [{"billed_charge": 15.0, "npi": [1679029136]}]}]}]}, {"name": "Pharmacy - General", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0250", "description": "Pharmacy (also see 063x, an extension of 025x)", "allowed_amounts": [{"tin": {"type": "ein", "value": "260194016"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 2.16, "npi": [1205018439]}, {"billed_charge": 2.8071, "npi": [1205018439]}, {"billed_charge": 17.27, "npi": [1205018439]}, {"billed_charge": 13.42, "npi": [1205018439]}, {"billed_charge": 0.3567, "npi": [1205018439]}, {"billed_charge": 15.6, "npi": [1205018439]}, {"billed_charge": 1.5869, "npi": [1205018439]}, {"billed_charge": 0.1267, "npi": [1205018439]}, {"billed_charge": 8.76, "npi": [1205018439]}, {"billed_charge": 0.4975, "npi": [1205018439]}, {"billed_charge": 3.32, "npi": [1205018439]}, {"billed_charge": 1.56, "npi": [1205018439]}, {"billed_charge": 6.6544, "npi": [1205018439]}, {"billed_charge": 1.7267, "npi": [1205018439]}, {"billed_charge": 1.065, "npi": [1205018439]}, {"billed_charge": 3.88, "npi": [1205018439]}, {"billed_charge": 1.525, "npi": [1205018439]}, {"billed_charge": 0.91, "npi": [1205018439]}, {"billed_charge": 1.225, "npi": [1205018439]}, {"billed_charge": 15.72, "npi": [1205018439]}, {"billed_charge": 0.92, "npi": [1205018439]}, {"billed_charge": 5.5671, "npi": [1205018439]}, {"billed_charge": 1.1733, "npi": [1205018439]}, {"billed_charge": 0.295, "npi": [1205018439]}, {"billed_charge": 2.8649, "npi": [1205018439]}, {"billed_charge": 26.5342, "npi": [1205018439]}, {"billed_charge": 0.5444, "npi": [1205018439]}, {"billed_charge": 0.29, "npi": [1205018439]}, {"billed_charge": 2.3, "npi": [1205018439]}, {"billed_charge": 0.08, "npi": [1205018439]}, {"billed_charge": 4.4653, "npi": [1205018439]}, {"billed_charge": 1.456, "npi": [1205018439]}, {"billed_charge": 2.6033, "npi": [1205018439]}, {"billed_charge": 2.4, "npi": [1205018439]}, {"billed_charge": 0.71, "npi": [1205018439]}, {"billed_charge": 3.7, "npi": [1205018439]}, {"billed_charge": 11.22, "npi": [1205018439]}]}]}]}, {"name": "Laboratory - Hematology", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0305", "description": "Laboratory", "allowed_amounts": [{"tin": {"type": "ein", "value": "260194016"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 185.4675, "npi": [1205018439]}, {"billed_charge": 149.84, "npi": [1205018439]}, {"billed_charge": 146.11, "npi": [1205018439]}, {"billed_charge": 72.35, "npi": [1205018439]}, {"billed_charge": 190.4564, "npi": [1205018439]}, {"billed_charge": 155.302, "npi": [1205018439]}, {"billed_charge": 248.29, "npi": [1205018439]}, {"billed_charge": 111.76, "npi": [1205018439]}, {"billed_charge": 130.3358, "npi": [1205018439]}, {"billed_charge": 93.56, "npi": [1205018439]}, {"billed_charge": 183.63, "npi": [1205018439]}, {"billed_charge": 140.91, "npi": [1205018439]}, {"billed_charge": 92.5537, "npi": [1205018439]}, {"billed_charge": 76.63, "npi": [1205018439]}]}]}]}, {"name": "Emergency Room - General", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0450", "description": "Emergency Room", "allowed_amounts": [{"tin": {"type": "ein", "value": "751837454"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 308.31, "billing_code_modifier": [""], "providers": [{"billed_charge": 814.34, "npi": [1447250253]}, {"billed_charge": 902.11, "npi": [1447250253]}, {"billed_charge": 524.33, "npi": [1447250253]}]}, {"allowed_amount": 222.56, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 782.31, "npi": [1447250253]}, {"billed_charge": 1103.51, "npi": [1447250253]}]}, {"allowed_amount": 67.8743, "billing_code_modifier": [""], "providers": [{"billed_charge": 317.78, "npi": [1447250253]}]}, {"allowed_amount": 308.31, "billing_code_modifier": ["XS"], "providers": [{"billed_charge": 814.34, "npi": [1447250253]}, {"billed_charge": 902.11, "npi": [1447250253]}, {"billed_charge": 524.33, "npi": [1447250253]}]}, {"allowed_amount": 8282.07, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 3879.67, "npi": [1447250253]}]}, {"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 361.12, "npi": [1447250253]}, {"billed_charge": 392.06, "npi": [1447250253]}, {"billed_charge": 806.34, "npi": [1447250253]}, {"billed_charge": 1598.6867, "npi": [1447250253]}, {"billed_charge": 1442.845, "npi": [1447250253]}, {"billed_charge": 1045.9567, "npi": [1447250253]}, {"billed_charge": 1311.71, "npi": [1447250253]}, {"billed_charge": 1024.7943, "npi": [1447250253]}, {"billed_charge": 2379.02, "npi": [1447250253]}, {"billed_charge": 814.34, "npi": [1447250253]}, {"billed_charge": 902.11, "npi": [1447250253]}, {"billed_charge": 755.1591, "npi": [1447250253]}, {"billed_charge": 801.4, "npi": [1447250253]}, {"billed_charge": 1886.7167, "npi": [1447250253]}, {"billed_charge": 1259.142, "npi": [1447250253]}, {"billed_charge": 948.43, "npi": [1447250253]}, {"billed_charge": 1831.8033, "npi": [1447250253]}, {"billed_charge": 896.4763, "npi": [1447250253]}, {"billed_charge": 1278.46, "npi": [1447250253]}, {"billed_charge": 1366.97, "npi": [1447250253]}, {"billed_charge": 1427.845, "npi": [1447250253]}, {"billed_charge": 317.78, "npi": [1447250253]}, {"billed_charge": 2567.91, "npi": [1447250253]}, {"billed_charge": 1842.6267, "npi": [1447250253]}, {"billed_charge": 753.62, "npi": [1447250253]}, {"billed_charge": 3879.67, "npi": [1447250253]}, {"billed_charge": 1157.132, "npi": [1447250253]}, {"billed_charge": 1386.145, "npi": [1447250253]}, {"billed_charge": 1283.4, "npi": [1447250253]}, {"billed_charge": 1171.988, "npi": [1447250253]}, {"billed_charge": 1868.0, "npi": [1447250253]}, {"billed_charge": 339.15, "npi": [1447250253]}, {"billed_charge": 1582.32, "npi": [1447250253]}, {"billed_charge": 2012.6433, "npi": [1447250253]}, {"billed_charge": 321.2, "npi": [1447250253]}, {"billed_charge": 1022.0157, "npi": [1447250253]}, {"billed_charge": 1075.9843, "npi": [1447250253]}, {"billed_charge": 330.56, "npi": [1447250253]}, {"billed_charge": 4233.71, "npi": [1447250253]}, {"billed_charge": 524.33, "npi": [1447250253]}, {"billed_charge": 1822.1267, "npi": [1447250253]}, {"billed_charge": 1573.9267, "npi": [1447250253]}]}, {"allowed_amount": 67.875, "billing_code_modifier": [""], "providers": [{"billed_charge": 392.06, "npi": [1447250253]}, {"billed_charge": 317.78, "npi": [1447250253]}]}, {"allowed_amount": 604.81, "billing_code_modifier": [""], "providers": [{"billed_charge": 2122.8, "npi": [1447250253]}]}, {"allowed_amount": 222.56, "billing_code_modifier": [""], "providers": [{"billed_charge": 782.31, "npi": [1447250253]}]}, {"allowed_amount": 122.22, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 478.23, "npi": [1447250253]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["XU"], "providers": [{"billed_charge": 321.2, "npi": [1447250253]}, {"billed_charge": 524.33, "npi": [1447250253]}]}, {"allowed_amount": 67.8733, "billing_code_modifier": ["XU"], "providers": [{"billed_charge": 392.06, "npi": [1447250253]}]}, {"allowed_amount": 3791.1, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 3879.67, "npi": [1447250253]}, {"billed_charge": 4233.71, "npi": [1447250253]}]}, {"allowed_amount": 67.874, "billing_code_modifier": ["XU"], "providers": [{"billed_charge": 392.06, "npi": [1447250253]}]}, {"allowed_amount": 67.87, "billing_code_modifier": [""], "providers": [{"billed_charge": 392.06, "npi": [1447250253]}, {"billed_charge": 317.78, "npi": [1447250253]}, {"billed_charge": 330.56, "npi": [1447250253]}]}, {"allowed_amount": 290.83, "billing_code_modifier": [""], "providers": [{"billed_charge": 994.45, "npi": [1447250253]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 3879.67, "npi": [1447250253]}, {"billed_charge": 4233.71, "npi": [1447250253]}]}, {"allowed_amount": 67.8733, "billing_code_modifier": [""], "providers": [{"billed_charge": 392.06, "npi": [1447250253]}, {"billed_charge": 317.78, "npi": [1447250253]}]}, {"allowed_amount": 1347.93, "billing_code_modifier": [""], "providers": [{"billed_charge": 2616.36, "npi": [1447250253]}]}, {"allowed_amount": 395.66, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 2125.51, "npi": [1447250253]}, {"billed_charge": 1283.4, "npi": [1447250253]}]}, {"allowed_amount": 395.66, "billing_code_modifier": [""], "providers": [{"billed_charge": 1283.4, "npi": [1447250253]}]}, {"allowed_amount": 308.31, "billing_code_modifier": ["XU"], "providers": [{"billed_charge": 524.33, "npi": [1447250253]}]}, {"allowed_amount": 231.23, "billing_code_modifier": [""], "providers": [{"billed_charge": 902.11, "npi": [1447250253]}]}, {"allowed_amount": 863.2, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 3879.67, "npi": [1447250253]}]}, {"allowed_amount": 395.66, "billing_code_modifier": ["27"], "providers": [{"billed_charge": 1283.4, "npi": [1447250253]}]}, {"allowed_amount": 8065.36, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 3879.67, "npi": [1447250253]}]}, {"allowed_amount": 122.22, "billing_code_modifier": [""], "providers": [{"billed_charge": 478.23, "npi": [1447250253]}]}, {"allowed_amount": 1197.29, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 4233.71, "npi": [1447250253]}]}, {"allowed_amount": 604.81, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 2122.8, "npi": [1447250253]}]}, {"allowed_amount": 357.54, "billing_code_modifier": ["LT"], "providers": [{"billed_charge": 1515.14, "npi": [1447250253]}]}]}]}, {"name": "Laboratory - General", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0300", "description": "Laboratory", "allowed_amounts": [{"tin": {"type": "ein", "value": "752586857"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 95.5, "npi": [1992700983]}, {"billed_charge": 40.0, "npi": [1992700983]}, {"billed_charge": 93.73, "npi": [1992700983]}, {"billed_charge": 110.16, "npi": [1992700983]}, {"billed_charge": 218.5767, "npi": [1992700983]}, {"billed_charge": 47.75, "npi": [1992700983]}, {"billed_charge": 143.25, "npi": [1992700983]}, {"billed_charge": 49.66, "npi": [1992700983]}, {"billed_charge": 392.86, "npi": [1992700983]}, {"billed_charge": 120.9967, "npi": [1992700983]}, {"billed_charge": 91.63, "npi": [1992700983]}, {"billed_charge": 211.0, "npi": [1992700983]}, {"billed_charge": 162.7867, "npi": [1992700983]}, {"billed_charge": 474.94, "npi": [1992700983]}, {"billed_charge": 43.875, "npi": [1992700983]}, {"billed_charge": 160.2033, "npi": [1992700983]}, {"billed_charge": 124.41, "npi": [1992700983]}]}]}]}, {"name": "IV Therapy -General", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0260", "description": "IV Therapy", "allowed_amounts": [{"tin": {"type": "ein", "value": "260194016"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 308.31, "billing_code_modifier": ["XS"], "providers": [{"billed_charge": 902.11, "npi": [1205018439]}]}, {"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 317.78, "npi": [1205018439]}, {"billed_charge": 361.12, "npi": [1205018439]}, {"billed_charge": 468.18, "npi": [1205018439]}, {"billed_charge": 902.11, "npi": [1205018439]}, {"billed_charge": 330.56, "npi": [1205018439]}, {"billed_charge": 392.06, "npi": [1205018439]}]}, {"allowed_amount": 67.875, "billing_code_modifier": [""], "providers": [{"billed_charge": 317.78, "npi": [1205018439]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["XU"], "providers": [{"billed_charge": 902.11, "npi": [1205018439]}, {"billed_charge": 392.06, "npi": [1205018439]}]}, {"allowed_amount": 67.87, "billing_code_modifier": [""], "providers": [{"billed_charge": 330.56, "npi": [1205018439]}]}, {"allowed_amount": 104.355, "billing_code_modifier": [""], "providers": [{"billed_charge": 468.18, "npi": [1205018439]}]}, {"allowed_amount": 67.8742, "billing_code_modifier": [""], "providers": [{"billed_charge": 317.78, "npi": [1205018439]}]}, {"allowed_amount": 104.36, "billing_code_modifier": [""], "providers": [{"billed_charge": 468.18, "npi": [1205018439]}]}]}]}, {"name": "Emergency Room - General", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0450", "description": "Emergency Room", "allowed_amounts": [{"tin": {"type": "ein", "value": "756001743"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 308.31, "billing_code_modifier": [""], "providers": [{"billed_charge": 779.25, "npi": [1336172105]}, {"billed_charge": 333.25, "npi": [1336172105]}]}, {"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 1768.75, "npi": [1336172105]}, {"billed_charge": 630.25, "npi": [1336172105]}, {"billed_charge": 1065.0, "npi": [1336172105]}, {"billed_charge": 103.5, "npi": [1336172105]}, {"billed_charge": 857.0833, "npi": [1336172105]}, {"billed_charge": 1839.0, "npi": [1336172105]}, {"billed_charge": 1211.3333, "npi": [1336172105]}, {"billed_charge": 646.8571, "npi": [1336172105]}, {"billed_charge": 254.75, "npi": [1336172105]}, {"billed_charge": 333.25, "npi": [1336172105]}]}, {"allowed_amount": 67.875, "billing_code_modifier": [""], "providers": [{"billed_charge": 103.5, "npi": [1336172105]}, {"billed_charge": 333.25, "npi": [1336172105]}]}, {"allowed_amount": 235.54, "billing_code_modifier": ["LT"], "providers": [{"billed_charge": 334.0, "npi": [1336172105]}]}, {"allowed_amount": 67.875, "billing_code_modifier": ["59"], "providers": [{"billed_charge": 333.25, "npi": [1336172105]}]}, {"allowed_amount": 222.56, "billing_code_modifier": [""], "providers": [{"billed_charge": 537.75, "npi": [1336172105]}]}, {"allowed_amount": 2330.73, "billing_code_modifier": ["LT"], "providers": [{"billed_charge": 2017.5, "npi": [1336172105]}]}, {"allowed_amount": 3791.1, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 2758.25, "npi": [1336172105]}]}, {"allowed_amount": 67.87, "billing_code_modifier": [""], "providers": [{"billed_charge": 103.5, "npi": [1336172105]}, {"billed_charge": 333.25, "npi": [1336172105]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 2758.25, "npi": [1336172105]}]}, {"allowed_amount": 395.66, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 1042.5, "npi": [1336172105]}]}, {"allowed_amount": 395.66, "billing_code_modifier": [""], "providers": [{"billed_charge": 1042.5, "npi": [1336172105]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["59"], "providers": [{"billed_charge": 103.5, "npi": [1336172105]}, {"billed_charge": 333.25, "npi": [1336172105]}]}, {"allowed_amount": 863.2, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 2758.25, "npi": [1336172105]}]}, {"allowed_amount": 733.41, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 1521.25, "npi": [1336172105]}]}, {"allowed_amount": 308.31, "billing_code_modifier": ["59"], "providers": [{"billed_charge": 779.25, "npi": [1336172105]}, {"billed_charge": 333.25, "npi": [1336172105]}]}, {"allowed_amount": 104.36, "billing_code_modifier": [""], "providers": [{"billed_charge": 683.75, "npi": [1336172105]}]}, {"allowed_amount": 122.22, "billing_code_modifier": [""], "providers": [{"billed_charge": 332.25, "npi": [1336172105]}]}, {"allowed_amount": 67.87, "billing_code_modifier": ["59"], "providers": [{"billed_charge": 333.25, "npi": [1336172105]}]}, {"allowed_amount": 604.81, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 1521.25, "npi": [1336172105]}, {"billed_charge": 7370.75, "npi": [1336172105]}]}]}]}, {"name": "Laboratory - Chemistry", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0301", "description": "Laboratory", "allowed_amounts": [{"tin": {"type": "ein", "value": "751837454"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 142.782, "npi": [1447250253]}, {"billed_charge": 143.5567, "npi": [1447250253]}, {"billed_charge": 167.4097, "npi": [1447250253]}, {"billed_charge": 459.04, "npi": [1447250253]}, {"billed_charge": 249.48, "npi": [1447250253]}, {"billed_charge": 122.582, "npi": [1447250253]}, {"billed_charge": 111.02, "npi": [1447250253]}, {"billed_charge": 163.41, "npi": [1447250253]}, {"billed_charge": 246.4388, "npi": [1447250253]}, {"billed_charge": 120.8943, "npi": [1447250253]}, {"billed_charge": 80.13, "npi": [1447250253]}, {"billed_charge": 114.4236, "npi": [1447250253]}, {"billed_charge": 122.4954, "npi": [1447250253]}, {"billed_charge": 222.504, "npi": [1447250253]}, {"billed_charge": 295.62, "npi": [1447250253]}, {"billed_charge": 139.5779, "npi": [1447250253]}, {"billed_charge": 125.0654, "npi": [1447250253]}, {"billed_charge": 104.78, "npi": [1447250253]}, {"billed_charge": 108.35, "npi": [1447250253]}, {"billed_charge": 148.33, "npi": [1447250253]}, {"billed_charge": 302.19, "npi": [1447250253]}, {"billed_charge": 100.1176, "npi": [1447250253]}, {"billed_charge": 229.02, "npi": [1447250253]}, {"billed_charge": 108.2733, "npi": [1447250253]}, {"billed_charge": 156.546, "npi": [1447250253]}, {"billed_charge": 119.9081, "npi": [1447250253]}, {"billed_charge": 124.3211, "npi": [1447250253]}, {"billed_charge": 102.54, "npi": [1447250253]}, {"billed_charge": 143.4315, "npi": [1447250253]}, {"billed_charge": 266.2536, "npi": [1447250253]}, {"billed_charge": 243.23, "npi": [1447250253]}, {"billed_charge": 150.94, "npi": [1447250253]}, {"billed_charge": 127.23, "npi": [1447250253]}, {"billed_charge": 241.0513, "npi": [1447250253]}, {"billed_charge": 167.4757, "npi": [1447250253]}, {"billed_charge": 222.4219, "npi": [1447250253]}, {"billed_charge": 249.74, "npi": [1447250253]}, {"billed_charge": 80.2827, "npi": [1447250253]}, {"billed_charge": 133.658, "npi": [1447250253]}, {"billed_charge": 153.91, "npi": [1447250253]}, {"billed_charge": 234.9225, "npi": [1447250253]}, {"billed_charge": 432.76, "npi": [1447250253]}, {"billed_charge": 56.6, "npi": [1447250253]}, {"billed_charge": 217.7, "npi": [1447250253]}, {"billed_charge": 185.85, "npi": [1447250253]}, {"billed_charge": 258.5295, "npi": [1447250253]}, {"billed_charge": 159.8, "npi": [1447250253]}, {"billed_charge": 87.97, "npi": [1447250253]}, {"billed_charge": 101.57, "npi": [1447250253]}, {"billed_charge": 99.79, "npi": [1447250253]}, {"billed_charge": 93.56, "npi": [1447250253]}, {"billed_charge": 96.1, "npi": [1447250253]}, {"billed_charge": 171.8184, "npi": [1447250253]}, {"billed_charge": 214.55, "npi": [1447250253]}, {"billed_charge": 272.9191, "npi": [1447250253]}, {"billed_charge": 103.7664, "npi": [1447250253]}, {"billed_charge": 131.7696, "npi": [1447250253]}, {"billed_charge": 206.4, "npi": [1447250253]}, {"billed_charge": 270.5247, "npi": [1447250253]}, {"billed_charge": 112.7622, "npi": [1447250253]}, {"billed_charge": 253.96, "npi": [1447250253]}, {"billed_charge": 285.79, "npi": [1447250253]}, {"billed_charge": 112.7747, "npi": [1447250253]}, {"billed_charge": 103.83, "npi": [1447250253]}, {"billed_charge": 239.5, "npi": [1447250253]}, {"billed_charge": 117.7367, "npi": [1447250253]}, {"billed_charge": 130.8023, "npi": [1447250253]}, {"billed_charge": 70.25, "npi": [1447250253]}, {"billed_charge": 159.62, "npi": [1447250253]}, {"billed_charge": 240.75, "npi": [1447250253]}, {"billed_charge": 306.86, "npi": [1447250253]}, {"billed_charge": 154.4836, "npi": [1447250253]}, {"billed_charge": 149.7832, "npi": [1447250253]}, {"billed_charge": 105.46, "npi": [1447250253]}, {"billed_charge": 103.54, "npi": [1447250253]}, {"billed_charge": 272.71, "npi": [1447250253]}, {"billed_charge": 88.72, "npi": [1447250253]}, {"billed_charge": 233.718, "npi": [1447250253]}, {"billed_charge": 407.22, "npi": [1447250253]}, {"billed_charge": 214.7413, "npi": [1447250253]}, {"billed_charge": 348.57, "npi": [1447250253]}, {"billed_charge": 157.2881, "npi": [1447250253]}, {"billed_charge": 129.62, "npi": [1447250253]}, {"billed_charge": 98.1643, "npi": [1447250253]}]}, {"allowed_amount": 5.7, "billing_code_modifier": ["XU"], "providers": [{"billed_charge": 99.79, "npi": [1447250253]}]}, {"allowed_amount": 19.42, "billing_code_modifier": [""], "providers": [{"billed_charge": 328.07, "npi": [1447250253]}]}, {"allowed_amount": 5.7, "billing_code_modifier": [""], "providers": [{"billed_charge": 99.79, "npi": [1447250253]}]}]}]}, {"name": "Emergency Room - General", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0450", "description": "Emergency Room", "allowed_amounts": [{"tin": {"type": "ein", "value": "831954982"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 122.83, "billing_code_modifier": [""], "providers": [{"billed_charge": 332.25, "npi": [1104381292]}]}, {"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 696.875, "npi": [1104381292]}, {"billed_charge": 333.25, "npi": [1104381292]}, {"billed_charge": 254.75, "npi": [1104381292]}]}, {"allowed_amount": 309.82, "billing_code_modifier": [""], "providers": [{"billed_charge": 779.25, "npi": [1104381292]}, {"billed_charge": 333.25, "npi": [1104381292]}]}, {"allowed_amount": 397.62, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 1042.5, "npi": [1104381292]}]}, {"allowed_amount": 104.88, "billing_code_modifier": [""], "providers": [{"billed_charge": 683.75, "npi": [1104381292]}]}, {"allowed_amount": 309.82, "billing_code_modifier": ["59"], "providers": [{"billed_charge": 779.25, "npi": [1104381292]}, {"billed_charge": 333.25, "npi": [1104381292]}]}, {"allowed_amount": 68.21, "billing_code_modifier": [""], "providers": [{"billed_charge": 333.25, "npi": [1104381292]}, {"billed_charge": 103.5, "npi": [1104381292]}]}, {"allowed_amount": 68.2067, "billing_code_modifier": [""], "providers": [{"billed_charge": 333.25, "npi": [1104381292]}]}, {"allowed_amount": 607.78, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 1521.25, "npi": [1104381292]}]}, {"allowed_amount": 68.2075, "billing_code_modifier": [""], "providers": [{"billed_charge": 333.25, "npi": [1104381292]}]}, {"allowed_amount": 397.62, "billing_code_modifier": [""], "providers": [{"billed_charge": 1042.5, "npi": [1104381292]}]}, {"allowed_amount": 867.45, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 2758.25, "npi": [1104381292]}]}, {"allowed_amount": 68.208, "billing_code_modifier": [""], "providers": [{"billed_charge": 333.25, "npi": [1104381292]}]}]}]}, {"name": "Laboratory - Urology", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0307", "description": "Laboratory", "allowed_amounts": [{"tin": {"type": "ein", "value": "750800628"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 121.2, "billing_code_modifier": [""], "providers": [{"billed_charge": 202.0, "npi": [1194743013]}]}, {"allowed_amount": 56.0571, "billing_code_modifier": [""], "providers": [{"billed_charge": 93.4286, "npi": [1194743013]}]}, {"allowed_amount": 80.4, "billing_code_modifier": [""], "providers": [{"billed_charge": 134.0, "npi": [1194743013]}]}, {"allowed_amount": 147.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 245.0, "npi": [1194743013]}]}]}]}, {"name": "Pharmacy - IV Solutions", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0258", "description": "Pharmacy (also see 063x, an extension of 025x)", "allowed_amounts": [{"tin": {"type": "ein", "value": "751037591"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 42.0, "npi": [1124305065]}, {"billed_charge": 50.0, "npi": [1124305065]}, {"billed_charge": 58.1034, "npi": [1124305065]}]}]}]}, {"name": "AMB SERVICE ALS EMERGENCY TRANSPORT LEVEL 1", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "A0427", "description": "AMB SERVICE ALS EMERGENCY TRANSPORT LEVEL 1", "allowed_amounts": [{"tin": {"type": "ein", "value": "756000508"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 1516.69, "billing_code_modifier": ["PH"], "providers": [{"billed_charge": 1516.69, "npi": [1861530990]}]}, {"allowed_amount": 1494.27, "billing_code_modifier": ["RH"], "providers": [{"billed_charge": 1494.27, "npi": [1861530990]}]}, {"allowed_amount": 1492.95, "billing_code_modifier": ["NH"], "providers": [{"billed_charge": 1492.95, "npi": [1861530990]}]}, {"allowed_amount": 1494.37, "billing_code_modifier": ["RH"], "providers": [{"billed_charge": 1494.37, "npi": [1861530990]}]}, {"allowed_amount": 1519.69, "billing_code_modifier": ["PH"], "providers": [{"billed_charge": 1519.69, "npi": [1861530990]}]}, {"allowed_amount": 1537.96, "billing_code_modifier": ["RH"], "providers": [{"billed_charge": 1537.96, "npi": [1861530990]}]}, {"allowed_amount": 1476.0, "billing_code_modifier": ["RH"], "providers": [{"billed_charge": 1476.0, "npi": [1861530990]}]}, {"allowed_amount": 1489.87, "billing_code_modifier": ["SH"], "providers": [{"billed_charge": 1489.87, "npi": [1861530990]}]}, {"allowed_amount": 1473.0, "billing_code_modifier": ["ETRH"], "providers": [{"billed_charge": 1473.0, "npi": [1861530990]}]}, {"allowed_amount": 1571.32, "billing_code_modifier": ["SH"], "providers": [{"billed_charge": 1571.32, "npi": [1861530990]}]}, {"allowed_amount": 1787.27, "billing_code_modifier": ["EH"], "providers": [{"billed_charge": 1870.25, "npi": [1861530990]}]}, {"allowed_amount": 1538.22, "billing_code_modifier": ["RH"], "providers": [{"billed_charge": 1538.22, "npi": [1861530990]}]}, {"allowed_amount": 1475.42, "billing_code_modifier": ["SH"], "providers": [{"billed_charge": 1475.42, "npi": [1861530990]}]}, {"allowed_amount": 1492.12, "billing_code_modifier": ["EH"], "providers": [{"billed_charge": 1492.12, "npi": [1861530990]}]}, {"allowed_amount": 1601.5, "billing_code_modifier": ["SH"], "providers": [{"billed_charge": 1601.5, "npi": [1861530990]}]}, {"allowed_amount": 1474.54, "billing_code_modifier": ["JH"], "providers": [{"billed_charge": 1474.54, "npi": [1861530990]}]}, {"allowed_amount": 1475.25, "billing_code_modifier": ["RH"], "providers": [{"billed_charge": 1475.25, "npi": [1861530990]}]}, {"allowed_amount": 1787.27, "billing_code_modifier": ["RH"], "providers": [{"billed_charge": 1913.94, "npi": [1861530990]}, {"billed_charge": 1870.25, "npi": [1861530990]}, {"billed_charge": 1868.0, "npi": [1861530990]}, {"billed_charge": 1930.81, "npi": [1861530990]}, {"billed_charge": 1887.12, "npi": [1861530990]}]}, {"allowed_amount": 1535.81, "billing_code_modifier": ["RH"], "providers": [{"billed_charge": 1535.81, "npi": [1861530990]}]}, {"allowed_amount": 1492.12, "billing_code_modifier": ["RH"], "providers": [{"billed_charge": 1492.12, "npi": [1861530990]}]}, {"allowed_amount": 1494.17, "billing_code_modifier": ["RH"], "providers": [{"billed_charge": 1494.17, "npi": [1861530990]}]}, {"allowed_amount": 1787.27, "billing_code_modifier": ["SH"], "providers": [{"billed_charge": 1913.94, "npi": [1861530990]}, {"billed_charge": 1870.25, "npi": [1861530990]}, {"billed_charge": 1868.0, "npi": [1861530990]}]}, {"allowed_amount": 1475.42, "billing_code_modifier": ["RH"], "providers": [{"billed_charge": 1475.42, "npi": [1861530990]}]}, {"allowed_amount": 1475.25, "billing_code_modifier": ["SH"], "providers": [{"billed_charge": 1475.25, "npi": [1861530990]}]}, {"allowed_amount": 1504.12, "billing_code_modifier": ["RH"], "providers": [{"billed_charge": 1504.12, "npi": [1861530990]}]}, {"allowed_amount": 1492.12, "billing_code_modifier": ["SH"], "providers": [{"billed_charge": 1492.12, "npi": [1861530990]}]}, {"allowed_amount": 1473.0, "billing_code_modifier": ["RH"], "providers": [{"billed_charge": 1473.0, "npi": [1861530990]}]}, {"allowed_amount": 1533.56, "billing_code_modifier": ["RH"], "providers": [{"billed_charge": 1533.56, "npi": [1861530990]}]}, {"allowed_amount": 1489.87, "billing_code_modifier": ["RH"], "providers": [{"billed_charge": 1489.87, "npi": [1861530990]}]}, {"allowed_amount": 1518.94, "billing_code_modifier": ["RH"], "providers": [{"billed_charge": 1518.94, "npi": [1861530990]}]}, {"allowed_amount": 1569.78, "billing_code_modifier": ["SH"], "providers": [{"billed_charge": 1569.78, "npi": [1861530990]}]}, {"allowed_amount": 1509.22, "billing_code_modifier": ["RH"], "providers": [{"billed_charge": 1509.22, "npi": [1861530990]}]}, {"allowed_amount": 1516.69, "billing_code_modifier": ["RH"], "providers": [{"billed_charge": 1516.69, "npi": [1861530990]}]}, {"allowed_amount": 1535.1, "billing_code_modifier": ["RH"], "providers": [{"billed_charge": 1535.1, "npi": [1861530990]}]}, {"allowed_amount": 1518.94, "billing_code_modifier": ["SH"], "providers": [{"billed_charge": 1518.94, "npi": [1861530990]}]}]}]}, {"name": "Pharmacy - Extension of 25X - Drug Requiring Detailed Coding", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0636", "description": "Pharmacy - Extension of 25x", "allowed_amounts": [{"tin": {"type": "ein", "value": "824052186"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.49, "billing_code_modifier": [""], "providers": [{"billed_charge": 5.25, "npi": [1801826839]}]}, {"allowed_amount": 457.07, "billing_code_modifier": ["JZ"], "providers": [{"billed_charge": 1868.6, "npi": [1801826839]}]}, {"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 0.576, "npi": [1801826839]}, {"billed_charge": 1.3033, "npi": [1801826839]}, {"billed_charge": 0.8983, "npi": [1801826839]}, {"billed_charge": 31.55, "npi": [1801826839]}, {"billed_charge": 103.0, "npi": [1801826839]}, {"billed_charge": 20.98, "npi": [1801826839]}, {"billed_charge": 18.74, "npi": [1801826839]}, {"billed_charge": 17.82, "npi": [1801826839]}, {"billed_charge": 6.175, "npi": [1801826839]}, {"billed_charge": 10.025, "npi": [1801826839]}, {"billed_charge": 42.0, "npi": [1801826839]}, {"billed_charge": 0.8988, "npi": [1801826839]}, {"billed_charge": 22.58, "npi": [1801826839]}, {"billed_charge": 12.52, "npi": [1801826839]}, {"billed_charge": 0.505, "npi": [1801826839]}, {"billed_charge": 0.2064, "npi": [1801826839]}, {"billed_charge": 3.215, "npi": [1801826839]}, {"billed_charge": 31.8, "npi": [1801826839]}, {"billed_charge": 15.24, "npi": [1801826839]}, {"billed_charge": 276.85, "npi": [1801826839]}, {"billed_charge": 0.1476, "npi": [1801826839]}, {"billed_charge": 1.305, "npi": [1801826839]}, {"billed_charge": 20.76, "npi": [1801826839]}, {"billed_charge": 0.72, "npi": [1801826839]}, {"billed_charge": 47.62, "npi": [1801826839]}]}, {"allowed_amount": 0.49, "billing_code_modifier": ["JW"], "providers": [{"billed_charge": 5.25, "npi": [1801826839]}]}, {"allowed_amount": 0.495, "billing_code_modifier": ["JZ"], "providers": [{"billed_charge": 2.1, "npi": [1801826839]}]}, {"allowed_amount": 351.157, "billing_code_modifier": ["JZ"], "providers": [{"billed_charge": 1021.572, "npi": [1801826839]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["JZ"], "providers": [{"billed_charge": 1.925, "npi": [1801826839]}, {"billed_charge": 12.6667, "npi": [1801826839]}, {"billed_charge": 10.62, "npi": [1801826839]}, {"billed_charge": 11.55, "npi": [1801826839]}, {"billed_charge": 2.85, "npi": [1801826839]}, {"billed_charge": 1.02, "npi": [1801826839]}, {"billed_charge": 1.1638, "npi": [1801826839]}, {"billed_charge": 9.04, "npi": [1801826839]}, {"billed_charge": 8.53, "npi": [1801826839]}, {"billed_charge": 5.7, "npi": [1801826839]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["JW"], "providers": [{"billed_charge": 47.62, "npi": [1801826839]}]}]}]}, {"name": "Laboratory - General", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0300", "description": "Laboratory", "allowed_amounts": [{"tin": {"type": "ein", "value": "452694620"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 206.81, "billing_code_modifier": [""], "providers": [{"billed_charge": 1345.33, "npi": [1033120423]}]}, {"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 457.58, "npi": [1033120423]}, {"billed_charge": 57.76, "npi": [1033120423]}, {"billed_charge": 257.37, "npi": [1033120423]}, {"billed_charge": 183.02, "npi": [1033120423]}, {"billed_charge": 144.567, "npi": [1033120423]}, {"billed_charge": 156.9157, "npi": [1033120423]}, {"billed_charge": 40.24, "npi": [1033120423]}, {"billed_charge": 253.0, "npi": [1033120423]}]}, {"allowed_amount": 13.54, "billing_code_modifier": [""], "providers": [{"billed_charge": 57.76, "npi": [1033120423]}]}]}]}, {"name": "Laboratory - General", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0300", "description": "Laboratory", "allowed_amounts": [{"tin": {"type": "ein", "value": "751777119"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 392.86, "npi": [1073511762]}, {"billed_charge": 91.63, "npi": [1073511762]}, {"billed_charge": 237.17, "npi": [1073511762]}, {"billed_charge": 47.75, "npi": [1073511762]}, {"billed_charge": 40.0, "npi": [1073511762]}, {"billed_charge": 119.0883, "npi": [1073511762]}, {"billed_charge": 95.5, "npi": [1073511762]}, {"billed_charge": 212.5, "npi": [1073511762]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["XU"], "providers": [{"billed_charge": 212.5, "npi": [1073511762]}]}]}]}, {"name": "CT Scan - Head Scan", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0351", "description": "CT Scan", "allowed_amounts": [{"tin": {"type": "ein", "value": "751844139"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 151.54, "billing_code_modifier": [""], "providers": [{"billed_charge": 3178.59, "npi": [1265430177]}]}, {"allowed_amount": 622.69, "billing_code_modifier": [""], "providers": [{"billed_charge": 3178.59, "npi": [1265430177]}]}, {"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 11751.19, "npi": [1265430177]}, {"billed_charge": 3178.59, "npi": [1265430177]}]}, {"allowed_amount": 254.23, "billing_code_modifier": [""], "providers": [{"billed_charge": 3306.97, "npi": [1265430177]}, {"billed_charge": 3340.68, "npi": [1265430177]}]}]}]}, {"name": "Operating Room Services - General", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0360", "description": "Operating Room Services", "allowed_amounts": [{"tin": {"type": "ein", "value": "751837454"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 10517.66, "billing_code_modifier": ["LT"], "providers": [{"billed_charge": 5876.28, "npi": [1447250253]}]}, {"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 2052.6171, "npi": [1447250253]}, {"billed_charge": 976.725, "npi": [1447250253]}, {"billed_charge": 1814.13, "npi": [1447250253]}, {"billed_charge": 891.0, "npi": [1447250253]}, {"billed_charge": 1416.6514, "npi": [1447250253]}, {"billed_charge": 3534.3, "npi": [1447250253]}, {"billed_charge": 2415.6, "npi": [1447250253]}, {"billed_charge": 2496.24, "npi": [1447250253]}, {"billed_charge": 3628.8, "npi": [1447250253]}, {"billed_charge": 1776.0185, "npi": [1447250253]}, {"billed_charge": 1257.66, "npi": [1447250253]}, {"billed_charge": 1258.9714, "npi": [1447250253]}, {"billed_charge": 4027.725, "npi": [1447250253]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["LT"], "providers": [{"billed_charge": 11752.56, "npi": [1447250253]}]}]}]}, {"name": "Laboratory - Chemistry", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0301", "description": "Laboratory", "allowed_amounts": [{"tin": {"type": "ein", "value": "820551704"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 217.82, "npi": [1649273434]}, {"billed_charge": 249.74, "npi": [1649273434]}, {"billed_charge": 229.02, "npi": [1649273434]}, {"billed_charge": 159.62, "npi": [1649273434]}, {"billed_charge": 259.73, "npi": [1649273434]}, {"billed_charge": 306.86, "npi": [1649273434]}, {"billed_charge": 459.04, "npi": [1649273434]}, {"billed_charge": 185.85, "npi": [1649273434]}, {"billed_charge": 273.89, "npi": [1649273434]}, {"billed_charge": 121.9197, "npi": [1649273434]}, {"billed_charge": 56.6, "npi": [1649273434]}, {"billed_charge": 477.4, "npi": [1649273434]}, {"billed_charge": 226.41, "npi": [1649273434]}, {"billed_charge": 159.8, "npi": [1649273434]}, {"billed_charge": 156.98, "npi": [1649273434]}, {"billed_charge": 217.7, "npi": [1649273434]}, {"billed_charge": 285.79, "npi": [1649273434]}, {"billed_charge": 153.91, "npi": [1649273434]}, {"billed_charge": 252.96, "npi": [1649273434]}]}, {"allowed_amount": 19.42, "billing_code_modifier": [""], "providers": [{"billed_charge": 328.07, "npi": [1649273434]}]}]}]}, {"name": "IV Therapy -General", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0260", "description": "IV Therapy", "allowed_amounts": [{"tin": {"type": "ein", "value": "750800628"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 228.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 380.0, "npi": [1194743013]}]}, {"allowed_amount": 210.6, "billing_code_modifier": [""], "providers": [{"billed_charge": 351.0, "npi": [1194743013]}]}, {"allowed_amount": 154.8, "billing_code_modifier": [""], "providers": [{"billed_charge": 258.0, "npi": [1194743013]}]}, {"allowed_amount": 460.8, "billing_code_modifier": [""], "providers": [{"billed_charge": 768.0, "npi": [1194743013]}]}, {"allowed_amount": 131.58, "billing_code_modifier": [""], "providers": [{"billed_charge": 258.0, "npi": [1194743013]}]}, {"allowed_amount": 118.32, "billing_code_modifier": [""], "providers": [{"billed_charge": 232.0, "npi": [1194743013]}]}, {"allowed_amount": 139.2, "billing_code_modifier": [""], "providers": [{"billed_charge": 232.0, "npi": [1194743013]}]}, {"allowed_amount": 189.6, "billing_code_modifier": [""], "providers": [{"billed_charge": 316.0, "npi": [1194743013]}]}, {"allowed_amount": 228.0, "billing_code_modifier": ["XU"], "providers": [{"billed_charge": 380.0, "npi": [1194743013]}]}, {"allowed_amount": 246.6, "billing_code_modifier": [""], "providers": [{"billed_charge": 411.0, "npi": [1194743013]}]}]}]}, {"name": "SCREENING MAMMOGRAPHY BI 2-VIEW BREAST INC CAD", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "77067", "description": "SCREENING MAMMOGRAPHY BI 2-VIEW BREAST INC CAD", "allowed_amounts": [{"tin": {"type": "ein", "value": "203324726"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 42.08, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 130.0, "npi": [1831199546]}]}]}]}, {"name": "Laboratory - Hematology", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0305", "description": "Laboratory", "allowed_amounts": [{"tin": {"type": "ein", "value": "820551704"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 140.91, "npi": [1649273434]}, {"billed_charge": 161.398, "npi": [1649273434]}, {"billed_charge": 190.98, "npi": [1649273434]}, {"billed_charge": 183.63, "npi": [1649273434]}, {"billed_charge": 146.11, "npi": [1649273434]}, {"billed_charge": 172.1671, "npi": [1649273434]}]}]}]}, {"name": "BLOOD COUNT COMPLETE AUTO AND AUTO DIFRNTL WBC", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "85025", "description": "BLOOD COUNT COMPLETE AUTO AND AUTO DIFRNTL WBC", "allowed_amounts": [{"tin": {"type": "ein", "value": "853503076"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": ["QW91"], "providers": [{"billed_charge": 319.06, "npi": [1124623889]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["QW"], "providers": [{"billed_charge": 319.06, "npi": [1124623889]}]}]}]}, {"name": "Medical/Surgical Supplies and Devices - General", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0270", "description": "Med/Surg Supplies &Devices (also see 062x, extension of 027x", "allowed_amounts": [{"tin": {"type": "ein", "value": "751837454"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 804.5792, "npi": [1447250253]}, {"billed_charge": 274.5, "npi": [1447250253]}]}]}]}, {"name": "Laboratory - General", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0300", "description": "Laboratory", "allowed_amounts": [{"tin": {"type": "ein", "value": "364755936"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 5.7, "billing_code_modifier": ["QW"], "providers": [{"billed_charge": 281.93, "npi": [1679903967]}, {"billed_charge": 281.93, "npi": [1831629526]}]}, {"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 102.74, "npi": [1679903967]}, {"billed_charge": 106.72, "npi": [1831629526]}, {"billed_charge": 170.43, "npi": [1831629526]}, {"billed_charge": 244.89, "npi": [1831629526]}, {"billed_charge": 97.16, "npi": [1831629526]}, {"billed_charge": 97.16, "npi": [1679903967]}, {"billed_charge": 376.7, "npi": [1679903967]}, {"billed_charge": 105.92, "npi": [1831629526]}, {"billed_charge": 309.0, "npi": [1831629526]}, {"billed_charge": 214.23, "npi": [1679903967]}, {"billed_charge": 238.12, "npi": [1831629526]}, {"billed_charge": 376.7, "npi": [1831629526]}, {"billed_charge": 230.96, "npi": [1679903967]}, {"billed_charge": 70.2, "npi": [1679903967]}, {"billed_charge": 108.6, "npi": [1679903967]}, {"billed_charge": 100.35, "npi": [1831629526]}, {"billed_charge": 106.72, "npi": [1679903967]}, {"billed_charge": 140.17, "npi": [1831629526]}, {"billed_charge": 129.42, "npi": [1831629526]}, {"billed_charge": 140.17, "npi": [1679903967]}, {"billed_charge": 194.11, "npi": [1679903967]}, {"billed_charge": 238.12, "npi": [1679903967]}, {"billed_charge": 185.56, "npi": [1831629526]}, {"billed_charge": 211.05, "npi": [1831629526]}, {"billed_charge": 211.05, "npi": [1679903967]}, {"billed_charge": 185.56, "npi": [1679903967]}, {"billed_charge": 271.76, "npi": [1679903967]}, {"billed_charge": 214.23, "npi": [1831629526]}, {"billed_charge": 170.43, "npi": [1679903967]}, {"billed_charge": 173.76, "npi": [1679903967]}, {"billed_charge": 100.35, "npi": [1679903967]}, {"billed_charge": 102.74, "npi": [1831629526]}, {"billed_charge": 129.42, "npi": [1679903967]}, {"billed_charge": 105.92, "npi": [1679903967]}, {"billed_charge": 70.2, "npi": [1831629526]}, {"billed_charge": 244.89, "npi": [1679903967]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["QW"], "providers": [{"billed_charge": 102.74, "npi": [1679903967]}, {"billed_charge": 97.16, "npi": [1679903967]}, {"billed_charge": 376.7, "npi": [1679903967]}, {"billed_charge": 105.92, "npi": [1831629526]}, {"billed_charge": 214.23, "npi": [1679903967]}, {"billed_charge": 238.12, "npi": [1831629526]}, {"billed_charge": 70.2, "npi": [1679903967]}, {"billed_charge": 140.17, "npi": [1679903967]}, {"billed_charge": 238.12, "npi": [1679903967]}, {"billed_charge": 211.05, "npi": [1831629526]}, {"billed_charge": 185.56, "npi": [1679903967]}, {"billed_charge": 211.05, "npi": [1679903967]}, {"billed_charge": 214.23, "npi": [1831629526]}, {"billed_charge": 170.43, "npi": [1679903967]}, {"billed_charge": 100.35, "npi": [1679903967]}, {"billed_charge": 105.92, "npi": [1679903967]}]}, {"allowed_amount": 5.7, "billing_code_modifier": [""], "providers": [{"billed_charge": 281.93, "npi": [1679903967]}, {"billed_charge": 281.93, "npi": [1831629526]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["91"], "providers": [{"billed_charge": 271.76, "npi": [1679903967]}]}]}]}, {"name": "Pharmacy - Extension of 25X - Drug Requiring Detailed Coding", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0636", "description": "Pharmacy - Extension of 25x", "allowed_amounts": [{"tin": {"type": "ein", "value": "751008430"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.49, "billing_code_modifier": ["JZ"], "providers": [{"billed_charge": 6.06, "npi": [1669472387]}]}, {"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 0.7498, "npi": [1669472387]}, {"billed_charge": 1.6515, "npi": [1669472387]}, {"billed_charge": 0.0295, "npi": [1669472387]}, {"billed_charge": 0.4716, "npi": [1669472387]}, {"billed_charge": 3.535, "npi": [1669472387]}, {"billed_charge": 3.3075, "npi": [1669472387]}, {"billed_charge": 6.2611, "npi": [1669472387]}, {"billed_charge": 1.1797, "npi": [1669472387]}, {"billed_charge": 29.85, "npi": [1669472387]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["JZ"], "providers": [{"billed_charge": 41.64, "npi": [1669472387]}, {"billed_charge": 2.4, "npi": [1669472387]}, {"billed_charge": 1.425, "npi": [1669472387]}, {"billed_charge": 1.02, "npi": [1669472387]}, {"billed_charge": 2.82, "npi": [1669472387]}, {"billed_charge": 23.1, "npi": [1669472387]}]}]}]}, {"name": "GROUND MILEAGE PER STATUTE MILE", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "A0425", "description": "GROUND MILEAGE PER STATUTE MILE", "allowed_amounts": [{"tin": {"type": "ein", "value": "756000566"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 15.0, "billing_code_modifier": ["SH"], "providers": [{"billed_charge": 15.0, "npi": [1962432930]}]}, {"allowed_amount": 15.0, "billing_code_modifier": ["PH"], "providers": [{"billed_charge": 15.0, "npi": [1962432930]}]}, {"allowed_amount": 15.0, "billing_code_modifier": ["RH"], "providers": [{"billed_charge": 15.0, "npi": [1962432930]}]}]}]}, {"name": "Pharmacy - Extension of 25X - Drug Requiring Detailed Coding", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0636", "description": "Pharmacy - Extension of 25x", "allowed_amounts": [{"tin": {"type": "ein", "value": "753175630"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.49, "billing_code_modifier": ["JZ"], "providers": [{"billed_charge": 10.0, "npi": [1285798918]}]}, {"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 17.43, "npi": [1285798918]}, {"billed_charge": 10.0, "npi": [1285798918]}, {"billed_charge": 10.91, "npi": [1285798918]}, {"billed_charge": 2.5, "npi": [1285798918]}, {"billed_charge": 48.56, "npi": [1285798918]}, {"billed_charge": 5.627, "npi": [1285798918]}, {"billed_charge": 0.2987, "npi": [1285798918]}, {"billed_charge": 200.91, "npi": [1285798918]}, {"billed_charge": 3.521, "npi": [1285798918]}, {"billed_charge": 0.5, "npi": [1285798918]}, {"billed_charge": 12.9, "npi": [1285798918]}, {"billed_charge": 19.5, "npi": [1285798918]}, {"billed_charge": 0.5828, "npi": [1285798918]}, {"billed_charge": 6.1246, "npi": [1285798918]}, {"billed_charge": 32.97, "npi": [1285798918]}, {"billed_charge": 0.2672, "npi": [1285798918]}, {"billed_charge": 6.1247, "npi": [1285798918]}, {"billed_charge": 0.3035, "npi": [1285798918]}, {"billed_charge": 7.365, "npi": [1285798918]}, {"billed_charge": 2.705, "npi": [1285798918]}, {"billed_charge": 1.0, "npi": [1285798918]}, {"billed_charge": 60.7, "npi": [1285798918]}, {"billed_charge": 2.3863, "npi": [1285798918]}, {"billed_charge": 6.1248, "npi": [1285798918]}, {"billed_charge": 5.633, "npi": [1285798918]}, {"billed_charge": 128.76, "npi": [1285798918]}, {"billed_charge": 3.035, "npi": [1285798918]}]}, {"allowed_amount": 0.495, "billing_code_modifier": ["JZ"], "providers": [{"billed_charge": 5.0, "npi": [1285798918]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["JZ"], "providers": [{"billed_charge": 2.1012, "npi": [1285798918]}]}]}]}, {"name": "Pharmacy - Extension of 25X - Drug Requiring Detailed Coding", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0636", "description": "Pharmacy - Extension of 25x", "allowed_amounts": [{"tin": {"type": "ein", "value": "751977850"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 0.5, "npi": [1396778064]}, {"billed_charge": 21.09, "npi": [1396778064]}, {"billed_charge": 0.125, "npi": [1396778064]}, {"billed_charge": 19.07, "npi": [1396778064]}, {"billed_charge": 22.08, "npi": [1396778064]}, {"billed_charge": 117.6, "npi": [1396778064]}, {"billed_charge": 7.5, "npi": [1396778064]}, {"billed_charge": 514.58, "npi": [1396778064]}, {"billed_charge": 0.1277, "npi": [1396778064]}, {"billed_charge": 6.0, "npi": [1396778064]}, {"billed_charge": 1.368, "npi": [1396778064]}, {"billed_charge": 31.875, "npi": [1396778064]}, {"billed_charge": 10.0, "npi": [1396778064]}, {"billed_charge": 50.0, "npi": [1396778064]}, {"billed_charge": 12.0625, "npi": [1396778064]}, {"billed_charge": 0.9843, "npi": [1396778064]}, {"billed_charge": 163.8, "npi": [1396778064]}, {"billed_charge": 186.78, "npi": [1396778064]}, {"billed_charge": 0.1667, "npi": [1396778064]}, {"billed_charge": 6.25, "npi": [1396778064]}, {"billed_charge": 15.28, "npi": [1396778064]}, {"billed_charge": 3.283, "npi": [1396778064]}, {"billed_charge": 1.0, "npi": [1396778064]}, {"billed_charge": 3.75, "npi": [1396778064]}, {"billed_charge": 0.2, "npi": [1396778064]}, {"billed_charge": 2.5, "npi": [1396778064]}, {"billed_charge": 41.04, "npi": [1396778064]}, {"billed_charge": 12.5, "npi": [1396778064]}, {"billed_charge": 5.32, "npi": [1396778064]}, {"billed_charge": 2.4575, "npi": [1396778064]}]}, {"allowed_amount": 0.51, "billing_code_modifier": [""], "providers": [{"billed_charge": 10.0, "npi": [1396778064]}]}, {"allowed_amount": 0.51, "billing_code_modifier": ["JZ"], "providers": [{"billed_charge": 17.1, "npi": [1396778064]}, {"billed_charge": 10.0, "npi": [1396778064]}, {"billed_charge": 5.0, "npi": [1396778064]}, {"billed_charge": 14.89, "npi": [1396778064]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["JZ"], "providers": [{"billed_charge": 0.5, "npi": [1396778064]}, {"billed_charge": 16.33, "npi": [1396778064]}, {"billed_charge": 1.846, "npi": [1396778064]}, {"billed_charge": 13.68, "npi": [1396778064]}, {"billed_charge": 7.5, "npi": [1396778064]}, {"billed_charge": 6.0, "npi": [1396778064]}, {"billed_charge": 1.97, "npi": [1396778064]}, {"billed_charge": 2.018, "npi": [1396778064]}, {"billed_charge": 0.2603, "npi": [1396778064]}, {"billed_charge": 9.0, "npi": [1396778064]}]}]}]}, {"name": "Anesthesia - General", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0370", "description": "Anesthesia", "allowed_amounts": [{"tin": {"type": "ein", "value": "751837454"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 283.2, "npi": [1447250253]}, {"billed_charge": 839.275, "npi": [1447250253]}, {"billed_charge": 413.1811, "npi": [1447250253]}, {"billed_charge": 397.7006, "npi": [1447250253]}, {"billed_charge": 179.03, "npi": [1447250253]}, {"billed_charge": 488.2633, "npi": [1447250253]}, {"billed_charge": 1387.11, "npi": [1447250253]}, {"billed_charge": 474.0517, "npi": [1447250253]}, {"billed_charge": 391.0464, "npi": [1447250253]}, {"billed_charge": 447.9643, "npi": [1447250253]}, {"billed_charge": 490.6527, "npi": [1447250253]}, {"billed_charge": 1500.0, "npi": [1447250253]}, {"billed_charge": 510.574, "npi": [1447250253]}, {"billed_charge": 387.37, "npi": [1447250253]}]}]}]}, {"name": "Laboratory - General", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0300", "description": "Laboratory", "allowed_amounts": [{"tin": {"type": "ein", "value": "752770738"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 41.5, "npi": [1770514077]}, {"billed_charge": 286.75, "npi": [1770514077]}, {"billed_charge": 258.65, "npi": [1770514077]}]}, {"allowed_amount": 13.54, "billing_code_modifier": [""], "providers": [{"billed_charge": 41.5, "npi": [1770514077]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["59"], "providers": [{"billed_charge": 296.5, "npi": [1770514077]}]}]}]}, {"name": "Occupational Therapy - General", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0430", "description": "Occupational Therapy", "allowed_amounts": [{"tin": {"type": "ein", "value": "751837454"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 202.4533, "npi": [1447250253]}, {"billed_charge": 200.92, "npi": [1447250253]}, {"billed_charge": 198.5893, "npi": [1447250253]}, {"billed_charge": 201.38, "npi": [1447250253]}, {"billed_charge": 202.325, "npi": [1447250253]}, {"billed_charge": 207.078, "npi": [1447250253]}, {"billed_charge": 198.16, "npi": [1447250253]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["GO"], "providers": [{"billed_charge": 198.16, "npi": [1447250253]}]}]}]}, {"name": "Pharmacy - Extension of 25X - Drug Requiring Detailed Coding", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0636", "description": "Pharmacy - Extension of 25x", "allowed_amounts": [{"tin": {"type": "ein", "value": "751047527"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.49, "billing_code_modifier": [""], "providers": [{"billed_charge": 10.0, "npi": [1396779948]}]}, {"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 12.0625, "npi": [1396779948]}, {"billed_charge": 3.3608, "npi": [1396779948]}, {"billed_charge": 22.8, "npi": [1396779948]}, {"billed_charge": 1.25, "npi": [1396779948]}, {"billed_charge": 2.5888, "npi": [1396779948]}, {"billed_charge": 3.1373, "npi": [1396779948]}, {"billed_charge": 2.28, "npi": [1396779948]}, {"billed_charge": 3.4191, "npi": [1396779948]}, {"billed_charge": 10.0, "npi": [1396779948]}, {"billed_charge": 11.2945, "npi": [1396779948]}, {"billed_charge": 45.395, "npi": [1396779948]}, {"billed_charge": 2.0, "npi": [1396779948]}, {"billed_charge": 6.25, "npi": [1396779948]}, {"billed_charge": 0.5153, "npi": [1396779948]}, {"billed_charge": 19.07, "npi": [1396779948]}, {"billed_charge": 50.0, "npi": [1396779948]}, {"billed_charge": 3.75, "npi": [1396779948]}, {"billed_charge": 0.05, "npi": [1396779948]}, {"billed_charge": 2.9827, "npi": [1396779948]}, {"billed_charge": 5.0268, "npi": [1396779948]}, {"billed_charge": 1.596, "npi": [1396779948]}, {"billed_charge": 0.3584, "npi": [1396779948]}, {"billed_charge": 0.984, "npi": [1396779948]}, {"billed_charge": 1.26, "npi": [1396779948]}, {"billed_charge": 15.0, "npi": [1396779948]}, {"billed_charge": 31.01, "npi": [1396779948]}, {"billed_charge": 1.1598, "npi": [1396779948]}, {"billed_charge": 5.0, "npi": [1396779948]}, {"billed_charge": 6.0, "npi": [1396779948]}, {"billed_charge": 41.04, "npi": [1396779948]}, {"billed_charge": 0.2, "npi": [1396779948]}, {"billed_charge": 16.1817, "npi": [1396779948]}, {"billed_charge": 1.5892, "npi": [1396779948]}, {"billed_charge": 2.8571, "npi": [1396779948]}, {"billed_charge": 37.2046, "npi": [1396779948]}, {"billed_charge": 12.5, "npi": [1396779948]}, {"billed_charge": 3.502, "npi": [1396779948]}, {"billed_charge": 0.1277, "npi": [1396779948]}, {"billed_charge": 2.5, "npi": [1396779948]}, {"billed_charge": 0.5, "npi": [1396779948]}, {"billed_charge": 514.58, "npi": [1396779948]}, {"billed_charge": 9.0, "npi": [1396779948]}, {"billed_charge": 19.8233, "npi": [1396779948]}, {"billed_charge": 0.684, "npi": [1396779948]}, {"billed_charge": 1.0, "npi": [1396779948]}, {"billed_charge": 1.875, "npi": [1396779948]}]}, {"allowed_amount": 195.75, "billing_code_modifier": ["JZ"], "providers": [{"billed_charge": 909.65, "npi": [1396779948]}]}, {"allowed_amount": 0.49, "billing_code_modifier": ["JW"], "providers": [{"billed_charge": 10.0, "npi": [1396779948]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["59"], "providers": [{"billed_charge": 186.78, "npi": [1396779948]}]}, {"allowed_amount": 2.043, "billing_code_modifier": ["JZ"], "providers": [{"billed_charge": 5.1934, "npi": [1396779948]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["JZ"], "providers": [{"billed_charge": 1.9004, "npi": [1396779948]}, {"billed_charge": 16.33, "npi": [1396779948]}, {"billed_charge": 5.9975, "npi": [1396779948]}, {"billed_charge": 909.65, "npi": [1396779948]}, {"billed_charge": 7.5, "npi": [1396779948]}, {"billed_charge": 0.5, "npi": [1396779948]}, {"billed_charge": 9.0, "npi": [1396779948]}, {"billed_charge": 0.5472, "npi": [1396779948]}, {"billed_charge": 0.1961, "npi": [1396779948]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["JW"], "providers": [{"billed_charge": 6.0, "npi": [1396779948]}, {"billed_charge": 9.0, "npi": [1396779948]}]}]}]}, {"name": "Emergency Room - General", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0450", "description": "Emergency Room", "allowed_amounts": [{"tin": {"type": "ein", "value": "750800628"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 3321.6, "billing_code_modifier": ["LT"], "providers": [{"billed_charge": 5536.0, "npi": [1720480627]}]}, {"allowed_amount": 266.4, "billing_code_modifier": ["RT"], "providers": [{"billed_charge": 444.0, "npi": [1194743013]}]}, {"allowed_amount": 266.4, "billing_code_modifier": ["LT"], "providers": [{"billed_charge": 444.0, "npi": [1194743013]}]}, {"allowed_amount": 546.6, "billing_code_modifier": [""], "providers": [{"billed_charge": 911.0, "npi": [1194743013]}, {"billed_charge": 911.0, "npi": [1720480627]}]}, {"allowed_amount": 303.0, "billing_code_modifier": ["LTFA"], "providers": [{"billed_charge": 505.0, "npi": [1720480627]}]}, {"allowed_amount": 228.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 380.0, "npi": [1720480627]}, {"billed_charge": 380.0, "npi": [1194743013]}]}, {"allowed_amount": 2344.8, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 3908.0, "npi": [1194743013]}, {"billed_charge": 3908.0, "npi": [1720480627]}]}, {"allowed_amount": 210.6, "billing_code_modifier": [""], "providers": [{"billed_charge": 351.0, "npi": [1194743013]}]}, {"allowed_amount": 115.83, "billing_code_modifier": ["XU"], "providers": [{"billed_charge": 351.0, "npi": [1720480627]}]}, {"allowed_amount": 460.8, "billing_code_modifier": [""], "providers": [{"billed_charge": 768.0, "npi": [1194743013]}]}, {"allowed_amount": 311.4, "billing_code_modifier": [""], "providers": [{"billed_charge": 519.0, "npi": [1194743013]}, {"billed_charge": 519.0, "npi": [1720480627]}]}, {"allowed_amount": 532.2, "billing_code_modifier": [""], "providers": [{"billed_charge": 887.0, "npi": [1720480627]}]}, {"allowed_amount": 258.6, "billing_code_modifier": [""], "providers": [{"billed_charge": 431.0, "npi": [1720480627]}]}, {"allowed_amount": 125.4, "billing_code_modifier": ["XU"], "providers": [{"billed_charge": 380.0, "npi": [1720480627]}]}, {"allowed_amount": 432.6, "billing_code_modifier": [""], "providers": [{"billed_charge": 721.0, "npi": [1194743013]}]}, {"allowed_amount": 2344.8, "billing_code_modifier": [""], "providers": [{"billed_charge": 3908.0, "npi": [1194743013]}, {"billed_charge": 3908.0, "npi": [1720480627]}]}, {"allowed_amount": 189.6, "billing_code_modifier": [""], "providers": [{"billed_charge": 316.0, "npi": [1194743013]}]}, {"allowed_amount": 291.0, "billing_code_modifier": ["RT"], "providers": [{"billed_charge": 485.0, "npi": [1194743013]}]}, {"allowed_amount": 210.6, "billing_code_modifier": ["XU"], "providers": [{"billed_charge": 351.0, "npi": [1720480627]}]}, {"allowed_amount": 189.6, "billing_code_modifier": ["XU"], "providers": [{"billed_charge": 316.0, "npi": [1720480627]}]}, {"allowed_amount": 246.6, "billing_code_modifier": ["XU"], "providers": [{"billed_charge": 411.0, "npi": [1720480627]}]}, {"allowed_amount": 228.0, "billing_code_modifier": ["XU"], "providers": [{"billed_charge": 380.0, "npi": [1720480627]}]}, {"allowed_amount": 981.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 1635.0, "npi": [1194743013]}, {"billed_charge": 1635.0, "npi": [1720480627]}]}, {"allowed_amount": 460.8, "billing_code_modifier": ["XU"], "providers": [{"billed_charge": 768.0, "npi": [1720480627]}]}, {"allowed_amount": 1289.64, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 3908.0, "npi": [1720480627]}]}, {"allowed_amount": 1021.02, "billing_code_modifier": [""], "providers": [{"billed_charge": 2618.0, "npi": [1194743013]}]}, {"allowed_amount": 1570.8, "billing_code_modifier": [""], "providers": [{"billed_charge": 2618.0, "npi": [1194743013]}, {"billed_charge": 2618.0, "npi": [1720480627]}]}, {"allowed_amount": 1570.8, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 2618.0, "npi": [1194743013]}, {"billed_charge": 2618.0, "npi": [1720480627]}]}, {"allowed_amount": 445.8, "billing_code_modifier": [""], "providers": [{"billed_charge": 743.0, "npi": [1720480627]}]}, {"allowed_amount": 391.68, "billing_code_modifier": [""], "providers": [{"billed_charge": 768.0, "npi": [1194743013]}]}]}]}, {"name": "Laboratory - Hematology", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0305", "description": "Laboratory", "allowed_amounts": [{"tin": {"type": "ein", "value": "752586857"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 139.5838, "npi": [1992700983]}, {"billed_charge": 149.84, "npi": [1992700983]}, {"billed_charge": 95.6157, "npi": [1992700983]}, {"billed_charge": 190.98, "npi": [1992700983]}, {"billed_charge": 111.76, "npi": [1992700983]}, {"billed_charge": 153.7322, "npi": [1992700983]}, {"billed_charge": 152.665, "npi": [1992700983]}, {"billed_charge": 93.56, "npi": [1992700983]}, {"billed_charge": 248.29, "npi": [1992700983]}, {"billed_charge": 183.63, "npi": [1992700983]}, {"billed_charge": 140.91, "npi": [1992700983]}, {"billed_charge": 166.1, "npi": [1992700983]}, {"billed_charge": 106.26, "npi": [1992700983]}, {"billed_charge": 147.695, "npi": [1992700983]}, {"billed_charge": 146.11, "npi": [1992700983]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["91"], "providers": [{"billed_charge": 149.84, "npi": [1992700983]}, {"billed_charge": 76.63, "npi": [1992700983]}, {"billed_charge": 72.35, "npi": [1992700983]}]}]}]}, {"name": "SCREENING MAMMOGRAPHY BI 2-VIEW BREAST INC CAD", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "77067", "description": "SCREENING MAMMOGRAPHY BI 2-VIEW BREAST INC CAD", "allowed_amounts": [{"tin": {"type": "ein", "value": "741680498"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 42.08, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 316.0, "npi": [1447391487]}, {"billed_charge": 316.0, "npi": [1457542631]}, {"billed_charge": 316.0, "npi": [1750404380]}]}, {"allowed_amount": 41.99, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 316.0, "npi": [1457542631]}, {"billed_charge": 316.0, "npi": [1750404380]}]}, {"allowed_amount": 41.38, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 316.0, "npi": [1457542631]}, {"billed_charge": 316.0, "npi": [1821047374]}]}]}]}, {"name": "Physical Therapy - General", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0420", "description": "Physical Therapy", "allowed_amounts": [{"tin": {"type": "ein", "value": "741152597"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 37.635, "billing_code_modifier": ["GP"], "providers": [{"billed_charge": 371.75, "npi": [1982666111]}]}, {"allowed_amount": 45.295, "billing_code_modifier": ["GP"], "providers": [{"billed_charge": 307.0, "npi": [1982666111]}]}, {"allowed_amount": 33.615, "billing_code_modifier": ["GP"], "providers": [{"billed_charge": 374.5, "npi": [1982666111]}]}, {"allowed_amount": 32.1, "billing_code_modifier": ["GP"], "providers": [{"billed_charge": 410.5, "npi": [1982666111]}]}, {"allowed_amount": 52.76, "billing_code_modifier": ["GP"], "providers": [{"billed_charge": 307.0, "npi": [1982666111]}]}, {"allowed_amount": 43.48, "billing_code_modifier": ["GP"], "providers": [{"billed_charge": 371.75, "npi": [1982666111]}]}]}]}, {"name": "EKG/ECG (Electrocardiogram) - General", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0730", "description": "EKG/ECG (Electrocardiogram)", "allowed_amounts": [{"tin": {"type": "ein", "value": "753175630"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 471.0, "npi": [1285798918]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["XU"], "providers": [{"billed_charge": 471.0, "npi": [1285798918]}]}]}]}, {"name": "Laboratory - Chemistry", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0301", "description": "Laboratory", "allowed_amounts": [{"tin": {"type": "ein", "value": "260194016"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 459.04, "npi": [1205018439]}, {"billed_charge": 127.23, "npi": [1205018439]}, {"billed_charge": 249.74, "npi": [1205018439]}, {"billed_charge": 319.13, "npi": [1205018439]}, {"billed_charge": 254.9821, "npi": [1205018439]}, {"billed_charge": 129.62, "npi": [1205018439]}, {"billed_charge": 101.57, "npi": [1205018439]}, {"billed_charge": 87.97, "npi": [1205018439]}, {"billed_charge": 153.91, "npi": [1205018439]}, {"billed_charge": 111.02, "npi": [1205018439]}, {"billed_charge": 56.6, "npi": [1205018439]}, {"billed_charge": 229.02, "npi": [1205018439]}, {"billed_charge": 96.1, "npi": [1205018439]}, {"billed_charge": 372.39, "npi": [1205018439]}, {"billed_charge": 324.88, "npi": [1205018439]}, {"billed_charge": 103.54, "npi": [1205018439]}, {"billed_charge": 105.46, "npi": [1205018439]}, {"billed_charge": 217.7, "npi": [1205018439]}, {"billed_charge": 108.35, "npi": [1205018439]}, {"billed_charge": 108.97, "npi": [1205018439]}, {"billed_charge": 160.07, "npi": [1205018439]}, {"billed_charge": 93.56, "npi": [1205018439]}, {"billed_charge": 214.55, "npi": [1205018439]}, {"billed_charge": 103.83, "npi": [1205018439]}, {"billed_charge": 285.79, "npi": [1205018439]}, {"billed_charge": 224.4029, "npi": [1205018439]}, {"billed_charge": 104.78, "npi": [1205018439]}, {"billed_charge": 297.22, "npi": [1205018439]}, {"billed_charge": 407.22, "npi": [1205018439]}, {"billed_charge": 159.4376, "npi": [1205018439]}, {"billed_charge": 88.72, "npi": [1205018439]}, {"billed_charge": 304.35, "npi": [1205018439]}, {"billed_charge": 306.86, "npi": [1205018439]}, {"billed_charge": 243.23, "npi": [1205018439]}, {"billed_charge": 259.73, "npi": [1205018439]}, {"billed_charge": 185.85, "npi": [1205018439]}, {"billed_charge": 80.13, "npi": [1205018439]}, {"billed_charge": 233.89, "npi": [1205018439]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["GZ"], "providers": [{"billed_charge": 459.04, "npi": [1205018439]}]}, {"allowed_amount": 19.42, "billing_code_modifier": [""], "providers": [{"billed_charge": 341.19, "npi": [1205018439]}, {"billed_charge": 328.07, "npi": [1205018439]}]}, {"allowed_amount": 5.7, "billing_code_modifier": [""], "providers": [{"billed_charge": 99.79, "npi": [1205018439]}]}]}]}, {"name": "Laboratory - Chemistry", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0301", "description": "Laboratory", "allowed_amounts": [{"tin": {"type": "ein", "value": "751748586"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 335.75, "npi": [1508899204]}, {"billed_charge": 340.0, "npi": [1508899204]}, {"billed_charge": 493.5, "npi": [1508899204]}, {"billed_charge": 410.0, "npi": [1508899204]}, {"billed_charge": 679.25, "npi": [1508899204]}, {"billed_charge": 565.0, "npi": [1508899204]}, {"billed_charge": 247.0, "npi": [1508899204]}, {"billed_charge": 120.75, "npi": [1508899204]}, {"billed_charge": 278.25, "npi": [1508899204]}, {"billed_charge": 324.5, "npi": [1508899204]}, {"billed_charge": 334.25, "npi": [1508899204]}, {"billed_charge": 561.75, "npi": [1508899204]}, {"billed_charge": 291.25, "npi": [1508899204]}, {"billed_charge": 257.75, "npi": [1508899204]}, {"billed_charge": 348.5, "npi": [1508899204]}, {"billed_charge": 231.0, "npi": [1508899204]}, {"billed_charge": 210.75, "npi": [1508899204]}, {"billed_charge": 288.25, "npi": [1508899204]}, {"billed_charge": 161.0, "npi": [1508899204]}, {"billed_charge": 153.5, "npi": [1508899204]}, {"billed_charge": 179.5, "npi": [1508899204]}, {"billed_charge": 112.75, "npi": [1508899204]}, {"billed_charge": 123.25, "npi": [1508899204]}, {"billed_charge": 328.75, "npi": [1508899204]}, {"billed_charge": 235.0, "npi": [1508899204]}, {"billed_charge": 225.75, "npi": [1508899204]}, {"billed_charge": 274.25, "npi": [1508899204]}, {"billed_charge": 671.0, "npi": [1508899204]}, {"billed_charge": 229.25, "npi": [1508899204]}]}, {"allowed_amount": 5.7, "billing_code_modifier": [""], "providers": [{"billed_charge": 140.0, "npi": [1508899204]}]}]}]}, {"name": "BEHAVIORAL HEALTH DAY TREATMENT PER HOUR", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "H2012", "description": "BEHAVIORAL HEALTH DAY TREATMENT PER HOUR", "allowed_amounts": [{"tin": {"type": "ein", "value": "851283674"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 24.32, "billing_code_modifier": [""], "providers": [{"billed_charge": 75.0, "npi": [1679029136]}]}]}]}, {"name": "Laboratory - Immunology", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0302", "description": "Laboratory", "allowed_amounts": [{"tin": {"type": "ein", "value": "751837454"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 176.0967, "npi": [1447250253]}, {"billed_charge": 127.41, "npi": [1447250253]}, {"billed_charge": 211.11, "npi": [1447250253]}, {"billed_charge": 212.3143, "npi": [1447250253]}, {"billed_charge": 227.1794, "npi": [1447250253]}, {"billed_charge": 198.3083, "npi": [1447250253]}, {"billed_charge": 216.7383, "npi": [1447250253]}, {"billed_charge": 201.6012, "npi": [1447250253]}, {"billed_charge": 205.1425, "npi": [1447250253]}, {"billed_charge": 234.8786, "npi": [1447250253]}, {"billed_charge": 205.33, "npi": [1447250253]}, {"billed_charge": 171.97, "npi": [1447250253]}, {"billed_charge": 313.7, "npi": [1447250253]}, {"billed_charge": 235.3537, "npi": [1447250253]}, {"billed_charge": 182.6561, "npi": [1447250253]}, {"billed_charge": 145.1167, "npi": [1447250253]}, {"billed_charge": 169.31, "npi": [1447250253]}, {"billed_charge": 187.64, "npi": [1447250253]}, {"billed_charge": 231.138, "npi": [1447250253]}, {"billed_charge": 211.47, "npi": [1447250253]}, {"billed_charge": 254.96, "npi": [1447250253]}, {"billed_charge": 183.2, "npi": [1447250253]}, {"billed_charge": 276.5533, "npi": [1447250253]}, {"billed_charge": 234.48, "npi": [1447250253]}, {"billed_charge": 282.54, "npi": [1447250253]}, {"billed_charge": 228.91, "npi": [1447250253]}, {"billed_charge": 197.09, "npi": [1447250253]}, {"billed_charge": 180.88, "npi": [1447250253]}, {"billed_charge": 226.195, "npi": [1447250253]}, {"billed_charge": 202.792, "npi": [1447250253]}, {"billed_charge": 144.74, "npi": [1447250253]}, {"billed_charge": 171.76, "npi": [1447250253]}]}]}]}, {"name": "Cardiology - Echocardiology", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0483", "description": "Cardiology", "allowed_amounts": [{"tin": {"type": "ein", "value": "751837454"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 1397.4, "npi": [1447250253]}, {"billed_charge": 2928.9225, "npi": [1447250253]}, {"billed_charge": 1263.4, "npi": [1447250253]}, {"billed_charge": 2856.665, "npi": [1447250253]}, {"billed_charge": 4315.93, "npi": [1447250253]}, {"billed_charge": 2628.365, "npi": [1447250253]}, {"billed_charge": 1174.0667, "npi": [1447250253]}, {"billed_charge": 2430.812, "npi": [1447250253]}]}, {"allowed_amount": 345.85, "billing_code_modifier": [""], "providers": [{"billed_charge": 1397.4, "npi": [1447250253]}]}]}]}, {"name": "SBSQ HOSPITAL IP/OBS CARE HIGH MDM 50 MINUTES", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "99233", "description": "SBSQ HOSPITAL IP/OBS CARE HIGH MDM 50 MINUTES", "allowed_amounts": [{"tin": {"type": "ein", "value": "270794018"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 128.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 150.0, "npi": [1932300779]}]}]}]}, {"name": "Pharmacy - General", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0250", "description": "Pharmacy (also see 063x, an extension of 025x)", "allowed_amounts": [{"tin": {"type": "ein", "value": "751037591"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 9.8583, "npi": [1124305065]}, {"billed_charge": 30.2, "npi": [1124305065]}, {"billed_charge": 27.3, "npi": [1124305065]}, {"billed_charge": 19.4933, "npi": [1124305065]}, {"billed_charge": 0.315, "npi": [1124305065]}, {"billed_charge": 1.5543, "npi": [1124305065]}, {"billed_charge": 2.0, "npi": [1124305065]}, {"billed_charge": 23.44, "npi": [1124305065]}, {"billed_charge": 0.1667, "npi": [1124305065]}, {"billed_charge": 0.6825, "npi": [1124305065]}, {"billed_charge": 4.0164, "npi": [1124305065]}, {"billed_charge": 3.132, "npi": [1124305065]}, {"billed_charge": 3.95, "npi": [1124305065]}, {"billed_charge": 16.97, "npi": [1124305065]}, {"billed_charge": 2.3, "npi": [1124305065]}, {"billed_charge": 15.72, "npi": [1124305065]}, {"billed_charge": 3.0035, "npi": [1124305065]}, {"billed_charge": 9.797, "npi": [1124305065]}, {"billed_charge": 4.495, "npi": [1124305065]}, {"billed_charge": 1.46, "npi": [1124305065]}, {"billed_charge": 9.3457, "npi": [1124305065]}, {"billed_charge": 0.1267, "npi": [1124305065]}, {"billed_charge": 1.7171, "npi": [1124305065]}, {"billed_charge": 3.88, "npi": [1124305065]}, {"billed_charge": 23.74, "npi": [1124305065]}, {"billed_charge": 3.79, "npi": [1124305065]}, {"billed_charge": 3.721, "npi": [1124305065]}, {"billed_charge": 2.17, "npi": [1124305065]}, {"billed_charge": 3.11, "npi": [1124305065]}, {"billed_charge": 3.99, "npi": [1124305065]}]}]}]}, {"name": "Pharmacy - General", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0250", "description": "Pharmacy (also see 063x, an extension of 025x)", "allowed_amounts": [{"tin": {"type": "ein", "value": "752890358"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 1.5, "npi": [1548291883]}, {"billed_charge": 1.43, "npi": [1548291883]}, {"billed_charge": 20.96, "npi": [1548291883]}, {"billed_charge": 8.2367, "npi": [1548291883]}, {"billed_charge": 5.628, "npi": [1548291883]}, {"billed_charge": 16.15, "npi": [1548291883]}, {"billed_charge": 1.0, "npi": [1548291883]}, {"billed_charge": 8.575, "npi": [1548291883]}, {"billed_charge": 10.0, "npi": [1548291883]}, {"billed_charge": 12.76, "npi": [1548291883]}, {"billed_charge": 0.25, "npi": [1548291883]}, {"billed_charge": 1.4677, "npi": [1548291883]}, {"billed_charge": 2.0, "npi": [1548291883]}, {"billed_charge": 1.03, "npi": [1548291883]}, {"billed_charge": 9.3033, "npi": [1548291883]}, {"billed_charge": 8.6667, "npi": [1548291883]}, {"billed_charge": 1.215, "npi": [1548291883]}, {"billed_charge": 35.0086, "npi": [1548291883]}, {"billed_charge": 4.4619, "npi": [1548291883]}, {"billed_charge": 39.9, "npi": [1548291883]}]}]}]}, {"name": "Laboratory - Hematology", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0305", "description": "Laboratory", "allowed_amounts": [{"tin": {"type": "ein", "value": "751047527"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 225.1071, "npi": [1396779948]}, {"billed_charge": 145.75, "npi": [1396779948]}, {"billed_charge": 221.125, "npi": [1396779948]}, {"billed_charge": 233.5, "npi": [1396779948]}, {"billed_charge": 206.5, "npi": [1396779948]}, {"billed_charge": 216.875, "npi": [1396779948]}, {"billed_charge": 706.5, "npi": [1396779948]}, {"billed_charge": 226.5, "npi": [1396779948]}, {"billed_charge": 208.75, "npi": [1396779948]}, {"billed_charge": 235.375, "npi": [1396779948]}, {"billed_charge": 195.8308, "npi": [1396779948]}, {"billed_charge": 201.0, "npi": [1396779948]}, {"billed_charge": 222.1667, "npi": [1396779948]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["91"], "providers": [{"billed_charge": 109.5, "npi": [1396779948]}]}]}]}, {"name": "CT Scan - General", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0350", "description": "CT Scan", "allowed_amounts": [{"tin": {"type": "ein", "value": "751837454"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 320.73, "billing_code_modifier": [""], "providers": [{"billed_charge": 3403.77, "npi": [1447250253]}]}, {"allowed_amount": 622.69, "billing_code_modifier": [""], "providers": [{"billed_charge": 3403.77, "npi": [1447250253]}]}, {"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 2462.46, "npi": [1447250253]}, {"billed_charge": 3403.77, "npi": [1447250253]}]}]}]}, {"name": "Laboratory - General", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0300", "description": "Laboratory", "allowed_amounts": [{"tin": {"type": "ein", "value": "262978009"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 170.43, "npi": [1407010622]}, {"billed_charge": 129.42, "npi": [1407010622]}, {"billed_charge": 106.72, "npi": [1619308319]}, {"billed_charge": 238.12, "npi": [1619308319]}, {"billed_charge": 238.99, "npi": [1619308319]}, {"billed_charge": 100.35, "npi": [1619308319]}, {"billed_charge": 376.7, "npi": [1619308319]}, {"billed_charge": 127.1578, "npi": [1619308319]}, {"billed_charge": 376.7, "npi": [1407010622]}, {"billed_charge": 140.17, "npi": [1619308319]}, {"billed_charge": 101.36, "npi": [1407010622]}, {"billed_charge": 139.37, "npi": [1619308319]}, {"billed_charge": 185.56, "npi": [1619308319]}, {"billed_charge": 97.16, "npi": [1407010622]}, {"billed_charge": 214.23, "npi": [1619308319]}, {"billed_charge": 100.35, "npi": [1407010622]}, {"billed_charge": 214.23, "npi": [1407010622]}, {"billed_charge": 105.92, "npi": [1619308319]}, {"billed_charge": 106.72, "npi": [1407010622]}, {"billed_charge": 230.96, "npi": [1407010622]}, {"billed_charge": 211.05, "npi": [1619308319]}, {"billed_charge": 70.2, "npi": [1619308319]}, {"billed_charge": 363.01, "npi": [1407010622]}, {"billed_charge": 345.37, "npi": [1619308319]}, {"billed_charge": 17.2, "npi": [1619308319]}, {"billed_charge": 185.56, "npi": [1407010622]}, {"billed_charge": 170.43, "npi": [1619308319]}, {"billed_charge": 305.82, "npi": [1407010622]}, {"billed_charge": 180.1, "npi": [1619308319]}, {"billed_charge": 102.74, "npi": [1619308319]}, {"billed_charge": 244.89, "npi": [1407010622]}, {"billed_charge": 150.9167, "npi": [1619308319]}, {"billed_charge": 105.92, "npi": [1407010622]}, {"billed_charge": 70.2, "npi": [1407010622]}, {"billed_charge": 194.11, "npi": [1619308319]}, {"billed_charge": 238.12, "npi": [1407010622]}, {"billed_charge": 140.17, "npi": [1407010622]}, {"billed_charge": 309.0, "npi": [1407010622]}, {"billed_charge": 102.74, "npi": [1407010622]}, {"billed_charge": 97.16, "npi": [1619308319]}, {"billed_charge": 129.42, "npi": [1619308319]}, {"billed_charge": 211.05, "npi": [1407010622]}]}, {"allowed_amount": 5.7, "billing_code_modifier": ["59"], "providers": [{"billed_charge": 79.64, "npi": [1407010622]}]}, {"allowed_amount": 5.7, "billing_code_modifier": ["5991"], "providers": [{"billed_charge": 79.64, "npi": [1407010622]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["QW"], "providers": [{"billed_charge": 106.72, "npi": [1619308319]}, {"billed_charge": 238.12, "npi": [1619308319]}, {"billed_charge": 137.78, "npi": [1407010622]}, {"billed_charge": 309.0, "npi": [1619308319]}]}, {"allowed_amount": 5.7, "billing_code_modifier": [""], "providers": [{"billed_charge": 281.93, "npi": [1619308319]}, {"billed_charge": 281.93, "npi": [1407010622]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["91"], "providers": [{"billed_charge": 244.89, "npi": [1407010622]}]}, {"allowed_amount": 101.92, "billing_code_modifier": [""], "providers": [{"billed_charge": 137.78, "npi": [1619308319]}]}]}]}, {"name": "SCREENING DIGITAL BREAST TOMOSYNTHESIS BI", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "77063", "description": "SCREENING DIGITAL BREAST TOMOSYNTHESIS BI", "allowed_amounts": [{"tin": {"type": "ein", "value": "741680498"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 33.28, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 213.0, "npi": [1457542631]}, {"billed_charge": 213.0, "npi": [1447391487]}, {"billed_charge": 213.0, "npi": [1750404380]}]}, {"allowed_amount": 32.72, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 213.0, "npi": [1457542631]}, {"billed_charge": 213.0, "npi": [1821047374]}]}, {"allowed_amount": 33.2, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 213.0, "npi": [1457542631]}, {"billed_charge": 213.0, "npi": [1750404380]}]}]}]}, {"name": "Medical/Surgical Supplies and Devices - Sterile Supply", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0272", "description": "Med/Surg Supplies &Devices (also see 062x, extension of 027x", "allowed_amounts": [{"tin": {"type": "ein", "value": "751047527"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 415.0, "npi": [1396779948]}, {"billed_charge": 58.3473, "npi": [1396779948]}, {"billed_charge": 10.0, "npi": [1396779948]}, {"billed_charge": 83.875, "npi": [1396779948]}, {"billed_charge": 47.1111, "npi": [1396779948]}, {"billed_charge": 394.4375, "npi": [1396779948]}, {"billed_charge": 792.0, "npi": [1396779948]}, {"billed_charge": 63.0, "npi": [1396779948]}, {"billed_charge": 31.5833, "npi": [1396779948]}, {"billed_charge": 12.8, "npi": [1396779948]}]}]}]}, {"name": "Emergency Room - General", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0450", "description": "Emergency Room", "allowed_amounts": [{"tin": {"type": "ein", "value": "752771437"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 308.31, "billing_code_modifier": [""], "providers": [{"billed_charge": 333.25, "npi": [1457382798]}]}, {"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 254.75, "npi": [1457382798]}]}, {"allowed_amount": 235.54, "billing_code_modifier": ["RT"], "providers": [{"billed_charge": 334.0, "npi": [1457382798]}]}, {"allowed_amount": 589.22, "billing_code_modifier": [""], "providers": [{"billed_charge": 542.5, "npi": [1457382798]}]}, {"allowed_amount": 67.87, "billing_code_modifier": [""], "providers": [{"billed_charge": 103.5, "npi": [1457382798]}]}, {"allowed_amount": 67.8733, "billing_code_modifier": [""], "providers": [{"billed_charge": 333.25, "npi": [1457382798]}]}, {"allowed_amount": 395.66, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 1042.5, "npi": [1457382798]}]}, {"allowed_amount": 395.66, "billing_code_modifier": [""], "providers": [{"billed_charge": 1042.5, "npi": [1457382798]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["59"], "providers": [{"billed_charge": 254.75, "npi": [1457382798]}]}, {"allowed_amount": 104.36, "billing_code_modifier": [""], "providers": [{"billed_charge": 254.75, "npi": [1457382798]}]}, {"allowed_amount": 122.22, "billing_code_modifier": [""], "providers": [{"billed_charge": 332.25, "npi": [1457382798]}]}, {"allowed_amount": 604.81, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 1521.25, "npi": [1457382798]}]}]}]}, {"name": "Pharmacy - General", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0250", "description": "Pharmacy (also see 063x, an extension of 025x)", "allowed_amounts": [{"tin": {"type": "ein", "value": "741152597"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 0.875, "npi": [1982666111]}, {"billed_charge": 1.8333, "npi": [1982666111]}, {"billed_charge": 16.25, "npi": [1982666111]}, {"billed_charge": 0.5833, "npi": [1982666111]}, {"billed_charge": 20.0, "npi": [1982666111]}, {"billed_charge": 1.5, "npi": [1982666111]}, {"billed_charge": 93.25, "npi": [1982666111]}, {"billed_charge": 2.5, "npi": [1982666111]}, {"billed_charge": 12.4722, "npi": [1982666111]}, {"billed_charge": 3.4167, "npi": [1982666111]}, {"billed_charge": 2.8125, "npi": [1982666111]}, {"billed_charge": 0.6875, "npi": [1982666111]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["U8JZ"], "providers": [{"billed_charge": 0.3594, "npi": [1982666111]}]}, {"allowed_amount": 0.51, "billing_code_modifier": [""], "providers": [{"billed_charge": 5.75, "npi": [1982666111]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["U8"], "providers": [{"billed_charge": 3.875, "npi": [1982666111]}, {"billed_charge": 4.125, "npi": [1982666111]}, {"billed_charge": 0.1125, "npi": [1982666111]}, {"billed_charge": 83.0, "npi": [1982666111]}, {"billed_charge": 2.25, "npi": [1982666111]}]}, {"allowed_amount": 0.51, "billing_code_modifier": ["JW"], "providers": [{"billed_charge": 5.75, "npi": [1982666111]}]}]}]}, {"name": "Laboratory - General", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0300", "description": "Laboratory", "allowed_amounts": [{"tin": {"type": "ein", "value": "831173631"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 64.0, "npi": [1427536325]}, {"billed_charge": 144.0, "npi": [1427536325]}, {"billed_charge": 57.0, "npi": [1427536325]}, {"billed_charge": 68.0, "npi": [1427536325]}, {"billed_charge": 24.0, "npi": [1427536325]}, {"billed_charge": 49.0, "npi": [1427536325]}, {"billed_charge": 780.0, "npi": [1427536325]}, {"billed_charge": 44.0, "npi": [1427536325]}, {"billed_charge": 38.0, "npi": [1427536325]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["59"], "providers": [{"billed_charge": 14.0, "npi": [1427536325]}]}]}]}, {"name": "GROUND MILEAGE PER STATUTE MILE", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "A0425", "description": "GROUND MILEAGE PER STATUTE MILE", "allowed_amounts": [{"tin": {"type": "ein", "value": "756000508"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 10.0, "billing_code_modifier": ["PH"], "providers": [{"billed_charge": 10.0, "npi": [1861530990]}]}, {"allowed_amount": 10.0, "billing_code_modifier": ["NH"], "providers": [{"billed_charge": 10.0, "npi": [1861530990]}]}, {"allowed_amount": 5.5, "billing_code_modifier": ["RH"], "providers": [{"billed_charge": 10.0, "npi": [1861530990]}]}, {"allowed_amount": 10.0, "billing_code_modifier": ["RH"], "providers": [{"billed_charge": 10.0, "npi": [1861530990]}]}, {"allowed_amount": 10.0, "billing_code_modifier": ["JH"], "providers": [{"billed_charge": 10.0, "npi": [1861530990]}]}, {"allowed_amount": 10.0, "billing_code_modifier": ["EH"], "providers": [{"billed_charge": 10.0, "npi": [1861530990]}]}, {"allowed_amount": 10.0, "billing_code_modifier": ["SH"], "providers": [{"billed_charge": 10.0, "npi": [1861530990]}]}, {"allowed_amount": 10.0, "billing_code_modifier": ["ETRH"], "providers": [{"billed_charge": 10.0, "npi": [1861530990]}]}]}]}, {"name": "EMERGENCY DEPARTMENT VISIT MODERATE MDM", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "99284", "description": "EMERGENCY DEPARTMENT VISIT MODERATE MDM", "allowed_amounts": [{"tin": {"type": "ein", "value": "461415202"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 466.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 1152.0, "npi": [1376143529]}]}, {"allowed_amount": 407.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 1152.0, "npi": [1376143529]}]}, {"allowed_amount": 174.54, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 1152.0, "npi": [1376143529]}]}, {"allowed_amount": 407.0, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 1152.0, "npi": [1376143529]}]}, {"allowed_amount": 174.54, "billing_code_modifier": [""], "providers": [{"billed_charge": 1152.0, "npi": [1376143529]}]}]}]}, {"name": "Laboratory - Bacteriology & Microbiology", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0306", "description": "Laboratory", "allowed_amounts": [{"tin": {"type": "ein", "value": "750972805"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 206.81, "billing_code_modifier": [""], "providers": [{"billed_charge": 494.0, "npi": [1174533343]}]}, {"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 324.7708, "npi": [1174533343]}, {"billed_charge": 237.75, "npi": [1174533343]}, {"billed_charge": 298.625, "npi": [1174533343]}, {"billed_charge": 414.5, "npi": [1174533343]}, {"billed_charge": 252.75, "npi": [1174533343]}, {"billed_charge": 403.0, "npi": [1174533343]}, {"billed_charge": 364.0, "npi": [1174533343]}, {"billed_charge": 494.0, "npi": [1174533343]}, {"billed_charge": 229.5, "npi": [1174533343]}, {"billed_charge": 361.625, "npi": [1174533343]}, {"billed_charge": 370.375, "npi": [1174533343]}, {"billed_charge": 399.5, "npi": [1174533343]}, {"billed_charge": 317.75, "npi": [1174533343]}, {"billed_charge": 158.5, "npi": [1174533343]}, {"billed_charge": 252.8438, "npi": [1174533343]}, {"billed_charge": 253.7826, "npi": [1174533343]}, {"billed_charge": 474.0, "npi": [1174533343]}, {"billed_charge": 313.3409, "npi": [1174533343]}]}, {"allowed_amount": 74.4, "billing_code_modifier": [""], "providers": [{"billed_charge": 225.25, "npi": [1174533343]}]}, {"allowed_amount": 381.34, "billing_code_modifier": [""], "providers": [{"billed_charge": 293.75, "npi": [1174533343]}]}]}]}, {"name": "Pharmacy - IV Solutions", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0258", "description": "Pharmacy (also see 063x, an extension of 025x)", "allowed_amounts": [{"tin": {"type": "ein", "value": "820551704"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 50.0, "npi": [1649273434]}]}]}]}, {"name": "CT Scan - Body Scan", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0352", "description": "CT Scan", "allowed_amounts": [{"tin": {"type": "ein", "value": "452694620"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 3553.67, "npi": [1033120423]}, {"billed_charge": 4320.66, "npi": [1033120423]}, {"billed_charge": 2853.74, "npi": [1033120423]}, {"billed_charge": 10034.98, "npi": [1033120423]}, {"billed_charge": 4463.64, "npi": [1033120423]}, {"billed_charge": 3822.73, "npi": [1033120423]}, {"billed_charge": 8559.13, "npi": [1033120423]}, {"billed_charge": 5706.435, "npi": [1033120423]}]}, {"allowed_amount": 346.42, "billing_code_modifier": [""], "providers": [{"billed_charge": 8559.13, "npi": [1033120423]}]}, {"allowed_amount": 321.26, "billing_code_modifier": [""], "providers": [{"billed_charge": 8559.13, "npi": [1033120423]}]}]}]}, {"name": "Laboratory - General", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0300", "description": "Laboratory", "allowed_amounts": [{"tin": {"type": "ein", "value": "751844139"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 40.0, "npi": [1265430177]}, {"billed_charge": 392.86, "npi": [1265430177]}, {"billed_charge": 211.0, "npi": [1265430177]}, {"billed_charge": 164.8265, "npi": [1265430177]}, {"billed_charge": 220.305, "npi": [1265430177]}, {"billed_charge": 139.0527, "npi": [1265430177]}, {"billed_charge": 149.3455, "npi": [1265430177]}, {"billed_charge": 47.75, "npi": [1265430177]}, {"billed_charge": 150.1, "npi": [1265430177]}, {"billed_charge": 154.0316, "npi": [1265430177]}, {"billed_charge": 117.0514, "npi": [1265430177]}, {"billed_charge": 203.2091, "npi": [1265430177]}, {"billed_charge": 159.33, "npi": [1265430177]}]}]}]}, {"name": "Laboratory - Hematology", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0305", "description": "Laboratory", "allowed_amounts": [{"tin": {"type": "ein", "value": "432008974"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 145.75, "npi": [1003883158]}, {"billed_charge": 180.5, "npi": [1003883158]}, {"billed_charge": 706.5, "npi": [1003883158]}, {"billed_charge": 233.5, "npi": [1003883158]}, {"billed_charge": 206.5, "npi": [1003883158]}, {"billed_charge": 226.5, "npi": [1003883158]}, {"billed_charge": 219.5833, "npi": [1003883158]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["91"], "providers": [{"billed_charge": 109.5, "npi": [1003883158]}]}]}]}, {"name": "Pharmacy - General", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0250", "description": "Pharmacy (also see 063x, an extension of 025x)", "allowed_amounts": [{"tin": {"type": "ein", "value": "752586857"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 176.94, "npi": [1992700983]}, {"billed_charge": 15.5167, "npi": [1992700983]}, {"billed_charge": 5.1189, "npi": [1992700983]}, {"billed_charge": 0.6967, "npi": [1992700983]}, {"billed_charge": 11.22, "npi": [1992700983]}, {"billed_charge": 12.083, "npi": [1992700983]}, {"billed_charge": 50.0, "npi": [1992700983]}, {"billed_charge": 0.075, "npi": [1992700983]}, {"billed_charge": 0.92, "npi": [1992700983]}, {"billed_charge": 1.29, "npi": [1992700983]}, {"billed_charge": 3.535, "npi": [1992700983]}, {"billed_charge": 1.03, "npi": [1992700983]}, {"billed_charge": 1.492, "npi": [1992700983]}, {"billed_charge": 0.1067, "npi": [1992700983]}, {"billed_charge": 2.5824, "npi": [1992700983]}, {"billed_charge": 9.92, "npi": [1992700983]}, {"billed_charge": 0.8125, "npi": [1992700983]}, {"billed_charge": 1.0667, "npi": [1992700983]}, {"billed_charge": 0.1367, "npi": [1992700983]}, {"billed_charge": 3.2203, "npi": [1992700983]}, {"billed_charge": 56.3367, "npi": [1992700983]}, {"billed_charge": 6.8, "npi": [1992700983]}, {"billed_charge": 0.68, "npi": [1992700983]}, {"billed_charge": 135.07, "npi": [1992700983]}, {"billed_charge": 4.05, "npi": [1992700983]}, {"billed_charge": 0.19, "npi": [1992700983]}, {"billed_charge": 15.955, "npi": [1992700983]}, {"billed_charge": 1.6889, "npi": [1992700983]}, {"billed_charge": 17.85, "npi": [1992700983]}, {"billed_charge": 1.9325, "npi": [1992700983]}, {"billed_charge": 3.9571, "npi": [1992700983]}, {"billed_charge": 0.44, "npi": [1992700983]}, {"billed_charge": 16.632, "npi": [1992700983]}, {"billed_charge": 8.864, "npi": [1992700983]}, {"billed_charge": 8.33, "npi": [1992700983]}, {"billed_charge": 2.515, "npi": [1992700983]}, {"billed_charge": 0.3567, "npi": [1992700983]}, {"billed_charge": 6.804, "npi": [1992700983]}, {"billed_charge": 3.3875, "npi": [1992700983]}, {"billed_charge": 1.7757, "npi": [1992700983]}, {"billed_charge": 1.22, "npi": [1992700983]}, {"billed_charge": 0.74, "npi": [1992700983]}, {"billed_charge": 11.384, "npi": [1992700983]}, {"billed_charge": 4.075, "npi": [1992700983]}, {"billed_charge": 14.9075, "npi": [1992700983]}, {"billed_charge": 1.497, "npi": [1992700983]}, {"billed_charge": 7.754, "npi": [1992700983]}, {"billed_charge": 9.0725, "npi": [1992700983]}, {"billed_charge": 19.51, "npi": [1992700983]}, {"billed_charge": 0.0575, "npi": [1992700983]}, {"billed_charge": 3.88, "npi": [1992700983]}, {"billed_charge": 1.15, "npi": [1992700983]}, {"billed_charge": 0.63, "npi": [1992700983]}, {"billed_charge": 5.2256, "npi": [1992700983]}, {"billed_charge": 13.37, "npi": [1992700983]}, {"billed_charge": 21.0, "npi": [1992700983]}, {"billed_charge": 19.0545, "npi": [1992700983]}, {"billed_charge": 14.7, "npi": [1992700983]}, {"billed_charge": 4.3067, "npi": [1992700983]}, {"billed_charge": 2.2533, "npi": [1992700983]}, {"billed_charge": 2.25, "npi": [1992700983]}, {"billed_charge": 2.3, "npi": [1992700983]}, {"billed_charge": 7.505, "npi": [1992700983]}, {"billed_charge": 5.8541, "npi": [1992700983]}, {"billed_charge": 0.1075, "npi": [1992700983]}, {"billed_charge": 0.488, "npi": [1992700983]}, {"billed_charge": 8.76, "npi": [1992700983]}, {"billed_charge": 7.5, "npi": [1992700983]}, {"billed_charge": 1.9, "npi": [1992700983]}, {"billed_charge": 10.9625, "npi": [1992700983]}, {"billed_charge": 0.0833, "npi": [1992700983]}, {"billed_charge": 0.17, "npi": [1992700983]}, {"billed_charge": 12.315, "npi": [1992700983]}, {"billed_charge": 1.714, "npi": [1992700983]}, {"billed_charge": 5.9733, "npi": [1992700983]}, {"billed_charge": 0.165, "npi": [1992700983]}, {"billed_charge": 0.15, "npi": [1992700983]}, {"billed_charge": 0.542, "npi": [1992700983]}, {"billed_charge": 0.6167, "npi": [1992700983]}, {"billed_charge": 1.315, "npi": [1992700983]}, {"billed_charge": 67.245, "npi": [1992700983]}]}]}]}, {"name": "Laboratory - Chemistry", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0301", "description": "Laboratory", "allowed_amounts": [{"tin": {"type": "ein", "value": "751844139"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 56.6, "npi": [1265430177]}, {"billed_charge": 306.86, "npi": [1265430177]}, {"billed_charge": 302.19, "npi": [1265430177]}, {"billed_charge": 229.4754, "npi": [1265430177]}, {"billed_charge": 99.79, "npi": [1265430177]}, {"billed_charge": 198.34, "npi": [1265430177]}, {"billed_charge": 148.33, "npi": [1265430177]}, {"billed_charge": 153.91, "npi": [1265430177]}, {"billed_charge": 243.23, "npi": [1265430177]}, {"billed_charge": 214.55, "npi": [1265430177]}, {"billed_charge": 105.8823, "npi": [1265430177]}, {"billed_charge": 110.6743, "npi": [1265430177]}, {"billed_charge": 229.02, "npi": [1265430177]}, {"billed_charge": 104.0379, "npi": [1265430177]}, {"billed_charge": 120.2331, "npi": [1265430177]}, {"billed_charge": 407.22, "npi": [1265430177]}, {"billed_charge": 285.79, "npi": [1265430177]}, {"billed_charge": 249.48, "npi": [1265430177]}, {"billed_charge": 190.6131, "npi": [1265430177]}, {"billed_charge": 459.04, "npi": [1265430177]}, {"billed_charge": 135.1184, "npi": [1265430177]}, {"billed_charge": 222.3675, "npi": [1265430177]}, {"billed_charge": 194.8212, "npi": [1265430177]}, {"billed_charge": 217.7, "npi": [1265430177]}, {"billed_charge": 104.78, "npi": [1265430177]}, {"billed_charge": 159.62, "npi": [1265430177]}, {"billed_charge": 284.41, "npi": [1265430177]}, {"billed_charge": 185.85, "npi": [1265430177]}, {"billed_charge": 240.75, "npi": [1265430177]}, {"billed_charge": 273.89, "npi": [1265430177]}]}, {"allowed_amount": 5.7, "billing_code_modifier": ["91"], "providers": [{"billed_charge": 99.79, "npi": [1265430177]}]}, {"allowed_amount": 19.42, "billing_code_modifier": [""], "providers": [{"billed_charge": 328.07, "npi": [1265430177]}]}]}]}, {"name": "Laboratory - Chemistry", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0301", "description": "Laboratory", "allowed_amounts": [{"tin": {"type": "ein", "value": "831954982"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 442.5, "npi": [1104381292]}, {"billed_charge": 324.5, "npi": [1104381292]}, {"billed_charge": 255.5, "npi": [1104381292]}, {"billed_charge": 335.75, "npi": [1104381292]}, {"billed_charge": 229.25, "npi": [1104381292]}, {"billed_charge": 679.25, "npi": [1104381292]}, {"billed_charge": 272.3654, "npi": [1104381292]}, {"billed_charge": 278.25, "npi": [1104381292]}, {"billed_charge": 153.5, "npi": [1104381292]}]}]}]}, {"name": "Pharmacy - Extension of 25X - Drug Requiring Detailed Coding", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0636", "description": "Pharmacy - Extension of 25x", "allowed_amounts": [{"tin": {"type": "ein", "value": "752890358"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.49, "billing_code_modifier": [""], "providers": [{"billed_charge": 10.0, "npi": [1548291883]}, {"billed_charge": 13.0, "npi": [1548291883]}]}, {"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 9.0, "npi": [1548291883]}, {"billed_charge": 34.2, "npi": [1548291883]}, {"billed_charge": 5.0, "npi": [1548291883]}, {"billed_charge": 1.893, "npi": [1548291883]}, {"billed_charge": 2.1019, "npi": [1548291883]}, {"billed_charge": 1.0, "npi": [1548291883]}, {"billed_charge": 10.0, "npi": [1548291883]}, {"billed_charge": 50.0, "npi": [1548291883]}, {"billed_charge": 0.25, "npi": [1548291883]}, {"billed_charge": 19.08, "npi": [1548291883]}, {"billed_charge": 0.125, "npi": [1548291883]}, {"billed_charge": 1.368, "npi": [1548291883]}, {"billed_charge": 3.9417, "npi": [1548291883]}, {"billed_charge": 12.5, "npi": [1548291883]}, {"billed_charge": 2.5, "npi": [1548291883]}, {"billed_charge": 2.5823, "npi": [1548291883]}, {"billed_charge": 0.3903, "npi": [1548291883]}]}, {"allowed_amount": 0.49, "billing_code_modifier": ["JW"], "providers": [{"billed_charge": 10.0, "npi": [1548291883]}, {"billed_charge": 13.0, "npi": [1548291883]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["JZ"], "providers": [{"billed_charge": 16.33, "npi": [1548291883]}, {"billed_charge": 1.4844, "npi": [1548291883]}, {"billed_charge": 13.68, "npi": [1548291883]}, {"billed_charge": 0.5, "npi": [1548291883]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["JW"], "providers": [{"billed_charge": 9.0, "npi": [1548291883]}]}]}]}, {"name": "CT Scan - Head Scan", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0351", "description": "CT Scan", "allowed_amounts": [{"tin": {"type": "ein", "value": "751837454"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 151.54, "billing_code_modifier": [""], "providers": [{"billed_charge": 3178.59, "npi": [1447250253]}]}, {"allowed_amount": 622.69, "billing_code_modifier": [""], "providers": [{"billed_charge": 3178.59, "npi": [1447250253]}]}, {"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 2840.9, "npi": [1447250253]}, {"billed_charge": 4250.165, "npi": [1447250253]}, {"billed_charge": 2798.1, "npi": [1447250253]}, {"billed_charge": 11751.19, "npi": [1447250253]}, {"billed_charge": 6036.1233, "npi": [1447250253]}, {"billed_charge": 5844.12, "npi": [1447250253]}, {"billed_charge": 3178.59, "npi": [1447250253]}, {"billed_charge": 5321.74, "npi": [1447250253]}, {"billed_charge": 3306.97, "npi": [1447250253]}]}, {"allowed_amount": 151.54, "billing_code_modifier": ["U6"], "providers": [{"billed_charge": 3178.59, "npi": [1447250253]}]}]}]}, {"name": "SBSQ HOSPITAL IP/OBS CARE MOD MDM 35 MINUTES", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "99232", "description": "SBSQ HOSPITAL IP/OBS CARE MOD MDM 35 MINUTES", "allowed_amounts": [{"tin": {"type": "ein", "value": "751772118"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 84.4, "billing_code_modifier": [""], "providers": [{"billed_charge": 238.0, "npi": [1871733188]}]}, {"allowed_amount": 84.4, "billing_code_modifier": ["FS"], "providers": [{"billed_charge": 238.0, "npi": [1871733188]}]}]}]}, {"name": "Laboratory - General", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0300", "description": "Laboratory", "allowed_amounts": [{"tin": {"type": "ein", "value": "461353294"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 22.8, "billing_code_modifier": [""], "providers": [{"billed_charge": 80.0, "npi": [1760417646]}]}, {"allowed_amount": 14.82, "billing_code_modifier": [""], "providers": [{"billed_charge": 80.0, "npi": [1760417646]}]}, {"allowed_amount": 146.49, "billing_code_modifier": [""], "providers": [{"billed_charge": 514.0, "npi": [1760417646]}]}, {"allowed_amount": 172.43, "billing_code_modifier": [""], "providers": [{"billed_charge": 605.0, "npi": [1760417646]}]}, {"allowed_amount": 112.08, "billing_code_modifier": [""], "providers": [{"billed_charge": 605.0, "npi": [1760417646]}]}, {"allowed_amount": 95.22, "billing_code_modifier": [""], "providers": [{"billed_charge": 514.0, "npi": [1760417646]}]}]}]}, {"name": "Pharmacy - Drugs Incident to Radiology", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0255", "description": "Pharmacy (also see 063x, an extension of 025x)", "allowed_amounts": [{"tin": {"type": "ein", "value": "260194016"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 36.0431, "npi": [1205018439]}, {"billed_charge": 4.908, "npi": [1205018439]}, {"billed_charge": 1.108, "npi": [1205018439]}, {"billed_charge": 5.076, "npi": [1205018439]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["JZ"], "providers": [{"billed_charge": 4.176, "npi": [1205018439]}, {"billed_charge": 4.5405, "npi": [1205018439]}, {"billed_charge": 5.076, "npi": [1205018439]}]}]}]}, {"name": "SBSQ HOSPITAL IP/OBS CARE HIGH MDM 50 MINUTES", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "99233", "description": "SBSQ HOSPITAL IP/OBS CARE HIGH MDM 50 MINUTES", "allowed_amounts": [{"tin": {"type": "ein", "value": "473312833"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 128.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 328.35, "npi": [1356755144]}]}]}]}, {"name": "Pharmacy - General", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0250", "description": "Pharmacy (also see 063x, an extension of 025x)", "allowed_amounts": [{"tin": {"type": "ein", "value": "824052186"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 1.005, "npi": [1801826839]}, {"billed_charge": 3.465, "npi": [1801826839]}, {"billed_charge": 1.5309, "npi": [1801826839]}, {"billed_charge": 48.588, "npi": [1801826839]}, {"billed_charge": 14.1125, "npi": [1801826839]}, {"billed_charge": 3.0788, "npi": [1801826839]}, {"billed_charge": 26.2288, "npi": [1801826839]}, {"billed_charge": 9.1667, "npi": [1801826839]}, {"billed_charge": 50.0, "npi": [1801826839]}, {"billed_charge": 33.54, "npi": [1801826839]}, {"billed_charge": 0.112, "npi": [1801826839]}, {"billed_charge": 19.41, "npi": [1801826839]}, {"billed_charge": 1.56, "npi": [1801826839]}, {"billed_charge": 27.3, "npi": [1801826839]}, {"billed_charge": 0.09, "npi": [1801826839]}, {"billed_charge": 3.054, "npi": [1801826839]}, {"billed_charge": 18.9267, "npi": [1801826839]}, {"billed_charge": 3.88, "npi": [1801826839]}, {"billed_charge": 2.5068, "npi": [1801826839]}, {"billed_charge": 1.9477, "npi": [1801826839]}, {"billed_charge": 0.38, "npi": [1801826839]}, {"billed_charge": 15.6, "npi": [1801826839]}, {"billed_charge": 1.53, "npi": [1801826839]}]}]}]}, {"name": "EKG/ECG (Electrocardiogram) - General", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0730", "description": "EKG/ECG (Electrocardiogram)", "allowed_amounts": [{"tin": {"type": "ein", "value": "752586857"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 453.2, "npi": [1992700983]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["XU"], "providers": [{"billed_charge": 453.2, "npi": [1992700983]}]}]}]}, {"name": "Laboratory - Hematology", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0305", "description": "Laboratory", "allowed_amounts": [{"tin": {"type": "ein", "value": "751037591"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 132.8408, "npi": [1124305065]}, {"billed_charge": 140.91, "npi": [1124305065]}, {"billed_charge": 248.29, "npi": [1124305065]}, {"billed_charge": 111.76, "npi": [1124305065]}, {"billed_charge": 152.665, "npi": [1124305065]}, {"billed_charge": 342.42, "npi": [1124305065]}, {"billed_charge": 165.2467, "npi": [1124305065]}, {"billed_charge": 149.84, "npi": [1124305065]}, {"billed_charge": 166.735, "npi": [1124305065]}, {"billed_charge": 146.11, "npi": [1124305065]}, {"billed_charge": 245.6, "npi": [1124305065]}, {"billed_charge": 183.63, "npi": [1124305065]}, {"billed_charge": 278.15, "npi": [1124305065]}, {"billed_charge": 156.598, "npi": [1124305065]}, {"billed_charge": 93.56, "npi": [1124305065]}]}]}]}, {"name": "Emergency Room - General", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0450", "description": "Emergency Room", "allowed_amounts": [{"tin": {"type": "ein", "value": "752770738"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 308.31, "billing_code_modifier": [""], "providers": [{"billed_charge": 333.25, "npi": [1770514077]}, {"billed_charge": 779.25, "npi": [1770514077]}]}, {"allowed_amount": 222.56, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 537.75, "npi": [1770514077]}]}, {"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 254.75, "npi": [1770514077]}, {"billed_charge": 652.6667, "npi": [1770514077]}, {"billed_charge": 333.25, "npi": [1770514077]}, {"billed_charge": 1521.25, "npi": [1770514077]}, {"billed_charge": 449.0962, "npi": [1770514077]}, {"billed_charge": 653.5938, "npi": [1770514077]}]}, {"allowed_amount": 67.875, "billing_code_modifier": [""], "providers": [{"billed_charge": 333.25, "npi": [1770514077]}, {"billed_charge": 103.5, "npi": [1770514077]}]}, {"allowed_amount": 604.81, "billing_code_modifier": [""], "providers": [{"billed_charge": 1521.25, "npi": [1770514077]}]}, {"allowed_amount": 222.56, "billing_code_modifier": [""], "providers": [{"billed_charge": 537.75, "npi": [1770514077]}]}, {"allowed_amount": 67.874, "billing_code_modifier": ["59"], "providers": [{"billed_charge": 333.25, "npi": [1770514077]}]}, {"allowed_amount": 67.87, "billing_code_modifier": [""], "providers": [{"billed_charge": 333.25, "npi": [1770514077]}, {"billed_charge": 103.5, "npi": [1770514077]}]}, {"allowed_amount": 290.83, "billing_code_modifier": [""], "providers": [{"billed_charge": 811.0, "npi": [1770514077]}]}, {"allowed_amount": 863.2, "billing_code_modifier": [""], "providers": [{"billed_charge": 2758.25, "npi": [1770514077]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 2758.25, "npi": [1770514077]}]}, {"allowed_amount": 67.8733, "billing_code_modifier": [""], "providers": [{"billed_charge": 333.25, "npi": [1770514077]}, {"billed_charge": 103.5, "npi": [1770514077]}]}, {"allowed_amount": 395.66, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 1042.5, "npi": [1770514077]}]}, {"allowed_amount": 395.66, "billing_code_modifier": [""], "providers": [{"billed_charge": 1042.5, "npi": [1770514077]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["59"], "providers": [{"billed_charge": 254.75, "npi": [1770514077]}, {"billed_charge": 333.25, "npi": [1770514077]}, {"billed_charge": 103.5, "npi": [1770514077]}, {"billed_charge": 779.25, "npi": [1770514077]}]}, {"allowed_amount": 863.2, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 2758.25, "npi": [1770514077]}]}, {"allowed_amount": 308.31, "billing_code_modifier": ["59"], "providers": [{"billed_charge": 333.25, "npi": [1770514077]}, {"billed_charge": 779.25, "npi": [1770514077]}]}, {"allowed_amount": 122.22, "billing_code_modifier": [""], "providers": [{"billed_charge": 332.25, "npi": [1770514077]}]}, {"allowed_amount": 67.87, "billing_code_modifier": ["59"], "providers": [{"billed_charge": 333.25, "npi": [1770514077]}]}, {"allowed_amount": 604.81, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 1521.25, "npi": [1770514077]}]}]}]}, {"name": "Pharmacy - Extension of 25X - Drug Requiring Detailed Coding", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0636", "description": "Pharmacy - Extension of 25x", "allowed_amounts": [{"tin": {"type": "ein", "value": "752302928"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.51, "billing_code_modifier": ["U8"], "providers": [{"billed_charge": 10.0, "npi": [1740273994]}, {"billed_charge": 15.0, "npi": [1740273994]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["U8"], "providers": [{"billed_charge": 0.2, "npi": [1740273994]}, {"billed_charge": 11.0, "npi": [1740273994]}, {"billed_charge": 13.0, "npi": [1740273994]}, {"billed_charge": 36.0, "npi": [1740273994]}, {"billed_charge": 0.6, "npi": [1740273994]}, {"billed_charge": 1.0, "npi": [1740273994]}, {"billed_charge": 1.47, "npi": [1740273994]}, {"billed_charge": 2.0, "npi": [1740273994]}, {"billed_charge": 3.59, "npi": [1740273994]}, {"billed_charge": 0.35, "npi": [1740273994]}, {"billed_charge": 9.0, "npi": [1740273994]}, {"billed_charge": 1.5, "npi": [1740273994]}, {"billed_charge": 98.0, "npi": [1740273994]}, {"billed_charge": 14.0, "npi": [1740273994]}, {"billed_charge": 0.16, "npi": [1740273994]}]}]}]}, {"name": "Radiology - Diagnostic - Chest X-Ray", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0324", "description": "Radiology - Diagnostic", "allowed_amounts": [{"tin": {"type": "ein", "value": "751844139"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 366.74, "npi": [1265430177]}]}, {"allowed_amount": 126.14, "billing_code_modifier": [""], "providers": [{"billed_charge": 656.37, "npi": [1265430177]}, {"billed_charge": 366.74, "npi": [1265430177]}]}]}]}, {"name": "Pharmacy - Extension of 25X - Drug Requiring Detailed Coding", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0636", "description": "Pharmacy - Extension of 25x", "allowed_amounts": [{"tin": {"type": "ein", "value": "750800628"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 11.25, "billing_code_modifier": [""], "providers": [{"billed_charge": 18.75, "npi": [1194743013]}]}, {"allowed_amount": 6.062, "billing_code_modifier": [""], "providers": [{"billed_charge": 10.1034, "npi": [1194743013]}]}, {"allowed_amount": 9.7476, "billing_code_modifier": [""], "providers": [{"billed_charge": 16.246, "npi": [1194743013]}]}, {"allowed_amount": 15.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 25.0, "npi": [1194743013]}]}, {"allowed_amount": 6.8614, "billing_code_modifier": [""], "providers": [{"billed_charge": 11.4356, "npi": [1194743013]}]}, {"allowed_amount": 52.65, "billing_code_modifier": [""], "providers": [{"billed_charge": 87.75, "npi": [1194743013]}]}, {"allowed_amount": 16.785, "billing_code_modifier": [""], "providers": [{"billed_charge": 27.975, "npi": [1194743013]}]}, {"allowed_amount": 25.2, "billing_code_modifier": [""], "providers": [{"billed_charge": 42.0, "npi": [1194743013]}]}, {"allowed_amount": 22.5, "billing_code_modifier": [""], "providers": [{"billed_charge": 37.5, "npi": [1194743013]}]}, {"allowed_amount": 25.875, "billing_code_modifier": [""], "providers": [{"billed_charge": 43.125, "npi": [1194743013]}]}, {"allowed_amount": 21.995, "billing_code_modifier": [""], "providers": [{"billed_charge": 43.125, "npi": [1194743013]}]}, {"allowed_amount": 52.44, "billing_code_modifier": [""], "providers": [{"billed_charge": 87.4, "npi": [1194743013]}]}, {"allowed_amount": 22.685, "billing_code_modifier": [""], "providers": [{"billed_charge": 37.8083, "npi": [1194743013]}]}, {"allowed_amount": 6.5693, "billing_code_modifier": [""], "providers": [{"billed_charge": 10.9488, "npi": [1194743013]}]}, {"allowed_amount": 45.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 75.0, "npi": [1194743013]}]}, {"allowed_amount": 12.75, "billing_code_modifier": [""], "providers": [{"billed_charge": 25.0, "npi": [1194743013]}]}, {"allowed_amount": 8.1734, "billing_code_modifier": [""], "providers": [{"billed_charge": 13.6224, "npi": [1194743013]}]}, {"allowed_amount": 30.255, "billing_code_modifier": ["JZ"], "providers": [{"billed_charge": 50.425, "npi": [1194743013]}]}]}]}, {"name": "Laboratory - General", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0300", "description": "Laboratory", "allowed_amounts": [{"tin": {"type": "ein", "value": "260194016"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 99.1785, "npi": [1205018439]}, {"billed_charge": 91.63, "npi": [1205018439]}, {"billed_charge": 95.44, "npi": [1205018439]}, {"billed_charge": 40.0, "npi": [1205018439]}, {"billed_charge": 211.0, "npi": [1205018439]}, {"billed_charge": 146.3529, "npi": [1205018439]}, {"billed_charge": 47.75, "npi": [1205018439]}, {"billed_charge": 392.86, "npi": [1205018439]}, {"billed_charge": 134.0275, "npi": [1205018439]}, {"billed_charge": 95.5, "npi": [1205018439]}, {"billed_charge": 175.215, "npi": [1205018439]}]}]}]}, {"name": "Pharmacy - Extension of 25X - Drug Requiring Detailed Coding", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0636", "description": "Pharmacy - Extension of 25x", "allowed_amounts": [{"tin": {"type": "ein", "value": "202848116"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 12.59, "npi": [1629138029]}, {"billed_charge": 8.3778, "npi": [1629138029]}, {"billed_charge": 3.1411, "npi": [1629138029]}, {"billed_charge": 1.0, "npi": [1629138029]}, {"billed_charge": 8.8727, "npi": [1629138029]}, {"billed_charge": 50.0, "npi": [1629138029]}, {"billed_charge": 9.0, "npi": [1629138029]}, {"billed_charge": 10.0, "npi": [1629138029]}, {"billed_charge": 2.8407, "npi": [1629138029]}, {"billed_charge": 3.75, "npi": [1629138029]}, {"billed_charge": 21.09, "npi": [1629138029]}, {"billed_charge": 2.5, "npi": [1629138029]}, {"billed_charge": 0.2, "npi": [1629138029]}, {"billed_charge": 1.3, "npi": [1629138029]}, {"billed_charge": 22.4, "npi": [1629138029]}, {"billed_charge": 3.8722, "npi": [1629138029]}]}, {"allowed_amount": 0.495, "billing_code_modifier": ["JZ"], "providers": [{"billed_charge": 10.0, "npi": [1629138029]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["JZ"], "providers": [{"billed_charge": 16.33, "npi": [1629138029]}, {"billed_charge": 9.0, "npi": [1629138029]}, {"billed_charge": 0.5, "npi": [1629138029]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["JW"], "providers": [{"billed_charge": 9.0, "npi": [1629138029]}, {"billed_charge": 1.3, "npi": [1629138029]}]}]}]}, {"name": "Laboratory - Chemistry", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0301", "description": "Laboratory", "allowed_amounts": [{"tin": {"type": "ein", "value": "831869297"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 161.97, "npi": [1356960132]}, {"billed_charge": 715.04, "npi": [1356960132]}, {"billed_charge": 303.5, "npi": [1356960132]}, {"billed_charge": 272.4, "npi": [1356960132]}, {"billed_charge": 86.45, "npi": [1356960132]}, {"billed_charge": 140.15, "npi": [1356960132]}, {"billed_charge": 453.13, "npi": [1356960132]}, {"billed_charge": 91.04, "npi": [1356960132]}, {"billed_charge": 183.38, "npi": [1356960132]}, {"billed_charge": 170.57, "npi": [1356960132]}]}, {"allowed_amount": 5.7, "billing_code_modifier": ["91"], "providers": [{"billed_charge": 70.38, "npi": [1356960132]}]}, {"allowed_amount": 6.052, "billing_code_modifier": ["91"], "providers": [{"billed_charge": 70.38, "npi": [1356960132]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["QW"], "providers": [{"billed_charge": 715.04, "npi": [1356960132]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["91"], "providers": [{"billed_charge": 272.4, "npi": [1356960132]}, {"billed_charge": 183.38, "npi": [1356960132]}, {"billed_charge": 91.04, "npi": [1356960132]}]}, {"allowed_amount": 5.698, "billing_code_modifier": ["91"], "providers": [{"billed_charge": 70.38, "npi": [1356960132]}]}]}]}, {"name": "IV Therapy -General", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0260", "description": "IV Therapy", "allowed_amounts": [{"tin": {"type": "ein", "value": "753175630"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 308.31, "billing_code_modifier": [""], "providers": [{"billed_charge": 426.0, "npi": [1285798918]}]}, {"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 418.0, "npi": [1285798918]}, {"billed_charge": 533.0, "npi": [1285798918]}, {"billed_charge": 426.0, "npi": [1285798918]}, {"billed_charge": 452.2, "npi": [1285798918]}, {"billed_charge": 396.25, "npi": [1285798918]}, {"billed_charge": 374.5, "npi": [1285798918]}]}, {"allowed_amount": 67.875, "billing_code_modifier": [""], "providers": [{"billed_charge": 432.0, "npi": [1285798918]}, {"billed_charge": 323.0, "npi": [1285798918]}]}, {"allowed_amount": 67.875, "billing_code_modifier": ["59"], "providers": [{"billed_charge": 323.0, "npi": [1285798918]}]}, {"allowed_amount": 67.87, "billing_code_modifier": [""], "providers": [{"billed_charge": 323.0, "npi": [1285798918]}]}, {"allowed_amount": 308.31, "billing_code_modifier": ["59"], "providers": [{"billed_charge": 684.0, "npi": [1285798918]}, {"billed_charge": 426.0, "npi": [1285798918]}]}]}]}, {"name": "Laboratory - Chemistry", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0301", "description": "Laboratory", "allowed_amounts": [{"tin": {"type": "ein", "value": "752682017"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 12.69, "billing_code_modifier": [""], "providers": [{"billed_charge": 1021.0, "npi": [1114998911]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["ER"], "providers": [{"billed_charge": 540.0, "npi": [1114998911]}, {"billed_charge": 1939.0, "npi": [1114998911]}]}, {"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 145.0, "npi": [1114998911]}, {"billed_charge": 423.0, "npi": [1114998911]}, {"billed_charge": 1012.0, "npi": [1114998911]}, {"billed_charge": 670.0, "npi": [1114998911]}, {"billed_charge": 1447.0, "npi": [1114998911]}, {"billed_charge": 540.0, "npi": [1114998911]}, {"billed_charge": 398.0, "npi": [1114998911]}, {"billed_charge": 213.0, "npi": [1114998911]}, {"billed_charge": 1939.0, "npi": [1114998911]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["91"], "providers": [{"billed_charge": 145.0, "npi": [1114998911]}, {"billed_charge": 1447.0, "npi": [1114998911]}]}]}]}, {"name": "INFUSION NORMAL SALINE SOLUTION 1000 CC", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "J7030", "description": "INFUSION NORMAL SALINE SOLUTION 1000 CC", "allowed_amounts": [{"tin": {"type": "ein", "value": "853503076"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 59.03, "npi": [1124623889]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["76"], "providers": [{"billed_charge": 59.03, "npi": [1124623889]}]}]}]}, {"name": "CT Scan - Body Scan", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0352", "description": "CT Scan", "allowed_amounts": [{"tin": {"type": "ein", "value": "260194016"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 151.54, "billing_code_modifier": [""], "providers": [{"billed_charge": 3424.65, "npi": [1205018439]}]}, {"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 6484.35, "npi": [1205018439]}, {"billed_charge": 3339.84, "npi": [1205018439]}, {"billed_charge": 6290.97, "npi": [1205018439]}, {"billed_charge": 9294.97, "npi": [1205018439]}]}, {"allowed_amount": 254.23, "billing_code_modifier": [""], "providers": [{"billed_charge": 6290.97, "npi": [1205018439]}]}, {"allowed_amount": 345.85, "billing_code_modifier": [""], "providers": [{"billed_charge": 6132.67, "npi": [1205018439]}, {"billed_charge": 5896.8, "npi": [1205018439]}]}, {"allowed_amount": 505.67, "billing_code_modifier": [""], "providers": [{"billed_charge": 6484.35, "npi": [1205018439]}, {"billed_charge": 9294.97, "npi": [1205018439]}]}]}]}, {"name": "Laboratory - Chemistry", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0301", "description": "Laboratory", "allowed_amounts": [{"tin": {"type": "ein", "value": "752586857"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 148.33, "npi": [1992700983]}, {"billed_charge": 84.9037, "npi": [1992700983]}, {"billed_charge": 217.7, "npi": [1992700983]}, {"billed_charge": 105.46, "npi": [1992700983]}, {"billed_charge": 259.73, "npi": [1992700983]}, {"billed_charge": 93.334, "npi": [1992700983]}, {"billed_charge": 302.19, "npi": [1992700983]}, {"billed_charge": 306.86, "npi": [1992700983]}, {"billed_charge": 249.48, "npi": [1992700983]}, {"billed_charge": 88.72, "npi": [1992700983]}, {"billed_charge": 295.62, "npi": [1992700983]}, {"billed_charge": 87.97, "npi": [1992700983]}, {"billed_charge": 104.78, "npi": [1992700983]}, {"billed_charge": 304.35, "npi": [1992700983]}, {"billed_charge": 185.85, "npi": [1992700983]}, {"billed_charge": 96.1, "npi": [1992700983]}, {"billed_charge": 407.22, "npi": [1992700983]}, {"billed_charge": 229.02, "npi": [1992700983]}, {"billed_charge": 56.6, "npi": [1992700983]}, {"billed_charge": 134.0181, "npi": [1992700983]}, {"billed_charge": 169.5775, "npi": [1992700983]}, {"billed_charge": 243.23, "npi": [1992700983]}, {"billed_charge": 103.54, "npi": [1992700983]}, {"billed_charge": 93.56, "npi": [1992700983]}, {"billed_charge": 163.41, "npi": [1992700983]}, {"billed_charge": 99.79, "npi": [1992700983]}, {"billed_charge": 80.13, "npi": [1992700983]}, {"billed_charge": 153.91, "npi": [1992700983]}, {"billed_charge": 459.04, "npi": [1992700983]}, {"billed_charge": 117.2043, "npi": [1992700983]}, {"billed_charge": 209.6797, "npi": [1992700983]}, {"billed_charge": 117.24, "npi": [1992700983]}, {"billed_charge": 166.0, "npi": [1992700983]}, {"billed_charge": 214.55, "npi": [1992700983]}, {"billed_charge": 150.94, "npi": [1992700983]}, {"billed_charge": 111.02, "npi": [1992700983]}, {"billed_charge": 126.6834, "npi": [1992700983]}, {"billed_charge": 137.21, "npi": [1992700983]}, {"billed_charge": 285.79, "npi": [1992700983]}, {"billed_charge": 432.76, "npi": [1992700983]}, {"billed_charge": 324.88, "npi": [1992700983]}, {"billed_charge": 124.74, "npi": [1992700983]}, {"billed_charge": 103.83, "npi": [1992700983]}, {"billed_charge": 249.74, "npi": [1992700983]}, {"billed_charge": 101.57, "npi": [1992700983]}, {"billed_charge": 97.17, "npi": [1992700983]}, {"billed_charge": 159.62, "npi": [1992700983]}, {"billed_charge": 108.35, "npi": [1992700983]}]}, {"allowed_amount": 19.42, "billing_code_modifier": [""], "providers": [{"billed_charge": 328.07, "npi": [1992700983]}]}, {"allowed_amount": 5.7, "billing_code_modifier": ["XU91"], "providers": [{"billed_charge": 99.79, "npi": [1992700983]}]}, {"allowed_amount": 5.7, "billing_code_modifier": [""], "providers": [{"billed_charge": 99.79, "npi": [1992700983]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["91"], "providers": [{"billed_charge": 56.6, "npi": [1992700983]}, {"billed_charge": 111.02, "npi": [1992700983]}]}]}]}, {"name": "Emergency Room - General", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0450", "description": "Emergency Room", "allowed_amounts": [{"tin": {"type": "ein", "value": "750972805"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 67.99, "billing_code_modifier": ["59"], "providers": [{"billed_charge": 103.5, "npi": [1174533343]}, {"billed_charge": 333.25, "npi": [1174533343]}]}, {"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 2758.25, "npi": [1174533343]}, {"billed_charge": 993.5625, "npi": [1174533343]}, {"billed_charge": 729.25, "npi": [1174533343]}, {"billed_charge": 654.6389, "npi": [1174533343]}, {"billed_charge": 254.75, "npi": [1174533343]}, {"billed_charge": 1521.25, "npi": [1174533343]}, {"billed_charge": 1545.75, "npi": [1174533343]}, {"billed_charge": 542.5, "npi": [1174533343]}, {"billed_charge": 737.4167, "npi": [1174533343]}, {"billed_charge": 333.25, "npi": [1174533343]}]}, {"allowed_amount": 308.82, "billing_code_modifier": ["59"], "providers": [{"billed_charge": 779.25, "npi": [1174533343]}, {"billed_charge": 333.25, "npi": [1174533343]}]}, {"allowed_amount": 396.31, "billing_code_modifier": [""], "providers": [{"billed_charge": 1042.5, "npi": [1174533343]}]}, {"allowed_amount": 222.92, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 537.75, "npi": [1174533343]}]}, {"allowed_amount": 291.31, "billing_code_modifier": [""], "providers": [{"billed_charge": 811.0, "npi": [1174533343]}]}, {"allowed_amount": 122.42, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 332.25, "npi": [1174533343]}]}, {"allowed_amount": 864.64, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 2758.25, "npi": [1174533343]}, {"billed_charge": 10265.25, "npi": [1174533343]}]}, {"allowed_amount": 605.81, "billing_code_modifier": [""], "providers": [{"billed_charge": 1521.25, "npi": [1174533343]}]}, {"allowed_amount": 864.64, "billing_code_modifier": [""], "providers": [{"billed_charge": 2758.25, "npi": [1174533343]}]}, {"allowed_amount": 605.81, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 1521.25, "npi": [1174533343]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 1521.25, "npi": [1174533343]}]}, {"allowed_amount": 396.31, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 1042.5, "npi": [1174533343]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["59"], "providers": [{"billed_charge": 106.75, "npi": [1174533343]}, {"billed_charge": 333.25, "npi": [1174533343]}]}, {"allowed_amount": 222.92, "billing_code_modifier": [""], "providers": [{"billed_charge": 537.75, "npi": [1174533343]}]}, {"allowed_amount": 67.99, "billing_code_modifier": [""], "providers": [{"billed_charge": 103.5, "npi": [1174533343]}, {"billed_charge": 333.25, "npi": [1174533343]}]}, {"allowed_amount": 308.82, "billing_code_modifier": [""], "providers": [{"billed_charge": 779.25, "npi": [1174533343]}, {"billed_charge": 333.25, "npi": [1174533343]}]}]}]}, {"name": "IV INFUSION THERAPY/PROPHYLAXIS /DX 1ST TO 1 HR", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "96365", "description": "IV INFUSION THERAPY/PROPHYLAXIS /DX 1ST TO 1 HR", "allowed_amounts": [{"tin": {"type": "ein", "value": "853503076"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": ["59"], "providers": [{"billed_charge": 1563.01, "npi": [1124623889]}]}]}]}, {"name": "Behavioral Health Treatments/Services -IOP Psychiatric", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0905", "description": "Behavioral Health Treatments/Serv(also see 091x,ext of 090x)", "allowed_amounts": [{"tin": {"type": "ein", "value": "834188451"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 450.0, "npi": [1922642040]}]}]}]}, {"name": "Pharmacy - Extension of 25X - Drug Requiring Detailed Coding", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0636", "description": "Pharmacy - Extension of 25x", "allowed_amounts": [{"tin": {"type": "ein", "value": "752682017"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": ["ER"], "providers": [{"billed_charge": 32.0, "npi": [1114998911]}, {"billed_charge": 33.0, "npi": [1114998911]}, {"billed_charge": 17.0, "npi": [1114998911]}, {"billed_charge": 6.7, "npi": [1114998911]}]}, {"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 12.0, "npi": [1114998911]}, {"billed_charge": 120.0, "npi": [1114998911]}, {"billed_charge": 32.0, "npi": [1114998911]}, {"billed_charge": 242.0, "npi": [1114998911]}, {"billed_charge": 30.0, "npi": [1114998911]}, {"billed_charge": 27.0, "npi": [1114998911]}, {"billed_charge": 4.2, "npi": [1114998911]}, {"billed_charge": 33.0, "npi": [1114998911]}, {"billed_charge": 11.0, "npi": [1114998911]}, {"billed_charge": 5.3, "npi": [1114998911]}, {"billed_charge": 1026.0, "npi": [1114998911]}, {"billed_charge": 513.0, "npi": [1114998911]}, {"billed_charge": 71.0, "npi": [1114998911]}, {"billed_charge": 349.0, "npi": [1114998911]}, {"billed_charge": 19.0, "npi": [1114998911]}, {"billed_charge": 17.0, "npi": [1114998911]}, {"billed_charge": 6.7, "npi": [1114998911]}, {"billed_charge": 0.1, "npi": [1114998911]}, {"billed_charge": 15.0, "npi": [1114998911]}, {"billed_charge": 1.8, "npi": [1114998911]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["JZER"], "providers": [{"billed_charge": 57.0, "npi": [1114998911]}]}, {"allowed_amount": 0.51, "billing_code_modifier": ["JZ"], "providers": [{"billed_charge": 115.0, "npi": [1114998911]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["JZ"], "providers": [{"billed_charge": 69.0, "npi": [1114998911]}, {"billed_charge": 233.0, "npi": [1114998911]}, {"billed_charge": 57.0, "npi": [1114998911]}, {"billed_charge": 5.9, "npi": [1114998911]}]}, {"allowed_amount": 2.1135, "billing_code_modifier": ["JZ"], "providers": [{"billed_charge": 18.0, "npi": [1114998911]}]}]}]}, {"name": "Pharmacy - General", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0250", "description": "Pharmacy (also see 063x, an extension of 025x)", "allowed_amounts": [{"tin": {"type": "ein", "value": "751977850"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 0.25, "npi": [1396778064]}, {"billed_charge": 2.0333, "npi": [1396778064]}, {"billed_charge": 7.03, "npi": [1396778064]}, {"billed_charge": 18.6525, "npi": [1396778064]}, {"billed_charge": 20.69, "npi": [1396778064]}, {"billed_charge": 1.3333, "npi": [1396778064]}, {"billed_charge": 0.8333, "npi": [1396778064]}, {"billed_charge": 12.95, "npi": [1396778064]}, {"billed_charge": 2.0, "npi": [1396778064]}, {"billed_charge": 50.0, "npi": [1396778064]}, {"billed_charge": 17.4, "npi": [1396778064]}, {"billed_charge": 1.195, "npi": [1396778064]}, {"billed_charge": 59.4, "npi": [1396778064]}, {"billed_charge": 1.5, "npi": [1396778064]}, {"billed_charge": 43.6079, "npi": [1396778064]}, {"billed_charge": 1.0, "npi": [1396778064]}, {"billed_charge": 32.99, "npi": [1396778064]}, {"billed_charge": 1.475, "npi": [1396778064]}, {"billed_charge": 37.5879, "npi": [1396778064]}, {"billed_charge": 18.0, "npi": [1396778064]}]}]}]}, {"name": "THERAPEUTIC INJECTION IV PUSH EACH NEW DRUG", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "96375", "description": "THERAPEUTIC INJECTION IV PUSH EACH NEW DRUG", "allowed_amounts": [{"tin": {"type": "ein", "value": "853503076"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": ["59"], "providers": [{"billed_charge": 938.26, "npi": [1124623889]}]}]}]}, {"name": "Pharmacy - Extension of 25X - Drug Requiring Detailed Coding", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0636", "description": "Pharmacy - Extension of 25x", "allowed_amounts": [{"tin": {"type": "ein", "value": "751438726"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 26.4175, "npi": [1104845015]}, {"billed_charge": 9.7501, "npi": [1104845015]}, {"billed_charge": 186.78, "npi": [1104845015]}, {"billed_charge": 3.99, "npi": [1104845015]}, {"billed_charge": 10.0, "npi": [1104845015]}, {"billed_charge": 38.86, "npi": [1104845015]}, {"billed_charge": 10.3518, "npi": [1104845015]}, {"billed_charge": 50.0, "npi": [1104845015]}, {"billed_charge": 10.1581, "npi": [1104845015]}, {"billed_charge": 24.81, "npi": [1104845015]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["U8JZ"], "providers": [{"billed_charge": 0.5472, "npi": [1104845015]}, {"billed_charge": 16.33, "npi": [1104845015]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["U8JW"], "providers": [{"billed_charge": 9.0, "npi": [1104845015]}, {"billed_charge": 18.24, "npi": [1104845015]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["U8"], "providers": [{"billed_charge": 9.0, "npi": [1104845015]}, {"billed_charge": 12.5, "npi": [1104845015]}, {"billed_charge": 11.3125, "npi": [1104845015]}, {"billed_charge": 3.25, "npi": [1104845015]}, {"billed_charge": 2.5, "npi": [1104845015]}, {"billed_charge": 10.0, "npi": [1104845015]}, {"billed_charge": 18.24, "npi": [1104845015]}, {"billed_charge": 50.0, "npi": [1104845015]}, {"billed_charge": 0.05, "npi": [1104845015]}, {"billed_charge": 3.42, "npi": [1104845015]}]}, {"allowed_amount": 0.495, "billing_code_modifier": ["TBU8JZ"], "providers": [{"billed_charge": 5.0, "npi": [1104845015]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["JZ"], "providers": [{"billed_charge": 9.0, "npi": [1104845015]}, {"billed_charge": 0.5472, "npi": [1104845015]}]}, {"allowed_amount": 0.49, "billing_code_modifier": ["TBU8JZ"], "providers": [{"billed_charge": 10.0, "npi": [1104845015]}]}]}]}, {"name": "Emergency Room - General", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0450", "description": "Emergency Room", "allowed_amounts": [{"tin": {"type": "ein", "value": "751008430"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 308.31, "billing_code_modifier": [""], "providers": [{"billed_charge": 524.33, "npi": [1669472387]}]}, {"allowed_amount": 222.56, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 813.6, "npi": [1669472387]}]}, {"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 321.2, "npi": [1669472387]}, {"billed_charge": 330.56, "npi": [1669472387]}, {"billed_charge": 1468.57, "npi": [1669472387]}, {"billed_charge": 902.11, "npi": [1669472387]}, {"billed_charge": 395.21, "npi": [1669472387]}]}, {"allowed_amount": 67.875, "billing_code_modifier": [""], "providers": [{"billed_charge": 317.78, "npi": [1669472387]}]}, {"allowed_amount": 3791.1, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 4233.71, "npi": [1669472387]}]}, {"allowed_amount": 67.87, "billing_code_modifier": [""], "providers": [{"billed_charge": 317.78, "npi": [1669472387]}, {"billed_charge": 392.06, "npi": [1669472387]}]}, {"allowed_amount": 395.66, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 1283.4, "npi": [1669472387]}]}, {"allowed_amount": 308.31, "billing_code_modifier": ["XU"], "providers": [{"billed_charge": 524.33, "npi": [1669472387]}]}, {"allowed_amount": 290.83, "billing_code_modifier": ["F7"], "providers": [{"billed_charge": 870.42, "npi": [1669472387]}]}, {"allowed_amount": 604.81, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 2122.8, "npi": [1669472387]}]}]}]}, {"name": "Laboratory - Hematology", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0305", "description": "Laboratory", "allowed_amounts": [{"tin": {"type": "ein", "value": "751844139"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 145.4463, "npi": [1265430177]}, {"billed_charge": 248.29, "npi": [1265430177]}, {"billed_charge": 172.3667, "npi": [1265430177]}, {"billed_charge": 175.086, "npi": [1265430177]}, {"billed_charge": 148.0054, "npi": [1265430177]}, {"billed_charge": 133.46, "npi": [1265430177]}, {"billed_charge": 171.6241, "npi": [1265430177]}, {"billed_charge": 149.84, "npi": [1265430177]}, {"billed_charge": 146.11, "npi": [1265430177]}, {"billed_charge": 183.63, "npi": [1265430177]}, {"billed_charge": 140.91, "npi": [1265430177]}, {"billed_charge": 161.1033, "npi": [1265430177]}, {"billed_charge": 159.7, "npi": [1265430177]}, {"billed_charge": 159.615, "npi": [1265430177]}, {"billed_charge": 93.56, "npi": [1265430177]}]}]}]}, {"name": "ANESTHESIA LOWER INTST ENDOSCOPIC PX SCR COLSC", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "00812", "description": "ANESTHESIA LOWER INTST ENDOSCOPIC PX SCR COLSC", "allowed_amounts": [{"tin": {"type": "ein", "value": "453710597"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 53.352, "billing_code_modifier": ["AAP2"], "providers": [{"billed_charge": 660.0, "npi": [1265438311]}]}, {"allowed_amount": 67.0471, "billing_code_modifier": ["AAP3"], "providers": [{"billed_charge": 684.0, "npi": [1265438311]}]}, {"allowed_amount": 49.3379, "billing_code_modifier": ["AAP2"], "providers": [{"billed_charge": 708.0, "npi": [1265438311]}]}, {"allowed_amount": 76.2143, "billing_code_modifier": ["AAP1"], "providers": [{"billed_charge": 528.0, "npi": [1265438311]}]}, {"allowed_amount": 72.7533, "billing_code_modifier": ["AAP3"], "providers": [{"billed_charge": 660.0, "npi": [1265438311]}]}, {"allowed_amount": 62.5421, "billing_code_modifier": ["AAP1"], "providers": [{"billed_charge": 588.0, "npi": [1265438311]}]}, {"allowed_amount": 64.6667, "billing_code_modifier": ["AAP2"], "providers": [{"billed_charge": 576.0, "npi": [1265438311]}]}, {"allowed_amount": 72.7533, "billing_code_modifier": ["AAP2"], "providers": [{"billed_charge": 540.0, "npi": [1265438311]}]}, {"allowed_amount": 55.8826, "billing_code_modifier": ["AAP1"], "providers": [{"billed_charge": 636.0, "npi": [1265438311]}]}, {"allowed_amount": 55.8826, "billing_code_modifier": ["AAP2"], "providers": [{"billed_charge": 636.0, "npi": [1265438311]}]}, {"allowed_amount": 80.2154, "billing_code_modifier": ["AAP1"], "providers": [{"billed_charge": 516.0, "npi": [1265438311]}]}, {"allowed_amount": 57.3182, "billing_code_modifier": ["AAP2"], "providers": [{"billed_charge": 624.0, "npi": [1265438311]}]}, {"allowed_amount": 80.2154, "billing_code_modifier": ["AAP3"], "providers": [{"billed_charge": 636.0, "npi": [1265438311]}]}, {"allowed_amount": 58.8952, "billing_code_modifier": ["AAP3"], "providers": [{"billed_charge": 732.0, "npi": [1265438311]}]}, {"allowed_amount": 41.9951, "billing_code_modifier": ["AAP2"], "providers": [{"billed_charge": 852.0, "npi": [1265438311]}]}, {"allowed_amount": 62.5421, "billing_code_modifier": ["AAP2"], "providers": [{"billed_charge": 588.0, "npi": [1265438311]}]}, {"allowed_amount": 47.7194, "billing_code_modifier": ["AAP2"], "providers": [{"billed_charge": 732.0, "npi": [1265438311]}]}, {"allowed_amount": 67.0471, "billing_code_modifier": ["AAP2"], "providers": [{"billed_charge": 564.0, "npi": [1265438311]}]}, {"allowed_amount": 48.5, "billing_code_modifier": ["AAP3"], "providers": [{"billed_charge": 840.0, "npi": [1265438311]}]}, {"allowed_amount": 47.7194, "billing_code_modifier": ["AAP1"], "providers": [{"billed_charge": 732.0, "npi": [1265438311]}]}, {"allowed_amount": 50.2321, "billing_code_modifier": ["AAP2"], "providers": [{"billed_charge": 696.0, "npi": [1265438311]}]}, {"allowed_amount": 67.0471, "billing_code_modifier": ["AAP1"], "providers": [{"billed_charge": 564.0, "npi": [1265438311]}]}, {"allowed_amount": 76.2143, "billing_code_modifier": ["AAP3"], "providers": [{"billed_charge": 648.0, "npi": [1265438311]}]}, {"allowed_amount": 51.1963, "billing_code_modifier": ["AAP2"], "providers": [{"billed_charge": 684.0, "npi": [1265438311]}]}, {"allowed_amount": 69.7188, "billing_code_modifier": ["AAP2"], "providers": [{"billed_charge": 552.0, "npi": [1265438311]}]}, {"allowed_amount": 72.7533, "billing_code_modifier": ["AAP1"], "providers": [{"billed_charge": 540.0, "npi": [1265438311]}]}]}]}, {"name": "EMERGENCY DEPARTMENT VISIT HIGH MDM", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "99285", "description": "EMERGENCY DEPARTMENT VISIT HIGH MDM", "allowed_amounts": [{"tin": {"type": "ein", "value": "853503076"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 5992.84, "npi": [1124623889]}]}, {"allowed_amount": 10210.76, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 5992.84, "npi": [1124623889]}]}, {"allowed_amount": 2899.97, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 5992.84, "npi": [1124623889]}]}]}]}, {"name": "Emergency Room - General", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0450", "description": "Emergency Room", "allowed_amounts": [{"tin": {"type": "ein", "value": "621789402"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 308.31, "billing_code_modifier": [""], "providers": [{"billed_charge": 749.06, "npi": [1700805678]}]}, {"allowed_amount": 222.56, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 1065.68, "npi": [1700805678]}]}, {"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 309.23, "npi": [1700805678]}]}, {"allowed_amount": 122.22, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 649.26, "npi": [1700805678]}]}, {"allowed_amount": 3791.1, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 4860.24, "npi": [1700805678]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["RT"], "providers": [{"billed_charge": 1333.02, "npi": [1700805678]}]}, {"allowed_amount": 395.66, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 1724.8, "npi": [1700805678]}]}, {"allowed_amount": 863.2, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 4860.24, "npi": [1700805678]}]}, {"allowed_amount": 604.81, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 2981.44, "npi": [1700805678]}]}]}]}, {"name": "EKG/ECG (Electrocardiogram) - General", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0730", "description": "EKG/ECG (Electrocardiogram)", "allowed_amounts": [{"tin": {"type": "ein", "value": "751837454"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 453.2, "npi": [1447250253]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["XU"], "providers": [{"billed_charge": 453.2, "npi": [1447250253]}]}]}]}, {"name": "IV INFUSION HYDRATION EACH ADDITIONAL HOUR", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "96361", "description": "IV INFUSION HYDRATION EACH ADDITIONAL HOUR", "allowed_amounts": [{"tin": {"type": "ein", "value": "853503076"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": ["59"], "providers": [{"billed_charge": 957.51, "npi": [1124623889]}]}]}]}, {"name": "Emergency Room - General", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0450", "description": "Emergency Room", "allowed_amounts": [{"tin": {"type": "ein", "value": "824052186"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 308.31, "billing_code_modifier": [""], "providers": [{"billed_charge": 814.34, "npi": [1801826839]}, {"billed_charge": 524.33, "npi": [1801826839]}]}, {"allowed_amount": 222.56, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 782.31, "npi": [1801826839]}]}, {"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 317.78, "npi": [1801826839]}, {"billed_charge": 361.12, "npi": [1801826839]}, {"billed_charge": 2122.8, "npi": [1801826839]}, {"billed_charge": 806.34, "npi": [1801826839]}, {"billed_charge": 392.06, "npi": [1801826839]}, {"billed_charge": 524.33, "npi": [1801826839]}]}, {"allowed_amount": 67.875, "billing_code_modifier": [""], "providers": [{"billed_charge": 317.78, "npi": [1801826839]}]}, {"allowed_amount": 604.81, "billing_code_modifier": [""], "providers": [{"billed_charge": 2122.8, "npi": [1801826839]}]}, {"allowed_amount": 67.875, "billing_code_modifier": ["XU"], "providers": [{"billed_charge": 392.06, "npi": [1801826839]}]}, {"allowed_amount": 67.87, "billing_code_modifier": ["XU"], "providers": [{"billed_charge": 392.06, "npi": [1801826839]}]}, {"allowed_amount": 222.56, "billing_code_modifier": [""], "providers": [{"billed_charge": 782.31, "npi": [1801826839]}]}, {"allowed_amount": 296.75, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 1283.4, "npi": [1801826839]}]}, {"allowed_amount": 3791.1, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 4233.71, "npi": [1801826839]}]}, {"allowed_amount": 589.22, "billing_code_modifier": [""], "providers": [{"billed_charge": 1503.07, "npi": [1801826839]}]}, {"allowed_amount": 67.87, "billing_code_modifier": [""], "providers": [{"billed_charge": 317.78, "npi": [1801826839]}, {"billed_charge": 392.06, "npi": [1801826839]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 3879.67, "npi": [1801826839]}]}, {"allowed_amount": 395.66, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 1283.4, "npi": [1801826839]}]}, {"allowed_amount": 308.31, "billing_code_modifier": ["XU"], "providers": [{"billed_charge": 902.11, "npi": [1801826839]}, {"billed_charge": 524.33, "npi": [1801826839]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["LT"], "providers": [{"billed_charge": 618.19, "npi": [1801826839]}]}, {"allowed_amount": 1197.29, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 4233.71, "npi": [1801826839]}]}, {"allowed_amount": 604.81, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 2122.8, "npi": [1801826839]}]}]}]}, {"name": "Pharmacy - General", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0250", "description": "Pharmacy (also see 063x, an extension of 025x)", "allowed_amounts": [{"tin": {"type": "ein", "value": "750800628"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 117.93, "billing_code_modifier": [""], "providers": [{"billed_charge": 196.55, "npi": [1720480627]}]}, {"allowed_amount": 68.5721, "billing_code_modifier": [""], "providers": [{"billed_charge": 114.2868, "npi": [1194743013]}]}, {"allowed_amount": 2.81, "billing_code_modifier": [""], "providers": [{"billed_charge": 4.6833, "npi": [1720480627]}]}, {"allowed_amount": 12.054, "billing_code_modifier": [""], "providers": [{"billed_charge": 20.09, "npi": [1194743013]}]}, {"allowed_amount": 3.51, "billing_code_modifier": [""], "providers": [{"billed_charge": 5.85, "npi": [1194743013]}]}, {"allowed_amount": 15.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 25.0, "npi": [1194743013]}]}, {"allowed_amount": 5.736, "billing_code_modifier": [""], "providers": [{"billed_charge": 9.56, "npi": [1194743013]}]}, {"allowed_amount": 3.72, "billing_code_modifier": [""], "providers": [{"billed_charge": 6.2, "npi": [1720480627]}]}, {"allowed_amount": 35.9817, "billing_code_modifier": [""], "providers": [{"billed_charge": 59.9694, "npi": [1194743013]}]}, {"allowed_amount": 4.14, "billing_code_modifier": [""], "providers": [{"billed_charge": 6.9, "npi": [1194743013]}]}, {"allowed_amount": 40.73, "billing_code_modifier": [""], "providers": [{"billed_charge": 67.8833, "npi": [1194743013]}]}, {"allowed_amount": 25.932, "billing_code_modifier": [""], "providers": [{"billed_charge": 43.22, "npi": [1194743013]}]}, {"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 55.7643, "npi": [1720480627]}, {"billed_charge": 28.3929, "npi": [1194743013]}, {"billed_charge": 70.425, "npi": [1720480627]}]}, {"allowed_amount": 7.08, "billing_code_modifier": [""], "providers": [{"billed_charge": 11.8, "npi": [1720480627]}]}, {"allowed_amount": 34.814, "billing_code_modifier": [""], "providers": [{"billed_charge": 58.0233, "npi": [1720480627]}]}, {"allowed_amount": 16.3325, "billing_code_modifier": [""], "providers": [{"billed_charge": 27.2208, "npi": [1194743013]}]}, {"allowed_amount": 35.7, "billing_code_modifier": [""], "providers": [{"billed_charge": 59.5, "npi": [1194743013]}]}, {"allowed_amount": 21.8365, "billing_code_modifier": [""], "providers": [{"billed_charge": 36.3941, "npi": [1194743013]}]}, {"allowed_amount": 22.7411, "billing_code_modifier": [""], "providers": [{"billed_charge": 37.9019, "npi": [1194743013]}]}, {"allowed_amount": 4.32, "billing_code_modifier": [""], "providers": [{"billed_charge": 7.2, "npi": [1194743013]}]}, {"allowed_amount": 22.785, "billing_code_modifier": [""], "providers": [{"billed_charge": 37.975, "npi": [1720480627]}]}, {"allowed_amount": 37.8185, "billing_code_modifier": [""], "providers": [{"billed_charge": 63.0308, "npi": [1720480627]}]}, {"allowed_amount": 17.0357, "billing_code_modifier": [""], "providers": [{"billed_charge": 28.3929, "npi": [1194743013]}]}, {"allowed_amount": 51.23, "billing_code_modifier": [""], "providers": [{"billed_charge": 85.3833, "npi": [1194743013]}]}, {"allowed_amount": 3.42, "billing_code_modifier": [""], "providers": [{"billed_charge": 5.7, "npi": [1194743013]}, {"billed_charge": 5.7, "npi": [1720480627]}]}, {"allowed_amount": 2.7825, "billing_code_modifier": [""], "providers": [{"billed_charge": 4.6375, "npi": [1720480627]}]}, {"allowed_amount": 39.85, "billing_code_modifier": [""], "providers": [{"billed_charge": 66.4167, "npi": [1720480627]}]}, {"allowed_amount": 32.43, "billing_code_modifier": [""], "providers": [{"billed_charge": 54.05, "npi": [1720480627]}]}, {"allowed_amount": 4.92, "billing_code_modifier": [""], "providers": [{"billed_charge": 8.2, "npi": [1194743013]}]}, {"allowed_amount": 8.5975, "billing_code_modifier": [""], "providers": [{"billed_charge": 14.3292, "npi": [1194743013]}]}, {"allowed_amount": 3.195, "billing_code_modifier": [""], "providers": [{"billed_charge": 5.325, "npi": [1194743013]}]}, {"allowed_amount": 29.3775, "billing_code_modifier": [""], "providers": [{"billed_charge": 48.9625, "npi": [1194743013]}]}, {"allowed_amount": 52.12, "billing_code_modifier": [""], "providers": [{"billed_charge": 86.8667, "npi": [1194743013]}]}, {"allowed_amount": 2.23, "billing_code_modifier": [""], "providers": [{"billed_charge": 3.7167, "npi": [1720480627]}]}, {"allowed_amount": 18.18, "billing_code_modifier": [""], "providers": [{"billed_charge": 30.3, "npi": [1194743013]}]}, {"allowed_amount": 40.836, "billing_code_modifier": [""], "providers": [{"billed_charge": 68.06, "npi": [1720480627]}]}, {"allowed_amount": 14.3, "billing_code_modifier": [""], "providers": [{"billed_charge": 23.8333, "npi": [1194743013]}]}, {"allowed_amount": 2.6475, "billing_code_modifier": [""], "providers": [{"billed_charge": 4.4125, "npi": [1194743013]}]}, {"allowed_amount": 4.11, "billing_code_modifier": [""], "providers": [{"billed_charge": 6.85, "npi": [1720480627]}, {"billed_charge": 6.85, "npi": [1194743013]}]}, {"allowed_amount": 1.2, "billing_code_modifier": [""], "providers": [{"billed_charge": 2.0, "npi": [1720480627]}, {"billed_charge": 2.0, "npi": [1194743013]}]}, {"allowed_amount": 21.7988, "billing_code_modifier": [""], "providers": [{"billed_charge": 36.3313, "npi": [1720480627]}]}, {"allowed_amount": 53.4, "billing_code_modifier": [""], "providers": [{"billed_charge": 89.0, "npi": [1720480627]}]}, {"allowed_amount": 62.77, "billing_code_modifier": [""], "providers": [{"billed_charge": 104.6167, "npi": [1194743013]}]}, {"allowed_amount": 40.4, "billing_code_modifier": [""], "providers": [{"billed_charge": 67.3333, "npi": [1720480627]}]}, {"allowed_amount": 4.876, "billing_code_modifier": [""], "providers": [{"billed_charge": 9.56, "npi": [1194743013]}]}, {"allowed_amount": 4.56, "billing_code_modifier": [""], "providers": [{"billed_charge": 7.6, "npi": [1720480627]}]}, {"allowed_amount": 3.45, "billing_code_modifier": [""], "providers": [{"billed_charge": 5.75, "npi": [1194743013]}]}, {"allowed_amount": 2.79, "billing_code_modifier": [""], "providers": [{"billed_charge": 4.65, "npi": [1720480627]}]}, {"allowed_amount": 19.0569, "billing_code_modifier": [""], "providers": [{"billed_charge": 31.7615, "npi": [1720480627]}]}, {"allowed_amount": 13.215, "billing_code_modifier": [""], "providers": [{"billed_charge": 22.025, "npi": [1720480627]}]}, {"allowed_amount": 22.28, "billing_code_modifier": [""], "providers": [{"billed_charge": 37.1333, "npi": [1194743013]}]}, {"allowed_amount": 60.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 100.0, "npi": [1720480627]}]}, {"allowed_amount": 40.45, "billing_code_modifier": [""], "providers": [{"billed_charge": 67.4167, "npi": [1194743013]}]}, {"allowed_amount": 55.608, "billing_code_modifier": [""], "providers": [{"billed_charge": 92.68, "npi": [1194743013]}]}, {"allowed_amount": 15.72, "billing_code_modifier": [""], "providers": [{"billed_charge": 26.2, "npi": [1194743013]}]}, {"allowed_amount": 42.255, "billing_code_modifier": [""], "providers": [{"billed_charge": 70.425, "npi": [1720480627]}]}, {"allowed_amount": 2.5586, "billing_code_modifier": [""], "providers": [{"billed_charge": 4.2643, "npi": [1720480627]}]}, {"allowed_amount": 5.7, "billing_code_modifier": [""], "providers": [{"billed_charge": 9.5, "npi": [1194743013]}]}, {"allowed_amount": 27.7873, "billing_code_modifier": [""], "providers": [{"billed_charge": 46.3122, "npi": [1194743013]}]}, {"allowed_amount": 11.94, "billing_code_modifier": [""], "providers": [{"billed_charge": 19.9, "npi": [1194743013]}]}, {"allowed_amount": 35.64, "billing_code_modifier": [""], "providers": [{"billed_charge": 59.4, "npi": [1720480627]}]}, {"allowed_amount": 54.87, "billing_code_modifier": [""], "providers": [{"billed_charge": 91.45, "npi": [1194743013]}]}, {"allowed_amount": 113.91, "billing_code_modifier": [""], "providers": [{"billed_charge": 189.85, "npi": [1720480627]}, {"billed_charge": 189.85, "npi": [1194743013]}]}, {"allowed_amount": 83.1043, "billing_code_modifier": [""], "providers": [{"billed_charge": 138.5071, "npi": [1194743013]}]}, {"allowed_amount": 93.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 155.0, "npi": [1194743013]}]}, {"allowed_amount": 45.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 75.0, "npi": [1194743013]}]}, {"allowed_amount": 18.9367, "billing_code_modifier": [""], "providers": [{"billed_charge": 37.1333, "npi": [1194743013]}]}, {"allowed_amount": 3.255, "billing_code_modifier": [""], "providers": [{"billed_charge": 5.425, "npi": [1194743013]}]}, {"allowed_amount": 3.06, "billing_code_modifier": [""], "providers": [{"billed_charge": 5.1, "npi": [1194743013]}, {"billed_charge": 5.1, "npi": [1720480627]}]}, {"allowed_amount": 48.6263, "billing_code_modifier": [""], "providers": [{"billed_charge": 81.0438, "npi": [1194743013]}]}, {"allowed_amount": 40.18, "billing_code_modifier": [""], "providers": [{"billed_charge": 66.9667, "npi": [1194743013]}]}, {"allowed_amount": 115.92, "billing_code_modifier": [""], "providers": [{"billed_charge": 193.2, "npi": [1194743013]}]}, {"allowed_amount": 22.35, "billing_code_modifier": [""], "providers": [{"billed_charge": 37.25, "npi": [1720480627]}]}, {"allowed_amount": 36.93, "billing_code_modifier": [""], "providers": [{"billed_charge": 61.55, "npi": [1194743013]}]}, {"allowed_amount": 2.6, "billing_code_modifier": [""], "providers": [{"billed_charge": 4.3333, "npi": [1194743013]}]}, {"allowed_amount": 12.75, "billing_code_modifier": [""], "providers": [{"billed_charge": 25.0, "npi": [1194743013]}]}, {"allowed_amount": 41.07, "billing_code_modifier": [""], "providers": [{"billed_charge": 68.45, "npi": [1720480627]}]}, {"allowed_amount": 12.87, "billing_code_modifier": [""], "providers": [{"billed_charge": 21.45, "npi": [1194743013]}]}, {"allowed_amount": 15.315, "billing_code_modifier": [""], "providers": [{"billed_charge": 25.525, "npi": [1720480627]}]}, {"allowed_amount": 33.4586, "billing_code_modifier": [""], "providers": [{"billed_charge": 55.7643, "npi": [1720480627]}]}, {"allowed_amount": 10.3929, "billing_code_modifier": [""], "providers": [{"billed_charge": 17.3214, "npi": [1194743013]}]}, {"allowed_amount": 2.97, "billing_code_modifier": [""], "providers": [{"billed_charge": 4.95, "npi": [1194743013]}]}, {"allowed_amount": 24.498, "billing_code_modifier": [""], "providers": [{"billed_charge": 40.83, "npi": [1720480627]}]}, {"allowed_amount": 37.5, "billing_code_modifier": [""], "providers": [{"billed_charge": 62.5, "npi": [1720480627]}]}, {"allowed_amount": 16.89, "billing_code_modifier": [""], "providers": [{"billed_charge": 28.15, "npi": [1720480627]}]}, {"allowed_amount": 14.4, "billing_code_modifier": [""], "providers": [{"billed_charge": 24.0, "npi": [1720480627]}]}]}]}, {"name": "Laboratory - Chemistry", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0301", "description": "Laboratory", "allowed_amounts": [{"tin": {"type": "ein", "value": "621789402"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 752.4, "npi": [1700805678]}, {"billed_charge": 636.05, "npi": [1700805678]}, {"billed_charge": 620.53, "npi": [1700805678]}, {"billed_charge": 90.0, "npi": [1700805678]}, {"billed_charge": 406.4525, "npi": [1700805678]}, {"billed_charge": 814.45, "npi": [1700805678]}, {"billed_charge": 44.1, "npi": [1700805678]}, {"billed_charge": 136.52, "npi": [1700805678]}, {"billed_charge": 248.21, "npi": [1700805678]}, {"billed_charge": 302.52, "npi": [1700805678]}, {"billed_charge": 1061.11, "npi": [1700805678]}, {"billed_charge": 376.99, "npi": [1700805678]}, {"billed_charge": 392.49, "npi": [1700805678]}]}]}]}, {"name": "IAADIADOO STREPTOCOCCUS GROUP A", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "87880", "description": "IAADIADOO STREPTOCOCCUS GROUP A", "allowed_amounts": [{"tin": {"type": "ein", "value": "853503076"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": ["QW"], "providers": [{"billed_charge": 538.66, "npi": [1124623889]}]}]}]}, {"name": "Laboratory - Hematology", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0305", "description": "Laboratory", "allowed_amounts": [{"tin": {"type": "ein", "value": "750800628"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 141.6, "billing_code_modifier": [""], "providers": [{"billed_charge": 236.0, "npi": [1194743013]}]}, {"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 236.0, "npi": [1194743013]}, {"billed_charge": 223.0, "npi": [1194743013]}]}, {"allowed_amount": 165.6, "billing_code_modifier": [""], "providers": [{"billed_charge": 276.0, "npi": [1194743013]}]}, {"allowed_amount": 43.86, "billing_code_modifier": [""], "providers": [{"billed_charge": 86.0, "npi": [1194743013]}]}, {"allowed_amount": 140.7, "billing_code_modifier": [""], "providers": [{"billed_charge": 234.5, "npi": [1194743013]}]}, {"allowed_amount": 158.6809, "billing_code_modifier": [""], "providers": [{"billed_charge": 264.4681, "npi": [1194743013]}]}, {"allowed_amount": 133.8, "billing_code_modifier": [""], "providers": [{"billed_charge": 223.0, "npi": [1194743013]}]}, {"allowed_amount": 54.6, "billing_code_modifier": [""], "providers": [{"billed_charge": 91.0, "npi": [1194743013]}]}, {"allowed_amount": 70.8, "billing_code_modifier": [""], "providers": [{"billed_charge": 118.0, "npi": [1194743013]}]}, {"allowed_amount": 51.6, "billing_code_modifier": [""], "providers": [{"billed_charge": 86.0, "npi": [1194743013]}]}, {"allowed_amount": 229.8, "billing_code_modifier": [""], "providers": [{"billed_charge": 383.0, "npi": [1194743013]}]}, {"allowed_amount": 126.4667, "billing_code_modifier": [""], "providers": [{"billed_charge": 210.7778, "npi": [1194743013]}]}, {"allowed_amount": 147.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 245.0, "npi": [1194743013]}]}, {"allowed_amount": 195.33, "billing_code_modifier": [""], "providers": [{"billed_charge": 383.0, "npi": [1194743013]}]}, {"allowed_amount": 141.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 235.0, "npi": [1194743013]}]}]}]}, {"name": "CT Scan - Body Scan", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0352", "description": "CT Scan", "allowed_amounts": [{"tin": {"type": "ein", "value": "751837454"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 622.69, "billing_code_modifier": [""], "providers": [{"billed_charge": 6290.97, "npi": [1447250253]}]}, {"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 6093.885, "npi": [1447250253]}, {"billed_charge": 4912.095, "npi": [1447250253]}, {"billed_charge": 6417.572, "npi": [1447250253]}, {"billed_charge": 6290.97, "npi": [1447250253]}, {"billed_charge": 9294.97, "npi": [1447250253]}, {"billed_charge": 4529.075, "npi": [1447250253]}, {"billed_charge": 2858.93, "npi": [1447250253]}, {"billed_charge": 5191.8367, "npi": [1447250253]}, {"billed_charge": 4817.7367, "npi": [1447250253]}, {"billed_charge": 3150.74, "npi": [1447250253]}, {"billed_charge": 6090.5783, "npi": [1447250253]}, {"billed_charge": 5240.33, "npi": [1447250253]}, {"billed_charge": 3424.65, "npi": [1447250253]}, {"billed_charge": 5436.18, "npi": [1447250253]}, {"billed_charge": 6484.35, "npi": [1447250253]}, {"billed_charge": 2800.19, "npi": [1447250253]}, {"billed_charge": 3339.84, "npi": [1447250253]}]}, {"allowed_amount": 254.23, "billing_code_modifier": [""], "providers": [{"billed_charge": 6290.97, "npi": [1447250253]}]}, {"allowed_amount": 345.85, "billing_code_modifier": [""], "providers": [{"billed_charge": 5896.8, "npi": [1447250253]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["RT"], "providers": [{"billed_charge": 3078.86, "npi": [1447250253]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["LT"], "providers": [{"billed_charge": 2858.93, "npi": [1447250253]}, {"billed_charge": 5648.73, "npi": [1447250253]}]}, {"allowed_amount": 505.67, "billing_code_modifier": [""], "providers": [{"billed_charge": 9294.97, "npi": [1447250253]}, {"billed_charge": 6484.35, "npi": [1447250253]}]}]}]}, {"name": "Laboratory - Bacteriology & Microbiology", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0306", "description": "Laboratory", "allowed_amounts": [{"tin": {"type": "ein", "value": "472177648"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 1013.0, "npi": [1790174860]}, {"billed_charge": 298.73, "npi": [1790174860]}, {"billed_charge": 181.0, "npi": [1790174860]}, {"billed_charge": 412.3533, "npi": [1790174860]}, {"billed_charge": 728.4033, "npi": [1790174860]}, {"billed_charge": 539.7, "npi": [1790174860]}, {"billed_charge": 313.67, "npi": [1790174860]}, {"billed_charge": 1929.0, "npi": [1790174860]}, {"billed_charge": 581.55, "npi": [1790174860]}, {"billed_charge": 514.0, "npi": [1790174860]}, {"billed_charge": 190.05, "npi": [1790174860]}, {"billed_charge": 434.0, "npi": [1790174860]}, {"billed_charge": 844.0925, "npi": [1790174860]}, {"billed_charge": 641.57, "npi": [1790174860]}, {"billed_charge": 553.85, "npi": [1790174860]}, {"billed_charge": 200.0, "npi": [1790174860]}]}, {"allowed_amount": 108.25, "billing_code_modifier": [""], "providers": [{"billed_charge": 298.73, "npi": [1790174860]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["91"], "providers": [{"billed_charge": 539.7, "npi": [1790174860]}, {"billed_charge": 514.0, "npi": [1790174860]}]}, {"allowed_amount": 101.92, "billing_code_modifier": [""], "providers": [{"billed_charge": 298.73, "npi": [1790174860]}]}]}]}, {"name": "BLS ROUTINE DISPOSABLE SUPPLIES", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "A0382", "description": "BLS ROUTINE DISPOSABLE SUPPLIES", "allowed_amounts": [{"tin": {"type": "ein", "value": "300688582"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": ["HE"], "providers": [{"billed_charge": 182.0, "npi": [1750676870]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["HH"], "providers": [{"billed_charge": 182.0, "npi": [1750676870]}, {"billed_charge": 50.0, "npi": [1750676870]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["PE"], "providers": [{"billed_charge": 182.0, "npi": [1750676870]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["EP"], "providers": [{"billed_charge": 182.0, "npi": [1750676870]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["HR"], "providers": [{"billed_charge": 182.0, "npi": [1750676870]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["RH"], "providers": [{"billed_charge": 182.0, "npi": [1750676870]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["EH"], "providers": [{"billed_charge": 182.0, "npi": [1750676870]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["HRGY"], "providers": [{"billed_charge": 182.0, "npi": [1750676870]}]}]}]}, {"name": "ALCOHL  AND OR RX SRVC; METHADONE ADMIN  AND OR SERVICE", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "H0020", "description": "ALCOHL  AND OR RX SRVC; METHADONE ADMIN  AND OR SERVICE", "allowed_amounts": [{"tin": {"type": "ein", "value": "204680462"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 9.84, "billing_code_modifier": ["U1"], "providers": [{"billed_charge": 9.84, "npi": [1992966584]}]}, {"allowed_amount": 18.84, "billing_code_modifier": ["UA"], "providers": [{"billed_charge": 18.84, "npi": [1992966584]}]}]}]}, {"name": "Laboratory - Chemistry", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0301", "description": "Laboratory", "allowed_amounts": [{"tin": {"type": "ein", "value": "461353294"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 105.17, "billing_code_modifier": ["91"], "providers": [{"billed_charge": 369.0, "npi": [1760417646]}]}, {"allowed_amount": 147.63, "billing_code_modifier": [""], "providers": [{"billed_charge": 518.0, "npi": [1760417646]}]}, {"allowed_amount": 275.6, "billing_code_modifier": [""], "providers": [{"billed_charge": 967.0, "npi": [1760417646]}]}, {"allowed_amount": 64.66, "billing_code_modifier": [""], "providers": [{"billed_charge": 349.0, "npi": [1760417646]}]}, {"allowed_amount": 82.65, "billing_code_modifier": [""], "providers": [{"billed_charge": 290.0, "npi": [1760417646]}]}, {"allowed_amount": 147.63, "billing_code_modifier": ["91"], "providers": [{"billed_charge": 518.0, "npi": [1760417646]}]}, {"allowed_amount": 71.54, "billing_code_modifier": [""], "providers": [{"billed_charge": 251.0, "npi": [1760417646]}]}, {"allowed_amount": 69.28, "billing_code_modifier": [""], "providers": [{"billed_charge": 374.0, "npi": [1760417646]}]}, {"allowed_amount": 29.07, "billing_code_modifier": [""], "providers": [{"billed_charge": 102.0, "npi": [1760417646]}]}, {"allowed_amount": 105.17, "billing_code_modifier": [""], "providers": [{"billed_charge": 369.0, "npi": [1760417646]}]}, {"allowed_amount": 46.5, "billing_code_modifier": [""], "providers": [{"billed_charge": 251.0, "npi": [1760417646]}]}, {"allowed_amount": 66.41, "billing_code_modifier": [""], "providers": [{"billed_charge": 233.0, "npi": [1760417646]}]}, {"allowed_amount": 53.72, "billing_code_modifier": [""], "providers": [{"billed_charge": 290.0, "npi": [1760417646]}]}, {"allowed_amount": 99.47, "billing_code_modifier": [""], "providers": [{"billed_charge": 349.0, "npi": [1760417646]}]}, {"allowed_amount": 106.59, "billing_code_modifier": [""], "providers": [{"billed_charge": 374.0, "npi": [1760417646]}]}, {"allowed_amount": 68.36, "billing_code_modifier": ["91"], "providers": [{"billed_charge": 369.0, "npi": [1760417646]}]}, {"allowed_amount": 29.07, "billing_code_modifier": ["91"], "providers": [{"billed_charge": 102.0, "npi": [1760417646]}]}, {"allowed_amount": 68.36, "billing_code_modifier": [""], "providers": [{"billed_charge": 369.0, "npi": [1760417646]}]}]}]}, {"name": "Laboratory - Bacteriology & Microbiology", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0306", "description": "Laboratory", "allowed_amounts": [{"tin": {"type": "ein", "value": "751844139"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 206.81, "billing_code_modifier": [""], "providers": [{"billed_charge": 174.88, "npi": [1265430177]}]}, {"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 334.2057, "npi": [1265430177]}, {"billed_charge": 120.7, "npi": [1265430177]}, {"billed_charge": 125.99, "npi": [1265430177]}, {"billed_charge": 102.41, "npi": [1265430177]}, {"billed_charge": 215.5, "npi": [1265430177]}, {"billed_charge": 17.0, "npi": [1265430177]}, {"billed_charge": 158.955, "npi": [1265430177]}, {"billed_charge": 272.5425, "npi": [1265430177]}, {"billed_charge": 337.9582, "npi": [1265430177]}, {"billed_charge": 282.44, "npi": [1265430177]}, {"billed_charge": 210.209, "npi": [1265430177]}, {"billed_charge": 173.2582, "npi": [1265430177]}, {"billed_charge": 340.52, "npi": [1265430177]}]}, {"allowed_amount": 148.49, "billing_code_modifier": [""], "providers": [{"billed_charge": 102.41, "npi": [1265430177]}]}]}]}, {"name": "Laboratory - General", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0300", "description": "Laboratory", "allowed_amounts": [{"tin": {"type": "ein", "value": "820551704"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 219.44, "npi": [1649273434]}, {"billed_charge": 49.66, "npi": [1649273434]}, {"billed_charge": 211.0, "npi": [1649273434]}, {"billed_charge": 392.86, "npi": [1649273434]}, {"billed_charge": 133.0588, "npi": [1649273434]}, {"billed_charge": 47.75, "npi": [1649273434]}, {"billed_charge": 408.57, "npi": [1649273434]}, {"billed_charge": 113.672, "npi": [1649273434]}, {"billed_charge": 40.0, "npi": [1649273434]}]}]}]}, {"name": "Emergency Room - General", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0450", "description": "Emergency Room", "allowed_amounts": [{"tin": {"type": "ein", "value": "751748586"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 254.75, "npi": [1508899204]}, {"billed_charge": 542.5, "npi": [1508899204]}, {"billed_charge": 333.25, "npi": [1508899204]}]}, {"allowed_amount": 308.82, "billing_code_modifier": ["59"], "providers": [{"billed_charge": 779.25, "npi": [1508899204]}, {"billed_charge": 333.25, "npi": [1508899204]}]}, {"allowed_amount": 396.31, "billing_code_modifier": [""], "providers": [{"billed_charge": 1042.5, "npi": [1508899204]}]}, {"allowed_amount": 3797.35, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 2758.25, "npi": [1508899204]}]}, {"allowed_amount": 864.64, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 2758.25, "npi": [1508899204]}]}, {"allowed_amount": 222.92, "billing_code_modifier": ["27"], "providers": [{"billed_charge": 537.75, "npi": [1508899204]}]}, {"allowed_amount": 605.81, "billing_code_modifier": [""], "providers": [{"billed_charge": 1521.25, "npi": [1508899204]}]}, {"allowed_amount": 605.81, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 1521.25, "npi": [1508899204]}]}, {"allowed_amount": 396.31, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 1042.5, "npi": [1508899204]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["59"], "providers": [{"billed_charge": 254.75, "npi": [1508899204]}, {"billed_charge": 333.25, "npi": [1508899204]}]}, {"allowed_amount": 222.92, "billing_code_modifier": [""], "providers": [{"billed_charge": 537.75, "npi": [1508899204]}]}, {"allowed_amount": 67.99, "billing_code_modifier": [""], "providers": [{"billed_charge": 103.5, "npi": [1508899204]}, {"billed_charge": 333.25, "npi": [1508899204]}]}, {"allowed_amount": 308.82, "billing_code_modifier": [""], "providers": [{"billed_charge": 779.25, "npi": [1508899204]}, {"billed_charge": 333.25, "npi": [1508899204]}]}]}]}, {"name": "Laboratory - Chemistry", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0301", "description": "Laboratory", "allowed_amounts": [{"tin": {"type": "ein", "value": "262037695"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 18.75, "billing_code_modifier": [""], "providers": [{"billed_charge": 293.0, "npi": [1992799050]}]}, {"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 255.0, "npi": [1992799050]}, {"billed_charge": 574.0, "npi": [1992799050]}, {"billed_charge": 229.0, "npi": [1992799050]}, {"billed_charge": 282.0, "npi": [1992799050]}, {"billed_charge": 458.0, "npi": [1992799050]}, {"billed_charge": 231.0, "npi": [1992799050]}, {"billed_charge": 478.0, "npi": [1992799050]}, {"billed_charge": 314.0, "npi": [1992799050]}, {"billed_charge": 533.0, "npi": [1992799050]}, {"billed_charge": 395.0, "npi": [1992799050]}, {"billed_charge": 216.0, "npi": [1992799050]}, {"billed_charge": 150.0, "npi": [1992799050]}]}, {"allowed_amount": 54.96, "billing_code_modifier": [""], "providers": [{"billed_charge": 533.0, "npi": [1992799050]}]}, {"allowed_amount": 11.84, "billing_code_modifier": [""], "providers": [{"billed_charge": 421.0, "npi": [1992799050]}]}]}]}, {"name": "Laboratory - General", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0300", "description": "Laboratory", "allowed_amounts": [{"tin": {"type": "ein", "value": "751047527"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 91.2188, "npi": [1396779948]}, {"billed_charge": 68.0, "npi": [1396779948]}, {"billed_charge": 384.75, "npi": [1396779948]}, {"billed_charge": 273.3696, "npi": [1396779948]}, {"billed_charge": 230.3125, "npi": [1396779948]}, {"billed_charge": 307.65, "npi": [1396779948]}, {"billed_charge": 41.5, "npi": [1396779948]}, {"billed_charge": 164.125, "npi": [1396779948]}, {"billed_charge": 341.75, "npi": [1396779948]}]}]}]}, {"name": "EKG/ECG (Electrocardiogram) - General", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0730", "description": "EKG/ECG (Electrocardiogram)", "allowed_amounts": [{"tin": {"type": "ein", "value": "752890358"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 356.0, "npi": [1548291883]}]}]}]}, {"name": "EMERGENCY DEPARTMENT VISIT HIGH MDM", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "99285", "description": "EMERGENCY DEPARTMENT VISIT HIGH MDM", "allowed_amounts": [{"tin": {"type": "ein", "value": "752684562"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 295.19, "billing_code_modifier": [""], "providers": [{"billed_charge": 1516.0, "npi": [1679151369]}]}]}]}, {"name": "Pharmacy - Extension of 25X - Drug Requiring Detailed Coding", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0636", "description": "Pharmacy - Extension of 25x", "allowed_amounts": [{"tin": {"type": "ein", "value": "756001743"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 8.3338, "npi": [1336172105]}, {"billed_charge": 5.6445, "npi": [1336172105]}, {"billed_charge": 2.025, "npi": [1336172105]}, {"billed_charge": 0.8572, "npi": [1336172105]}, {"billed_charge": 3.42, "npi": [1336172105]}, {"billed_charge": 6.592, "npi": [1336172105]}, {"billed_charge": 4.4672, "npi": [1336172105]}, {"billed_charge": 50.0, "npi": [1336172105]}, {"billed_charge": 3.9175, "npi": [1336172105]}, {"billed_charge": 5.8074, "npi": [1336172105]}, {"billed_charge": 12.5, "npi": [1336172105]}, {"billed_charge": 2.5, "npi": [1336172105]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["U8JZ"], "providers": [{"billed_charge": 10.0, "npi": [1336172105]}, {"billed_charge": 0.5, "npi": [1336172105]}, {"billed_charge": 1.9004, "npi": [1336172105]}, {"billed_charge": 16.33, "npi": [1336172105]}, {"billed_charge": 0.0407, "npi": [1336172105]}, {"billed_charge": 3.27, "npi": [1336172105]}, {"billed_charge": 0.7314, "npi": [1336172105]}, {"billed_charge": 7.5, "npi": [1336172105]}, {"billed_charge": 1.893, "npi": [1336172105]}, {"billed_charge": 5.016, "npi": [1336172105]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["U8JW"], "providers": [{"billed_charge": 9.0, "npi": [1336172105]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["U8"], "providers": [{"billed_charge": 2.728, "npi": [1336172105]}, {"billed_charge": 10.0, "npi": [1336172105]}, {"billed_charge": 0.3584, "npi": [1336172105]}, {"billed_charge": 19.07, "npi": [1336172105]}, {"billed_charge": 0.5, "npi": [1336172105]}, {"billed_charge": 22.6875, "npi": [1336172105]}, {"billed_charge": 6.25, "npi": [1336172105]}, {"billed_charge": 0.5385, "npi": [1336172105]}, {"billed_charge": 37.62, "npi": [1336172105]}, {"billed_charge": 13.73, "npi": [1336172105]}, {"billed_charge": 1.368, "npi": [1336172105]}, {"billed_charge": 5.0, "npi": [1336172105]}, {"billed_charge": 3.75, "npi": [1336172105]}, {"billed_charge": 3.42, "npi": [1336172105]}, {"billed_charge": 50.0, "npi": [1336172105]}, {"billed_charge": 0.125, "npi": [1336172105]}, {"billed_charge": 1.0, "npi": [1336172105]}, {"billed_charge": 12.5, "npi": [1336172105]}, {"billed_charge": 9.0, "npi": [1336172105]}, {"billed_charge": 3.99, "npi": [1336172105]}, {"billed_charge": 0.0365, "npi": [1336172105]}, {"billed_charge": 7.5, "npi": [1336172105]}, {"billed_charge": 0.1, "npi": [1336172105]}, {"billed_charge": 2.5, "npi": [1336172105]}, {"billed_charge": 514.58, "npi": [1336172105]}]}, {"allowed_amount": 0.49, "billing_code_modifier": ["U8JZ"], "providers": [{"billed_charge": 17.1, "npi": [1336172105]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["JZ"], "providers": [{"billed_charge": 0.5, "npi": [1336172105]}, {"billed_charge": 9.0, "npi": [1336172105]}]}, {"allowed_amount": 0.49, "billing_code_modifier": ["TBU8JZ"], "providers": [{"billed_charge": 10.0, "npi": [1336172105]}, {"billed_charge": 17.1, "npi": [1336172105]}]}]}]}, {"name": "Radiology - Diagnostic - General", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0320", "description": "Radiology - Diagnostic", "allowed_amounts": [{"tin": {"type": "ein", "value": "752890358"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 664.25, "npi": [1548291883]}, {"billed_charge": 638.8333, "npi": [1548291883]}]}, {"allowed_amount": 126.14, "billing_code_modifier": [""], "providers": [{"billed_charge": 664.25, "npi": [1548291883]}, {"billed_charge": 792.25, "npi": [1548291883]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["RT"], "providers": [{"billed_charge": 599.5, "npi": [1548291883]}, {"billed_charge": 701.0, "npi": [1548291883]}, {"billed_charge": 644.75, "npi": [1548291883]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["LT"], "providers": [{"billed_charge": 701.0, "npi": [1548291883]}, {"billed_charge": 870.25, "npi": [1548291883]}, {"billed_charge": 644.75, "npi": [1548291883]}, {"billed_charge": 489.25, "npi": [1548291883]}]}]}]}, {"name": "AMBULANCE SERVICE BLS EMERGENCY TRANSPORT", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "A0429", "description": "AMBULANCE SERVICE BLS EMERGENCY TRANSPORT", "allowed_amounts": [{"tin": {"type": "ein", "value": "756000508"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 1455.42, "billing_code_modifier": ["PH"], "providers": [{"billed_charge": 1870.25, "npi": [1861530990]}]}, {"allowed_amount": 1473.0, "billing_code_modifier": ["ETRH"], "providers": [{"billed_charge": 1473.0, "npi": [1861530990]}]}, {"allowed_amount": 1505.08, "billing_code_modifier": ["QL"], "providers": [{"billed_charge": 1658.94, "npi": [1861530990]}]}, {"allowed_amount": 1473.0, "billing_code_modifier": ["SH"], "providers": [{"billed_charge": 1473.0, "npi": [1861530990]}]}, {"allowed_amount": 1475.25, "billing_code_modifier": ["RH"], "providers": [{"billed_charge": 1475.25, "npi": [1861530990]}]}, {"allowed_amount": 1473.0, "billing_code_modifier": ["PH"], "providers": [{"billed_charge": 1473.0, "npi": [1861530990]}]}, {"allowed_amount": 1505.08, "billing_code_modifier": ["RH"], "providers": [{"billed_charge": 1960.17, "npi": [1861530990]}, {"billed_charge": 1870.25, "npi": [1861530990]}, {"billed_charge": 1516.69, "npi": [1861530990]}]}, {"allowed_amount": 1475.25, "billing_code_modifier": ["SH"], "providers": [{"billed_charge": 1475.25, "npi": [1861530990]}]}, {"allowed_amount": 1473.0, "billing_code_modifier": ["RH"], "providers": [{"billed_charge": 1473.0, "npi": [1861530990]}]}, {"allowed_amount": 1505.08, "billing_code_modifier": ["PH"], "providers": [{"billed_charge": 1870.25, "npi": [1861530990]}]}, {"allowed_amount": 125.0, "billing_code_modifier": ["ETRW"], "providers": [{"billed_charge": 125.0, "npi": [1861530990]}]}, {"allowed_amount": 1505.08, "billing_code_modifier": ["SH"], "providers": [{"billed_charge": 1518.94, "npi": [1861530990]}, {"billed_charge": 1870.25, "npi": [1861530990]}, {"billed_charge": 1516.69, "npi": [1861530990]}, {"billed_charge": 1868.0, "npi": [1861530990]}, {"billed_charge": 1911.69, "npi": [1861530990]}]}]}]}, {"name": "Pharmacy - General", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0250", "description": "Pharmacy (also see 063x, an extension of 025x)", "allowed_amounts": [{"tin": {"type": "ein", "value": "750972805"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 2.276, "npi": [1174533343]}, {"billed_charge": 3.1741, "npi": [1174533343]}, {"billed_charge": 2.3325, "npi": [1174533343]}, {"billed_charge": 4.7402, "npi": [1174533343]}, {"billed_charge": 2.9017, "npi": [1174533343]}, {"billed_charge": 10.525, "npi": [1174533343]}, {"billed_charge": 8.2033, "npi": [1174533343]}, {"billed_charge": 9.572, "npi": [1174533343]}, {"billed_charge": 1.0, "npi": [1174533343]}, {"billed_charge": 19.55, "npi": [1174533343]}, {"billed_charge": 12.624, "npi": [1174533343]}, {"billed_charge": 1.2933, "npi": [1174533343]}, {"billed_charge": 4.145, "npi": [1174533343]}, {"billed_charge": 0.25, "npi": [1174533343]}, {"billed_charge": 1.42, "npi": [1174533343]}, {"billed_charge": 1.95, "npi": [1174533343]}, {"billed_charge": 9.5167, "npi": [1174533343]}, {"billed_charge": 7.85, "npi": [1174533343]}, {"billed_charge": 7.585, "npi": [1174533343]}, {"billed_charge": 31.92, "npi": [1174533343]}, {"billed_charge": 8.74, "npi": [1174533343]}, {"billed_charge": 6.69, "npi": [1174533343]}, {"billed_charge": 2.0, "npi": [1174533343]}, {"billed_charge": 6.2983, "npi": [1174533343]}, {"billed_charge": 4.6394, "npi": [1174533343]}, {"billed_charge": 1.4736, "npi": [1174533343]}, {"billed_charge": 2.0211, "npi": [1174533343]}, {"billed_charge": 55.8356, "npi": [1174533343]}]}]}]}, {"name": "Radiology - Diagnostic - General", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0320", "description": "Radiology - Diagnostic", "allowed_amounts": [{"tin": {"type": "ein", "value": "752586857"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 151.54, "billing_code_modifier": [""], "providers": [{"billed_charge": 909.4, "npi": [1992700983]}]}, {"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 464.28, "npi": [1992700983]}, {"billed_charge": 562.56, "npi": [1992700983]}, {"billed_charge": 412.73, "npi": [1992700983]}, {"billed_charge": 726.93, "npi": [1992700983]}, {"billed_charge": 1007.06, "npi": [1992700983]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["RT"], "providers": [{"billed_charge": 529.64, "npi": [1992700983]}, {"billed_charge": 493.42, "npi": [1992700983]}, {"billed_charge": 515.76, "npi": [1992700983]}, {"billed_charge": 529.37, "npi": [1992700983]}, {"billed_charge": 532.06, "npi": [1992700983]}, {"billed_charge": 319.76, "npi": [1992700983]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["50"], "providers": [{"billed_charge": 683.0, "npi": [1992700983]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["LT"], "providers": [{"billed_charge": 511.46, "npi": [1992700983]}, {"billed_charge": 493.74, "npi": [1992700983]}, {"billed_charge": 657.82, "npi": [1992700983]}, {"billed_charge": 510.79, "npi": [1992700983]}, {"billed_charge": 608.85, "npi": [1992700983]}, {"billed_charge": 515.76, "npi": [1992700983]}, {"billed_charge": 503.43, "npi": [1992700983]}, {"billed_charge": 529.37, "npi": [1992700983]}, {"billed_charge": 513.16, "npi": [1992700983]}]}]}]}, {"name": "Laboratory - General", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0300", "description": "Laboratory", "allowed_amounts": [{"tin": {"type": "ein", "value": "750972805"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 164.125, "npi": [1174533343]}, {"billed_charge": 286.75, "npi": [1174533343]}, {"billed_charge": 151.5833, "npi": [1174533343]}, {"billed_charge": 41.5, "npi": [1174533343]}, {"billed_charge": 66.6731, "npi": [1174533343]}, {"billed_charge": 134.25, "npi": [1174533343]}, {"billed_charge": 64.1786, "npi": [1174533343]}, {"billed_charge": 263.4063, "npi": [1174533343]}]}]}]}, {"name": "EKG/ECG (Electrocardiogram) - General", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0730", "description": "EKG/ECG (Electrocardiogram)", "allowed_amounts": [{"tin": {"type": "ein", "value": "756001743"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 356.0, "npi": [1336172105]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["59"], "providers": [{"billed_charge": 356.0, "npi": [1336172105]}]}]}]}, {"name": "INFUS SPL EXT RX INFUS PUMP CASSETTE/BAG", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "A4222", "description": "INFUS SPL EXT RX INFUS PUMP CASSETTE/BAG", "allowed_amounts": [{"tin": {"type": "ein", "value": "853503076"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 368.99, "npi": [1124623889]}]}]}]}, {"name": "Pharmacy - Extension of 25X - Drug Requiring Detailed Coding", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0636", "description": "Pharmacy - Extension of 25x", "allowed_amounts": [{"tin": {"type": "ein", "value": "752586857"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.49, "billing_code_modifier": [""], "providers": [{"billed_charge": 17.1, "npi": [1992700983]}, {"billed_charge": 4.56, "npi": [1992700983]}, {"billed_charge": 3.99, "npi": [1992700983]}, {"billed_charge": 2.76, "npi": [1992700983]}, {"billed_charge": 3.68, "npi": [1992700983]}, {"billed_charge": 1.93, "npi": [1992700983]}, {"billed_charge": 11.97, "npi": [1992700983]}, {"billed_charge": 5.25, "npi": [1992700983]}]}, {"allowed_amount": 0.49, "billing_code_modifier": ["JZ"], "providers": [{"billed_charge": 5.25, "npi": [1992700983]}]}, {"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 18.565, "npi": [1992700983]}, {"billed_charge": 21.35, "npi": [1992700983]}, {"billed_charge": 21.22, "npi": [1992700983]}, {"billed_charge": 173.33, "npi": [1992700983]}, {"billed_charge": 31.55, "npi": [1992700983]}, {"billed_charge": 8.28, "npi": [1992700983]}, {"billed_charge": 6.8129, "npi": [1992700983]}, {"billed_charge": 5.762, "npi": [1992700983]}, {"billed_charge": 18.77, "npi": [1992700983]}, {"billed_charge": 10.592, "npi": [1992700983]}, {"billed_charge": 0.42, "npi": [1992700983]}, {"billed_charge": 20.98, "npi": [1992700983]}, {"billed_charge": 3.535, "npi": [1992700983]}, {"billed_charge": 42.0, "npi": [1992700983]}, {"billed_charge": 0.708, "npi": [1992700983]}, {"billed_charge": 1.059, "npi": [1992700983]}, {"billed_charge": 2.795, "npi": [1992700983]}, {"billed_charge": 1.36, "npi": [1992700983]}, {"billed_charge": 17.49, "npi": [1992700983]}, {"billed_charge": 6.62, "npi": [1992700983]}, {"billed_charge": 1.8, "npi": [1992700983]}, {"billed_charge": 276.85, "npi": [1992700983]}, {"billed_charge": 31.8, "npi": [1992700983]}, {"billed_charge": 0.1488, "npi": [1992700983]}, {"billed_charge": 29.85, "npi": [1992700983]}, {"billed_charge": 7.162, "npi": [1992700983]}, {"billed_charge": 0.3081, "npi": [1992700983]}, {"billed_charge": 19.26, "npi": [1992700983]}, {"billed_charge": 5.395, "npi": [1992700983]}, {"billed_charge": 4.32, "npi": [1992700983]}, {"billed_charge": 0.4716, "npi": [1992700983]}, {"billed_charge": 23.03, "npi": [1992700983]}, {"billed_charge": 1.296, "npi": [1992700983]}, {"billed_charge": 0.2064, "npi": [1992700983]}, {"billed_charge": 1.35, "npi": [1992700983]}, {"billed_charge": 15.24, "npi": [1992700983]}, {"billed_charge": 4.3769, "npi": [1992700983]}, {"billed_charge": 17.82, "npi": [1992700983]}, {"billed_charge": 10.2, "npi": [1992700983]}, {"billed_charge": 0.1256, "npi": [1992700983]}, {"billed_charge": 0.2867, "npi": [1992700983]}, {"billed_charge": 16.44, "npi": [1992700983]}, {"billed_charge": 34.6, "npi": [1992700983]}, {"billed_charge": 173.53, "npi": [1992700983]}, {"billed_charge": 3.4129, "npi": [1992700983]}, {"billed_charge": 7.688, "npi": [1992700983]}, {"billed_charge": 0.3375, "npi": [1992700983]}, {"billed_charge": 3.215, "npi": [1992700983]}, {"billed_charge": 35.96, "npi": [1992700983]}, {"billed_charge": 65.19, "npi": [1992700983]}, {"billed_charge": 18.06, "npi": [1992700983]}, {"billed_charge": 2.68, "npi": [1992700983]}, {"billed_charge": 5.7684, "npi": [1992700983]}, {"billed_charge": 10.49, "npi": [1992700983]}, {"billed_charge": 0.0756, "npi": [1992700983]}, {"billed_charge": 3.74, "npi": [1992700983]}, {"billed_charge": 20.11, "npi": [1992700983]}, {"billed_charge": 0.102, "npi": [1992700983]}, {"billed_charge": 45.3644, "npi": [1992700983]}, {"billed_charge": 0.2952, "npi": [1992700983]}, {"billed_charge": 2.7183, "npi": [1992700983]}, {"billed_charge": 8.1438, "npi": [1992700983]}]}, {"allowed_amount": 0.49, "billing_code_modifier": ["JW"], "providers": [{"billed_charge": 17.1, "npi": [1992700983]}, {"billed_charge": 4.56, "npi": [1992700983]}, {"billed_charge": 6.83, "npi": [1992700983]}, {"billed_charge": 2.76, "npi": [1992700983]}, {"billed_charge": 3.59, "npi": [1992700983]}, {"billed_charge": 5.25, "npi": [1992700983]}, {"billed_charge": 7.41, "npi": [1992700983]}, {"billed_charge": 22.23, "npi": [1992700983]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["U8"], "providers": [{"billed_charge": 17.82, "npi": [1992700983]}]}, {"allowed_amount": 0.495, "billing_code_modifier": ["JZ"], "providers": [{"billed_charge": 17.1, "npi": [1992700983]}, {"billed_charge": 2.76, "npi": [1992700983]}, {"billed_charge": 5.25, "npi": [1992700983]}, {"billed_charge": 14.97, "npi": [1992700983]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["JZ"], "providers": [{"billed_charge": 1.1133, "npi": [1992700983]}, {"billed_charge": 8.75, "npi": [1992700983]}, {"billed_charge": 19.275, "npi": [1992700983]}, {"billed_charge": 4.8, "npi": [1992700983]}, {"billed_charge": 3.18, "npi": [1992700983]}, {"billed_charge": 43.3825, "npi": [1992700983]}, {"billed_charge": 24.176, "npi": [1992700983]}, {"billed_charge": 11.9667, "npi": [1992700983]}, {"billed_charge": 0.75, "npi": [1992700983]}, {"billed_charge": 272.375, "npi": [1992700983]}, {"billed_charge": 0.4594, "npi": [1992700983]}, {"billed_charge": 7.03, "npi": [1992700983]}, {"billed_charge": 11.41, "npi": [1992700983]}, {"billed_charge": 1.772, "npi": [1992700983]}, {"billed_charge": 5.7, "npi": [1992700983]}, {"billed_charge": 1.59, "npi": [1992700983]}, {"billed_charge": 1.925, "npi": [1992700983]}, {"billed_charge": 1.165, "npi": [1992700983]}, {"billed_charge": 17.65, "npi": [1992700983]}, {"billed_charge": 9.03, "npi": [1992700983]}, {"billed_charge": 14.52, "npi": [1992700983]}, {"billed_charge": 29.04, "npi": [1992700983]}, {"billed_charge": 10.62, "npi": [1992700983]}, {"billed_charge": 1.1638, "npi": [1992700983]}, {"billed_charge": 1.02, "npi": [1992700983]}, {"billed_charge": 3.52, "npi": [1992700983]}, {"billed_charge": 3.22, "npi": [1992700983]}, {"billed_charge": 9.19, "npi": [1992700983]}, {"billed_charge": 2.5004, "npi": [1992700983]}, {"billed_charge": 0.5098, "npi": [1992700983]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["JW"], "providers": [{"billed_charge": 1.73, "npi": [1992700983]}, {"billed_charge": 1.8, "npi": [1992700983]}, {"billed_charge": 4.32, "npi": [1992700983]}]}]}]}, {"name": "IV Therapy -General", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0260", "description": "IV Therapy", "allowed_amounts": [{"tin": {"type": "ein", "value": "452694620"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 72.21, "billing_code_modifier": ["XU"], "providers": [{"billed_charge": 431.77, "npi": [1033120423]}]}, {"allowed_amount": 327.99, "billing_code_modifier": ["XU"], "providers": [{"billed_charge": 945.65, "npi": [1033120423]}]}, {"allowed_amount": 72.21, "billing_code_modifier": [""], "providers": [{"billed_charge": 319.34, "npi": [1033120423]}]}, {"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 335.655, "npi": [1033120423]}, {"billed_charge": 285.81, "npi": [1033120423]}, {"billed_charge": 385.5, "npi": [1033120423]}, {"billed_charge": 822.21, "npi": [1033120423]}, {"billed_charge": 945.65, "npi": [1033120423]}, {"billed_charge": 431.77, "npi": [1033120423]}, {"billed_charge": 319.34, "npi": [1033120423]}, {"billed_charge": 367.6933, "npi": [1033120423]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["XU"], "providers": [{"billed_charge": 945.65, "npi": [1033120423]}, {"billed_charge": 431.77, "npi": [1033120423]}]}, {"allowed_amount": 67.99, "billing_code_modifier": ["XU"], "providers": [{"billed_charge": 285.81, "npi": [1033120423]}, {"billed_charge": 431.77, "npi": [1033120423]}]}, {"allowed_amount": 308.82, "billing_code_modifier": ["XU"], "providers": [{"billed_charge": 385.5, "npi": [1033120423]}]}, {"allowed_amount": 67.99, "billing_code_modifier": [""], "providers": [{"billed_charge": 285.81, "npi": [1033120423]}, {"billed_charge": 431.77, "npi": [1033120423]}]}, {"allowed_amount": 308.82, "billing_code_modifier": [""], "providers": [{"billed_charge": 862.59, "npi": [1033120423]}, {"billed_charge": 385.5, "npi": [1033120423]}, {"billed_charge": 945.65, "npi": [1033120423]}]}]}]}, {"name": "Laboratory - Chemistry", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0301", "description": "Laboratory", "allowed_amounts": [{"tin": {"type": "ein", "value": "751037591"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 99.8125, "npi": [1124305065]}, {"billed_charge": 249.74, "npi": [1124305065]}, {"billed_charge": 459.04, "npi": [1124305065]}, {"billed_charge": 243.23, "npi": [1124305065]}, {"billed_charge": 229.02, "npi": [1124305065]}, {"billed_charge": 56.6, "npi": [1124305065]}, {"billed_charge": 217.7, "npi": [1124305065]}, {"billed_charge": 159.62, "npi": [1124305065]}, {"billed_charge": 306.86, "npi": [1124305065]}, {"billed_charge": 869.42, "npi": [1124305065]}, {"billed_charge": 153.91, "npi": [1124305065]}, {"billed_charge": 362.5522, "npi": [1124305065]}, {"billed_charge": 117.24, "npi": [1124305065]}, {"billed_charge": 239.5417, "npi": [1124305065]}, {"billed_charge": 99.5674, "npi": [1124305065]}, {"billed_charge": 185.85, "npi": [1124305065]}, {"billed_charge": 285.79, "npi": [1124305065]}, {"billed_charge": 152.4417, "npi": [1124305065]}, {"billed_charge": 246.3205, "npi": [1124305065]}, {"billed_charge": 407.22, "npi": [1124305065]}, {"billed_charge": 263.64, "npi": [1124305065]}]}, {"allowed_amount": 19.42, "billing_code_modifier": [""], "providers": [{"billed_charge": 328.07, "npi": [1124305065]}]}]}]}, {"name": "Pharmacy - General", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0250", "description": "Pharmacy (also see 063x, an extension of 025x)", "allowed_amounts": [{"tin": {"type": "ein", "value": "472177648"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 33.875, "npi": [1790174860]}, {"billed_charge": 22.775, "npi": [1790174860]}, {"billed_charge": 7.8098, "npi": [1790174860]}, {"billed_charge": 198.35, "npi": [1790174860]}, {"billed_charge": 51.8, "npi": [1790174860]}, {"billed_charge": 10.0, "npi": [1790174860]}, {"billed_charge": 5.1833, "npi": [1790174860]}, {"billed_charge": 35.0143, "npi": [1790174860]}, {"billed_charge": 4.3, "npi": [1790174860]}, {"billed_charge": 22.1, "npi": [1790174860]}, {"billed_charge": 16.6, "npi": [1790174860]}, {"billed_charge": 14.4455, "npi": [1790174860]}, {"billed_charge": 8.0067, "npi": [1790174860]}, {"billed_charge": 5.123, "npi": [1790174860]}, {"billed_charge": 30.0, "npi": [1790174860]}, {"billed_charge": 23.6, "npi": [1790174860]}, {"billed_charge": 201.7667, "npi": [1790174860]}, {"billed_charge": 4.2698, "npi": [1790174860]}, {"billed_charge": 15.7, "npi": [1790174860]}, {"billed_charge": 41.15, "npi": [1790174860]}, {"billed_charge": 248.9667, "npi": [1790174860]}, {"billed_charge": 2.4805, "npi": [1790174860]}, {"billed_charge": 21.275, "npi": [1790174860]}, {"billed_charge": 8.5, "npi": [1790174860]}, {"billed_charge": 145.2, "npi": [1790174860]}, {"billed_charge": 4.547, "npi": [1790174860]}, {"billed_charge": 12.84, "npi": [1790174860]}, {"billed_charge": 0.4, "npi": [1790174860]}, {"billed_charge": 307.35, "npi": [1790174860]}, {"billed_charge": 4.8015, "npi": [1790174860]}, {"billed_charge": 57.0, "npi": [1790174860]}, {"billed_charge": 28.95, "npi": [1790174860]}, {"billed_charge": 30.5, "npi": [1790174860]}, {"billed_charge": 22.99, "npi": [1790174860]}, {"billed_charge": 34.0, "npi": [1790174860]}, {"billed_charge": 25.7, "npi": [1790174860]}, {"billed_charge": 23.387, "npi": [1790174860]}, {"billed_charge": 70.0, "npi": [1790174860]}, {"billed_charge": 4.2872, "npi": [1790174860]}, {"billed_charge": 0.3, "npi": [1790174860]}, {"billed_charge": 5.873, "npi": [1790174860]}, {"billed_charge": 324.9, "npi": [1790174860]}, {"billed_charge": 26.425, "npi": [1790174860]}, {"billed_charge": 69.0, "npi": [1790174860]}, {"billed_charge": 27.0593, "npi": [1790174860]}, {"billed_charge": 15.6333, "npi": [1790174860]}, {"billed_charge": 23.5333, "npi": [1790174860]}, {"billed_charge": 285.6667, "npi": [1790174860]}, {"billed_charge": 10.0797, "npi": [1790174860]}, {"billed_charge": 19.25, "npi": [1790174860]}, {"billed_charge": 3.5, "npi": [1790174860]}, {"billed_charge": 7.0, "npi": [1790174860]}, {"billed_charge": 10.6167, "npi": [1790174860]}, {"billed_charge": 17.3, "npi": [1790174860]}]}]}]}, {"name": "Pharmacy - General", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0250", "description": "Pharmacy (also see 063x, an extension of 025x)", "allowed_amounts": [{"tin": {"type": "ein", "value": "262978009"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 3.12, "npi": [1407010622]}, {"billed_charge": 87.39, "npi": [1619308319]}, {"billed_charge": 2.998, "npi": [1619308319]}, {"billed_charge": 106.12, "npi": [1619308319]}, {"billed_charge": 1.85, "npi": [1407010622]}, {"billed_charge": 5.2, "npi": [1407010622]}, {"billed_charge": 2.08, "npi": [1407010622]}, {"billed_charge": 0.52, "npi": [1407010622]}, {"billed_charge": 0.15, "npi": [1407010622]}, {"billed_charge": 1.04, "npi": [1407010622]}, {"billed_charge": 0.55, "npi": [1407010622]}, {"billed_charge": 10.4, "npi": [1407010622]}, {"billed_charge": 112.36, "npi": [1407010622]}, {"billed_charge": 34.33, "npi": [1619308319]}, {"billed_charge": 0.05, "npi": [1619308319]}, {"billed_charge": 0.47, "npi": [1407010622]}, {"billed_charge": 0.06, "npi": [1407010622]}, {"billed_charge": 2.4115, "npi": [1619308319]}, {"billed_charge": 1.86, "npi": [1407010622]}, {"billed_charge": 1.85, "npi": [1619308319]}, {"billed_charge": 0.05, "npi": [1407010622]}, {"billed_charge": 26.01, "npi": [1407010622]}, {"billed_charge": 0.47, "npi": [1619308319]}, {"billed_charge": 9.36, "npi": [1619308319]}, {"billed_charge": 0.39, "npi": [1407010622]}, {"billed_charge": 0.24, "npi": [1619308319]}, {"billed_charge": 4.16, "npi": [1407010622]}, {"billed_charge": 1.04, "npi": [1619308319]}, {"billed_charge": 10.4, "npi": [1619308319]}, {"billed_charge": 2.08, "npi": [1619308319]}, {"billed_charge": 42.66, "npi": [1619308319]}, {"billed_charge": 3.12, "npi": [1619308319]}, {"billed_charge": 2.6932, "npi": [1619308319]}, {"billed_charge": 106.12, "npi": [1407010622]}, {"billed_charge": 4.16, "npi": [1619308319]}, {"billed_charge": 176.87, "npi": [1407010622]}]}]}]}, {"name": "Laboratory - Urology", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0307", "description": "Laboratory", "allowed_amounts": [{"tin": {"type": "ein", "value": "753175630"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 41.5, "npi": [1285798918]}, {"billed_charge": 51.0, "npi": [1285798918]}, {"billed_charge": 32.0, "npi": [1285798918]}, {"billed_charge": 114.0, "npi": [1285798918]}]}]}]}, {"name": "Pharmacy - General", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0250", "description": "Pharmacy (also see 063x, an extension of 025x)", "allowed_amounts": [{"tin": {"type": "ein", "value": "452694620"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 30.2514, "npi": [1033120423]}, {"billed_charge": 34.7675, "npi": [1033120423]}, {"billed_charge": 42.4633, "npi": [1033120423]}, {"billed_charge": 33.19, "npi": [1033120423]}, {"billed_charge": 54.3092, "npi": [1033120423]}, {"billed_charge": 38.84, "npi": [1033120423]}, {"billed_charge": 50.09, "npi": [1033120423]}, {"billed_charge": 34.41, "npi": [1033120423]}, {"billed_charge": 34.72, "npi": [1033120423]}, {"billed_charge": 41.2769, "npi": [1033120423]}, {"billed_charge": 43.9964, "npi": [1033120423]}, {"billed_charge": 56.5333, "npi": [1033120423]}, {"billed_charge": 54.98, "npi": [1033120423]}, {"billed_charge": 36.3479, "npi": [1033120423]}]}]}]}, {"name": "Pharmacy - General", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0250", "description": "Pharmacy (also see 063x, an extension of 025x)", "allowed_amounts": [{"tin": {"type": "ein", "value": "753175630"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 0.827, "npi": [1285798918]}, {"billed_charge": 110.665, "npi": [1285798918]}, {"billed_charge": 8.3167, "npi": [1285798918]}, {"billed_charge": 4.5561, "npi": [1285798918]}, {"billed_charge": 21.0855, "npi": [1285798918]}, {"billed_charge": 2.1965, "npi": [1285798918]}, {"billed_charge": 8.5343, "npi": [1285798918]}, {"billed_charge": 111.17, "npi": [1285798918]}, {"billed_charge": 60.535, "npi": [1285798918]}, {"billed_charge": 2.2033, "npi": [1285798918]}, {"billed_charge": 5.0664, "npi": [1285798918]}, {"billed_charge": 9.895, "npi": [1285798918]}, {"billed_charge": 7.4515, "npi": [1285798918]}, {"billed_charge": 5.0, "npi": [1285798918]}, {"billed_charge": 1.3483, "npi": [1285798918]}]}]}]}, {"name": "SBSQ INTENSIVE CARE LBW INFANT 1,500-2,500 GRAMS", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "99479", "description": "SBSQ INTENSIVE CARE LBW INFANT 1,500-2,500 GRAMS", "allowed_amounts": [{"tin": {"type": "ein", "value": "752740653"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 184.08, "billing_code_modifier": [""], "providers": [{"billed_charge": 1309.0, "npi": [1255391462]}]}]}]}, {"name": "AMB SERVICE ALS EMERGENCY TRANSPORT LEVEL 1", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "A0427", "description": "AMB SERVICE ALS EMERGENCY TRANSPORT LEVEL 1", "allowed_amounts": [{"tin": {"type": "ein", "value": "756000640"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 1267.5, "billing_code_modifier": ["SH"], "providers": [{"billed_charge": 1267.5, "npi": [1982742698]}]}, {"allowed_amount": 1342.5, "billing_code_modifier": ["PH"], "providers": [{"billed_charge": 1342.5, "npi": [1982742698]}]}, {"allowed_amount": 1192.5, "billing_code_modifier": ["PH"], "providers": [{"billed_charge": 1192.5, "npi": [1982742698]}]}, {"allowed_amount": 1342.5, "billing_code_modifier": ["SH"], "providers": [{"billed_charge": 1342.5, "npi": [1982742698]}]}, {"allowed_amount": 1342.5, "billing_code_modifier": ["RH"], "providers": [{"billed_charge": 1342.5, "npi": [1982742698]}]}, {"allowed_amount": 1192.5, "billing_code_modifier": ["ETRH"], "providers": [{"billed_charge": 1192.5, "npi": [1982742698]}]}, {"allowed_amount": 1192.5, "billing_code_modifier": ["RH"], "providers": [{"billed_charge": 1192.5, "npi": [1982742698]}]}, {"allowed_amount": 1117.5, "billing_code_modifier": ["SH"], "providers": [{"billed_charge": 1117.5, "npi": [1982742698]}]}, {"allowed_amount": 1117.5, "billing_code_modifier": ["RH"], "providers": [{"billed_charge": 1117.5, "npi": [1982742698]}]}, {"allowed_amount": 1192.5, "billing_code_modifier": ["SH"], "providers": [{"billed_charge": 1192.5, "npi": [1982742698]}]}]}]}, {"name": "Radiology - Diagnostic - General", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0320", "description": "Radiology - Diagnostic", "allowed_amounts": [{"tin": {"type": "ein", "value": "750972805"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 676.5, "npi": [1174533343]}, {"billed_charge": 664.25, "npi": [1174533343]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["RT"], "providers": [{"billed_charge": 644.75, "npi": [1174533343]}, {"billed_charge": 511.25, "npi": [1174533343]}, {"billed_charge": 701.0, "npi": [1174533343]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["LT"], "providers": [{"billed_charge": 511.25, "npi": [1174533343]}, {"billed_charge": 701.0, "npi": [1174533343]}]}, {"allowed_amount": 126.34, "billing_code_modifier": [""], "providers": [{"billed_charge": 664.25, "npi": [1174533343]}]}]}]}, {"name": "IV Therapy -General", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0260", "description": "IV Therapy", "allowed_amounts": [{"tin": {"type": "ein", "value": "472177648"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 308.31, "billing_code_modifier": [""], "providers": [{"billed_charge": 1451.0, "npi": [1790174860]}]}, {"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 237.3, "npi": [1790174860]}, {"billed_charge": 1133.0, "npi": [1790174860]}, {"billed_charge": 496.42, "npi": [1790174860]}, {"billed_charge": 287.48, "npi": [1790174860]}, {"billed_charge": 735.0, "npi": [1790174860]}, {"billed_charge": 874.75, "npi": [1790174860]}, {"billed_charge": 472.78, "npi": [1790174860]}, {"billed_charge": 1189.65, "npi": [1790174860]}, {"billed_charge": 1523.55, "npi": [1790174860]}, {"billed_charge": 833.09, "npi": [1790174860]}, {"billed_charge": 771.75, "npi": [1790174860]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["XU"], "providers": [{"billed_charge": 1133.0, "npi": [1790174860]}, {"billed_charge": 1189.65, "npi": [1790174860]}, {"billed_charge": 1523.55, "npi": [1790174860]}, {"billed_charge": 771.75, "npi": [1790174860]}]}, {"allowed_amount": 67.87, "billing_code_modifier": [""], "providers": [{"billed_charge": 226.0, "npi": [1790174860]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["59"], "providers": [{"billed_charge": 1189.65, "npi": [1790174860]}]}]}]}, {"name": "Occupational Therapy - Evaluation or Reevaluation", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0434", "description": "Occupational Therapy", "allowed_amounts": [{"tin": {"type": "ein", "value": "751837454"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 623.53, "npi": [1447250253]}, {"billed_charge": 447.07, "npi": [1447250253]}, {"billed_charge": 586.75, "npi": [1447250253]}]}, {"allowed_amount": 146.1, "billing_code_modifier": ["GO"], "providers": [{"billed_charge": 447.07, "npi": [1447250253]}]}]}]}, {"name": "Preventive Care Services - Vaccine Administration", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0771", "description": "Preventive Care Services", "allowed_amounts": [{"tin": {"type": "ein", "value": "751837454"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 129.54, "npi": [1447250253]}, {"billed_charge": 13.75, "npi": [1447250253]}, {"billed_charge": 111.62, "npi": [1447250253]}, {"billed_charge": 120.58, "npi": [1447250253]}]}, {"allowed_amount": 104.36, "billing_code_modifier": [""], "providers": [{"billed_charge": 129.54, "npi": [1447250253]}]}]}]}, {"name": "Laboratory - Urology", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0307", "description": "Laboratory", "allowed_amounts": [{"tin": {"type": "ein", "value": "752770738"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 187.0, "npi": [1770514077]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["59"], "providers": [{"billed_charge": 187.0, "npi": [1770514077]}]}]}]}, {"name": "Laboratory - General", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0300", "description": "Laboratory", "allowed_amounts": [{"tin": {"type": "ein", "value": "751977850"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 286.75, "npi": [1396778064]}, {"billed_charge": 41.5, "npi": [1396778064]}, {"billed_charge": 134.25, "npi": [1396778064]}]}]}]}, {"name": "Radiology - Diagnostic - General", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0320", "description": "Radiology - Diagnostic", "allowed_amounts": [{"tin": {"type": "ein", "value": "756001743"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 909.0, "npi": [1336172105]}, {"billed_charge": 631.5, "npi": [1336172105]}, {"billed_charge": 644.75, "npi": [1336172105]}, {"billed_charge": 932.5, "npi": [1336172105]}, {"billed_charge": 1606.9167, "npi": [1336172105]}, {"billed_charge": 664.25, "npi": [1336172105]}, {"billed_charge": 618.1667, "npi": [1336172105]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["LT77"], "providers": [{"billed_charge": 870.25, "npi": [1336172105]}]}, {"allowed_amount": 126.14, "billing_code_modifier": [""], "providers": [{"billed_charge": 792.25, "npi": [1336172105]}, {"billed_charge": 664.25, "npi": [1336172105]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["RT"], "providers": [{"billed_charge": 870.25, "npi": [1336172105]}, {"billed_charge": 701.0, "npi": [1336172105]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["LT"], "providers": [{"billed_charge": 644.75, "npi": [1336172105]}, {"billed_charge": 870.25, "npi": [1336172105]}, {"billed_charge": 489.25, "npi": [1336172105]}, {"billed_charge": 701.0, "npi": [1336172105]}]}]}]}, {"name": "Physical Therapy - General", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0420", "description": "Physical Therapy", "allowed_amounts": [{"tin": {"type": "ein", "value": "751837454"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 206.3208, "npi": [1447250253]}, {"billed_charge": 200.8579, "npi": [1447250253]}, {"billed_charge": 203.6882, "npi": [1447250253]}, {"billed_charge": 204.7967, "npi": [1447250253]}, {"billed_charge": 200.116, "npi": [1447250253]}, {"billed_charge": 202.7317, "npi": [1447250253]}, {"billed_charge": 200.8633, "npi": [1447250253]}, {"billed_charge": 204.1083, "npi": [1447250253]}, {"billed_charge": 204.6, "npi": [1447250253]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["GP"], "providers": [{"billed_charge": 204.6, "npi": [1447250253]}]}]}]}, {"name": "Laboratory - Bacteriology & Microbiology", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0306", "description": "Laboratory", "allowed_amounts": [{"tin": {"type": "ein", "value": "260194016"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 206.81, "billing_code_modifier": [""], "providers": [{"billed_charge": 174.88, "npi": [1205018439]}]}, {"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 357.84, "npi": [1205018439]}, {"billed_charge": 465.18, "npi": [1205018439]}, {"billed_charge": 298.8467, "npi": [1205018439]}, {"billed_charge": 285.48, "npi": [1205018439]}, {"billed_charge": 241.82, "npi": [1205018439]}, {"billed_charge": 125.99, "npi": [1205018439]}, {"billed_charge": 448.72, "npi": [1205018439]}, {"billed_charge": 218.1367, "npi": [1205018439]}, {"billed_charge": 123.65, "npi": [1205018439]}, {"billed_charge": 310.9156, "npi": [1205018439]}, {"billed_charge": 215.5, "npi": [1205018439]}, {"billed_charge": 142.75, "npi": [1205018439]}, {"billed_charge": 199.29, "npi": [1205018439]}, {"billed_charge": 1425.75, "npi": [1205018439]}, {"billed_charge": 340.52, "npi": [1205018439]}]}, {"allowed_amount": 148.49, "billing_code_modifier": [""], "providers": [{"billed_charge": 102.41, "npi": [1205018439]}]}]}]}, {"name": "SBSQ HOSPITAL IP/OBS CARE MOD MDM 35 MINUTES", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "99232", "description": "SBSQ HOSPITAL IP/OBS CARE MOD MDM 35 MINUTES", "allowed_amounts": [{"tin": {"type": "ein", "value": "273837459"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 84.3, "billing_code_modifier": [""], "providers": [{"billed_charge": 138.0, "npi": [1932281342]}]}]}]}, {"name": "Laboratory - Urology", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0307", "description": "Laboratory", "allowed_amounts": [{"tin": {"type": "ein", "value": "472177648"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 189.6, "npi": [1790174860]}, {"billed_charge": 199.08, "npi": [1790174860]}, {"billed_charge": 197.4, "npi": [1790174860]}, {"billed_charge": 248.77, "npi": [1790174860]}, {"billed_charge": 236.92, "npi": [1790174860]}, {"billed_charge": 188.0, "npi": [1790174860]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["59"], "providers": [{"billed_charge": 197.4, "npi": [1790174860]}, {"billed_charge": 248.77, "npi": [1790174860]}, {"billed_charge": 236.92, "npi": [1790174860]}, {"billed_charge": 188.0, "npi": [1790174860]}]}]}]}, {"name": "GROUND MILEAGE PER STATUTE MILE", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "A0425", "description": "GROUND MILEAGE PER STATUTE MILE", "allowed_amounts": [{"tin": {"type": "ein", "value": "264304912"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 35.0, "billing_code_modifier": ["RH"], "providers": [{"billed_charge": 35.0, "npi": [1871724864]}]}, {"allowed_amount": 30.325, "billing_code_modifier": ["SH"], "providers": [{"billed_charge": 35.0, "npi": [1871724864]}]}, {"allowed_amount": 35.0, "billing_code_modifier": ["SH"], "providers": [{"billed_charge": 35.0, "npi": [1871724864]}]}, {"allowed_amount": 30.32, "billing_code_modifier": [""], "providers": [{"billed_charge": 35.0, "npi": [1871724864]}]}, {"allowed_amount": 30.3229, "billing_code_modifier": ["HH"], "providers": [{"billed_charge": 35.0, "npi": [1871724864]}]}, {"allowed_amount": 30.3227, "billing_code_modifier": ["RH"], "providers": [{"billed_charge": 35.0, "npi": [1871724864]}]}, {"allowed_amount": 30.3226, "billing_code_modifier": ["RH"], "providers": [{"billed_charge": 35.0, "npi": [1871724864]}]}, {"allowed_amount": 30.3225, "billing_code_modifier": ["RH"], "providers": [{"billed_charge": 35.0, "npi": [1871724864]}]}, {"allowed_amount": 30.3224, "billing_code_modifier": ["RH"], "providers": [{"billed_charge": 35.0, "npi": [1871724864]}]}, {"allowed_amount": 30.3226, "billing_code_modifier": ["SH"], "providers": [{"billed_charge": 35.0, "npi": [1871724864]}]}, {"allowed_amount": 30.3222, "billing_code_modifier": ["RH"], "providers": [{"billed_charge": 35.0, "npi": [1871724864]}]}, {"allowed_amount": 30.3225, "billing_code_modifier": ["HH"], "providers": [{"billed_charge": 35.0, "npi": [1871724864]}]}, {"allowed_amount": 30.3222, "billing_code_modifier": ["ETSH"], "providers": [{"billed_charge": 35.0, "npi": [1871724864]}]}]}]}, {"name": "SCREENING DIGITAL BREAST TOMOSYNTHESIS BI", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "77063", "description": "SCREENING DIGITAL BREAST TOMOSYNTHESIS BI", "allowed_amounts": [{"tin": {"type": "ein", "value": "203324726"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 33.28, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 75.0, "npi": [1831199546]}]}]}]}, {"name": "Laboratory - General", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0300", "description": "Laboratory", "allowed_amounts": [{"tin": {"type": "ein", "value": "472177648"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 98.02, "npi": [1790174860]}, {"billed_charge": 102.93, "npi": [1790174860]}]}, {"allowed_amount": 13.54, "billing_code_modifier": [""], "providers": [{"billed_charge": 102.93, "npi": [1790174860]}]}]}]}, {"name": "Laboratory - General", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0300", "description": "Laboratory", "allowed_amounts": [{"tin": {"type": "ein", "value": "751837454"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 59.0483, "npi": [1447250253]}, {"billed_charge": 214.91, "npi": [1447250253]}, {"billed_charge": 40.0, "npi": [1447250253]}, {"billed_charge": 220.305, "npi": [1447250253]}, {"billed_charge": 95.5, "npi": [1447250253]}, {"billed_charge": 132.09, "npi": [1447250253]}, {"billed_charge": 115.222, "npi": [1447250253]}, {"billed_charge": 143.25, "npi": [1447250253]}, {"billed_charge": 137.196, "npi": [1447250253]}, {"billed_charge": 178.0269, "npi": [1447250253]}, {"billed_charge": 90.8888, "npi": [1447250253]}, {"billed_charge": 67.1407, "npi": [1447250253]}, {"billed_charge": 62.3611, "npi": [1447250253]}, {"billed_charge": 89.525, "npi": [1447250253]}, {"billed_charge": 68.6375, "npi": [1447250253]}, {"billed_charge": 155.3952, "npi": [1447250253]}, {"billed_charge": 125.7612, "npi": [1447250253]}, {"billed_charge": 100.38, "npi": [1447250253]}, {"billed_charge": 241.8554, "npi": [1447250253]}, {"billed_charge": 85.3757, "npi": [1447250253]}, {"billed_charge": 175.2288, "npi": [1447250253]}, {"billed_charge": 160.2033, "npi": [1447250253]}, {"billed_charge": 62.91, "npi": [1447250253]}, {"billed_charge": 162.7867, "npi": [1447250253]}, {"billed_charge": 58.2708, "npi": [1447250253]}, {"billed_charge": 90.4725, "npi": [1447250253]}, {"billed_charge": 93.59, "npi": [1447250253]}, {"billed_charge": 203.57, "npi": [1447250253]}, {"billed_charge": 191.5458, "npi": [1447250253]}, {"billed_charge": 66.4922, "npi": [1447250253]}, {"billed_charge": 113.672, "npi": [1447250253]}, {"billed_charge": 190.9202, "npi": [1447250253]}, {"billed_charge": 161.4847, "npi": [1447250253]}, {"billed_charge": 102.0056, "npi": [1447250253]}, {"billed_charge": 97.0514, "npi": [1447250253]}, {"billed_charge": 216.2671, "npi": [1447250253]}, {"billed_charge": 211.0, "npi": [1447250253]}, {"billed_charge": 45.1667, "npi": [1447250253]}, {"billed_charge": 161.495, "npi": [1447250253]}, {"billed_charge": 392.86, "npi": [1447250253]}, {"billed_charge": 185.794, "npi": [1447250253]}, {"billed_charge": 202.1247, "npi": [1447250253]}, {"billed_charge": 178.9381, "npi": [1447250253]}, {"billed_charge": 131.1213, "npi": [1447250253]}, {"billed_charge": 160.4975, "npi": [1447250253]}, {"billed_charge": 225.591, "npi": [1447250253]}, {"billed_charge": 47.75, "npi": [1447250253]}, {"billed_charge": 91.63, "npi": [1447250253]}, {"billed_charge": 254.816, "npi": [1447250253]}, {"billed_charge": 128.0545, "npi": [1447250253]}, {"billed_charge": 174.0793, "npi": [1447250253]}]}]}]}, {"name": "Emergency Room - General", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0450", "description": "Emergency Room", "allowed_amounts": [{"tin": {"type": "ein", "value": "751777119"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 317.78, "npi": [1073511762]}, {"billed_charge": 500.62, "npi": [1073511762]}, {"billed_charge": 1788.61, "npi": [1073511762]}, {"billed_charge": 3879.67, "npi": [1073511762]}]}, {"allowed_amount": 222.92, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 782.31, "npi": [1073511762]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["XU"], "providers": [{"billed_charge": 524.33, "npi": [1073511762]}, {"billed_charge": 500.62, "npi": [1073511762]}]}, {"allowed_amount": 3797.35, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 3879.67, "npi": [1073511762]}]}, {"allowed_amount": 605.81, "billing_code_modifier": [""], "providers": [{"billed_charge": 2122.8, "npi": [1073511762]}]}, {"allowed_amount": 308.82, "billing_code_modifier": ["XU"], "providers": [{"billed_charge": 902.11, "npi": [1073511762]}]}, {"allowed_amount": 605.81, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 2122.8, "npi": [1073511762]}]}, {"allowed_amount": 396.31, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 1283.4, "npi": [1073511762]}]}, {"allowed_amount": 222.92, "billing_code_modifier": [""], "providers": [{"billed_charge": 782.31, "npi": [1073511762]}]}, {"allowed_amount": 67.99, "billing_code_modifier": [""], "providers": [{"billed_charge": 392.06, "npi": [1073511762]}]}, {"allowed_amount": 308.82, "billing_code_modifier": [""], "providers": [{"billed_charge": 814.34, "npi": [1073511762]}, {"billed_charge": 902.11, "npi": [1073511762]}]}, {"allowed_amount": 1199.27, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 4233.71, "npi": [1073511762]}]}]}]}, {"name": "Behavioral Health Treatments/Services - Partial Hospitalizat", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0912", "description": "Behavioral Health Treatments/Services - Extension of 090x", "allowed_amounts": [{"tin": {"type": "ein", "value": "834188451"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 765.0, "npi": [1922642040]}]}]}]}, {"name": "Radiology - Diagnostic - Chest X-Ray", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0324", "description": "Radiology - Diagnostic", "allowed_amounts": [{"tin": {"type": "ein", "value": "752586857"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 366.74, "npi": [1992700983]}, {"billed_charge": 656.37, "npi": [1992700983]}]}, {"allowed_amount": 126.14, "billing_code_modifier": [""], "providers": [{"billed_charge": 366.74, "npi": [1992700983]}, {"billed_charge": 656.37, "npi": [1992700983]}]}]}]}, {"name": "Laboratory - Hematology", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0305", "description": "Laboratory", "allowed_amounts": [{"tin": {"type": "ein", "value": "752770738"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 145.75, "npi": [1770514077]}, {"billed_charge": 208.75, "npi": [1770514077]}, {"billed_charge": 233.5, "npi": [1770514077]}, {"billed_charge": 226.5, "npi": [1770514077]}, {"billed_charge": 706.5, "npi": [1770514077]}, {"billed_charge": 206.5, "npi": [1770514077]}, {"billed_charge": 225.25, "npi": [1770514077]}, {"billed_charge": 229.9643, "npi": [1770514077]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["91"], "providers": [{"billed_charge": 109.5, "npi": [1770514077]}]}]}]}, {"name": "CT Scan - Body Scan", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0352", "description": "CT Scan", "allowed_amounts": [{"tin": {"type": "ein", "value": "751844139"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 151.54, "billing_code_modifier": [""], "providers": [{"billed_charge": 2800.19, "npi": [1265430177]}]}, {"allowed_amount": 151.54, "billing_code_modifier": ["RT"], "providers": [{"billed_charge": 2858.93, "npi": [1265430177]}]}, {"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 6484.35, "npi": [1265430177]}, {"billed_charge": 4912.095, "npi": [1265430177]}, {"billed_charge": 6743.72, "npi": [1265430177]}, {"billed_charge": 2800.19, "npi": [1265430177]}, {"billed_charge": 5896.8, "npi": [1265430177]}, {"billed_charge": 6290.97, "npi": [1265430177]}]}, {"allowed_amount": 254.23, "billing_code_modifier": [""], "providers": [{"billed_charge": 3339.84, "npi": [1265430177]}]}, {"allowed_amount": 345.85, "billing_code_modifier": [""], "providers": [{"billed_charge": 5896.8, "npi": [1265430177]}]}, {"allowed_amount": 505.67, "billing_code_modifier": [""], "providers": [{"billed_charge": 9294.97, "npi": [1265430177]}, {"billed_charge": 6484.35, "npi": [1265430177]}]}]}]}, {"name": "Laboratory - Urology", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0307", "description": "Laboratory", "allowed_amounts": [{"tin": {"type": "ein", "value": "751844139"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 129.78, "npi": [1265430177]}, {"billed_charge": 162.16, "npi": [1265430177]}, {"billed_charge": 134.97, "npi": [1265430177]}, {"billed_charge": 83.58, "npi": [1265430177]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["XU"], "providers": [{"billed_charge": 129.78, "npi": [1265430177]}]}]}]}, {"name": "Laboratory - General", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0300", "description": "Laboratory", "allowed_amounts": [{"tin": {"type": "ein", "value": "751008430"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 220.305, "npi": [1669472387]}, {"billed_charge": 190.9, "npi": [1669472387]}, {"billed_charge": 49.66, "npi": [1669472387]}, {"billed_charge": 392.86, "npi": [1669472387]}, {"billed_charge": 408.57, "npi": [1669472387]}, {"billed_charge": 47.75, "npi": [1669472387]}, {"billed_charge": 172.7694, "npi": [1669472387]}]}]}]}, {"name": "Radiology - Diagnostic - General", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0320", "description": "Radiology - Diagnostic", "allowed_amounts": [{"tin": {"type": "ein", "value": "824052186"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 412.73, "npi": [1801826839]}, {"billed_charge": 451.4, "npi": [1801826839]}, {"billed_charge": 542.99, "npi": [1801826839]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["RT"], "providers": [{"billed_charge": 511.46, "npi": [1801826839]}, {"billed_charge": 493.74, "npi": [1801826839]}, {"billed_charge": 532.06, "npi": [1801826839]}, {"billed_charge": 543.14, "npi": [1801826839]}, {"billed_charge": 608.85, "npi": [1801826839]}, {"billed_charge": 515.76, "npi": [1801826839]}, {"billed_charge": 510.79, "npi": [1801826839]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["LT"], "providers": [{"billed_charge": 532.06, "npi": [1801826839]}, {"billed_charge": 515.76, "npi": [1801826839]}, {"billed_charge": 484.07, "npi": [1801826839]}, {"billed_charge": 510.79, "npi": [1801826839]}, {"billed_charge": 529.37, "npi": [1801826839]}]}]}]}, {"name": "Pulmonary Function - General", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0460", "description": "Pulmonary Function", "allowed_amounts": [{"tin": {"type": "ein", "value": "752586857"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 323.88, "npi": [1992700983]}, {"billed_charge": 241.602, "npi": [1992700983]}, {"billed_charge": 186.75, "npi": [1992700983]}, {"billed_charge": 296.454, "npi": [1992700983]}]}]}]}, {"name": "SBSQ HOSPITAL IP/OBS CARE HIGH MDM 50 MINUTES", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "99233", "description": "SBSQ HOSPITAL IP/OBS CARE HIGH MDM 50 MINUTES", "allowed_amounts": [{"tin": {"type": "ein", "value": "752903739"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 126.29, "billing_code_modifier": [""], "providers": [{"billed_charge": 270.0, "npi": [1710900527]}]}]}]}, {"name": "Laboratory - Hematology", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0305", "description": "Laboratory", "allowed_amounts": [{"tin": {"type": "ein", "value": "452694620"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 240.62, "npi": [1033120423]}, {"billed_charge": 265.15, "npi": [1033120423]}, {"billed_charge": 169.2033, "npi": [1033120423]}, {"billed_charge": 245.4872, "npi": [1033120423]}, {"billed_charge": 186.366, "npi": [1033120423]}, {"billed_charge": 270.8817, "npi": [1033120423]}, {"billed_charge": 237.4233, "npi": [1033120423]}, {"billed_charge": 223.56, "npi": [1033120423]}, {"billed_charge": 215.56, "npi": [1033120423]}, {"billed_charge": 75.99, "npi": [1033120423]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["QW"], "providers": [{"billed_charge": 265.15, "npi": [1033120423]}]}]}]}, {"name": "EKG/ECG (Electrocardiogram) - General", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0730", "description": "EKG/ECG (Electrocardiogram)", "allowed_amounts": [{"tin": {"type": "ein", "value": "751844139"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 453.2, "npi": [1265430177]}]}]}]}, {"name": "Laboratory - Immunology", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0302", "description": "Laboratory", "allowed_amounts": [{"tin": {"type": "ein", "value": "751844139"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 313.7, "npi": [1265430177]}, {"billed_charge": 160.26, "npi": [1265430177]}, {"billed_charge": 171.97, "npi": [1265430177]}, {"billed_charge": 228.91, "npi": [1265430177]}, {"billed_charge": 169.31, "npi": [1265430177]}, {"billed_charge": 184.458, "npi": [1265430177]}, {"billed_charge": 127.41, "npi": [1265430177]}]}]}]}, {"name": "GROUND MILEAGE PER STATUTE MILE", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "A0425", "description": "GROUND MILEAGE PER STATUTE MILE", "allowed_amounts": [{"tin": {"type": "ein", "value": "752474011"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 20.01, "billing_code_modifier": ["RH"], "providers": [{"billed_charge": 22.03, "npi": [1881628014]}]}, {"allowed_amount": 19.62, "billing_code_modifier": ["RH"], "providers": [{"billed_charge": 22.03, "npi": [1881628014]}]}, {"allowed_amount": 20.0111, "billing_code_modifier": ["ETSH"], "providers": [{"billed_charge": 24.4778, "npi": [1881628014]}]}, {"allowed_amount": 20.01, "billing_code_modifier": ["HH"], "providers": [{"billed_charge": 22.03, "npi": [1881628014]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["RH"], "providers": [{"billed_charge": 22.03, "npi": [1881628014]}]}, {"allowed_amount": 20.0111, "billing_code_modifier": ["ETEH"], "providers": [{"billed_charge": 24.4778, "npi": [1881628014]}]}, {"allowed_amount": 20.01, "billing_code_modifier": ["RHET"], "providers": [{"billed_charge": 22.03, "npi": [1881628014]}]}, {"allowed_amount": 19.62, "billing_code_modifier": ["NH"], "providers": [{"billed_charge": 22.03, "npi": [1881628014]}]}, {"allowed_amount": 20.0103, "billing_code_modifier": ["ETRH"], "providers": [{"billed_charge": 22.5949, "npi": [1881628014]}]}, {"allowed_amount": 20.01, "billing_code_modifier": ["SH"], "providers": [{"billed_charge": 22.03, "npi": [1881628014]}]}, {"allowed_amount": 20.01, "billing_code_modifier": ["EH"], "providers": [{"billed_charge": 22.03, "npi": [1881628014]}]}]}]}, {"name": "Radiology - Diagnostic - General", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0320", "description": "Radiology - Diagnostic", "allowed_amounts": [{"tin": {"type": "ein", "value": "751837454"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 151.54, "billing_code_modifier": [""], "providers": [{"billed_charge": 909.4, "npi": [1447250253]}]}, {"allowed_amount": 126.14, "billing_code_modifier": ["LT"], "providers": [{"billed_charge": 455.33, "npi": [1447250253]}]}, {"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 773.0, "npi": [1447250253]}, {"billed_charge": 2001.51, "npi": [1447250253]}, {"billed_charge": 638.725, "npi": [1447250253]}, {"billed_charge": 529.64, "npi": [1447250253]}, {"billed_charge": 463.7343, "npi": [1447250253]}, {"billed_charge": 602.926, "npi": [1447250253]}, {"billed_charge": 507.04, "npi": [1447250253]}, {"billed_charge": 532.06, "npi": [1447250253]}, {"billed_charge": 670.0483, "npi": [1447250253]}, {"billed_charge": 909.4, "npi": [1447250253]}, {"billed_charge": 608.85, "npi": [1447250253]}, {"billed_charge": 535.3214, "npi": [1447250253]}, {"billed_charge": 412.73, "npi": [1447250253]}, {"billed_charge": 464.28, "npi": [1447250253]}, {"billed_charge": 709.895, "npi": [1447250253]}, {"billed_charge": 444.0105, "npi": [1447250253]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["RT76"], "providers": [{"billed_charge": 455.33, "npi": [1447250253]}]}, {"allowed_amount": 126.14, "billing_code_modifier": ["50"], "providers": [{"billed_charge": 683.0, "npi": [1447250253]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["RT"], "providers": [{"billed_charge": 515.76, "npi": [1447250253]}, {"billed_charge": 529.64, "npi": [1447250253]}, {"billed_charge": 511.46, "npi": [1447250253]}, {"billed_charge": 515.52, "npi": [1447250253]}, {"billed_charge": 532.06, "npi": [1447250253]}, {"billed_charge": 543.14, "npi": [1447250253]}, {"billed_charge": 493.42, "npi": [1447250253]}, {"billed_charge": 486.57, "npi": [1447250253]}, {"billed_charge": 493.74, "npi": [1447250253]}, {"billed_charge": 484.07, "npi": [1447250253]}, {"billed_charge": 608.85, "npi": [1447250253]}, {"billed_charge": 510.79, "npi": [1447250253]}, {"billed_charge": 455.33, "npi": [1447250253]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["50"], "providers": [{"billed_charge": 794.46, "npi": [1447250253]}, {"billed_charge": 798.09, "npi": [1447250253]}, {"billed_charge": 773.28, "npi": [1447250253]}, {"billed_charge": 766.19, "npi": [1447250253]}, {"billed_charge": 726.11, "npi": [1447250253]}, {"billed_charge": 683.0, "npi": [1447250253]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["LT"], "providers": [{"billed_charge": 515.76, "npi": [1447250253]}, {"billed_charge": 529.64, "npi": [1447250253]}, {"billed_charge": 362.58, "npi": [1447250253]}, {"billed_charge": 511.46, "npi": [1447250253]}, {"billed_charge": 486.95, "npi": [1447250253]}, {"billed_charge": 532.06, "npi": [1447250253]}, {"billed_charge": 363.38, "npi": [1447250253]}, {"billed_charge": 493.42, "npi": [1447250253]}, {"billed_charge": 529.37, "npi": [1447250253]}, {"billed_charge": 657.82, "npi": [1447250253]}, {"billed_charge": 493.74, "npi": [1447250253]}, {"billed_charge": 608.85, "npi": [1447250253]}, {"billed_charge": 510.79, "npi": [1447250253]}, {"billed_charge": 455.33, "npi": [1447250253]}]}]}]}, {"name": "Laboratory - Chemistry", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0301", "description": "Laboratory", "allowed_amounts": [{"tin": {"type": "ein", "value": "751438726"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 248.9861, "npi": [1104845015]}, {"billed_charge": 335.75, "npi": [1104845015]}, {"billed_charge": 324.5, "npi": [1104845015]}, {"billed_charge": 225.75, "npi": [1104845015]}, {"billed_charge": 565.0, "npi": [1104845015]}, {"billed_charge": 49.25, "npi": [1104845015]}, {"billed_charge": 191.3814, "npi": [1104845015]}, {"billed_charge": 209.2446, "npi": [1104845015]}, {"billed_charge": 231.0, "npi": [1104845015]}, {"billed_charge": 442.5, "npi": [1104845015]}, {"billed_charge": 278.25, "npi": [1104845015]}, {"billed_charge": 153.5, "npi": [1104845015]}, {"billed_charge": 679.25, "npi": [1104845015]}, {"billed_charge": 1474.5, "npi": [1104845015]}]}, {"allowed_amount": 19.42, "billing_code_modifier": [""], "providers": [{"billed_charge": 679.25, "npi": [1104845015]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["91"], "providers": [{"billed_charge": 49.25, "npi": [1104845015]}]}]}]}, {"name": "Laboratory - Bacteriology & Microbiology", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0306", "description": "Laboratory", "allowed_amounts": [{"tin": {"type": "ein", "value": "751047527"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 303.25, "npi": [1396779948]}, {"billed_charge": 225.25, "npi": [1396779948]}, {"billed_charge": 582.75, "npi": [1396779948]}, {"billed_charge": 410.6667, "npi": [1396779948]}, {"billed_charge": 399.5, "npi": [1396779948]}, {"billed_charge": 333.1667, "npi": [1396779948]}, {"billed_charge": 244.5, "npi": [1396779948]}, {"billed_charge": 158.5, "npi": [1396779948]}, {"billed_charge": 310.3333, "npi": [1396779948]}, {"billed_charge": 536.25, "npi": [1396779948]}, {"billed_charge": 441.1827, "npi": [1396779948]}, {"billed_charge": 317.75, "npi": [1396779948]}, {"billed_charge": 320.4375, "npi": [1396779948]}, {"billed_charge": 474.0, "npi": [1396779948]}, {"billed_charge": 637.75, "npi": [1396779948]}, {"billed_charge": 364.0, "npi": [1396779948]}, {"billed_charge": 414.5, "npi": [1396779948]}]}, {"allowed_amount": 74.4, "billing_code_modifier": [""], "providers": [{"billed_charge": 225.25, "npi": [1396779948]}]}]}]}, {"name": "Laboratory - Bacteriology & Microbiology", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0306", "description": "Laboratory", "allowed_amounts": [{"tin": {"type": "ein", "value": "752586857"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 206.81, "billing_code_modifier": [""], "providers": [{"billed_charge": 174.88, "npi": [1992700983]}]}, {"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 285.48, "npi": [1992700983]}, {"billed_charge": 448.72, "npi": [1992700983]}, {"billed_charge": 125.99, "npi": [1992700983]}, {"billed_charge": 282.44, "npi": [1992700983]}, {"billed_charge": 361.38, "npi": [1992700983]}, {"billed_charge": 123.65, "npi": [1992700983]}, {"billed_charge": 346.77, "npi": [1992700983]}, {"billed_charge": 298.8467, "npi": [1992700983]}, {"billed_charge": 358.3117, "npi": [1992700983]}, {"billed_charge": 174.15, "npi": [1992700983]}, {"billed_charge": 196.9, "npi": [1992700983]}, {"billed_charge": 197.09, "npi": [1992700983]}, {"billed_charge": 146.91, "npi": [1992700983]}, {"billed_charge": 304.4867, "npi": [1992700983]}, {"billed_charge": 142.75, "npi": [1992700983]}, {"billed_charge": 465.18, "npi": [1992700983]}, {"billed_charge": 357.84, "npi": [1992700983]}, {"billed_charge": 340.52, "npi": [1992700983]}, {"billed_charge": 215.5, "npi": [1992700983]}]}, {"allowed_amount": 148.49, "billing_code_modifier": [""], "providers": [{"billed_charge": 102.41, "npi": [1992700983]}]}]}]}, {"name": "Laboratory - Chemistry", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0301", "description": "Laboratory", "allowed_amounts": [{"tin": {"type": "ein", "value": "202848116"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 410.0, "npi": [1629138029]}, {"billed_charge": 561.75, "npi": [1629138029]}, {"billed_charge": 49.25, "npi": [1629138029]}, {"billed_charge": 225.75, "npi": [1629138029]}, {"billed_charge": 153.5, "npi": [1629138029]}, {"billed_charge": 679.25, "npi": [1629138029]}, {"billed_charge": 340.0, "npi": [1629138029]}, {"billed_charge": 362.913, "npi": [1629138029]}, {"billed_charge": 671.0, "npi": [1629138029]}, {"billed_charge": 324.5, "npi": [1629138029]}, {"billed_charge": 565.0, "npi": [1629138029]}, {"billed_charge": 278.25, "npi": [1629138029]}, {"billed_charge": 224.1848, "npi": [1629138029]}, {"billed_charge": 229.25, "npi": [1629138029]}, {"billed_charge": 408.3929, "npi": [1629138029]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["91"], "providers": [{"billed_charge": 49.25, "npi": [1629138029]}]}]}]}, {"name": "IV Therapy -General", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0260", "description": "IV Therapy", "allowed_amounts": [{"tin": {"type": "ein", "value": "752586857"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 393.07, "npi": [1992700983]}, {"billed_charge": 902.11, "npi": [1992700983]}, {"billed_charge": 392.06, "npi": [1992700983]}, {"billed_charge": 524.33, "npi": [1992700983]}, {"billed_charge": 361.12, "npi": [1992700983]}, {"billed_charge": 317.78, "npi": [1992700983]}, {"billed_charge": 330.56, "npi": [1992700983]}]}, {"allowed_amount": 67.875, "billing_code_modifier": [""], "providers": [{"billed_charge": 330.56, "npi": [1992700983]}]}, {"allowed_amount": 67.875, "billing_code_modifier": ["XU"], "providers": [{"billed_charge": 317.78, "npi": [1992700983]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["XU"], "providers": [{"billed_charge": 902.11, "npi": [1992700983]}, {"billed_charge": 392.06, "npi": [1992700983]}, {"billed_charge": 361.12, "npi": [1992700983]}, {"billed_charge": 330.56, "npi": [1992700983]}]}, {"allowed_amount": 67.8733, "billing_code_modifier": ["XU"], "providers": [{"billed_charge": 330.56, "npi": [1992700983]}]}, {"allowed_amount": 67.87, "billing_code_modifier": [""], "providers": [{"billed_charge": 330.56, "npi": [1992700983]}]}, {"allowed_amount": 308.31, "billing_code_modifier": ["XU"], "providers": [{"billed_charge": 902.11, "npi": [1992700983]}]}]}]}, {"name": "Laboratory - Chemistry", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0301", "description": "Laboratory", "allowed_amounts": [{"tin": {"type": "ein", "value": "472177648"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 701.0, "npi": [1790174860]}, {"billed_charge": 486.33, "npi": [1790174860]}, {"billed_charge": 325.68, "npi": [1790174860]}, {"billed_charge": 492.046, "npi": [1790174860]}, {"billed_charge": 281.5, "npi": [1790174860]}, {"billed_charge": 762.48, "npi": [1790174860]}, {"billed_charge": 748.12, "npi": [1790174860]}, {"billed_charge": 450.7753, "npi": [1790174860]}, {"billed_charge": 772.11, "npi": [1790174860]}, {"billed_charge": 798.0, "npi": [1790174860]}, {"billed_charge": 277.03, "npi": [1790174860]}, {"billed_charge": 351.0, "npi": [1790174860]}, {"billed_charge": 303.1966, "npi": [1790174860]}, {"billed_charge": 917.1, "npi": [1790174860]}, {"billed_charge": 410.55, "npi": [1790174860]}, {"billed_charge": 760.0, "npi": [1790174860]}, {"billed_charge": 397.0, "npi": [1790174860]}, {"billed_charge": 445.0, "npi": [1790174860]}, {"billed_charge": 295.58, "npi": [1790174860]}, {"billed_charge": 917.96, "npi": [1790174860]}, {"billed_charge": 363.3, "npi": [1790174860]}, {"billed_charge": 185.85, "npi": [1790174860]}, {"billed_charge": 245.7267, "npi": [1790174860]}, {"billed_charge": 921.95, "npi": [1790174860]}, {"billed_charge": 864.89, "npi": [1790174860]}, {"billed_charge": 416.85, "npi": [1790174860]}, {"billed_charge": 148.0, "npi": [1790174860]}, {"billed_charge": 525.8215, "npi": [1790174860]}, {"billed_charge": 365.6, "npi": [1790174860]}, {"billed_charge": 657.2309, "npi": [1790174860]}, {"billed_charge": 284.55, "npi": [1790174860]}, {"billed_charge": 346.5, "npi": [1790174860]}, {"billed_charge": 155.4, "npi": [1790174860]}, {"billed_charge": 962.96, "npi": [1790174860]}, {"billed_charge": 878.04, "npi": [1790174860]}, {"billed_charge": 271.0, "npi": [1790174860]}, {"billed_charge": 205.0, "npi": [1790174860]}, {"billed_charge": 510.65, "npi": [1790174860]}, {"billed_charge": 557.0992, "npi": [1790174860]}, {"billed_charge": 385.56, "npi": [1790174860]}, {"billed_charge": 800.61, "npi": [1790174860]}, {"billed_charge": 712.49, "npi": [1790174860]}, {"billed_charge": 706.47, "npi": [1790174860]}, {"billed_charge": 341.97, "npi": [1790174860]}, {"billed_charge": 874.24, "npi": [1790174860]}, {"billed_charge": 330.0, "npi": [1790174860]}, {"billed_charge": 215.25, "npi": [1790174860]}]}, {"allowed_amount": 19.42, "billing_code_modifier": [""], "providers": [{"billed_charge": 619.85, "npi": [1790174860]}, {"billed_charge": 590.33, "npi": [1790174860]}]}, {"allowed_amount": 6.35, "billing_code_modifier": [""], "providers": [{"billed_charge": 87.0, "npi": [1790174860]}]}, {"allowed_amount": 10.68, "billing_code_modifier": [""], "providers": [{"billed_charge": 619.85, "npi": [1790174860]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["91"], "providers": [{"billed_charge": 397.0, "npi": [1790174860]}, {"billed_charge": 416.85, "npi": [1790174860]}, {"billed_charge": 148.0, "npi": [1790174860]}, {"billed_charge": 155.4, "npi": [1790174860]}, {"billed_charge": 205.0, "npi": [1790174860]}, {"billed_charge": 138.6, "npi": [1790174860]}]}, {"allowed_amount": 15.31, "billing_code_modifier": [""], "providers": [{"billed_charge": 962.96, "npi": [1790174860]}]}]}]}, {"name": "Pharmacy - Extension of 25X - Drug Requiring Detailed Coding", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0636", "description": "Pharmacy - Extension of 25x", "allowed_amounts": [{"tin": {"type": "ein", "value": "831954982"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.49, "billing_code_modifier": ["JZ"], "providers": [{"billed_charge": 10.0, "npi": [1104381292]}]}, {"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 22.08, "npi": [1104381292]}, {"billed_charge": 50.0, "npi": [1104381292]}, {"billed_charge": 1.0, "npi": [1104381292]}, {"billed_charge": 10.0, "npi": [1104381292]}, {"billed_charge": 0.837, "npi": [1104381292]}, {"billed_charge": 2.5, "npi": [1104381292]}, {"billed_charge": 12.5, "npi": [1104381292]}, {"billed_charge": 3.99, "npi": [1104381292]}]}, {"allowed_amount": 0.495, "billing_code_modifier": ["JZ"], "providers": [{"billed_charge": 5.0, "npi": [1104381292]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["JZ"], "providers": [{"billed_charge": 0.5, "npi": [1104381292]}, {"billed_charge": 9.0, "npi": [1104381292]}, {"billed_charge": 16.11, "npi": [1104381292]}, {"billed_charge": 16.33, "npi": [1104381292]}, {"billed_charge": 2.018, "npi": [1104381292]}]}]}]}, {"name": "Pharmacy - Extension of 25X - Drug Requiring Detailed Coding", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0636", "description": "Pharmacy - Extension of 25x", "allowed_amounts": [{"tin": {"type": "ein", "value": "432008974"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.49, "billing_code_modifier": ["JZ"], "providers": [{"billed_charge": 10.0, "npi": [1003883158]}]}, {"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 0.6692, "npi": [1003883158]}, {"billed_charge": 0.25, "npi": [1003883158]}, {"billed_charge": 10.0, "npi": [1003883158]}, {"billed_charge": 0.1277, "npi": [1003883158]}, {"billed_charge": 8.7569, "npi": [1003883158]}, {"billed_charge": 2.8153, "npi": [1003883158]}, {"billed_charge": 41.04, "npi": [1003883158]}, {"billed_charge": 22.8, "npi": [1003883158]}, {"billed_charge": 5.985, "npi": [1003883158]}, {"billed_charge": 2.5, "npi": [1003883158]}, {"billed_charge": 64.35, "npi": [1003883158]}, {"billed_charge": 12.5, "npi": [1003883158]}, {"billed_charge": 50.0, "npi": [1003883158]}, {"billed_charge": 11.04, "npi": [1003883158]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["JZ"], "providers": [{"billed_charge": 16.33, "npi": [1003883158]}, {"billed_charge": 9.0, "npi": [1003883158]}, {"billed_charge": 0.5, "npi": [1003883158]}]}]}]}, {"name": "Pharmacy - Extension of 25X - Drug Requiring Detailed Coding", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0636", "description": "Pharmacy - Extension of 25x", "allowed_amounts": [{"tin": {"type": "ein", "value": "260194016"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.49, "billing_code_modifier": ["JZ"], "providers": [{"billed_charge": 5.46, "npi": [1205018439]}, {"billed_charge": 4.04, "npi": [1205018439]}, {"billed_charge": 6.06, "npi": [1205018439]}]}, {"allowed_amount": 0.49, "billing_code_modifier": [""], "providers": [{"billed_charge": 2.76, "npi": [1205018439]}, {"billed_charge": 5.25, "npi": [1205018439]}, {"billed_charge": 5.46, "npi": [1205018439]}]}, {"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 29.28, "npi": [1205018439]}, {"billed_charge": 17.7, "npi": [1205018439]}, {"billed_charge": 3.6375, "npi": [1205018439]}, {"billed_charge": 22.4515, "npi": [1205018439]}, {"billed_charge": 1.5697, "npi": [1205018439]}, {"billed_charge": 0.0684, "npi": [1205018439]}, {"billed_charge": 42.0, "npi": [1205018439]}, {"billed_charge": 3.535, "npi": [1205018439]}, {"billed_charge": 31.55, "npi": [1205018439]}, {"billed_charge": 3.74, "npi": [1205018439]}, {"billed_charge": 10.592, "npi": [1205018439]}, {"billed_charge": 17.68, "npi": [1205018439]}, {"billed_charge": 7.45, "npi": [1205018439]}, {"billed_charge": 17.0469, "npi": [1205018439]}, {"billed_charge": 0.3775, "npi": [1205018439]}, {"billed_charge": 0.2064, "npi": [1205018439]}, {"billed_charge": 0.901, "npi": [1205018439]}, {"billed_charge": 36.0, "npi": [1205018439]}, {"billed_charge": 2.795, "npi": [1205018439]}, {"billed_charge": 5.4, "npi": [1205018439]}, {"billed_charge": 20.35, "npi": [1205018439]}, {"billed_charge": 0.2159, "npi": [1205018439]}, {"billed_charge": 18.06, "npi": [1205018439]}, {"billed_charge": 23.22, "npi": [1205018439]}, {"billed_charge": 0.857, "npi": [1205018439]}, {"billed_charge": 11.395, "npi": [1205018439]}, {"billed_charge": 1.0048, "npi": [1205018439]}, {"billed_charge": 12.52, "npi": [1205018439]}, {"billed_charge": 17.82, "npi": [1205018439]}, {"billed_charge": 18.77, "npi": [1205018439]}, {"billed_charge": 0.708, "npi": [1205018439]}, {"billed_charge": 6.25, "npi": [1205018439]}, {"billed_charge": 0.939, "npi": [1205018439]}]}, {"allowed_amount": 0.49, "billing_code_modifier": ["JW"], "providers": [{"billed_charge": 2.76, "npi": [1205018439]}, {"billed_charge": 5.25, "npi": [1205018439]}]}, {"allowed_amount": 0.495, "billing_code_modifier": ["JZ"], "providers": [{"billed_charge": 2.76, "npi": [1205018439]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["JZ"], "providers": [{"billed_charge": 0.0675, "npi": [1205018439]}, {"billed_charge": 0.9, "npi": [1205018439]}, {"billed_charge": 22.58, "npi": [1205018439]}, {"billed_charge": 10.0, "npi": [1205018439]}, {"billed_charge": 1.02, "npi": [1205018439]}, {"billed_charge": 1.35, "npi": [1205018439]}, {"billed_charge": 1.67, "npi": [1205018439]}, {"billed_charge": 3.35, "npi": [1205018439]}, {"billed_charge": 1.925, "npi": [1205018439]}, {"billed_charge": 3.18, "npi": [1205018439]}, {"billed_charge": 20.77, "npi": [1205018439]}, {"billed_charge": 4.23, "npi": [1205018439]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["JW"], "providers": [{"billed_charge": 2.76, "npi": [1205018439]}]}]}]}, {"name": "CT Scan - General", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0350", "description": "CT Scan", "allowed_amounts": [{"tin": {"type": "ein", "value": "756001743"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 151.54, "billing_code_modifier": [""], "providers": [{"billed_charge": 4150.0, "npi": [1336172105]}]}, {"allowed_amount": 320.73, "billing_code_modifier": [""], "providers": [{"billed_charge": 4150.0, "npi": [1336172105]}]}, {"allowed_amount": 622.69, "billing_code_modifier": [""], "providers": [{"billed_charge": 6795.5, "npi": [1336172105]}, {"billed_charge": 4150.0, "npi": [1336172105]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["U6"], "providers": [{"billed_charge": 6795.5, "npi": [1336172105]}]}, {"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 6795.5, "npi": [1336172105]}, {"billed_charge": 5817.25, "npi": [1336172105]}, {"billed_charge": 4150.0, "npi": [1336172105]}]}, {"allowed_amount": 345.85, "billing_code_modifier": [""], "providers": [{"billed_charge": 5817.25, "npi": [1336172105]}]}, {"allowed_amount": 622.69, "billing_code_modifier": ["U6"], "providers": [{"billed_charge": 4150.0, "npi": [1336172105]}]}, {"allowed_amount": 505.67, "billing_code_modifier": [""], "providers": [{"billed_charge": 6795.5, "npi": [1336172105]}]}, {"allowed_amount": 254.23, "billing_code_modifier": ["LT"], "providers": [{"billed_charge": 7167.75, "npi": [1336172105]}]}]}]}, {"name": "CHIROPRACTIC MANIPULATIVE TX SPINAL 3-4 REGIONS", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "98941", "description": "CHIROPRACTIC MANIPULATIVE TX SPINAL 3-4 REGIONS", "allowed_amounts": [{"tin": {"type": "ein", "value": "830673541"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 46.21, "billing_code_modifier": [""], "providers": [{"billed_charge": 92.0, "npi": [1336892173]}, {"billed_charge": 92.0, "npi": [1164122420]}]}, {"allowed_amount": 46.21, "billing_code_modifier": ["AT"], "providers": [{"billed_charge": 92.0, "npi": [1336892173]}, {"billed_charge": 92.0, "npi": [1164122420]}]}]}]}, {"name": "IAADIADOO INFLUENZA", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "87804", "description": "IAADIADOO INFLUENZA", "allowed_amounts": [{"tin": {"type": "ein", "value": "853503076"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": ["QW59"], "providers": [{"billed_charge": 342.53, "npi": [1124623889]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["QW"], "providers": [{"billed_charge": 342.53, "npi": [1124623889]}]}]}]}, {"name": "Laboratory - Hematology", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0305", "description": "Laboratory", "allowed_amounts": [{"tin": {"type": "ein", "value": "752890358"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 233.5, "npi": [1548291883]}, {"billed_charge": 208.75, "npi": [1548291883]}, {"billed_charge": 206.5, "npi": [1548291883]}, {"billed_charge": 216.1071, "npi": [1548291883]}, {"billed_charge": 226.5, "npi": [1548291883]}, {"billed_charge": 706.5, "npi": [1548291883]}, {"billed_charge": 230.75, "npi": [1548291883]}]}]}]}, {"name": "Laboratory - Hematology", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0305", "description": "Laboratory", "allowed_amounts": [{"tin": {"type": "ein", "value": "753175630"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 71.0, "npi": [1285798918]}, {"billed_charge": 99.6, "npi": [1285798918]}, {"billed_charge": 119.0, "npi": [1285798918]}, {"billed_charge": 108.0, "npi": [1285798918]}, {"billed_charge": 49.0, "npi": [1285798918]}, {"billed_charge": 117.0, "npi": [1285798918]}, {"billed_charge": 176.0, "npi": [1285798918]}, {"billed_charge": 78.7, "npi": [1285798918]}, {"billed_charge": 110.0, "npi": [1285798918]}, {"billed_charge": 106.5, "npi": [1285798918]}]}, {"allowed_amount": 11.27, "billing_code_modifier": [""], "providers": [{"billed_charge": 119.0, "npi": [1285798918]}]}]}]}, {"name": "Radiology - Diagnostic - Chest X-Ray", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0324", "description": "Radiology - Diagnostic", "allowed_amounts": [{"tin": {"type": "ein", "value": "751837454"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 511.555, "npi": [1447250253]}, {"billed_charge": 366.74, "npi": [1447250253]}]}, {"allowed_amount": 126.14, "billing_code_modifier": [""], "providers": [{"billed_charge": 656.37, "npi": [1447250253]}, {"billed_charge": 366.74, "npi": [1447250253]}]}, {"allowed_amount": 94.61, "billing_code_modifier": [""], "providers": [{"billed_charge": 366.74, "npi": [1447250253]}]}]}]}, {"name": "SERVICES PROVIDED BTW 10 PM AND 8 AM AT 24-HR FACI", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "99053", "description": "SERVICES PROVIDED BTW 10 PM AND 8 AM AT 24-HR FACI", "allowed_amounts": [{"tin": {"type": "ein", "value": "751286819"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 45.0, "npi": [1811307259]}, {"billed_charge": 45.0, "npi": [1780902593]}]}]}]}, {"name": "Emergency Room - General", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0450", "description": "Emergency Room", "allowed_amounts": [{"tin": {"type": "ein", "value": "452694620"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 3886.45, "npi": [1033120423]}, {"billed_charge": 8264.08, "npi": [1033120423]}, {"billed_charge": 586.58, "npi": [1033120423]}]}, {"allowed_amount": 396.31, "billing_code_modifier": [""], "providers": [{"billed_charge": 1551.97, "npi": [1033120423]}]}, {"allowed_amount": 3797.35, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 3886.45, "npi": [1033120423]}]}, {"allowed_amount": 864.64, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 3886.45, "npi": [1033120423]}, {"billed_charge": 8264.08, "npi": [1033120423]}]}, {"allowed_amount": 122.42, "billing_code_modifier": [""], "providers": [{"billed_charge": 510.19, "npi": [1033120423]}]}, {"allowed_amount": 605.81, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 2804.94, "npi": [1033120423]}]}, {"allowed_amount": 3797.35, "billing_code_modifier": [""], "providers": [{"billed_charge": 8264.08, "npi": [1033120423]}]}, {"allowed_amount": 222.92, "billing_code_modifier": [""], "providers": [{"billed_charge": 868.32, "npi": [1033120423]}]}]}]}, {"name": "Respiratory Services - General", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0410", "description": "Respiratory Services", "allowed_amounts": [{"tin": {"type": "ein", "value": "751837454"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 459.836, "npi": [1447250253]}, {"billed_charge": 2978.89, "npi": [1447250253]}, {"billed_charge": 2559.905, "npi": [1447250253]}, {"billed_charge": 329.3008, "npi": [1447250253]}, {"billed_charge": 379.3787, "npi": [1447250253]}, {"billed_charge": 345.88, "npi": [1447250253]}, {"billed_charge": 344.6371, "npi": [1447250253]}, {"billed_charge": 584.868, "npi": [1447250253]}, {"billed_charge": 339.15, "npi": [1447250253]}, {"billed_charge": 3140.09, "npi": [1447250253]}, {"billed_charge": 309.8821, "npi": [1447250253]}, {"billed_charge": 2258.73, "npi": [1447250253]}, {"billed_charge": 1546.01, "npi": [1447250253]}]}]}]}, {"name": "Laboratory - Urology", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0307", "description": "Laboratory", "allowed_amounts": [{"tin": {"type": "ein", "value": "752586857"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 134.97, "npi": [1992700983]}, {"billed_charge": 168.65, "npi": [1992700983]}, {"billed_charge": 83.58, "npi": [1992700983]}, {"billed_charge": 162.16, "npi": [1992700983]}, {"billed_charge": 129.78, "npi": [1992700983]}]}]}]}, {"name": "Laboratory - Hematology", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0305", "description": "Laboratory", "allowed_amounts": [{"tin": {"type": "ein", "value": "751977850"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 206.5, "npi": [1396778064]}, {"billed_charge": 208.75, "npi": [1396778064]}, {"billed_charge": 233.5, "npi": [1396778064]}, {"billed_charge": 706.5, "npi": [1396778064]}, {"billed_charge": 226.5, "npi": [1396778064]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["91"], "providers": [{"billed_charge": 109.5, "npi": [1396778064]}]}]}]}, {"name": "Pharmacy - Extension of 25X - Drug Requiring Detailed Coding", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0636", "description": "Pharmacy - Extension of 25x", "allowed_amounts": [{"tin": {"type": "ein", "value": "751748586"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.49, "billing_code_modifier": [""], "providers": [{"billed_charge": 10.0, "npi": [1508899204]}]}, {"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 0.2563, "npi": [1508899204]}, {"billed_charge": 7.5, "npi": [1508899204]}, {"billed_charge": 12.5, "npi": [1508899204]}, {"billed_charge": 186.78, "npi": [1508899204]}, {"billed_charge": 0.5385, "npi": [1508899204]}, {"billed_charge": 2.0, "npi": [1508899204]}, {"billed_charge": 13.66, "npi": [1508899204]}, {"billed_charge": 22.6875, "npi": [1508899204]}, {"billed_charge": 51.69, "npi": [1508899204]}, {"billed_charge": 1.0, "npi": [1508899204]}, {"billed_charge": 15.0, "npi": [1508899204]}, {"billed_charge": 10.0, "npi": [1508899204]}, {"billed_charge": 12.54, "npi": [1508899204]}, {"billed_charge": 50.0, "npi": [1508899204]}, {"billed_charge": 9.0, "npi": [1508899204]}, {"billed_charge": 11.04, "npi": [1508899204]}, {"billed_charge": 13.73, "npi": [1508899204]}, {"billed_charge": 0.1278, "npi": [1508899204]}, {"billed_charge": 0.1373, "npi": [1508899204]}, {"billed_charge": 0.125, "npi": [1508899204]}, {"billed_charge": 84.0, "npi": [1508899204]}, {"billed_charge": 3.42, "npi": [1508899204]}, {"billed_charge": 12.12, "npi": [1508899204]}, {"billed_charge": 2.5, "npi": [1508899204]}, {"billed_charge": 22.69, "npi": [1508899204]}, {"billed_charge": 34.2, "npi": [1508899204]}]}, {"allowed_amount": 0.49, "billing_code_modifier": ["JW"], "providers": [{"billed_charge": 10.0, "npi": [1508899204]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["JZ"], "providers": [{"billed_charge": 0.5, "npi": [1508899204]}, {"billed_charge": 9.0, "npi": [1508899204]}, {"billed_charge": 1.4844, "npi": [1508899204]}, {"billed_charge": 0.2602, "npi": [1508899204]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["JW"], "providers": [{"billed_charge": 1.0, "npi": [1508899204]}]}]}]}, {"name": "Radiology - Diagnostic - General", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0320", "description": "Radiology - Diagnostic", "allowed_amounts": [{"tin": {"type": "ein", "value": "750800628"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 503.4, "billing_code_modifier": ["RT"], "providers": [{"billed_charge": 839.0, "npi": [1194743013]}, {"billed_charge": 839.0, "npi": [1720480627]}]}, {"allowed_amount": 442.2, "billing_code_modifier": ["LT"], "providers": [{"billed_charge": 737.0, "npi": [1720480627]}]}, {"allowed_amount": 373.2, "billing_code_modifier": ["RT"], "providers": [{"billed_charge": 622.0, "npi": [1194743013]}, {"billed_charge": 622.0, "npi": [1720480627]}]}, {"allowed_amount": 411.0, "billing_code_modifier": ["LT"], "providers": [{"billed_charge": 685.0, "npi": [1720480627]}]}, {"allowed_amount": 412.2, "billing_code_modifier": ["RT"], "providers": [{"billed_charge": 687.0, "npi": [1720480627]}, {"billed_charge": 687.0, "npi": [1194743013]}]}, {"allowed_amount": 373.2, "billing_code_modifier": ["LT"], "providers": [{"billed_charge": 622.0, "npi": [1720480627]}, {"billed_charge": 622.0, "npi": [1194743013]}]}, {"allowed_amount": 396.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 660.0, "npi": [1194743013]}, {"billed_charge": 660.0, "npi": [1720480627]}]}, {"allowed_amount": 411.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 685.0, "npi": [1194743013]}]}, {"allowed_amount": 424.8, "billing_code_modifier": [""], "providers": [{"billed_charge": 708.0, "npi": [1194743013]}]}, {"allowed_amount": 311.4, "billing_code_modifier": [""], "providers": [{"billed_charge": 519.0, "npi": [1194743013]}]}, {"allowed_amount": 493.8, "billing_code_modifier": ["XU"], "providers": [{"billed_charge": 823.0, "npi": [1194743013]}]}, {"allowed_amount": 334.8, "billing_code_modifier": ["RT"], "providers": [{"billed_charge": 558.0, "npi": [1720480627]}, {"billed_charge": 558.0, "npi": [1194743013]}]}, {"allowed_amount": 385.8, "billing_code_modifier": ["RT"], "providers": [{"billed_charge": 643.0, "npi": [1720480627]}]}, {"allowed_amount": 413.4, "billing_code_modifier": [""], "providers": [{"billed_charge": 689.0, "npi": [1720480627]}, {"billed_charge": 689.0, "npi": [1194743013]}]}, {"allowed_amount": 403.8, "billing_code_modifier": ["RT"], "providers": [{"billed_charge": 673.0, "npi": [1720480627]}]}, {"allowed_amount": 319.8, "billing_code_modifier": ["LT"], "providers": [{"billed_charge": 533.0, "npi": [1194743013]}]}, {"allowed_amount": 442.2, "billing_code_modifier": ["RT"], "providers": [{"billed_charge": 737.0, "npi": [1194743013]}]}, {"allowed_amount": 412.2, "billing_code_modifier": ["LT"], "providers": [{"billed_charge": 687.0, "npi": [1720480627]}]}, {"allowed_amount": 205.26, "billing_code_modifier": ["LT"], "providers": [{"billed_charge": 622.0, "npi": [1720480627]}]}, {"allowed_amount": 516.2, "billing_code_modifier": [""], "providers": [{"billed_charge": 860.3333, "npi": [1194743013]}]}, {"allowed_amount": 276.87, "billing_code_modifier": ["LT"], "providers": [{"billed_charge": 839.0, "npi": [1720480627]}]}, {"allowed_amount": 503.4, "billing_code_modifier": ["LT"], "providers": [{"billed_charge": 839.0, "npi": [1194743013]}, {"billed_charge": 839.0, "npi": [1720480627]}]}, {"allowed_amount": 330.6, "billing_code_modifier": ["LT"], "providers": [{"billed_charge": 551.0, "npi": [1720480627]}]}]}]}, {"name": "Pharmacy - Drugs Incident to Radiology", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0255", "description": "Pharmacy (also see 063x, an extension of 025x)", "allowed_amounts": [{"tin": {"type": "ein", "value": "751837454"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 4.6283, "npi": [1447250253]}, {"billed_charge": 4.059, "npi": [1447250253]}, {"billed_charge": 4.5366, "npi": [1447250253]}, {"billed_charge": 6.773, "npi": [1447250253]}, {"billed_charge": 4.288, "npi": [1447250253]}, {"billed_charge": 783.285, "npi": [1447250253]}, {"billed_charge": 4.5435, "npi": [1447250253]}, {"billed_charge": 9.6977, "npi": [1447250253]}, {"billed_charge": 4.1606, "npi": [1447250253]}, {"billed_charge": 4.0163, "npi": [1447250253]}, {"billed_charge": 4.5315, "npi": [1447250253]}, {"billed_charge": 4.908, "npi": [1447250253]}, {"billed_charge": 4.5405, "npi": [1447250253]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["JZ"], "providers": [{"billed_charge": 4.059, "npi": [1447250253]}, {"billed_charge": 4.5406, "npi": [1447250253]}, {"billed_charge": 783.285, "npi": [1447250253]}, {"billed_charge": 4.5315, "npi": [1447250253]}, {"billed_charge": 4.5405, "npi": [1447250253]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["JW"], "providers": [{"billed_charge": 4.5407, "npi": [1447250253]}, {"billed_charge": 4.532, "npi": [1447250253]}, {"billed_charge": 4.5405, "npi": [1447250253]}]}]}]}, {"name": "Pharmacy - Extension of 25X - Drug Requiring Detailed Coding", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0636", "description": "Pharmacy - Extension of 25x", "allowed_amounts": [{"tin": {"type": "ein", "value": "472177648"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.49, "billing_code_modifier": [""], "providers": [{"billed_charge": 34.2, "npi": [1790174860]}]}, {"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 4.575, "npi": [1790174860]}, {"billed_charge": 18.0, "npi": [1790174860]}, {"billed_charge": 5.08, "npi": [1790174860]}, {"billed_charge": 2.59, "npi": [1790174860]}, {"billed_charge": 8.45, "npi": [1790174860]}, {"billed_charge": 1.44, "npi": [1790174860]}, {"billed_charge": 0.12, "npi": [1790174860]}, {"billed_charge": 4.35, "npi": [1790174860]}, {"billed_charge": 16.8, "npi": [1790174860]}, {"billed_charge": 16.0, "npi": [1790174860]}, {"billed_charge": 8.65, "npi": [1790174860]}, {"billed_charge": 3.625, "npi": [1790174860]}, {"billed_charge": 9.9, "npi": [1790174860]}, {"billed_charge": 0.6, "npi": [1790174860]}, {"billed_charge": 2.575, "npi": [1790174860]}, {"billed_charge": 9.1, "npi": [1790174860]}, {"billed_charge": 30.0, "npi": [1790174860]}, {"billed_charge": 1.8, "npi": [1790174860]}, {"billed_charge": 12.11, "npi": [1790174860]}, {"billed_charge": 60.0, "npi": [1790174860]}, {"billed_charge": 50.2, "npi": [1790174860]}, {"billed_charge": 29.5, "npi": [1790174860]}, {"billed_charge": 114.875, "npi": [1790174860]}, {"billed_charge": 10.867, "npi": [1790174860]}, {"billed_charge": 1.4455, "npi": [1790174860]}, {"billed_charge": 4.44, "npi": [1790174860]}, {"billed_charge": 6.05, "npi": [1790174860]}, {"billed_charge": 70.0, "npi": [1790174860]}, {"billed_charge": 0.115, "npi": [1790174860]}, {"billed_charge": 40.0, "npi": [1790174860]}, {"billed_charge": 7.85, "npi": [1790174860]}, {"billed_charge": 33.0, "npi": [1790174860]}, {"billed_charge": 3.8667, "npi": [1790174860]}, {"billed_charge": 43.0, "npi": [1790174860]}, {"billed_charge": 16.5, "npi": [1790174860]}, {"billed_charge": 0.222, "npi": [1790174860]}, {"billed_charge": 8.64, "npi": [1790174860]}, {"billed_charge": 57.8, "npi": [1790174860]}, {"billed_charge": 290.9, "npi": [1790174860]}, {"billed_charge": 3.6, "npi": [1790174860]}, {"billed_charge": 12.7, "npi": [1790174860]}, {"billed_charge": 4.75, "npi": [1790174860]}, {"billed_charge": 7.0, "npi": [1790174860]}, {"billed_charge": 6.4, "npi": [1790174860]}, {"billed_charge": 6.3, "npi": [1790174860]}]}, {"allowed_amount": 0.49, "billing_code_modifier": ["JW"], "providers": [{"billed_charge": 34.2, "npi": [1790174860]}]}, {"allowed_amount": 0.495, "billing_code_modifier": ["JZ"], "providers": [{"billed_charge": 10.5, "npi": [1790174860]}, {"billed_charge": 34.2, "npi": [1790174860]}]}, {"allowed_amount": 0.4925, "billing_code_modifier": ["JZ"], "providers": [{"billed_charge": 34.2, "npi": [1790174860]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["JZ"], "providers": [{"billed_charge": 15.0, "npi": [1790174860]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["JW"], "providers": [{"billed_charge": 18.0, "npi": [1790174860]}, {"billed_charge": 2.59, "npi": [1790174860]}, {"billed_charge": 11.2667, "npi": [1790174860]}, {"billed_charge": 8.65, "npi": [1790174860]}, {"billed_charge": 1.4444, "npi": [1790174860]}]}]}]}, {"name": "Pharmacy - General", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0250", "description": "Pharmacy (also see 063x, an extension of 025x)", "allowed_amounts": [{"tin": {"type": "ein", "value": "621789402"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 17.7167, "npi": [1700805678]}, {"billed_charge": 263.8, "npi": [1700805678]}, {"billed_charge": 13.5, "npi": [1700805678]}, {"billed_charge": 9.275, "npi": [1700805678]}, {"billed_charge": 23.0385, "npi": [1700805678]}, {"billed_charge": 38.7, "npi": [1700805678]}, {"billed_charge": 13.0409, "npi": [1700805678]}, {"billed_charge": 19.1857, "npi": [1700805678]}, {"billed_charge": 10.0, "npi": [1700805678]}, {"billed_charge": 20.632, "npi": [1700805678]}, {"billed_charge": 17.2474, "npi": [1700805678]}, {"billed_charge": 12.0609, "npi": [1700805678]}, {"billed_charge": 7.0, "npi": [1700805678]}, {"billed_charge": 3.6167, "npi": [1700805678]}, {"billed_charge": 28.1231, "npi": [1700805678]}, {"billed_charge": 57.5667, "npi": [1700805678]}, {"billed_charge": 11.9955, "npi": [1700805678]}, {"billed_charge": 42.8, "npi": [1700805678]}, {"billed_charge": 56.1333, "npi": [1700805678]}, {"billed_charge": 40.5, "npi": [1700805678]}, {"billed_charge": 6.7, "npi": [1700805678]}]}]}]}, {"name": "Room & Board - Private - General", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0110", "description": "Room & Board - Private (One Bed)", "allowed_amounts": [{"tin": {"type": "ein", "value": "751837454"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 5779.5367, "billing_code_modifier": [""], "providers": [{"billed_charge": 1308.15, "npi": [1447250253]}]}, {"allowed_amount": 11237.4775, "billing_code_modifier": [""], "providers": [{"billed_charge": 1308.15, "npi": [1447250253]}]}, {"allowed_amount": 1594.264, "billing_code_modifier": [""], "providers": [{"billed_charge": 1308.15, "npi": [1447250253]}]}, {"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 1360.48, "npi": [1447250253]}]}, {"allowed_amount": 1422.966, "billing_code_modifier": [""], "providers": [{"billed_charge": 1308.15, "npi": [1447250253]}]}, {"allowed_amount": 13076.47, "billing_code_modifier": [""], "providers": [{"billed_charge": 1308.15, "npi": [1447250253]}]}, {"allowed_amount": 7450.8229, "billing_code_modifier": [""], "providers": [{"billed_charge": 1308.15, "npi": [1447250253]}]}, {"allowed_amount": 25570.46, "billing_code_modifier": [""], "providers": [{"billed_charge": 1308.15, "npi": [1447250253]}]}, {"allowed_amount": 11244.3, "billing_code_modifier": [""], "providers": [{"billed_charge": 1308.15, "npi": [1447250253]}]}, {"allowed_amount": 961.327, "billing_code_modifier": [""], "providers": [{"billed_charge": 1308.15, "npi": [1447250253]}]}, {"allowed_amount": 3826.3775, "billing_code_modifier": [""], "providers": [{"billed_charge": 1308.15, "npi": [1447250253]}]}, {"allowed_amount": 3963.355, "billing_code_modifier": [""], "providers": [{"billed_charge": 1308.15, "npi": [1447250253]}]}, {"allowed_amount": 1249.3667, "billing_code_modifier": [""], "providers": [{"billed_charge": 1308.15, "npi": [1447250253]}]}, {"allowed_amount": 4829.69, "billing_code_modifier": [""], "providers": [{"billed_charge": 1308.15, "npi": [1447250253]}]}, {"allowed_amount": 2297.5856, "billing_code_modifier": [""], "providers": [{"billed_charge": 1308.15, "npi": [1447250253]}]}, {"allowed_amount": 1552.305, "billing_code_modifier": [""], "providers": [{"billed_charge": 1308.15, "npi": [1447250253]}]}, {"allowed_amount": 4993.98, "billing_code_modifier": [""], "providers": [{"billed_charge": 1308.15, "npi": [1447250253]}]}, {"allowed_amount": 1632.053, "billing_code_modifier": [""], "providers": [{"billed_charge": 1308.15, "npi": [1447250253]}]}, {"allowed_amount": 996.259, "billing_code_modifier": [""], "providers": [{"billed_charge": 1308.15, "npi": [1447250253]}]}, {"allowed_amount": 4691.04, "billing_code_modifier": [""], "providers": [{"billed_charge": 1308.15, "npi": [1447250253]}]}, {"allowed_amount": 4274.2525, "billing_code_modifier": [""], "providers": [{"billed_charge": 1308.15, "npi": [1447250253]}]}, {"allowed_amount": 12156.3, "billing_code_modifier": [""], "providers": [{"billed_charge": 1308.15, "npi": [1447250253]}]}, {"allowed_amount": 2209.9025, "billing_code_modifier": [""], "providers": [{"billed_charge": 1308.15, "npi": [1447250253]}]}, {"allowed_amount": 1353.8863, "billing_code_modifier": [""], "providers": [{"billed_charge": 1308.15, "npi": [1447250253]}]}, {"allowed_amount": 12032.935, "billing_code_modifier": [""], "providers": [{"billed_charge": 1308.15, "npi": [1447250253]}]}, {"allowed_amount": 22972.82, "billing_code_modifier": [""], "providers": [{"billed_charge": 1308.15, "npi": [1447250253]}]}, {"allowed_amount": 4535.6614, "billing_code_modifier": [""], "providers": [{"billed_charge": 1308.15, "npi": [1447250253]}]}, {"allowed_amount": 1632.763, "billing_code_modifier": [""], "providers": [{"billed_charge": 1308.15, "npi": [1447250253]}]}, {"allowed_amount": 2329.44, "billing_code_modifier": [""], "providers": [{"billed_charge": 1308.15, "npi": [1447250253]}]}, {"allowed_amount": 15883.49, "billing_code_modifier": [""], "providers": [{"billed_charge": 1308.15, "npi": [1447250253]}]}, {"allowed_amount": 4654.9, "billing_code_modifier": [""], "providers": [{"billed_charge": 1308.15, "npi": [1447250253]}]}, {"allowed_amount": 2615.294, "billing_code_modifier": [""], "providers": [{"billed_charge": 1308.15, "npi": [1447250253]}]}, {"allowed_amount": 14600.11, "billing_code_modifier": [""], "providers": [{"billed_charge": 1308.15, "npi": [1447250253]}]}, {"allowed_amount": 931.383, "billing_code_modifier": [""], "providers": [{"billed_charge": 1308.15, "npi": [1447250253]}]}, {"allowed_amount": 841.9119, "billing_code_modifier": [""], "providers": [{"billed_charge": 1308.15, "npi": [1447250253]}]}, {"allowed_amount": 3118.8633, "billing_code_modifier": [""], "providers": [{"billed_charge": 1308.15, "npi": [1447250253]}]}]}]}, {"name": "Laboratory - General", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0300", "description": "Laboratory", "allowed_amounts": [{"tin": {"type": "ein", "value": "824052186"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 40.0, "npi": [1801826839]}, {"billed_charge": 191.0, "npi": [1801826839]}, {"billed_charge": 392.86, "npi": [1801826839]}, {"billed_charge": 47.75, "npi": [1801826839]}]}]}]}, {"name": "Laboratory - Chemistry", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0301", "description": "Laboratory", "allowed_amounts": [{"tin": {"type": "ein", "value": "751777119"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 108.35, "npi": [1073511762]}, {"billed_charge": 153.91, "npi": [1073511762]}, {"billed_charge": 87.97, "npi": [1073511762]}, {"billed_charge": 407.22, "npi": [1073511762]}, {"billed_charge": 161.4773, "npi": [1073511762]}, {"billed_charge": 185.85, "npi": [1073511762]}, {"billed_charge": 96.1, "npi": [1073511762]}, {"billed_charge": 432.76, "npi": [1073511762]}, {"billed_charge": 103.54, "npi": [1073511762]}, {"billed_charge": 459.04, "npi": [1073511762]}, {"billed_charge": 132.3233, "npi": [1073511762]}, {"billed_charge": 285.79, "npi": [1073511762]}, {"billed_charge": 229.02, "npi": [1073511762]}, {"billed_charge": 306.86, "npi": [1073511762]}, {"billed_charge": 105.46, "npi": [1073511762]}, {"billed_charge": 88.72, "npi": [1073511762]}, {"billed_charge": 243.23, "npi": [1073511762]}, {"billed_charge": 249.74, "npi": [1073511762]}, {"billed_charge": 56.6, "npi": [1073511762]}, {"billed_charge": 101.57, "npi": [1073511762]}, {"billed_charge": 93.56, "npi": [1073511762]}, {"billed_charge": 80.13, "npi": [1073511762]}, {"billed_charge": 111.02, "npi": [1073511762]}]}, {"allowed_amount": 5.7, "billing_code_modifier": [""], "providers": [{"billed_charge": 99.79, "npi": [1073511762]}]}]}]}, {"name": "Laboratory - Chemistry", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0301", "description": "Laboratory", "allowed_amounts": [{"tin": {"type": "ein", "value": "750972805"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 679.25, "npi": [1174533343]}, {"billed_charge": 326.6, "npi": [1174533343]}, {"billed_charge": 340.0, "npi": [1174533343]}, {"billed_charge": 155.8259, "npi": [1174533343]}, {"billed_charge": 240.7083, "npi": [1174533343]}, {"billed_charge": 231.0, "npi": [1174533343]}, {"billed_charge": 387.75, "npi": [1174533343]}, {"billed_charge": 671.0, "npi": [1174533343]}, {"billed_charge": 410.0, "npi": [1174533343]}, {"billed_charge": 208.8, "npi": [1174533343]}, {"billed_charge": 335.75, "npi": [1174533343]}, {"billed_charge": 153.5, "npi": [1174533343]}, {"billed_charge": 265.2381, "npi": [1174533343]}, {"billed_charge": 198.6356, "npi": [1174533343]}, {"billed_charge": 442.5, "npi": [1174533343]}, {"billed_charge": 229.25, "npi": [1174533343]}, {"billed_charge": 561.75, "npi": [1174533343]}, {"billed_charge": 225.75, "npi": [1174533343]}, {"billed_charge": 278.25, "npi": [1174533343]}, {"billed_charge": 324.5, "npi": [1174533343]}, {"billed_charge": 129.5, "npi": [1174533343]}, {"billed_charge": 378.4688, "npi": [1174533343]}, {"billed_charge": 223.13, "npi": [1174533343]}, {"billed_charge": 463.25, "npi": [1174533343]}, {"billed_charge": 334.25, "npi": [1174533343]}]}, {"allowed_amount": 5.7, "billing_code_modifier": ["91"], "providers": [{"billed_charge": 49.25, "npi": [1174533343]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["91"], "providers": [{"billed_charge": 335.75, "npi": [1174533343]}]}, {"allowed_amount": 5.698, "billing_code_modifier": ["91"], "providers": [{"billed_charge": 49.25, "npi": [1174533343]}]}]}]}, {"name": "Pharmacy - General", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0250", "description": "Pharmacy (also see 063x, an extension of 025x)", "allowed_amounts": [{"tin": {"type": "ein", "value": "751844139"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 1.3833, "npi": [1265430177]}, {"billed_charge": 1.5611, "npi": [1265430177]}, {"billed_charge": 0.71, "npi": [1265430177]}, {"billed_charge": 28.8486, "npi": [1265430177]}, {"billed_charge": 19.0621, "npi": [1265430177]}, {"billed_charge": 3.97, "npi": [1265430177]}, {"billed_charge": 4.9371, "npi": [1265430177]}, {"billed_charge": 3.2395, "npi": [1265430177]}, {"billed_charge": 0.3425, "npi": [1265430177]}, {"billed_charge": 14.17, "npi": [1265430177]}, {"billed_charge": 1.6, "npi": [1265430177]}, {"billed_charge": 0.578, "npi": [1265430177]}, {"billed_charge": 21.45, "npi": [1265430177]}, {"billed_charge": 4.532, "npi": [1265430177]}, {"billed_charge": 7.8027, "npi": [1265430177]}, {"billed_charge": 3.3529, "npi": [1265430177]}, {"billed_charge": 2.85, "npi": [1265430177]}, {"billed_charge": 0.68, "npi": [1265430177]}, {"billed_charge": 7.3, "npi": [1265430177]}, {"billed_charge": 1.365, "npi": [1265430177]}, {"billed_charge": 1.735, "npi": [1265430177]}, {"billed_charge": 0.16, "npi": [1265430177]}, {"billed_charge": 5.23, "npi": [1265430177]}, {"billed_charge": 6.9933, "npi": [1265430177]}, {"billed_charge": 0.075, "npi": [1265430177]}, {"billed_charge": 6.8867, "npi": [1265430177]}, {"billed_charge": 1.08, "npi": [1265430177]}, {"billed_charge": 0.11, "npi": [1265430177]}, {"billed_charge": 9.89, "npi": [1265430177]}, {"billed_charge": 5.8, "npi": [1265430177]}, {"billed_charge": 2.4616, "npi": [1265430177]}, {"billed_charge": 0.285, "npi": [1265430177]}, {"billed_charge": 0.7875, "npi": [1265430177]}, {"billed_charge": 21.96, "npi": [1265430177]}, {"billed_charge": 16.085, "npi": [1265430177]}, {"billed_charge": 15.9333, "npi": [1265430177]}, {"billed_charge": 11.72, "npi": [1265430177]}, {"billed_charge": 6.1013, "npi": [1265430177]}, {"billed_charge": 0.1625, "npi": [1265430177]}, {"billed_charge": 1.045, "npi": [1265430177]}, {"billed_charge": 0.42, "npi": [1265430177]}, {"billed_charge": 0.7733, "npi": [1265430177]}, {"billed_charge": 1.852, "npi": [1265430177]}, {"billed_charge": 28.2, "npi": [1265430177]}, {"billed_charge": 2.4433, "npi": [1265430177]}, {"billed_charge": 10.0631, "npi": [1265430177]}, {"billed_charge": 10.3783, "npi": [1265430177]}, {"billed_charge": 1.4067, "npi": [1265430177]}, {"billed_charge": 4.955, "npi": [1265430177]}, {"billed_charge": 2.155, "npi": [1265430177]}, {"billed_charge": 11.063, "npi": [1265430177]}, {"billed_charge": 15.28, "npi": [1265430177]}, {"billed_charge": 21.9, "npi": [1265430177]}, {"billed_charge": 15.72, "npi": [1265430177]}]}]}]}, {"name": "Pharmacy - Extension of 25X - Drug Requiring Detailed Coding", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0636", "description": "Pharmacy - Extension of 25x", "allowed_amounts": [{"tin": {"type": "ein", "value": "751037591"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.49, "billing_code_modifier": [""], "providers": [{"billed_charge": 2.1, "npi": [1124305065]}, {"billed_charge": 17.1, "npi": [1124305065]}, {"billed_charge": 2.76, "npi": [1124305065]}, {"billed_charge": 5.25, "npi": [1124305065]}]}, {"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 0.0654, "npi": [1124305065]}, {"billed_charge": 1.2396, "npi": [1124305065]}, {"billed_charge": 100.985, "npi": [1124305065]}, {"billed_charge": 1.35, "npi": [1124305065]}, {"billed_charge": 18.06, "npi": [1124305065]}, {"billed_charge": 13.4947, "npi": [1124305065]}, {"billed_charge": 42.0, "npi": [1124305065]}, {"billed_charge": 17.82, "npi": [1124305065]}, {"billed_charge": 0.1475, "npi": [1124305065]}, {"billed_charge": 5.6167, "npi": [1124305065]}, {"billed_charge": 20.76, "npi": [1124305065]}, {"billed_charge": 12.52, "npi": [1124305065]}, {"billed_charge": 276.85, "npi": [1124305065]}, {"billed_charge": 2.795, "npi": [1124305065]}, {"billed_charge": 2.04, "npi": [1124305065]}, {"billed_charge": 20.1, "npi": [1124305065]}, {"billed_charge": 0.857, "npi": [1124305065]}, {"billed_charge": 6.2231, "npi": [1124305065]}, {"billed_charge": 48.3, "npi": [1124305065]}, {"billed_charge": 7.713, "npi": [1124305065]}, {"billed_charge": 5.224, "npi": [1124305065]}, {"billed_charge": 31.8, "npi": [1124305065]}, {"billed_charge": 5.4575, "npi": [1124305065]}, {"billed_charge": 0.3775, "npi": [1124305065]}, {"billed_charge": 157.105, "npi": [1124305065]}]}, {"allowed_amount": 0.49, "billing_code_modifier": ["JW"], "providers": [{"billed_charge": 2.1, "npi": [1124305065]}, {"billed_charge": 17.1, "npi": [1124305065]}, {"billed_charge": 2.76, "npi": [1124305065]}, {"billed_charge": 5.25, "npi": [1124305065]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["JZ"], "providers": [{"billed_charge": 5.016, "npi": [1124305065]}, {"billed_charge": 2.82, "npi": [1124305065]}, {"billed_charge": 2.159, "npi": [1124305065]}, {"billed_charge": 1.67, "npi": [1124305065]}, {"billed_charge": 0.84, "npi": [1124305065]}, {"billed_charge": 0.0675, "npi": [1124305065]}, {"billed_charge": 1.925, "npi": [1124305065]}, {"billed_charge": 0.3775, "npi": [1124305065]}, {"billed_charge": 1.02, "npi": [1124305065]}]}]}]}, {"name": "Pharmacy - Drugs Incident to Radiology", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0255", "description": "Pharmacy (also see 063x, an extension of 025x)", "allowed_amounts": [{"tin": {"type": "ein", "value": "752586857"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 4.5405, "npi": [1992700983]}, {"billed_charge": 1.538, "npi": [1992700983]}, {"billed_charge": 4.389, "npi": [1992700983]}, {"billed_charge": 4.086, "npi": [1992700983]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["JZ"], "providers": [{"billed_charge": 4.5405, "npi": [1992700983]}, {"billed_charge": 4.5315, "npi": [1992700983]}, {"billed_charge": 4.086, "npi": [1992700983]}]}]}]}, {"name": "Medical/Surgical Supplies and Devices - Nonsterile Supply", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0271", "description": "Med/Surg Supplies &Devices (also see 062x, extension of 027x", "allowed_amounts": [{"tin": {"type": "ein", "value": "472177648"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 105.0, "npi": [1790174860]}, {"billed_charge": 24.3071, "npi": [1790174860]}, {"billed_charge": 120.0, "npi": [1790174860]}, {"billed_charge": 5.0, "npi": [1790174860]}, {"billed_charge": 31.38, "npi": [1790174860]}, {"billed_charge": 8.2, "npi": [1790174860]}, {"billed_charge": 13.95, "npi": [1790174860]}, {"billed_charge": 11.5333, "npi": [1790174860]}, {"billed_charge": 135.0, "npi": [1790174860]}, {"billed_charge": 24.7571, "npi": [1790174860]}, {"billed_charge": 269.75, "npi": [1790174860]}, {"billed_charge": 31.0, "npi": [1790174860]}, {"billed_charge": 37.5, "npi": [1790174860]}, {"billed_charge": 55.0, "npi": [1790174860]}, {"billed_charge": 258.895, "npi": [1790174860]}]}]}]}, {"name": "Laboratory - Bacteriology & Microbiology", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0306", "description": "Laboratory", "allowed_amounts": [{"tin": {"type": "ein", "value": "751748586"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 225.25, "npi": [1508899204]}, {"billed_charge": 252.75, "npi": [1508899204]}, {"billed_charge": 317.75, "npi": [1508899204]}, {"billed_charge": 364.0, "npi": [1508899204]}, {"billed_charge": 237.75, "npi": [1508899204]}, {"billed_charge": 414.5, "npi": [1508899204]}, {"billed_charge": 397.25, "npi": [1508899204]}, {"billed_charge": 1550.0, "npi": [1508899204]}, {"billed_charge": 399.5, "npi": [1508899204]}, {"billed_charge": 229.25, "npi": [1508899204]}]}, {"allowed_amount": 74.4, "billing_code_modifier": [""], "providers": [{"billed_charge": 234.0, "npi": [1508899204]}, {"billed_charge": 225.25, "npi": [1508899204]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["59"], "providers": [{"billed_charge": 601.75, "npi": [1508899204]}]}]}]}, {"name": "Emergency Room - General", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0450", "description": "Emergency Room", "allowed_amounts": [{"tin": {"type": "ein", "value": "752682017"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 636.96, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 5248.0, "npi": [1114998911]}]}, {"allowed_amount": 324.71, "billing_code_modifier": ["ER"], "providers": [{"billed_charge": 1708.0, "npi": [1114998911]}]}, {"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 434.0, "npi": [1114998911]}]}, {"allowed_amount": 1077.56, "billing_code_modifier": ["ER59"], "providers": [{"billed_charge": 1332.0, "npi": [1114998911]}]}, {"allowed_amount": 109.905, "billing_code_modifier": ["ER59"], "providers": [{"billed_charge": 757.0, "npi": [1114998911]}]}, {"allowed_amount": 416.7, "billing_code_modifier": ["ER25"], "providers": [{"billed_charge": 3024.0, "npi": [1114998911]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["LT"], "providers": [{"billed_charge": 1332.0, "npi": [1114998911]}]}, {"allowed_amount": 416.7, "billing_code_modifier": [""], "providers": [{"billed_charge": 3024.0, "npi": [1114998911]}]}, {"allowed_amount": 416.7, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 3024.0, "npi": [1114998911]}]}, {"allowed_amount": 234.39, "billing_code_modifier": [""], "providers": [{"billed_charge": 2103.0, "npi": [1114998911]}]}, {"allowed_amount": 234.39, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 2103.0, "npi": [1114998911]}]}, {"allowed_amount": 71.49, "billing_code_modifier": ["ER59"], "providers": [{"billed_charge": 757.0, "npi": [1114998911]}]}]}]}, {"name": "Laboratory - Chemistry", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0301", "description": "Laboratory", "allowed_amounts": [{"tin": {"type": "ein", "value": "432008974"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 679.25, "npi": [1003883158]}, {"billed_charge": 335.75, "npi": [1003883158]}, {"billed_charge": 153.5, "npi": [1003883158]}, {"billed_charge": 668.5, "npi": [1003883158]}, {"billed_charge": 227.3017, "npi": [1003883158]}, {"billed_charge": 225.75, "npi": [1003883158]}, {"billed_charge": 256.5948, "npi": [1003883158]}, {"billed_charge": 278.25, "npi": [1003883158]}, {"billed_charge": 324.5, "npi": [1003883158]}, {"billed_charge": 450.15, "npi": [1003883158]}, {"billed_charge": 671.0, "npi": [1003883158]}, {"billed_charge": 410.0, "npi": [1003883158]}]}]}]}, {"name": "Emergency Room - General", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0450", "description": "Emergency Room", "allowed_amounts": [{"tin": {"type": "ein", "value": "753175630"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 3758.0, "npi": [1285798918]}]}, {"allowed_amount": 122.22, "billing_code_modifier": ["2527"], "providers": [{"billed_charge": 452.0, "npi": [1285798918]}]}, {"allowed_amount": 604.81, "billing_code_modifier": [""], "providers": [{"billed_charge": 2443.0, "npi": [1285798918]}]}, {"allowed_amount": 3791.1, "billing_code_modifier": [""], "providers": [{"billed_charge": 3758.0, "npi": [1285798918]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["RT"], "providers": [{"billed_charge": 593.0, "npi": [1285798918]}]}, {"allowed_amount": 395.66, "billing_code_modifier": [""], "providers": [{"billed_charge": 1541.0, "npi": [1285798918]}]}, {"allowed_amount": 863.2, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 3758.0, "npi": [1285798918]}]}, {"allowed_amount": 122.22, "billing_code_modifier": [""], "providers": [{"billed_charge": 452.0, "npi": [1285798918]}]}, {"allowed_amount": 604.81, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 2443.0, "npi": [1285798918]}]}]}]}, {"name": "Medical/Surgical Supplies and Devices - Sterile Supply", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0272", "description": "Med/Surg Supplies &Devices (also see 062x, extension of 027x", "allowed_amounts": [{"tin": {"type": "ein", "value": "750972805"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 9.0, "npi": [1174533343]}, {"billed_charge": 51.5, "npi": [1174533343]}, {"billed_charge": 10.0, "npi": [1174533343]}, {"billed_charge": 42.4138, "npi": [1174533343]}, {"billed_charge": 28.4375, "npi": [1174533343]}, {"billed_charge": 3.8, "npi": [1174533343]}, {"billed_charge": 18.2432, "npi": [1174533343]}, {"billed_charge": 32.0, "npi": [1174533343]}, {"billed_charge": 139.0, "npi": [1174533343]}]}]}]}, {"name": "Laboratory - Hematology", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0305", "description": "Laboratory", "allowed_amounts": [{"tin": {"type": "ein", "value": "750972805"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 142.5833, "npi": [1174533343]}, {"billed_charge": 206.5, "npi": [1174533343]}, {"billed_charge": 706.5, "npi": [1174533343]}, {"billed_charge": 226.4286, "npi": [1174533343]}, {"billed_charge": 226.5, "npi": [1174533343]}, {"billed_charge": 302.5417, "npi": [1174533343]}, {"billed_charge": 209.2321, "npi": [1174533343]}, {"billed_charge": 211.425, "npi": [1174533343]}, {"billed_charge": 150.8333, "npi": [1174533343]}, {"billed_charge": 233.5, "npi": [1174533343]}, {"billed_charge": 227.8333, "npi": [1174533343]}, {"billed_charge": 145.75, "npi": [1174533343]}, {"billed_charge": 208.75, "npi": [1174533343]}, {"billed_charge": 185.1346, "npi": [1174533343]}, {"billed_charge": 199.1875, "npi": [1174533343]}]}]}]}, {"name": "Laboratory - Chemistry", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0301", "description": "Laboratory", "allowed_amounts": [{"tin": {"type": "ein", "value": "752890358"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 324.5, "npi": [1548291883]}, {"billed_charge": 211.0, "npi": [1548291883]}, {"billed_charge": 225.75, "npi": [1548291883]}, {"billed_charge": 278.25, "npi": [1548291883]}, {"billed_charge": 49.25, "npi": [1548291883]}, {"billed_charge": 220.25, "npi": [1548291883]}, {"billed_charge": 334.25, "npi": [1548291883]}, {"billed_charge": 679.25, "npi": [1548291883]}, {"billed_charge": 565.0, "npi": [1548291883]}, {"billed_charge": 231.0, "npi": [1548291883]}, {"billed_charge": 340.0, "npi": [1548291883]}, {"billed_charge": 246.8333, "npi": [1548291883]}, {"billed_charge": 410.0, "npi": [1548291883]}, {"billed_charge": 318.0577, "npi": [1548291883]}, {"billed_charge": 1474.5, "npi": [1548291883]}, {"billed_charge": 442.5, "npi": [1548291883]}, {"billed_charge": 153.5, "npi": [1548291883]}, {"billed_charge": 336.8553, "npi": [1548291883]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["91"], "providers": [{"billed_charge": 49.25, "npi": [1548291883]}]}]}]}, {"name": "Laboratory - Hematology", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0305", "description": "Laboratory", "allowed_amounts": [{"tin": {"type": "ein", "value": "756001743"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 212.875, "npi": [1336172105]}, {"billed_charge": 233.5, "npi": [1336172105]}, {"billed_charge": 145.75, "npi": [1336172105]}, {"billed_charge": 206.5, "npi": [1336172105]}, {"billed_charge": 166.6625, "npi": [1336172105]}, {"billed_charge": 286.6071, "npi": [1336172105]}, {"billed_charge": 248.1429, "npi": [1336172105]}, {"billed_charge": 706.5, "npi": [1336172105]}, {"billed_charge": 206.9722, "npi": [1336172105]}, {"billed_charge": 226.5, "npi": [1336172105]}]}]}]}, {"name": "EMERGENCY DEPARTMENT VISIT MODERATE MDM", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "99284", "description": "EMERGENCY DEPARTMENT VISIT MODERATE MDM", "allowed_amounts": [{"tin": {"type": "ein", "value": "853503076"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 1403.44, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 4957.82, "npi": [1124623889]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 4957.82, "npi": [1124623889]}]}, {"allowed_amount": 3237.81, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 4957.82, "npi": [1124623889]}]}, {"allowed_amount": 4493.5, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 4957.82, "npi": [1124623889]}]}, {"allowed_amount": 2861.25, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 4957.82, "npi": [1124623889]}]}]}]}, {"name": "Pharmacy - General", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0250", "description": "Pharmacy (also see 063x, an extension of 025x)", "allowed_amounts": [{"tin": {"type": "ein", "value": "752682017"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 98.0, "npi": [1114998911]}, {"billed_charge": 25.0, "npi": [1114998911]}, {"billed_charge": 12.0, "npi": [1114998911]}, {"billed_charge": 407.0, "npi": [1114998911]}, {"billed_charge": 32.0, "npi": [1114998911]}, {"billed_charge": 145.0, "npi": [1114998911]}, {"billed_charge": 11.0, "npi": [1114998911]}, {"billed_charge": 26.0, "npi": [1114998911]}, {"billed_charge": 23.0, "npi": [1114998911]}, {"billed_charge": 1.1, "npi": [1114998911]}, {"billed_charge": 13.0, "npi": [1114998911]}, {"billed_charge": 0.6, "npi": [1114998911]}, {"billed_charge": 36.0, "npi": [1114998911]}, {"billed_charge": 19.0, "npi": [1114998911]}, {"billed_charge": 6.2, "npi": [1114998911]}, {"billed_charge": 46.0, "npi": [1114998911]}, {"billed_charge": 1179.0, "npi": [1114998911]}, {"billed_charge": 2.7, "npi": [1114998911]}, {"billed_charge": 31.0, "npi": [1114998911]}, {"billed_charge": 24.0, "npi": [1114998911]}, {"billed_charge": 15.0, "npi": [1114998911]}, {"billed_charge": 38.0, "npi": [1114998911]}, {"billed_charge": 1036.0, "npi": [1114998911]}, {"billed_charge": 164.0, "npi": [1114998911]}, {"billed_charge": 1646.0, "npi": [1114998911]}]}]}]}, {"name": "Medical/Surgical Supplies and Devices - General", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0270", "description": "Med/Surg Supplies &Devices (also see 062x, extension of 027x", "allowed_amounts": [{"tin": {"type": "ein", "value": "472177648"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 5.0, "npi": [1790174860]}, {"billed_charge": 26.52, "npi": [1790174860]}, {"billed_charge": 16.7125, "npi": [1790174860]}, {"billed_charge": 7.4944, "npi": [1790174860]}, {"billed_charge": 74.02, "npi": [1790174860]}, {"billed_charge": 62.7709, "npi": [1790174860]}, {"billed_charge": 30.825, "npi": [1790174860]}, {"billed_charge": 14.975, "npi": [1790174860]}, {"billed_charge": 11.8375, "npi": [1790174860]}, {"billed_charge": 6.6267, "npi": [1790174860]}, {"billed_charge": 63.7214, "npi": [1790174860]}, {"billed_charge": 47.225, "npi": [1790174860]}, {"billed_charge": 8.4857, "npi": [1790174860]}, {"billed_charge": 47.475, "npi": [1790174860]}, {"billed_charge": 27.45, "npi": [1790174860]}, {"billed_charge": 34.2, "npi": [1790174860]}]}]}]}, {"name": "Emergency Room - General", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0450", "description": "Emergency Room", "allowed_amounts": [{"tin": {"type": "ein", "value": "751844139"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 308.31, "billing_code_modifier": [""], "providers": [{"billed_charge": 902.11, "npi": [1265430177]}, {"billed_charge": 814.34, "npi": [1265430177]}, {"billed_charge": 524.33, "npi": [1265430177]}]}, {"allowed_amount": 222.56, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 782.31, "npi": [1265430177]}]}, {"allowed_amount": 308.31, "billing_code_modifier": ["XS"], "providers": [{"billed_charge": 524.33, "npi": [1265430177]}]}, {"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 1598.6867, "npi": [1265430177]}, {"billed_charge": 2122.8, "npi": [1265430177]}, {"billed_charge": 1897.8025, "npi": [1265430177]}, {"billed_charge": 1099.8067, "npi": [1265430177]}, {"billed_charge": 1408.3417, "npi": [1265430177]}, {"billed_charge": 321.2, "npi": [1265430177]}, {"billed_charge": 814.34, "npi": [1265430177]}, {"billed_charge": 4233.71, "npi": [1265430177]}, {"billed_charge": 753.62, "npi": [1265430177]}, {"billed_charge": 524.33, "npi": [1265430177]}, {"billed_charge": 1385.54, "npi": [1265430177]}, {"billed_charge": 2379.02, "npi": [1265430177]}, {"billed_charge": 977.8367, "npi": [1265430177]}, {"billed_charge": 806.34, "npi": [1265430177]}, {"billed_charge": 2308.84, "npi": [1265430177]}, {"billed_charge": 361.12, "npi": [1265430177]}]}, {"allowed_amount": 67.875, "billing_code_modifier": [""], "providers": [{"billed_charge": 392.06, "npi": [1265430177]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["XS"], "providers": [{"billed_charge": 524.33, "npi": [1265430177]}]}, {"allowed_amount": 604.81, "billing_code_modifier": [""], "providers": [{"billed_charge": 2122.8, "npi": [1265430177]}]}, {"allowed_amount": 67.875, "billing_code_modifier": ["XU"], "providers": [{"billed_charge": 392.06, "npi": [1265430177]}]}, {"allowed_amount": 362.15, "billing_code_modifier": [""], "providers": [{"billed_charge": 886.6, "npi": [1265430177]}]}, {"allowed_amount": 222.56, "billing_code_modifier": [""], "providers": [{"billed_charge": 782.31, "npi": [1265430177]}]}, {"allowed_amount": 122.22, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 478.23, "npi": [1265430177]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["XU"], "providers": [{"billed_charge": 902.11, "npi": [1265430177]}, {"billed_charge": 524.33, "npi": [1265430177]}]}, {"allowed_amount": 3791.1, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 3879.67, "npi": [1265430177]}]}, {"allowed_amount": 67.87, "billing_code_modifier": [""], "providers": [{"billed_charge": 392.06, "npi": [1265430177]}, {"billed_charge": 317.78, "npi": [1265430177]}, {"billed_charge": 330.56, "npi": [1265430177]}]}, {"allowed_amount": 290.83, "billing_code_modifier": [""], "providers": [{"billed_charge": 994.45, "npi": [1265430177]}]}, {"allowed_amount": 67.8733, "billing_code_modifier": [""], "providers": [{"billed_charge": 392.06, "npi": [1265430177]}, {"billed_charge": 317.78, "npi": [1265430177]}]}, {"allowed_amount": 395.66, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 1283.4, "npi": [1265430177]}]}, {"allowed_amount": 308.31, "billing_code_modifier": ["XU"], "providers": [{"billed_charge": 902.11, "npi": [1265430177]}, {"billed_charge": 524.33, "npi": [1265430177]}]}, {"allowed_amount": 863.2, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 3879.67, "npi": [1265430177]}]}, {"allowed_amount": 122.22, "billing_code_modifier": [""], "providers": [{"billed_charge": 478.23, "npi": [1265430177]}]}, {"allowed_amount": 604.81, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 2122.8, "npi": [1265430177]}, {"billed_charge": 3039.19, "npi": [1265430177]}]}, {"allowed_amount": 1197.29, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 4233.71, "npi": [1265430177]}]}]}]}, {"name": "Pharmacy - General", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0250", "description": "Pharmacy (also see 063x, an extension of 025x)", "allowed_amounts": [{"tin": {"type": "ein", "value": "820551704"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 7.8814, "npi": [1649273434]}, {"billed_charge": 15.72, "npi": [1649273434]}, {"billed_charge": 4.87, "npi": [1649273434]}, {"billed_charge": 0.5525, "npi": [1649273434]}, {"billed_charge": 3.4228, "npi": [1649273434]}, {"billed_charge": 1.7033, "npi": [1649273434]}, {"billed_charge": 4.435, "npi": [1649273434]}, {"billed_charge": 4.44, "npi": [1649273434]}, {"billed_charge": 6.2525, "npi": [1649273434]}, {"billed_charge": 0.685, "npi": [1649273434]}, {"billed_charge": 4.5117, "npi": [1649273434]}, {"billed_charge": 0.545, "npi": [1649273434]}, {"billed_charge": 6.6457, "npi": [1649273434]}, {"billed_charge": 15.68, "npi": [1649273434]}, {"billed_charge": 0.075, "npi": [1649273434]}, {"billed_charge": 7.726, "npi": [1649273434]}, {"billed_charge": 0.77, "npi": [1649273434]}, {"billed_charge": 8.22, "npi": [1649273434]}, {"billed_charge": 1.4552, "npi": [1649273434]}, {"billed_charge": 7.142, "npi": [1649273434]}]}]}]}, {"name": "GROUP PSYCHOTHERAPY", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "90853", "description": "GROUP PSYCHOTHERAPY", "allowed_amounts": [{"tin": {"type": "ein", "value": "742127841"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 29.44, "billing_code_modifier": ["HF"], "providers": [{"billed_charge": 115.0, "npi": [1124124375]}]}, {"allowed_amount": 29.44, "billing_code_modifier": ["5995HF"], "providers": [{"billed_charge": 110.0, "npi": [1124124375]}]}, {"allowed_amount": 29.44, "billing_code_modifier": ["95HF"], "providers": [{"billed_charge": 115.0, "npi": [1124124375]}]}, {"allowed_amount": 29.44, "billing_code_modifier": ["59HF"], "providers": [{"billed_charge": 115.0, "npi": [1124124375]}]}]}]}, {"name": "Pharmacy - Extension of 25X - Drug Requiring Detailed Coding", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0636", "description": "Pharmacy - Extension of 25x", "allowed_amounts": [{"tin": {"type": "ein", "value": "752770738"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.4933, "billing_code_modifier": ["JW"], "providers": [{"billed_charge": 10.0, "npi": [1770514077]}, {"billed_charge": 3.3333, "npi": [1770514077]}]}, {"allowed_amount": 0.49, "billing_code_modifier": [""], "providers": [{"billed_charge": 10.0, "npi": [1770514077]}]}, {"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 15.0, "npi": [1770514077]}, {"billed_charge": 0.984, "npi": [1770514077]}, {"billed_charge": 3.2825, "npi": [1770514077]}, {"billed_charge": 3.74, "npi": [1770514077]}, {"billed_charge": 5.4698, "npi": [1770514077]}, {"billed_charge": 0.0772, "npi": [1770514077]}, {"billed_charge": 9.0, "npi": [1770514077]}, {"billed_charge": 2.5, "npi": [1770514077]}, {"billed_charge": 1.1059, "npi": [1770514077]}, {"billed_charge": 1.0, "npi": [1770514077]}, {"billed_charge": 3.2763, "npi": [1770514077]}, {"billed_charge": 64.35, "npi": [1770514077]}, {"billed_charge": 51.685, "npi": [1770514077]}, {"billed_charge": 19.07, "npi": [1770514077]}, {"billed_charge": 1.2675, "npi": [1770514077]}, {"billed_charge": 186.78, "npi": [1770514077]}, {"billed_charge": 3.83, "npi": [1770514077]}, {"billed_charge": 1.3, "npi": [1770514077]}, {"billed_charge": 2.6191, "npi": [1770514077]}, {"billed_charge": 61.56, "npi": [1770514077]}, {"billed_charge": 10.0, "npi": [1770514077]}, {"billed_charge": 41.04, "npi": [1770514077]}, {"billed_charge": 6.25, "npi": [1770514077]}, {"billed_charge": 37.75, "npi": [1770514077]}, {"billed_charge": 53.07, "npi": [1770514077]}, {"billed_charge": 50.0, "npi": [1770514077]}, {"billed_charge": 75.24, "npi": [1770514077]}, {"billed_charge": 3.283, "npi": [1770514077]}, {"billed_charge": 9.735, "npi": [1770514077]}, {"billed_charge": 3.99, "npi": [1770514077]}, {"billed_charge": 0.1248, "npi": [1770514077]}, {"billed_charge": 0.125, "npi": [1770514077]}, {"billed_charge": 25.0, "npi": [1770514077]}, {"billed_charge": 12.5, "npi": [1770514077]}]}, {"allowed_amount": 0.49, "billing_code_modifier": ["JW"], "providers": [{"billed_charge": 10.0, "npi": [1770514077]}]}, {"allowed_amount": 0.495, "billing_code_modifier": ["JZ"], "providers": [{"billed_charge": 5.0, "npi": [1770514077]}, {"billed_charge": 14.89, "npi": [1770514077]}]}, {"allowed_amount": 0.495, "billing_code_modifier": [""], "providers": [{"billed_charge": 5.0, "npi": [1770514077]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["JZ"], "providers": [{"billed_charge": 5.9975, "npi": [1770514077]}, {"billed_charge": 1.846, "npi": [1770514077]}, {"billed_charge": 3.0777, "npi": [1770514077]}, {"billed_charge": 0.1551, "npi": [1770514077]}, {"billed_charge": 182.815, "npi": [1770514077]}, {"billed_charge": 7.5, "npi": [1770514077]}, {"billed_charge": 9.0, "npi": [1770514077]}, {"billed_charge": 1.4844, "npi": [1770514077]}, {"billed_charge": 0.5, "npi": [1770514077]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["JW"], "providers": [{"billed_charge": 3.74, "npi": [1770514077]}, {"billed_charge": 9.0, "npi": [1770514077]}, {"billed_charge": 1.3, "npi": [1770514077]}, {"billed_charge": 37.75, "npi": [1770514077]}]}, {"allowed_amount": 0.4933, "billing_code_modifier": [""], "providers": [{"billed_charge": 10.0, "npi": [1770514077]}]}, {"allowed_amount": 0.495, "billing_code_modifier": ["JW"], "providers": [{"billed_charge": 5.0, "npi": [1770514077]}]}]}]}, {"name": "Laboratory - General", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0300", "description": "Laboratory", "allowed_amounts": [{"tin": {"type": "ein", "value": "750800628"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 382.8, "billing_code_modifier": [""], "providers": [{"billed_charge": 638.0, "npi": [1194743013]}]}, {"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 32.0, "npi": [1194743013]}]}, {"allowed_amount": 16.32, "billing_code_modifier": [""], "providers": [{"billed_charge": 32.0, "npi": [1194743013]}]}, {"allowed_amount": 55.56, "billing_code_modifier": [""], "providers": [{"billed_charge": 92.6, "npi": [1194743013]}]}, {"allowed_amount": 19.2, "billing_code_modifier": [""], "providers": [{"billed_charge": 32.0, "npi": [1194743013]}]}]}]}, {"name": "Medical/Surgical Supplies and Devices - Sterile Supply", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0272", "description": "Med/Surg Supplies &Devices (also see 062x, extension of 027x", "allowed_amounts": [{"tin": {"type": "ein", "value": "751837454"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 409.31, "npi": [1447250253]}, {"billed_charge": 1416.846, "npi": [1447250253]}, {"billed_charge": 107.415, "npi": [1447250253]}, {"billed_charge": 534.335, "npi": [1447250253]}, {"billed_charge": 948.04, "npi": [1447250253]}, {"billed_charge": 915.2425, "npi": [1447250253]}, {"billed_charge": 128.58, "npi": [1447250253]}, {"billed_charge": 1080.123, "npi": [1447250253]}, {"billed_charge": 714.555, "npi": [1447250253]}, {"billed_charge": 131.92, "npi": [1447250253]}, {"billed_charge": 69.21, "npi": [1447250253]}, {"billed_charge": 696.2445, "npi": [1447250253]}, {"billed_charge": 281.42, "npi": [1447250253]}, {"billed_charge": 271.953, "npi": [1447250253]}, {"billed_charge": 130.87, "npi": [1447250253]}]}]}]}, {"name": "GROUND MILEAGE PER STATUTE MILE", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "A0425", "description": "GROUND MILEAGE PER STATUTE MILE", "allowed_amounts": [{"tin": {"type": "ein", "value": "208424689"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 30.3228, "billing_code_modifier": ["ETHH"], "providers": [{"billed_charge": 85.0, "npi": [1952588329]}]}, {"allowed_amount": 30.3, "billing_code_modifier": ["ETHH"], "providers": [{"billed_charge": 85.0, "npi": [1952588329]}]}, {"allowed_amount": 30.3206, "billing_code_modifier": ["ETHH"], "providers": [{"billed_charge": 85.0, "npi": [1952588329]}]}, {"allowed_amount": 30.3125, "billing_code_modifier": ["ETHH"], "providers": [{"billed_charge": 85.0, "npi": [1952588329]}]}, {"allowed_amount": 30.3233, "billing_code_modifier": ["ETHH"], "providers": [{"billed_charge": 85.0, "npi": [1952588329]}]}, {"allowed_amount": 30.3233, "billing_code_modifier": ["HR"], "providers": [{"billed_charge": 85.0, "npi": [1952588329]}]}, {"allowed_amount": 30.3236, "billing_code_modifier": ["ETHH"], "providers": [{"billed_charge": 85.0, "npi": [1952588329]}]}, {"allowed_amount": 30.3227, "billing_code_modifier": ["ETHH"], "providers": [{"billed_charge": 85.0, "npi": [1952588329]}]}, {"allowed_amount": 30.3242, "billing_code_modifier": ["ETHH"], "providers": [{"billed_charge": 85.0, "npi": [1952588329]}]}, {"allowed_amount": 30.3216, "billing_code_modifier": ["ETHH"], "providers": [{"billed_charge": 85.0, "npi": [1952588329]}]}, {"allowed_amount": 30.323, "billing_code_modifier": ["ETHH"], "providers": [{"billed_charge": 85.0, "npi": [1952588329]}]}, {"allowed_amount": 30.3219, "billing_code_modifier": ["ETHH"], "providers": [{"billed_charge": 85.0, "npi": [1952588329]}]}, {"allowed_amount": 30.3273, "billing_code_modifier": ["ETHH"], "providers": [{"billed_charge": 85.0, "npi": [1952588329]}]}, {"allowed_amount": 30.3227, "billing_code_modifier": ["HH"], "providers": [{"billed_charge": 85.0, "npi": [1952588329]}]}, {"allowed_amount": 30.322, "billing_code_modifier": ["ETHH"], "providers": [{"billed_charge": 85.0, "npi": [1952588329]}]}, {"allowed_amount": 30.3226, "billing_code_modifier": ["ETHH"], "providers": [{"billed_charge": 85.0, "npi": [1952588329]}]}, {"allowed_amount": 30.3216, "billing_code_modifier": ["HH"], "providers": [{"billed_charge": 85.0, "npi": [1952588329]}]}, {"allowed_amount": 30.3221, "billing_code_modifier": ["ETHH"], "providers": [{"billed_charge": 85.0, "npi": [1952588329]}]}, {"allowed_amount": 30.3234, "billing_code_modifier": ["ETHH"], "providers": [{"billed_charge": 85.0, "npi": [1952588329]}]}, {"allowed_amount": 30.3225, "billing_code_modifier": ["ETHH"], "providers": [{"billed_charge": 85.0, "npi": [1952588329]}]}]}]}, {"name": "Laboratory - Chemistry", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0301", "description": "Laboratory", "allowed_amounts": [{"tin": {"type": "ein", "value": "751977850"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 20.09, "billing_code_modifier": [""], "providers": [{"billed_charge": 679.25, "npi": [1396778064]}]}, {"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 123.25, "npi": [1396778064]}, {"billed_charge": 1474.5, "npi": [1396778064]}, {"billed_charge": 231.0, "npi": [1396778064]}, {"billed_charge": 340.0, "npi": [1396778064]}, {"billed_charge": 225.75, "npi": [1396778064]}, {"billed_charge": 381.7969, "npi": [1396778064]}, {"billed_charge": 410.0, "npi": [1396778064]}, {"billed_charge": 565.0, "npi": [1396778064]}, {"billed_charge": 278.25, "npi": [1396778064]}, {"billed_charge": 229.25, "npi": [1396778064]}, {"billed_charge": 324.5, "npi": [1396778064]}, {"billed_charge": 442.5, "npi": [1396778064]}, {"billed_charge": 49.25, "npi": [1396778064]}, {"billed_charge": 561.75, "npi": [1396778064]}, {"billed_charge": 335.75, "npi": [1396778064]}, {"billed_charge": 679.25, "npi": [1396778064]}, {"billed_charge": 153.5, "npi": [1396778064]}]}]}]}, {"name": "Laboratory - Urology", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0307", "description": "Laboratory", "allowed_amounts": [{"tin": {"type": "ein", "value": "751047527"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 187.0, "npi": [1396779948]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["59"], "providers": [{"billed_charge": 187.0, "npi": [1396779948]}]}]}]}, {"name": "Laboratory - Urology", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0307", "description": "Laboratory", "allowed_amounts": [{"tin": {"type": "ein", "value": "260194016"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 129.78, "npi": [1205018439]}, {"billed_charge": 83.58, "npi": [1205018439]}, {"billed_charge": 134.97, "npi": [1205018439]}, {"billed_charge": 162.16, "npi": [1205018439]}, {"billed_charge": 168.65, "npi": [1205018439]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["XU"], "providers": [{"billed_charge": 129.78, "npi": [1205018439]}]}]}]}, {"name": "Emergency Room - General", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0450", "description": "Emergency Room", "allowed_amounts": [{"tin": {"type": "ein", "value": "820551704"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 39.015, "billing_code_modifier": [""], "providers": [{"billed_charge": 317.78, "npi": [1649273434]}]}, {"allowed_amount": 308.31, "billing_code_modifier": [""], "providers": [{"billed_charge": 524.33, "npi": [1649273434]}]}, {"allowed_amount": 222.56, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 782.31, "npi": [1649273434]}]}, {"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 407.74, "npi": [1649273434]}, {"billed_charge": 321.2, "npi": [1649273434]}, {"billed_charge": 317.78, "npi": [1649273434]}, {"billed_charge": 4233.71, "npi": [1649273434]}, {"billed_charge": 361.12, "npi": [1649273434]}, {"billed_charge": 2122.8, "npi": [1649273434]}]}, {"allowed_amount": 67.875, "billing_code_modifier": [""], "providers": [{"billed_charge": 317.78, "npi": [1649273434]}]}, {"allowed_amount": 222.56, "billing_code_modifier": [""], "providers": [{"billed_charge": 782.31, "npi": [1649273434]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["XU"], "providers": [{"billed_charge": 902.11, "npi": [1649273434]}, {"billed_charge": 938.19, "npi": [1649273434]}, {"billed_charge": 524.33, "npi": [1649273434]}]}, {"allowed_amount": 67.874, "billing_code_modifier": [""], "providers": [{"billed_charge": 392.06, "npi": [1649273434]}]}, {"allowed_amount": 3791.1, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 4403.06, "npi": [1649273434]}, {"billed_charge": 3879.67, "npi": [1649273434]}]}, {"allowed_amount": 67.87, "billing_code_modifier": [""], "providers": [{"billed_charge": 317.78, "npi": [1649273434]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 1283.4, "npi": [1649273434]}, {"billed_charge": 1408.48, "npi": [1649273434]}]}, {"allowed_amount": 395.66, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 1283.4, "npi": [1649273434]}]}, {"allowed_amount": 308.31, "billing_code_modifier": ["XU"], "providers": [{"billed_charge": 814.34, "npi": [1649273434]}, {"billed_charge": 902.11, "npi": [1649273434]}, {"billed_charge": 524.33, "npi": [1649273434]}]}, {"allowed_amount": 863.2, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 3879.67, "npi": [1649273434]}]}, {"allowed_amount": 200.4, "billing_code_modifier": [""], "providers": [{"billed_charge": 524.33, "npi": [1649273434]}]}, {"allowed_amount": 44.118, "billing_code_modifier": [""], "providers": [{"billed_charge": 392.06, "npi": [1649273434]}]}, {"allowed_amount": 3029.95, "billing_code_modifier": [""], "providers": [{"billed_charge": 7130.03, "npi": [1649273434]}]}, {"allowed_amount": 604.81, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 2964.91, "npi": [1649273434]}, {"billed_charge": 3083.5, "npi": [1649273434]}, {"billed_charge": 2122.8, "npi": [1649273434]}, {"billed_charge": 3356.97, "npi": [1649273434]}]}, {"allowed_amount": 1197.29, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 4233.71, "npi": [1649273434]}]}]}]}, {"name": "Laboratory - Bacteriology & Microbiology", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0306", "description": "Laboratory", "allowed_amounts": [{"tin": {"type": "ein", "value": "461353294"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 105.45, "billing_code_modifier": ["59"], "providers": [{"billed_charge": 370.0, "npi": [1760417646]}]}, {"allowed_amount": 105.45, "billing_code_modifier": [""], "providers": [{"billed_charge": 370.0, "npi": [1760417646]}]}, {"allowed_amount": 37.05, "billing_code_modifier": ["91"], "providers": [{"billed_charge": 200.0, "npi": [1760417646]}]}, {"allowed_amount": 103.19, "billing_code_modifier": [""], "providers": [{"billed_charge": 557.0, "npi": [1760417646]}]}, {"allowed_amount": 57.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 200.0, "npi": [1760417646]}]}, {"allowed_amount": 146.49, "billing_code_modifier": [""], "providers": [{"billed_charge": 514.0, "npi": [1760417646]}]}, {"allowed_amount": 96.33, "billing_code_modifier": [""], "providers": [{"billed_charge": 338.0, "npi": [1760417646]}]}, {"allowed_amount": 158.75, "billing_code_modifier": [""], "providers": [{"billed_charge": 557.0, "npi": [1760417646]}]}, {"allowed_amount": 90.35, "billing_code_modifier": [""], "providers": [{"billed_charge": 317.0, "npi": [1760417646]}]}, {"allowed_amount": 82.08, "billing_code_modifier": [""], "providers": [{"billed_charge": 288.0, "npi": [1760417646]}]}, {"allowed_amount": 58.73, "billing_code_modifier": [""], "providers": [{"billed_charge": 317.0, "npi": [1760417646]}]}, {"allowed_amount": 57.0, "billing_code_modifier": ["91"], "providers": [{"billed_charge": 200.0, "npi": [1760417646]}]}, {"allowed_amount": 103.19, "billing_code_modifier": ["91"], "providers": [{"billed_charge": 557.0, "npi": [1760417646]}]}, {"allowed_amount": 158.75, "billing_code_modifier": ["91"], "providers": [{"billed_charge": 557.0, "npi": [1760417646]}]}, {"allowed_amount": 37.05, "billing_code_modifier": [""], "providers": [{"billed_charge": 200.0, "npi": [1760417646]}]}, {"allowed_amount": 18.24, "billing_code_modifier": [""], "providers": [{"billed_charge": 64.0, "npi": [1760417646]}]}]}]}, {"name": "Pharmacy - General", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0250", "description": "Pharmacy (also see 063x, an extension of 025x)", "allowed_amounts": [{"tin": {"type": "ein", "value": "756001743"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 6.07, "npi": [1336172105]}, {"billed_charge": 37.756, "npi": [1336172105]}, {"billed_charge": 7.3444, "npi": [1336172105]}, {"billed_charge": 1.8325, "npi": [1336172105]}, {"billed_charge": 8.0, "npi": [1336172105]}, {"billed_charge": 5.7479, "npi": [1336172105]}, {"billed_charge": 13.246, "npi": [1336172105]}, {"billed_charge": 6.0882, "npi": [1336172105]}, {"billed_charge": 2.335, "npi": [1336172105]}, {"billed_charge": 3.9845, "npi": [1336172105]}, {"billed_charge": 5.904, "npi": [1336172105]}, {"billed_charge": 4.5, "npi": [1336172105]}, {"billed_charge": 15.075, "npi": [1336172105]}, {"billed_charge": 8.2033, "npi": [1336172105]}, {"billed_charge": 8.6667, "npi": [1336172105]}, {"billed_charge": 2.0, "npi": [1336172105]}, {"billed_charge": 50.0, "npi": [1336172105]}, {"billed_charge": 1.5, "npi": [1336172105]}, {"billed_charge": 1.11, "npi": [1336172105]}, {"billed_charge": 4.1475, "npi": [1336172105]}, {"billed_charge": 0.25, "npi": [1336172105]}, {"billed_charge": 4.8105, "npi": [1336172105]}, {"billed_charge": 18.0, "npi": [1336172105]}, {"billed_charge": 1.0, "npi": [1336172105]}, {"billed_charge": 8.0975, "npi": [1336172105]}, {"billed_charge": 1.835, "npi": [1336172105]}, {"billed_charge": 9.2047, "npi": [1336172105]}]}]}]}, {"name": "Pharmacy - General", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0250", "description": "Pharmacy (also see 063x, an extension of 025x)", "allowed_amounts": [{"tin": {"type": "ein", "value": "751748586"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 0.75, "npi": [1508899204]}, {"billed_charge": 6.4275, "npi": [1508899204]}, {"billed_charge": 2.925, "npi": [1508899204]}, {"billed_charge": 25.75, "npi": [1508899204]}, {"billed_charge": 2.0, "npi": [1508899204]}, {"billed_charge": 5.9721, "npi": [1508899204]}, {"billed_charge": 1.0, "npi": [1508899204]}, {"billed_charge": 2.775, "npi": [1508899204]}, {"billed_charge": 1.3333, "npi": [1508899204]}, {"billed_charge": 8.2367, "npi": [1508899204]}, {"billed_charge": 50.0, "npi": [1508899204]}, {"billed_charge": 1.24, "npi": [1508899204]}, {"billed_charge": 12.95, "npi": [1508899204]}, {"billed_charge": 1.6667, "npi": [1508899204]}, {"billed_charge": 1.055, "npi": [1508899204]}, {"billed_charge": 25.5, "npi": [1508899204]}, {"billed_charge": 2.882, "npi": [1508899204]}]}]}]}, {"name": "Emergency Room - General", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0450", "description": "Emergency Room", "allowed_amounts": [{"tin": {"type": "ein", "value": "751438726"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 103.5, "npi": [1104845015]}, {"billed_charge": 1065.0, "npi": [1104845015]}, {"billed_charge": 2758.25, "npi": [1104845015]}, {"billed_charge": 333.25, "npi": [1104845015]}, {"billed_charge": 254.75, "npi": [1104845015]}]}, {"allowed_amount": 308.82, "billing_code_modifier": ["59"], "providers": [{"billed_charge": 333.25, "npi": [1104845015]}]}, {"allowed_amount": 3797.35, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 2758.25, "npi": [1104845015]}]}, {"allowed_amount": 864.64, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 2758.25, "npi": [1104845015]}]}, {"allowed_amount": 605.81, "billing_code_modifier": [""], "providers": [{"billed_charge": 1521.25, "npi": [1104845015]}]}, {"allowed_amount": 605.81, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 1521.25, "npi": [1104845015]}]}, {"allowed_amount": 396.31, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 1042.5, "npi": [1104845015]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["59"], "providers": [{"billed_charge": 779.25, "npi": [1104845015]}]}, {"allowed_amount": 222.92, "billing_code_modifier": [""], "providers": [{"billed_charge": 537.75, "npi": [1104845015]}]}, {"allowed_amount": 67.99, "billing_code_modifier": [""], "providers": [{"billed_charge": 103.5, "npi": [1104845015]}, {"billed_charge": 333.25, "npi": [1104845015]}]}, {"allowed_amount": 308.82, "billing_code_modifier": [""], "providers": [{"billed_charge": 333.25, "npi": [1104845015]}]}]}]}, {"name": "Pharmacy - IV Solutions", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0258", "description": "Pharmacy (also see 063x, an extension of 025x)", "allowed_amounts": [{"tin": {"type": "ein", "value": "260194016"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 50.0, "npi": [1205018439]}, {"billed_charge": 49.3333, "npi": [1205018439]}]}]}]}, {"name": "EKG/ECG (Electrocardiogram) - General", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0730", "description": "EKG/ECG (Electrocardiogram)", "allowed_amounts": [{"tin": {"type": "ein", "value": "752770738"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 356.0, "npi": [1770514077]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["59"], "providers": [{"billed_charge": 356.0, "npi": [1770514077]}]}]}]}, {"name": "IV Therapy -General", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0260", "description": "IV Therapy", "allowed_amounts": [{"tin": {"type": "ein", "value": "751837454"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 361.12, "npi": [1447250253]}, {"billed_charge": 392.06, "npi": [1447250253]}, {"billed_charge": 317.78, "npi": [1447250253]}, {"billed_charge": 468.18, "npi": [1447250253]}, {"billed_charge": 330.56, "npi": [1447250253]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["XS"], "providers": [{"billed_charge": 902.11, "npi": [1447250253]}, {"billed_charge": 524.33, "npi": [1447250253]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["XU"], "providers": [{"billed_charge": 361.12, "npi": [1447250253]}, {"billed_charge": 392.06, "npi": [1447250253]}, {"billed_charge": 902.11, "npi": [1447250253]}, {"billed_charge": 317.78, "npi": [1447250253]}, {"billed_charge": 524.33, "npi": [1447250253]}]}]}]}, {"name": "Laboratory - Chemistry", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0301", "description": "Laboratory", "allowed_amounts": [{"tin": {"type": "ein", "value": "750800628"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 176.0914, "billing_code_modifier": [""], "providers": [{"billed_charge": 293.4857, "npi": [1194743013]}]}, {"allowed_amount": 166.6, "billing_code_modifier": [""], "providers": [{"billed_charge": 277.6667, "npi": [1194743013]}]}, {"allowed_amount": 106.2, "billing_code_modifier": [""], "providers": [{"billed_charge": 177.0, "npi": [1194743013]}]}, {"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 356.0, "npi": [1194743013]}]}, {"allowed_amount": 188.4, "billing_code_modifier": [""], "providers": [{"billed_charge": 314.0, "npi": [1194743013]}, {"billed_charge": 314.0, "npi": [1720480627]}]}, {"allowed_amount": 177.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 295.0, "npi": [1720480627]}]}, {"allowed_amount": 236.4, "billing_code_modifier": [""], "providers": [{"billed_charge": 394.0, "npi": [1720480627]}]}, {"allowed_amount": 342.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 570.0, "npi": [1720480627]}]}, {"allowed_amount": 223.8, "billing_code_modifier": [""], "providers": [{"billed_charge": 373.0, "npi": [1194743013]}]}, {"allowed_amount": 212.4, "billing_code_modifier": [""], "providers": [{"billed_charge": 354.0, "npi": [1194743013]}, {"billed_charge": 354.0, "npi": [1720480627]}]}, {"allowed_amount": 144.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 240.0, "npi": [1720480627]}, {"billed_charge": 240.0, "npi": [1194743013]}]}, {"allowed_amount": 174.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 290.0, "npi": [1194743013]}]}, {"allowed_amount": 87.6, "billing_code_modifier": [""], "providers": [{"billed_charge": 146.0, "npi": [1720480627]}, {"billed_charge": 146.0, "npi": [1194743013]}]}, {"allowed_amount": 216.3, "billing_code_modifier": [""], "providers": [{"billed_charge": 360.5, "npi": [1720480627]}]}, {"allowed_amount": 294.6, "billing_code_modifier": [""], "providers": [{"billed_charge": 491.0, "npi": [1194743013]}]}, {"allowed_amount": 69.6, "billing_code_modifier": [""], "providers": [{"billed_charge": 116.0, "npi": [1720480627]}]}, {"allowed_amount": 54.6, "billing_code_modifier": [""], "providers": [{"billed_charge": 91.0, "npi": [1194743013]}]}, {"allowed_amount": 213.6, "billing_code_modifier": [""], "providers": [{"billed_charge": 356.0, "npi": [1720480627]}, {"billed_charge": 356.0, "npi": [1194743013]}]}, {"allowed_amount": 188.14, "billing_code_modifier": [""], "providers": [{"billed_charge": 313.5667, "npi": [1194743013]}]}, {"allowed_amount": 153.6, "billing_code_modifier": [""], "providers": [{"billed_charge": 256.0, "npi": [1194743013]}]}, {"allowed_amount": 215.8286, "billing_code_modifier": [""], "providers": [{"billed_charge": 359.7143, "npi": [1194743013]}]}, {"allowed_amount": 130.2, "billing_code_modifier": [""], "providers": [{"billed_charge": 217.0, "npi": [1194743013]}, {"billed_charge": 217.0, "npi": [1720480627]}]}, {"allowed_amount": 202.2, "billing_code_modifier": [""], "providers": [{"billed_charge": 337.0, "npi": [1194743013]}]}, {"allowed_amount": 288.6, "billing_code_modifier": [""], "providers": [{"billed_charge": 481.0, "npi": [1720480627]}, {"billed_charge": 481.0, "npi": [1194743013]}]}, {"allowed_amount": 194.4, "billing_code_modifier": [""], "providers": [{"billed_charge": 324.0, "npi": [1194743013]}, {"billed_charge": 324.0, "npi": [1720480627]}]}, {"allowed_amount": 345.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 575.0, "npi": [1720480627]}, {"billed_charge": 575.0, "npi": [1194743013]}]}]}]}, {"name": "Pharmacy - Extension of 25X - Drug Requiring Detailed Coding", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0636", "description": "Pharmacy - Extension of 25x", "allowed_amounts": [{"tin": {"type": "ein", "value": "751844139"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.49, "billing_code_modifier": [""], "providers": [{"billed_charge": 3.64, "npi": [1265430177]}]}, {"allowed_amount": 0.49, "billing_code_modifier": ["JZ"], "providers": [{"billed_charge": 8.88, "npi": [1265430177]}, {"billed_charge": 5.92, "npi": [1265430177]}, {"billed_charge": 6.06, "npi": [1265430177]}, {"billed_charge": 4.04, "npi": [1265430177]}]}, {"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 13.015, "npi": [1265430177]}, {"billed_charge": 3.2552, "npi": [1265430177]}, {"billed_charge": 0.1304, "npi": [1265430177]}, {"billed_charge": 0.0295, "npi": [1265430177]}, {"billed_charge": 3.1781, "npi": [1265430177]}, {"billed_charge": 16.8, "npi": [1265430177]}, {"billed_charge": 1.7361, "npi": [1265430177]}, {"billed_charge": 0.576, "npi": [1265430177]}, {"billed_charge": 0.031, "npi": [1265430177]}, {"billed_charge": 276.85, "npi": [1265430177]}, {"billed_charge": 20.98, "npi": [1265430177]}, {"billed_charge": 18.06, "npi": [1265430177]}, {"billed_charge": 2.795, "npi": [1265430177]}, {"billed_charge": 8.28, "npi": [1265430177]}, {"billed_charge": 2.82, "npi": [1265430177]}, {"billed_charge": 14.02, "npi": [1265430177]}, {"billed_charge": 97.6, "npi": [1265430177]}, {"billed_charge": 0.95, "npi": [1265430177]}, {"billed_charge": 5.972, "npi": [1265430177]}, {"billed_charge": 29.85, "npi": [1265430177]}, {"billed_charge": 20.1, "npi": [1265430177]}, {"billed_charge": 14.907, "npi": [1265430177]}, {"billed_charge": 42.0, "npi": [1265430177]}, {"billed_charge": 0.3788, "npi": [1265430177]}, {"billed_charge": 10.05, "npi": [1265430177]}, {"billed_charge": 3.8343, "npi": [1265430177]}, {"billed_charge": 27.185, "npi": [1265430177]}, {"billed_charge": 6.06, "npi": [1265430177]}, {"billed_charge": 17.82, "npi": [1265430177]}, {"billed_charge": 0.857, "npi": [1265430177]}, {"billed_charge": 6.33, "npi": [1265430177]}, {"billed_charge": 26.2496, "npi": [1265430177]}, {"billed_charge": 2.16, "npi": [1265430177]}, {"billed_charge": 3.7877, "npi": [1265430177]}, {"billed_charge": 2.2635, "npi": [1265430177]}, {"billed_charge": 20.8932, "npi": [1265430177]}]}, {"allowed_amount": 115.2725, "billing_code_modifier": ["JZ"], "providers": [{"billed_charge": 524.2083, "npi": [1265430177]}]}, {"allowed_amount": 5.8551, "billing_code_modifier": [""], "providers": [{"billed_charge": 14.0556, "npi": [1265430177]}]}, {"allowed_amount": 88.814, "billing_code_modifier": ["JZ"], "providers": [{"billed_charge": 173.7124, "npi": [1265430177]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["JZ"], "providers": [{"billed_charge": 524.2083, "npi": [1265430177]}, {"billed_charge": 0.045, "npi": [1265430177]}, {"billed_charge": 0.468, "npi": [1265430177]}, {"billed_charge": 173.7124, "npi": [1265430177]}, {"billed_charge": 10.5, "npi": [1265430177]}, {"billed_charge": 3.52, "npi": [1265430177]}, {"billed_charge": 0.4668, "npi": [1265430177]}, {"billed_charge": 1.59, "npi": [1265430177]}, {"billed_charge": 2.5004, "npi": [1265430177]}, {"billed_charge": 1.67, "npi": [1265430177]}, {"billed_charge": 0.6398, "npi": [1265430177]}, {"billed_charge": 29.04, "npi": [1265430177]}, {"billed_charge": 14.52, "npi": [1265430177]}, {"billed_charge": 2.82, "npi": [1265430177]}, {"billed_charge": 8.53, "npi": [1265430177]}, {"billed_charge": 15.06, "npi": [1265430177]}, {"billed_charge": 14.5, "npi": [1265430177]}, {"billed_charge": 1.02, "npi": [1265430177]}, {"billed_charge": 8.57, "npi": [1265430177]}, {"billed_charge": 1.925, "npi": [1265430177]}, {"billed_charge": 0.92, "npi": [1265430177]}, {"billed_charge": 12.37, "npi": [1265430177]}, {"billed_charge": 1.6298, "npi": [1265430177]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["JW"], "providers": [{"billed_charge": 0.576, "npi": [1265430177]}, {"billed_charge": 2.2636, "npi": [1265430177]}, {"billed_charge": 0.179, "npi": [1265430177]}]}]}]}, {"name": "Pharmacy - Extension of 25X - Drug Requiring Detailed Coding", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0636", "description": "Pharmacy - Extension of 25x", "allowed_amounts": [{"tin": {"type": "ein", "value": "820551704"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.49, "billing_code_modifier": [""], "providers": [{"billed_charge": 5.25, "npi": [1649273434]}, {"billed_charge": 3.68, "npi": [1649273434]}, {"billed_charge": 1.93, "npi": [1649273434]}]}, {"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 27.6973, "npi": [1649273434]}, {"billed_charge": 3.888, "npi": [1649273434]}, {"billed_charge": 1.668, "npi": [1649273434]}, {"billed_charge": 35.94, "npi": [1649273434]}, {"billed_charge": 31.83, "npi": [1649273434]}, {"billed_charge": 16.5, "npi": [1649273434]}, {"billed_charge": 0.1488, "npi": [1649273434]}, {"billed_charge": 20.11, "npi": [1649273434]}, {"billed_charge": 0.857, "npi": [1649273434]}, {"billed_charge": 0.2952, "npi": [1649273434]}, {"billed_charge": 2.12, "npi": [1649273434]}, {"billed_charge": 42.0, "npi": [1649273434]}, {"billed_charge": 12.52, "npi": [1649273434]}, {"billed_charge": 48.0, "npi": [1649273434]}, {"billed_charge": 3.535, "npi": [1649273434]}, {"billed_charge": 10.2, "npi": [1649273434]}, {"billed_charge": 0.6609, "npi": [1649273434]}, {"billed_charge": 12.39, "npi": [1649273434]}]}, {"allowed_amount": 0.49, "billing_code_modifier": ["JW"], "providers": [{"billed_charge": 5.25, "npi": [1649273434]}]}, {"allowed_amount": 0.32, "billing_code_modifier": ["JW"], "providers": [{"billed_charge": 5.25, "npi": [1649273434]}]}, {"allowed_amount": 0.32, "billing_code_modifier": [""], "providers": [{"billed_charge": 5.25, "npi": [1649273434]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["JZ"], "providers": [{"billed_charge": 22.58, "npi": [1649273434]}, {"billed_charge": 2.2635, "npi": [1649273434]}, {"billed_charge": 0.3775, "npi": [1649273434]}, {"billed_charge": 2.82, "npi": [1649273434]}, {"billed_charge": 1.67, "npi": [1649273434]}, {"billed_charge": 3.35, "npi": [1649273434]}, {"billed_charge": 22.1625, "npi": [1649273434]}, {"billed_charge": 58.08, "npi": [1649273434]}, {"billed_charge": 11.0, "npi": [1649273434]}, {"billed_charge": 1.02, "npi": [1649273434]}, {"billed_charge": 1.59, "npi": [1649273434]}, {"billed_charge": 8.46, "npi": [1649273434]}, {"billed_charge": 5.016, "npi": [1649273434]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["JW"], "providers": [{"billed_charge": 3.59, "npi": [1649273434]}, {"billed_charge": 6.83, "npi": [1649273434]}]}]}]}, {"name": "PSYCHOSOCIAL REHAB SERVICES PER 15 MINUTES", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "H2017", "description": "PSYCHOSOCIAL REHAB SERVICES PER 15 MINUTES", "allowed_amounts": [{"tin": {"type": "ein", "value": "851283674"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 26.93, "billing_code_modifier": [""], "providers": [{"billed_charge": 80.0, "npi": [1679029136]}]}, {"allowed_amount": 5.39, "billing_code_modifier": ["HQ"], "providers": [{"billed_charge": 10.0, "npi": [1679029136]}]}, {"allowed_amount": 26.93, "billing_code_modifier": ["TD"], "providers": [{"billed_charge": 38.75, "npi": [1679029136]}]}]}]}, {"name": "Physical Therapy - Evaluation or Reevaluation", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0424", "description": "Physical Therapy", "allowed_amounts": [{"tin": {"type": "ein", "value": "751837454"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 475.16, "npi": [1447250253]}, {"billed_charge": 508.79, "npi": [1447250253]}, {"billed_charge": 395.47, "npi": [1447250253]}, {"billed_charge": 344.935, "npi": [1447250253]}]}, {"allowed_amount": 142.25, "billing_code_modifier": ["GP"], "providers": [{"billed_charge": 475.16, "npi": [1447250253]}]}, {"allowed_amount": 108.95, "billing_code_modifier": ["GP"], "providers": [{"billed_charge": 395.47, "npi": [1447250253]}]}]}]}, {"name": "Laboratory - General", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0300", "description": "Laboratory", "allowed_amounts": [{"tin": {"type": "ein", "value": "752890358"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 286.75, "npi": [1548291883]}, {"billed_charge": 121.0, "npi": [1548291883]}, {"billed_charge": 41.5, "npi": [1548291883]}]}]}]}, {"name": "Laboratory - Chemistry", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0301", "description": "Laboratory", "allowed_amounts": [{"tin": {"type": "ein", "value": "756001743"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 316.4531, "npi": [1336172105]}, {"billed_charge": 179.5, "npi": [1336172105]}, {"billed_charge": 225.75, "npi": [1336172105]}, {"billed_charge": 565.0, "npi": [1336172105]}, {"billed_charge": 679.25, "npi": [1336172105]}, {"billed_charge": 1474.5, "npi": [1336172105]}, {"billed_charge": 313.0, "npi": [1336172105]}, {"billed_charge": 170.498, "npi": [1336172105]}, {"billed_charge": 324.5, "npi": [1336172105]}, {"billed_charge": 396.1771, "npi": [1336172105]}, {"billed_charge": 334.25, "npi": [1336172105]}, {"billed_charge": 493.5, "npi": [1336172105]}, {"billed_charge": 49.25, "npi": [1336172105]}, {"billed_charge": 123.25, "npi": [1336172105]}, {"billed_charge": 451.75, "npi": [1336172105]}, {"billed_charge": 120.75, "npi": [1336172105]}, {"billed_charge": 157.6903, "npi": [1336172105]}, {"billed_charge": 561.75, "npi": [1336172105]}, {"billed_charge": 129.5, "npi": [1336172105]}, {"billed_charge": 340.0, "npi": [1336172105]}, {"billed_charge": 153.5, "npi": [1336172105]}, {"billed_charge": 611.0, "npi": [1336172105]}, {"billed_charge": 335.75, "npi": [1336172105]}, {"billed_charge": 442.5, "npi": [1336172105]}, {"billed_charge": 350.8676, "npi": [1336172105]}, {"billed_charge": 470.4444, "npi": [1336172105]}, {"billed_charge": 278.25, "npi": [1336172105]}]}, {"allowed_amount": 19.42, "billing_code_modifier": [""], "providers": [{"billed_charge": 679.25, "npi": [1336172105]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["91"], "providers": [{"billed_charge": 140.0, "npi": [1336172105]}, {"billed_charge": 49.25, "npi": [1336172105]}]}]}]}, {"name": "Laboratory - Bacteriology & Microbiology", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0306", "description": "Laboratory", "allowed_amounts": [{"tin": {"type": "ein", "value": "756001743"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 536.25, "npi": [1336172105]}, {"billed_charge": 376.7, "npi": [1336172105]}, {"billed_charge": 317.75, "npi": [1336172105]}, {"billed_charge": 414.5, "npi": [1336172105]}, {"billed_charge": 42.5, "npi": [1336172105]}, {"billed_charge": 515.4722, "npi": [1336172105]}, {"billed_charge": 784.75, "npi": [1336172105]}, {"billed_charge": 259.0152, "npi": [1336172105]}, {"billed_charge": 397.25, "npi": [1336172105]}, {"billed_charge": 252.75, "npi": [1336172105]}, {"billed_charge": 331.0, "npi": [1336172105]}, {"billed_charge": 364.0, "npi": [1336172105]}, {"billed_charge": 237.75, "npi": [1336172105]}, {"billed_charge": 403.0, "npi": [1336172105]}, {"billed_charge": 399.5, "npi": [1336172105]}, {"billed_charge": 294.0, "npi": [1336172105]}, {"billed_charge": 158.5, "npi": [1336172105]}, {"billed_charge": 399.0, "npi": [1336172105]}]}, {"allowed_amount": 74.4, "billing_code_modifier": [""], "providers": [{"billed_charge": 225.25, "npi": [1336172105]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["59"], "providers": [{"billed_charge": 601.75, "npi": [1336172105]}, {"billed_charge": 230.0, "npi": [1336172105]}, {"billed_charge": 1550.0, "npi": [1336172105]}, {"billed_charge": 298.75, "npi": [1336172105]}]}]}]}, {"name": "EKG/ECG (Electrocardiogram) - General", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0730", "description": "EKG/ECG (Electrocardiogram)", "allowed_amounts": [{"tin": {"type": "ein", "value": "751047527"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 356.0, "npi": [1396779948]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["59"], "providers": [{"billed_charge": 356.0, "npi": [1396779948]}]}]}]}, {"name": "Emergency Room - General", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0450", "description": "Emergency Room", "allowed_amounts": [{"tin": {"type": "ein", "value": "461353294"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 370.79, "billing_code_modifier": [""], "providers": [{"billed_charge": 1301.0, "npi": [1760417646]}]}, {"allowed_amount": 61.845, "billing_code_modifier": [""], "providers": [{"billed_charge": 217.0, "npi": [1760417646]}]}, {"allowed_amount": 867.83, "billing_code_modifier": [""], "providers": [{"billed_charge": 3045.0, "npi": [1760417646]}]}, {"allowed_amount": 551.76, "billing_code_modifier": [""], "providers": [{"billed_charge": 1936.0, "npi": [1760417646]}]}, {"allowed_amount": 1380.26, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 4843.0, "npi": [1760417646]}]}, {"allowed_amount": 826.79, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 2901.0, "npi": [1760417646]}]}, {"allowed_amount": 254.22, "billing_code_modifier": ["59"], "providers": [{"billed_charge": 892.0, "npi": [1760417646]}]}, {"allowed_amount": 805.98, "billing_code_modifier": [""], "providers": [{"billed_charge": 2828.0, "npi": [1760417646]}]}, {"allowed_amount": 68.97, "billing_code_modifier": [""], "providers": [{"billed_charge": 242.0, "npi": [1760417646]}]}, {"allowed_amount": 1140.86, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 4003.0, "npi": [1760417646]}]}, {"allowed_amount": 897.17, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 4843.0, "npi": [1760417646]}]}, {"allowed_amount": 1060.49, "billing_code_modifier": [""], "providers": [{"billed_charge": 3721.0, "npi": [1760417646]}]}, {"allowed_amount": 59.85, "billing_code_modifier": [""], "providers": [{"billed_charge": 210.0, "npi": [1760417646]}]}, {"allowed_amount": 551.76, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 1936.0, "npi": [1760417646]}]}]}]}, {"name": "Pharmacy - IV Solutions", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0258", "description": "Pharmacy (also see 063x, an extension of 025x)", "allowed_amounts": [{"tin": {"type": "ein", "value": "752586857"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 40.0, "npi": [1992700983]}, {"billed_charge": 48.0, "npi": [1992700983]}, {"billed_charge": 50.0, "npi": [1992700983]}, {"billed_charge": 47.5, "npi": [1992700983]}, {"billed_charge": 42.0, "npi": [1992700983]}, {"billed_charge": 46.0, "npi": [1992700983]}, {"billed_charge": 45.36, "npi": [1992700983]}, {"billed_charge": 47.958, "npi": [1992700983]}, {"billed_charge": 47.3333, "npi": [1992700983]}, {"billed_charge": 42.4, "npi": [1992700983]}, {"billed_charge": 28.75, "npi": [1992700983]}, {"billed_charge": 43.3333, "npi": [1992700983]}, {"billed_charge": 30.0, "npi": [1992700983]}]}]}]}, {"name": "Pharmacy - Extension of 25X - Drug Requiring Detailed Coding", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0636", "description": "Pharmacy - Extension of 25x", "allowed_amounts": [{"tin": {"type": "ein", "value": "751837454"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 13.861, "billing_code_modifier": ["JZ"], "providers": [{"billed_charge": 40.5, "npi": [1447250253]}]}, {"allowed_amount": 0.49, "billing_code_modifier": ["JZ"], "providers": [{"billed_charge": 5.01, "npi": [1447250253]}, {"billed_charge": 7.52, "npi": [1447250253]}, {"billed_charge": 5.46, "npi": [1447250253]}, {"billed_charge": 15.0, "npi": [1447250253]}, {"billed_charge": 5.92, "npi": [1447250253]}, {"billed_charge": 4.04, "npi": [1447250253]}, {"billed_charge": 22.5, "npi": [1447250253]}, {"billed_charge": 3.64, "npi": [1447250253]}, {"billed_charge": 6.06, "npi": [1447250253]}]}, {"allowed_amount": 0.49, "billing_code_modifier": [""], "providers": [{"billed_charge": 17.1, "npi": [1447250253]}, {"billed_charge": 5.25, "npi": [1447250253]}]}, {"allowed_amount": 457.07, "billing_code_modifier": ["JZ"], "providers": [{"billed_charge": 1868.6, "npi": [1447250253]}]}, {"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 0.5625, "npi": [1447250253]}, {"billed_charge": 1.6479, "npi": [1447250253]}, {"billed_charge": 2.2256, "npi": [1447250253]}, {"billed_charge": 9.4913, "npi": [1447250253]}, {"billed_charge": 3.535, "npi": [1447250253]}, {"billed_charge": 3.74, "npi": [1447250253]}, {"billed_charge": 15.24, "npi": [1447250253]}, {"billed_charge": 29.67, "npi": [1447250253]}, {"billed_charge": 0.9912, "npi": [1447250253]}, {"billed_charge": 17.7, "npi": [1447250253]}, {"billed_charge": 2.12, "npi": [1447250253]}, {"billed_charge": 7.844, "npi": [1447250253]}, {"billed_charge": 0.2064, "npi": [1447250253]}, {"billed_charge": 3.1295, "npi": [1447250253]}, {"billed_charge": 31.6177, "npi": [1447250253]}, {"billed_charge": 0.0173, "npi": [1447250253]}, {"billed_charge": 2.25, "npi": [1447250253]}, {"billed_charge": 29.85, "npi": [1447250253]}, {"billed_charge": 31.8, "npi": [1447250253]}, {"billed_charge": 8.28, "npi": [1447250253]}, {"billed_charge": 35.94, "npi": [1447250253]}, {"billed_charge": 0.2172, "npi": [1447250253]}, {"billed_charge": 0.41, "npi": [1447250253]}, {"billed_charge": 1.6913, "npi": [1447250253]}, {"billed_charge": 2.306, "npi": [1447250253]}, {"billed_charge": 4.9666, "npi": [1447250253]}, {"billed_charge": 0.78, "npi": [1447250253]}, {"billed_charge": 2.795, "npi": [1447250253]}, {"billed_charge": 0.5463, "npi": [1447250253]}, {"billed_charge": 7.5599, "npi": [1447250253]}, {"billed_charge": 9.6238, "npi": [1447250253]}, {"billed_charge": 1.2191, "npi": [1447250253]}, {"billed_charge": 1.9502, "npi": [1447250253]}, {"billed_charge": 18.77, "npi": [1447250253]}, {"billed_charge": 0.3117, "npi": [1447250253]}, {"billed_charge": 42.0, "npi": [1447250253]}, {"billed_charge": 29.28, "npi": [1447250253]}, {"billed_charge": 1.35, "npi": [1447250253]}, {"billed_charge": 0.9651, "npi": [1447250253]}, {"billed_charge": 12.7033, "npi": [1447250253]}, {"billed_charge": 0.0295, "npi": [1447250253]}, {"billed_charge": 0.7853, "npi": [1447250253]}, {"billed_charge": 0.0168, "npi": [1447250253]}, {"billed_charge": 0.1655, "npi": [1447250253]}, {"billed_charge": 4.32, "npi": [1447250253]}, {"billed_charge": 19.2, "npi": [1447250253]}, {"billed_charge": 19.26, "npi": [1447250253]}, {"billed_charge": 140.0, "npi": [1447250253]}, {"billed_charge": 5.0183, "npi": [1447250253]}, {"billed_charge": 0.709, "npi": [1447250253]}, {"billed_charge": 4.6327, "npi": [1447250253]}, {"billed_charge": 1.0111, "npi": [1447250253]}, {"billed_charge": 0.1464, "npi": [1447250253]}, {"billed_charge": 12.52, "npi": [1447250253]}, {"billed_charge": 1.4562, "npi": [1447250253]}, {"billed_charge": 4.8517, "npi": [1447250253]}, {"billed_charge": 2.16, "npi": [1447250253]}, {"billed_charge": 22.2685, "npi": [1447250253]}, {"billed_charge": 3.3435, "npi": [1447250253]}, {"billed_charge": 276.85, "npi": [1447250253]}, {"billed_charge": 1.296, "npi": [1447250253]}, {"billed_charge": 0.0714, "npi": [1447250253]}, {"billed_charge": 2.4807, "npi": [1447250253]}, {"billed_charge": 3.215, "npi": [1447250253]}, {"billed_charge": 0.102, "npi": [1447250253]}, {"billed_charge": 2.9733, "npi": [1447250253]}, {"billed_charge": 0.0715, "npi": [1447250253]}, {"billed_charge": 10.2971, "npi": [1447250253]}, {"billed_charge": 160.65, "npi": [1447250253]}, {"billed_charge": 18.06, "npi": [1447250253]}, {"billed_charge": 5.4928, "npi": [1447250253]}, {"billed_charge": 1.4294, "npi": [1447250253]}, {"billed_charge": 2.97, "npi": [1447250253]}, {"billed_charge": 27.01, "npi": [1447250253]}, {"billed_charge": 0.9845, "npi": [1447250253]}, {"billed_charge": 0.031, "npi": [1447250253]}, {"billed_charge": 18.74, "npi": [1447250253]}, {"billed_charge": 66.0, "npi": [1447250253]}, {"billed_charge": 23.22, "npi": [1447250253]}, {"billed_charge": 0.18, "npi": [1447250253]}, {"billed_charge": 1.1797, "npi": [1447250253]}, {"billed_charge": 19.275, "npi": [1447250253]}, {"billed_charge": 16.44, "npi": [1447250253]}, {"billed_charge": 2.8857, "npi": [1447250253]}, {"billed_charge": 1.655, "npi": [1447250253]}, {"billed_charge": 2.3046, "npi": [1447250253]}, {"billed_charge": 0.0297, "npi": [1447250253]}, {"billed_charge": 5.395, "npi": [1447250253]}, {"billed_charge": 172.03, "npi": [1447250253]}, {"billed_charge": 1.5891, "npi": [1447250253]}, {"billed_charge": 1.394, "npi": [1447250253]}, {"billed_charge": 6.72, "npi": [1447250253]}, {"billed_charge": 20.11, "npi": [1447250253]}, {"billed_charge": 17.82, "npi": [1447250253]}, {"billed_charge": 42.96, "npi": [1447250253]}, {"billed_charge": 11.395, "npi": [1447250253]}, {"billed_charge": 17.68, "npi": [1447250253]}, {"billed_charge": 8.2, "npi": [1447250253]}, {"billed_charge": 1.6683, "npi": [1447250253]}, {"billed_charge": 1.9859, "npi": [1447250253]}]}, {"allowed_amount": 0.49, "billing_code_modifier": ["JW"], "providers": [{"billed_charge": 17.1, "npi": [1447250253]}, {"billed_charge": 5.25, "npi": [1447250253]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["JZU8"], "providers": [{"billed_charge": 1.29, "npi": [1447250253]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["U8"], "providers": [{"billed_charge": 0.78, "npi": [1447250253]}, {"billed_charge": 66.0, "npi": [1447250253]}, {"billed_charge": 5.395, "npi": [1447250253]}]}, {"allowed_amount": 0.495, "billing_code_modifier": ["JZ"], "providers": [{"billed_charge": 17.1, "npi": [1447250253]}, {"billed_charge": 2.76, "npi": [1447250253]}, {"billed_charge": 5.25, "npi": [1447250253]}]}, {"allowed_amount": 351.157, "billing_code_modifier": ["JZ"], "providers": [{"billed_charge": 1021.572, "npi": [1447250253]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["JZ"], "providers": [{"billed_charge": 6.562, "npi": [1447250253]}, {"billed_charge": 1.29, "npi": [1447250253]}, {"billed_charge": 2.4, "npi": [1447250253]}, {"billed_charge": 14.52, "npi": [1447250253]}, {"billed_charge": 0.162, "npi": [1447250253]}, {"billed_charge": 11.22, "npi": [1447250253]}, {"billed_charge": 4.32, "npi": [1447250253]}, {"billed_charge": 19.2, "npi": [1447250253]}, {"billed_charge": 0.69, "npi": [1447250253]}, {"billed_charge": 6.18, "npi": [1447250253]}, {"billed_charge": 2.82, "npi": [1447250253]}, {"billed_charge": 6.47, "npi": [1447250253]}, {"billed_charge": 4.8517, "npi": [1447250253]}, {"billed_charge": 29.04, "npi": [1447250253]}, {"billed_charge": 2.5004, "npi": [1447250253]}, {"billed_charge": 0.9, "npi": [1447250253]}, {"billed_charge": 0.3288, "npi": [1447250253]}, {"billed_charge": 5.75, "npi": [1447250253]}, {"billed_charge": 0.0714, "npi": [1447250253]}, {"billed_charge": 6.36, "npi": [1447250253]}, {"billed_charge": 0.4668, "npi": [1447250253]}, {"billed_charge": 5.355, "npi": [1447250253]}, {"billed_charge": 1.02, "npi": [1447250253]}, {"billed_charge": 272.825, "npi": [1447250253]}, {"billed_charge": 3.52, "npi": [1447250253]}, {"billed_charge": 18.0, "npi": [1447250253]}, {"billed_charge": 1.925, "npi": [1447250253]}, {"billed_charge": 21.78, "npi": [1447250253]}, {"billed_charge": 0.0675, "npi": [1447250253]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["JW"], "providers": [{"billed_charge": 4.32, "npi": [1447250253]}, {"billed_charge": 4.8525, "npi": [1447250253]}]}]}]}, {"name": "Medical/Surgical Supplies and Devices - Sterile Supply", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0272", "description": "Med/Surg Supplies &Devices (also see 062x, extension of 027x", "allowed_amounts": [{"tin": {"type": "ein", "value": "756001743"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 10.0, "npi": [1336172105]}, {"billed_charge": 142.0, "npi": [1336172105]}, {"billed_charge": 9.4615, "npi": [1336172105]}, {"billed_charge": 182.7311, "npi": [1336172105]}, {"billed_charge": 14.3846, "npi": [1336172105]}, {"billed_charge": 12.3333, "npi": [1336172105]}, {"billed_charge": 5.0, "npi": [1336172105]}, {"billed_charge": 10.55, "npi": [1336172105]}, {"billed_charge": 1102.037, "npi": [1336172105]}, {"billed_charge": 31.4848, "npi": [1336172105]}, {"billed_charge": 3.0, "npi": [1336172105]}, {"billed_charge": 148.0, "npi": [1336172105]}, {"billed_charge": 12.5, "npi": [1336172105]}]}]}]}, {"name": "IADNA HUMAN PAPILLOMAVIRUS HI-RSK TYP POOLD RSLT", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "87624", "description": "IADNA HUMAN PAPILLOMAVIRUS HI-RSK TYP POOLD RSLT", "allowed_amounts": [{"tin": {"type": "ein", "value": "812532457"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 10.09, "billing_code_modifier": [""], "providers": [{"billed_charge": 145.0, "npi": [1295331221]}]}, {"allowed_amount": 35.09, "billing_code_modifier": [""], "providers": [{"billed_charge": 145.0, "npi": [1295331221]}]}]}]}, {"name": "Radiology - Diagnostic - General", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0320", "description": "Radiology - Diagnostic", "allowed_amounts": [{"tin": {"type": "ein", "value": "753175630"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 126.14, "billing_code_modifier": ["LT"], "providers": [{"billed_charge": 458.0, "npi": [1285798918]}]}, {"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 398.0, "npi": [1285798918]}, {"billed_charge": 728.0, "npi": [1285798918]}, {"billed_charge": 497.0, "npi": [1285798918]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["RT"], "providers": [{"billed_charge": 353.0, "npi": [1285798918]}, {"billed_charge": 306.0, "npi": [1285798918]}, {"billed_charge": 519.0, "npi": [1285798918]}, {"billed_charge": 453.0, "npi": [1285798918]}, {"billed_charge": 458.0, "npi": [1285798918]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["LT"], "providers": [{"billed_charge": 353.0, "npi": [1285798918]}, {"billed_charge": 306.0, "npi": [1285798918]}, {"billed_charge": 458.0, "npi": [1285798918]}]}]}]}, {"name": "Pharmacy - IV Solutions", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0258", "description": "Pharmacy (also see 063x, an extension of 025x)", "allowed_amounts": [{"tin": {"type": "ein", "value": "751837454"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 49.8857, "npi": [1447250253]}, {"billed_charge": 45.48, "npi": [1447250253]}, {"billed_charge": 49.3846, "npi": [1447250253]}, {"billed_charge": 42.0, "npi": [1447250253]}, {"billed_charge": 50.0, "npi": [1447250253]}, {"billed_charge": 48.875, "npi": [1447250253]}, {"billed_charge": 49.75, "npi": [1447250253]}, {"billed_charge": 39.5, "npi": [1447250253]}, {"billed_charge": 40.6667, "npi": [1447250253]}, {"billed_charge": 49.7576, "npi": [1447250253]}, {"billed_charge": 48.5054, "npi": [1447250253]}, {"billed_charge": 46.8, "npi": [1447250253]}, {"billed_charge": 47.629, "npi": [1447250253]}, {"billed_charge": 45.7386, "npi": [1447250253]}, {"billed_charge": 49.0833, "npi": [1447250253]}, {"billed_charge": 48.0, "npi": [1447250253]}, {"billed_charge": 38.0, "npi": [1447250253]}, {"billed_charge": 49.1111, "npi": [1447250253]}, {"billed_charge": 25.5, "npi": [1447250253]}, {"billed_charge": 48.9565, "npi": [1447250253]}, {"billed_charge": 29.9167, "npi": [1447250253]}, {"billed_charge": 47.3333, "npi": [1447250253]}, {"billed_charge": 43.8462, "npi": [1447250253]}, {"billed_charge": 49.8095, "npi": [1447250253]}]}]}]}, {"name": "Laboratory - General", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0300", "description": "Laboratory", "allowed_amounts": [{"tin": {"type": "ein", "value": "756001743"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 205.25, "npi": [1336172105]}, {"billed_charge": 208.25, "npi": [1336172105]}, {"billed_charge": 41.5, "npi": [1336172105]}, {"billed_charge": 563.9167, "npi": [1336172105]}, {"billed_charge": 286.75, "npi": [1336172105]}, {"billed_charge": 272.8125, "npi": [1336172105]}, {"billed_charge": 745.75, "npi": [1336172105]}]}]}]}, {"name": "Laboratory - Bacteriology & Microbiology", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0306", "description": "Laboratory", "allowed_amounts": [{"tin": {"type": "ein", "value": "751837454"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 206.81, "billing_code_modifier": [""], "providers": [{"billed_charge": 174.88, "npi": [1447250253]}]}, {"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 211.26, "npi": [1447250253]}, {"billed_charge": 219.4467, "npi": [1447250253]}, {"billed_charge": 239.1125, "npi": [1447250253]}, {"billed_charge": 173.75, "npi": [1447250253]}, {"billed_charge": 234.125, "npi": [1447250253]}, {"billed_charge": 123.65, "npi": [1447250253]}, {"billed_charge": 800.315, "npi": [1447250253]}, {"billed_charge": 125.99, "npi": [1447250253]}, {"billed_charge": 476.0733, "npi": [1447250253]}, {"billed_charge": 241.82, "npi": [1447250253]}, {"billed_charge": 239.4782, "npi": [1447250253]}, {"billed_charge": 292.71, "npi": [1447250253]}, {"billed_charge": 268.8938, "npi": [1447250253]}, {"billed_charge": 215.5, "npi": [1447250253]}, {"billed_charge": 323.69, "npi": [1447250253]}, {"billed_charge": 294.745, "npi": [1447250253]}, {"billed_charge": 293.935, "npi": [1447250253]}, {"billed_charge": 259.4014, "npi": [1447250253]}, {"billed_charge": 269.3862, "npi": [1447250253]}, {"billed_charge": 285.48, "npi": [1447250253]}, {"billed_charge": 214.958, "npi": [1447250253]}, {"billed_charge": 254.2, "npi": [1447250253]}, {"billed_charge": 457.286, "npi": [1447250253]}, {"billed_charge": 254.0341, "npi": [1447250253]}, {"billed_charge": 357.2425, "npi": [1447250253]}, {"billed_charge": 1425.75, "npi": [1447250253]}, {"billed_charge": 210.1733, "npi": [1447250253]}, {"billed_charge": 203.2842, "npi": [1447250253]}, {"billed_charge": 17.0, "npi": [1447250253]}, {"billed_charge": 246.6145, "npi": [1447250253]}, {"billed_charge": 279.589, "npi": [1447250253]}, {"billed_charge": 282.44, "npi": [1447250253]}, {"billed_charge": 249.8833, "npi": [1447250253]}, {"billed_charge": 240.5129, "npi": [1447250253]}, {"billed_charge": 248.808, "npi": [1447250253]}, {"billed_charge": 224.1971, "npi": [1447250253]}, {"billed_charge": 340.52, "npi": [1447250253]}, {"billed_charge": 102.41, "npi": [1447250253]}, {"billed_charge": 202.7271, "npi": [1447250253]}, {"billed_charge": 208.225, "npi": [1447250253]}, {"billed_charge": 269.01, "npi": [1447250253]}, {"billed_charge": 197.09, "npi": [1447250253]}, {"billed_charge": 277.865, "npi": [1447250253]}, {"billed_charge": 219.455, "npi": [1447250253]}, {"billed_charge": 247.4313, "npi": [1447250253]}, {"billed_charge": 702.2633, "npi": [1447250253]}]}, {"allowed_amount": 148.49, "billing_code_modifier": [""], "providers": [{"billed_charge": 102.41, "npi": [1447250253]}]}]}]}, {"name": "Laboratory - Bacteriology & Microbiology", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0306", "description": "Laboratory", "allowed_amounts": [{"tin": {"type": "ein", "value": "753175630"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 206.81, "billing_code_modifier": [""], "providers": [{"billed_charge": 520.0, "npi": [1285798918]}]}, {"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 159.3333, "npi": [1285798918]}, {"billed_charge": 43.0, "npi": [1285798918]}, {"billed_charge": 198.0, "npi": [1285798918]}, {"billed_charge": 119.0, "npi": [1285798918]}, {"billed_charge": 291.0, "npi": [1285798918]}, {"billed_charge": 133.0, "npi": [1285798918]}, {"billed_charge": 103.0, "npi": [1285798918]}, {"billed_charge": 105.0, "npi": [1285798918]}, {"billed_charge": 338.0, "npi": [1285798918]}, {"billed_charge": 67.0, "npi": [1285798918]}]}, {"allowed_amount": 604.33, "billing_code_modifier": [""], "providers": [{"billed_charge": 1250.0, "npi": [1285798918]}]}, {"allowed_amount": 123.4, "billing_code_modifier": [""], "providers": [{"billed_charge": 578.0, "npi": [1285798918]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["59"], "providers": [{"billed_charge": 105.0, "npi": [1285798918]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["91"], "providers": [{"billed_charge": 133.0, "npi": [1285798918]}]}]}]}, {"name": "GROUND MILEAGE PER STATUTE MILE", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "A0425", "description": "GROUND MILEAGE PER STATUTE MILE", "allowed_amounts": [{"tin": {"type": "ein", "value": "756000640"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 22.5, "billing_code_modifier": ["PH"], "providers": [{"billed_charge": 22.5, "npi": [1982742698]}]}, {"allowed_amount": 22.5, "billing_code_modifier": ["SH76"], "providers": [{"billed_charge": 22.5, "npi": [1982742698]}]}, {"allowed_amount": 22.5, "billing_code_modifier": ["SH"], "providers": [{"billed_charge": 22.5, "npi": [1982742698]}]}, {"allowed_amount": 22.5, "billing_code_modifier": ["RH"], "providers": [{"billed_charge": 22.5, "npi": [1982742698]}]}, {"allowed_amount": 22.5, "billing_code_modifier": ["ETRH"], "providers": [{"billed_charge": 22.5, "npi": [1982742698]}]}]}]}, {"name": "Pharmacy - Extension of 25X - Drug Requiring Detailed Coding", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0636", "description": "Pharmacy - Extension of 25x", "allowed_amounts": [{"tin": {"type": "ein", "value": "750972805"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.49, "billing_code_modifier": ["JZ"], "providers": [{"billed_charge": 10.0, "npi": [1174533343]}]}, {"allowed_amount": 0.49, "billing_code_modifier": [""], "providers": [{"billed_charge": 13.0, "npi": [1174533343]}, {"billed_charge": 10.0, "npi": [1174533343]}]}, {"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 0.3056, "npi": [1174533343]}, {"billed_charge": 22.69, "npi": [1174533343]}, {"billed_charge": 15.4287, "npi": [1174533343]}, {"billed_charge": 15.28, "npi": [1174533343]}, {"billed_charge": 0.1277, "npi": [1174533343]}, {"billed_charge": 9.0, "npi": [1174533343]}, {"billed_charge": 1.0, "npi": [1174533343]}, {"billed_charge": 12.5, "npi": [1174533343]}, {"billed_charge": 0.165, "npi": [1174533343]}, {"billed_charge": 0.9961, "npi": [1174533343]}, {"billed_charge": 1.4599, "npi": [1174533343]}, {"billed_charge": 1.368, "npi": [1174533343]}, {"billed_charge": 30.0, "npi": [1174533343]}, {"billed_charge": 10.0, "npi": [1174533343]}, {"billed_charge": 7.5, "npi": [1174533343]}, {"billed_charge": 2.4608, "npi": [1174533343]}, {"billed_charge": 64.35, "npi": [1174533343]}, {"billed_charge": 0.125, "npi": [1174533343]}, {"billed_charge": 3.42, "npi": [1174533343]}, {"billed_charge": 3.99, "npi": [1174533343]}, {"billed_charge": 28.28, "npi": [1174533343]}, {"billed_charge": 8.922, "npi": [1174533343]}, {"billed_charge": 6.25, "npi": [1174533343]}, {"billed_charge": 0.984, "npi": [1174533343]}, {"billed_charge": 25.0, "npi": [1174533343]}, {"billed_charge": 23.15, "npi": [1174533343]}, {"billed_charge": 102.83, "npi": [1174533343]}, {"billed_charge": 19.07, "npi": [1174533343]}, {"billed_charge": 2.5, "npi": [1174533343]}, {"billed_charge": 7.8375, "npi": [1174533343]}, {"billed_charge": 50.0, "npi": [1174533343]}, {"billed_charge": 10.57, "npi": [1174533343]}, {"billed_charge": 0.3546, "npi": [1174533343]}, {"billed_charge": 15.0, "npi": [1174533343]}, {"billed_charge": 0.3583, "npi": [1174533343]}, {"billed_charge": 2.7243, "npi": [1174533343]}, {"billed_charge": 8.8047, "npi": [1174533343]}, {"billed_charge": 2.1951, "npi": [1174533343]}, {"billed_charge": 9.1892, "npi": [1174533343]}, {"billed_charge": 5.0, "npi": [1174533343]}, {"billed_charge": 14.345, "npi": [1174533343]}, {"billed_charge": 0.2, "npi": [1174533343]}, {"billed_charge": 0.3584, "npi": [1174533343]}]}, {"allowed_amount": 0.49, "billing_code_modifier": ["JW"], "providers": [{"billed_charge": 13.0, "npi": [1174533343]}, {"billed_charge": 10.0, "npi": [1174533343]}]}, {"allowed_amount": 0.495, "billing_code_modifier": ["JZ"], "providers": [{"billed_charge": 13.0, "npi": [1174533343]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["JZ"], "providers": [{"billed_charge": 16.33, "npi": [1174533343]}, {"billed_charge": 9.0, "npi": [1174533343]}, {"billed_charge": 0.5, "npi": [1174533343]}, {"billed_charge": 1.9004, "npi": [1174533343]}, {"billed_charge": 7.5, "npi": [1174533343]}, {"billed_charge": 0.1551, "npi": [1174533343]}, {"billed_charge": 25.0, "npi": [1174533343]}, {"billed_charge": 0.5206, "npi": [1174533343]}, {"billed_charge": 10.41, "npi": [1174533343]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["JW"], "providers": [{"billed_charge": 9.0, "npi": [1174533343]}, {"billed_charge": 10.0, "npi": [1174533343]}, {"billed_charge": 5.0, "npi": [1174533343]}]}]}]}, {"name": "GROUND MILEAGE PER STATUTE MILE", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "A0425", "description": "GROUND MILEAGE PER STATUTE MILE", "allowed_amounts": [{"tin": {"type": "ein", "value": "300688582"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 30.3229, "billing_code_modifier": ["RH"], "providers": [{"billed_charge": 46.1, "npi": [1750676870]}]}, {"allowed_amount": 30.3227, "billing_code_modifier": ["HR"], "providers": [{"billed_charge": 46.1, "npi": [1750676870]}]}, {"allowed_amount": 30.322, "billing_code_modifier": ["HH"], "providers": [{"billed_charge": 46.1, "npi": [1750676870]}]}, {"allowed_amount": 30.3225, "billing_code_modifier": ["HE"], "providers": [{"billed_charge": 46.1, "npi": [1750676870]}]}, {"allowed_amount": 45.9225, "billing_code_modifier": ["HH"], "providers": [{"billed_charge": 46.1, "npi": [1750676870]}]}, {"allowed_amount": 30.3223, "billing_code_modifier": ["HH"], "providers": [{"billed_charge": 46.1, "npi": [1750676870]}]}, {"allowed_amount": 30.3229, "billing_code_modifier": ["HH"], "providers": [{"billed_charge": 46.1, "npi": [1750676870]}]}, {"allowed_amount": 30.32, "billing_code_modifier": ["HH"], "providers": [{"billed_charge": 46.1, "npi": [1750676870]}]}, {"allowed_amount": 30.3233, "billing_code_modifier": ["PH"], "providers": [{"billed_charge": 46.1, "npi": [1750676870]}]}, {"allowed_amount": 30.3227, "billing_code_modifier": ["HE"], "providers": [{"billed_charge": 46.1, "npi": [1750676870]}]}, {"allowed_amount": 30.3227, "billing_code_modifier": ["EH"], "providers": [{"billed_charge": 46.1, "npi": [1750676870]}]}, {"allowed_amount": 30.3224, "billing_code_modifier": ["RH"], "providers": [{"billed_charge": 46.1, "npi": [1750676870]}]}, {"allowed_amount": 30.325, "billing_code_modifier": ["HH"], "providers": [{"billed_charge": 46.1, "npi": [1750676870]}]}, {"allowed_amount": 30.3227, "billing_code_modifier": ["HH"], "providers": [{"billed_charge": 46.1, "npi": [1750676870]}]}, {"allowed_amount": 30.3225, "billing_code_modifier": ["HR"], "providers": [{"billed_charge": 46.1, "npi": [1750676870]}]}, {"allowed_amount": 30.32, "billing_code_modifier": ["PH"], "providers": [{"billed_charge": 46.1, "npi": [1750676870]}]}, {"allowed_amount": 30.3224, "billing_code_modifier": ["HH"], "providers": [{"billed_charge": 46.1, "npi": [1750676870]}]}, {"allowed_amount": 30.323, "billing_code_modifier": ["HE"], "providers": [{"billed_charge": 46.1, "npi": [1750676870]}]}, {"allowed_amount": 30.3233, "billing_code_modifier": ["HE"], "providers": [{"billed_charge": 46.1, "npi": [1750676870]}]}, {"allowed_amount": 30.3225, "billing_code_modifier": ["HH"], "providers": [{"billed_charge": 46.1, "npi": [1750676870]}]}, {"allowed_amount": 30.3226, "billing_code_modifier": ["HR"], "providers": [{"billed_charge": 46.1, "npi": [1750676870]}]}, {"allowed_amount": 30.3226, "billing_code_modifier": ["HH"], "providers": [{"billed_charge": 46.1, "npi": [1750676870]}]}]}]}, {"name": "EKG/ECG (Electrocardiogram) - General", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0730", "description": "EKG/ECG (Electrocardiogram)", "allowed_amounts": [{"tin": {"type": "ein", "value": "750972805"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 356.0, "npi": [1174533343]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["59"], "providers": [{"billed_charge": 356.0, "npi": [1174533343]}]}]}]}, {"name": "STERIL WATER SALINE  and  OR DXT DILUENT/FLUSH 10 ML", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "A4216", "description": "STERIL WATER SALINE  and  OR DXT DILUENT/FLUSH 10 ML", "allowed_amounts": [{"tin": {"type": "ein", "value": "853503076"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 139.3, "npi": [1124623889]}]}]}]}, {"name": "Pharmacy - IV Solutions", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0258", "description": "Pharmacy (also see 063x, an extension of 025x)", "allowed_amounts": [{"tin": {"type": "ein", "value": "751844139"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 49.68, "npi": [1265430177]}, {"billed_charge": 43.8333, "npi": [1265430177]}, {"billed_charge": 35.5, "npi": [1265430177]}, {"billed_charge": 45.7333, "npi": [1265430177]}, {"billed_charge": 50.0, "npi": [1265430177]}, {"billed_charge": 30.0, "npi": [1265430177]}, {"billed_charge": 47.0435, "npi": [1265430177]}, {"billed_charge": 43.9, "npi": [1265430177]}, {"billed_charge": 48.6667, "npi": [1265430177]}]}]}]}, {"name": "Laboratory - Hematology", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0305", "description": "Laboratory", "allowed_amounts": [{"tin": {"type": "ein", "value": "472177648"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 255.33, "npi": [1790174860]}, {"billed_charge": 237.3, "npi": [1790174860]}, {"billed_charge": 133.0, "npi": [1790174860]}, {"billed_charge": 239.2886, "npi": [1790174860]}, {"billed_charge": 246.0, "npi": [1790174860]}, {"billed_charge": 211.67, "npi": [1790174860]}, {"billed_charge": 226.0, "npi": [1790174860]}, {"billed_charge": 250.34, "npi": [1790174860]}, {"billed_charge": 181.65, "npi": [1790174860]}, {"billed_charge": 242.5575, "npi": [1790174860]}, {"billed_charge": 168.4444, "npi": [1790174860]}, {"billed_charge": 262.86, "npi": [1790174860]}, {"billed_charge": 258.3, "npi": [1790174860]}, {"billed_charge": 208.72, "npi": [1790174860]}, {"billed_charge": 173.0, "npi": [1790174860]}, {"billed_charge": 139.65, "npi": [1790174860]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["91"], "providers": [{"billed_charge": 250.34, "npi": [1790174860]}]}, {"allowed_amount": 11.27, "billing_code_modifier": [""], "providers": [{"billed_charge": 262.86, "npi": [1790174860]}]}, {"allowed_amount": 6.22, "billing_code_modifier": [""], "providers": [{"billed_charge": 258.3, "npi": [1790174860]}]}]}]}, {"name": "Emergency Room - General", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0450", "description": "Emergency Room", "allowed_amounts": [{"tin": {"type": "ein", "value": "432008974"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 308.31, "billing_code_modifier": [""], "providers": [{"billed_charge": 333.25, "npi": [1003883158]}, {"billed_charge": 779.25, "npi": [1003883158]}]}, {"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 939.5, "npi": [1003883158]}, {"billed_charge": 333.25, "npi": [1003883158]}, {"billed_charge": 542.5, "npi": [1003883158]}, {"billed_charge": 1290.25, "npi": [1003883158]}]}, {"allowed_amount": 67.875, "billing_code_modifier": [""], "providers": [{"billed_charge": 333.25, "npi": [1003883158]}]}, {"allowed_amount": 122.22, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 332.25, "npi": [1003883158]}]}, {"allowed_amount": 3791.1, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 2758.25, "npi": [1003883158]}]}, {"allowed_amount": 67.87, "billing_code_modifier": [""], "providers": [{"billed_charge": 333.25, "npi": [1003883158]}, {"billed_charge": 103.5, "npi": [1003883158]}]}, {"allowed_amount": 67.8733, "billing_code_modifier": [""], "providers": [{"billed_charge": 333.25, "npi": [1003883158]}]}, {"allowed_amount": 395.66, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 1042.5, "npi": [1003883158]}]}, {"allowed_amount": 395.66, "billing_code_modifier": [""], "providers": [{"billed_charge": 1042.5, "npi": [1003883158]}]}, {"allowed_amount": 863.2, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 2758.25, "npi": [1003883158]}]}, {"allowed_amount": 308.31, "billing_code_modifier": ["59"], "providers": [{"billed_charge": 333.25, "npi": [1003883158]}]}, {"allowed_amount": 604.81, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 1521.25, "npi": [1003883158]}]}]}]}, {"name": "CYTP C/V AUTO THIN LYR PREPJ SCR MNL RESCR PHYS", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "88175", "description": "CYTP C/V AUTO THIN LYR PREPJ SCR MNL RESCR PHYS", "allowed_amounts": [{"tin": {"type": "ein", "value": "812532457"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 26.61, "billing_code_modifier": [""], "providers": [{"billed_charge": 120.0, "npi": [1295331221]}]}]}]}, {"name": "Pharmacy - Extension of 25X - Drug Requiring Detailed Coding", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0636", "description": "Pharmacy - Extension of 25x", "allowed_amounts": [{"tin": {"type": "ein", "value": "452694620"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.49, "billing_code_modifier": [""], "providers": [{"billed_charge": 23.19, "npi": [1033120423]}]}, {"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 29.71, "npi": [1033120423]}, {"billed_charge": 49.22, "npi": [1033120423]}, {"billed_charge": 17.83, "npi": [1033120423]}, {"billed_charge": 0.68, "npi": [1033120423]}, {"billed_charge": 46.75, "npi": [1033120423]}, {"billed_charge": 41.86, "npi": [1033120423]}, {"billed_charge": 8.6025, "npi": [1033120423]}, {"billed_charge": 2.2236, "npi": [1033120423]}, {"billed_charge": 12.0843, "npi": [1033120423]}, {"billed_charge": 8.63, "npi": [1033120423]}, {"billed_charge": 36.59, "npi": [1033120423]}, {"billed_charge": 15.1124, "npi": [1033120423]}, {"billed_charge": 1.5077, "npi": [1033120423]}, {"billed_charge": 1.1021, "npi": [1033120423]}, {"billed_charge": 2.5316, "npi": [1033120423]}, {"billed_charge": 7.225, "npi": [1033120423]}, {"billed_charge": 19.1533, "npi": [1033120423]}, {"billed_charge": 7.6634, "npi": [1033120423]}, {"billed_charge": 49.29, "npi": [1033120423]}, {"billed_charge": 0.3714, "npi": [1033120423]}, {"billed_charge": 46.55, "npi": [1033120423]}, {"billed_charge": 251.04, "npi": [1033120423]}, {"billed_charge": 54.98, "npi": [1033120423]}, {"billed_charge": 16.7025, "npi": [1033120423]}, {"billed_charge": 5.0775, "npi": [1033120423]}]}, {"allowed_amount": 0.49, "billing_code_modifier": ["JW"], "providers": [{"billed_charge": 8.82, "npi": [1033120423]}]}, {"allowed_amount": 0.495, "billing_code_modifier": [""], "providers": [{"billed_charge": 16.0, "npi": [1033120423]}, {"billed_charge": 16.005, "npi": [1033120423]}]}, {"allowed_amount": 0.4925, "billing_code_modifier": ["JZ"], "providers": [{"billed_charge": 10.8575, "npi": [1033120423]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["JZ"], "providers": [{"billed_charge": 0.829, "npi": [1033120423]}, {"billed_charge": 1.4088, "npi": [1033120423]}, {"billed_charge": 5.0775, "npi": [1033120423]}]}]}]}, {"name": "INTENSIVE OP PSYCHIATRIC SERVICES PER DIEM", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "S9480", "description": "INTENSIVE OP PSYCHIATRIC SERVICES PER DIEM", "allowed_amounts": [{"tin": {"type": "ein", "value": "853060929"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 900.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 3000.0, "npi": [1548860406]}]}]}]}, {"name": "Laboratory - Bacteriology & Microbiology", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0306", "description": "Laboratory", "allowed_amounts": [{"tin": {"type": "ein", "value": "452694620"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 206.81, "billing_code_modifier": [""], "providers": [{"billed_charge": 1044.1, "npi": [1033120423]}]}, {"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 474.6967, "npi": [1033120423]}, {"billed_charge": 254.34, "npi": [1033120423]}, {"billed_charge": 311.53, "npi": [1033120423]}, {"billed_charge": 705.6433, "npi": [1033120423]}, {"billed_charge": 556.28, "npi": [1033120423]}, {"billed_charge": 448.1483, "npi": [1033120423]}, {"billed_charge": 359.52, "npi": [1033120423]}, {"billed_charge": 270.33, "npi": [1033120423]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["XU"], "providers": [{"billed_charge": 556.28, "npi": [1033120423]}]}]}]}, {"name": "Emergency Room - General", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0450", "description": "Emergency Room", "allowed_amounts": [{"tin": {"type": "ein", "value": "472177648"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 308.31, "billing_code_modifier": [""], "providers": [{"billed_charge": 1607.0, "npi": [1790174860]}, {"billed_charge": 1687.35, "npi": [1790174860]}, {"billed_charge": 874.75, "npi": [1790174860]}, {"billed_charge": 1451.0, "npi": [1790174860]}, {"billed_charge": 833.09, "npi": [1790174860]}]}, {"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 2141.07, "npi": [1790174860]}, {"billed_charge": 661.0, "npi": [1790174860]}, {"billed_charge": 1644.7025, "npi": [1790174860]}, {"billed_charge": 2060.1767, "npi": [1790174860]}, {"billed_charge": 1133.0, "npi": [1790174860]}, {"billed_charge": 4160.56, "npi": [1790174860]}, {"billed_charge": 3449.05, "npi": [1790174860]}, {"billed_charge": 1115.5386, "npi": [1790174860]}, {"billed_charge": 3962.43, "npi": [1790174860]}]}, {"allowed_amount": 67.875, "billing_code_modifier": [""], "providers": [{"billed_charge": 496.42, "npi": [1790174860]}]}, {"allowed_amount": 604.81, "billing_code_modifier": [""], "providers": [{"billed_charge": 1835.0, "npi": [1790174860]}]}, {"allowed_amount": 67.87, "billing_code_modifier": ["XU"], "providers": [{"billed_charge": 771.75, "npi": [1790174860]}]}, {"allowed_amount": 222.56, "billing_code_modifier": [""], "providers": [{"billed_charge": 690.0, "npi": [1790174860]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["XU"], "providers": [{"billed_charge": 1133.0, "npi": [1790174860]}, {"billed_charge": 1189.65, "npi": [1790174860]}]}, {"allowed_amount": 3791.1, "billing_code_modifier": [""], "providers": [{"billed_charge": 3962.43, "npi": [1790174860]}]}, {"allowed_amount": 3791.1, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 3621.51, "npi": [1790174860]}, {"billed_charge": 4160.56, "npi": [1790174860]}, {"billed_charge": 3962.43, "npi": [1790174860]}]}, {"allowed_amount": 589.22, "billing_code_modifier": [""], "providers": [{"billed_charge": 1549.85, "npi": [1790174860]}]}, {"allowed_amount": 67.87, "billing_code_modifier": [""], "providers": [{"billed_charge": 496.42, "npi": [1790174860]}, {"billed_charge": 735.0, "npi": [1790174860]}, {"billed_charge": 472.78, "npi": [1790174860]}, {"billed_charge": 771.75, "npi": [1790174860]}]}, {"allowed_amount": 863.2, "billing_code_modifier": [""], "providers": [{"billed_charge": 4160.56, "npi": [1790174860]}, {"billed_charge": 3962.43, "npi": [1790174860]}]}, {"allowed_amount": 67.8733, "billing_code_modifier": [""], "providers": [{"billed_charge": 496.42, "npi": [1790174860]}, {"billed_charge": 735.0, "npi": [1790174860]}, {"billed_charge": 771.75, "npi": [1790174860]}]}, {"allowed_amount": 395.66, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 1179.46, "npi": [1790174860]}]}, {"allowed_amount": 395.66, "billing_code_modifier": [""], "providers": [{"billed_charge": 1238.44, "npi": [1790174860]}, {"billed_charge": 1179.46, "npi": [1790174860]}]}, {"allowed_amount": 308.31, "billing_code_modifier": ["XU"], "providers": [{"billed_charge": 874.75, "npi": [1790174860]}, {"billed_charge": 1451.0, "npi": [1790174860]}]}, {"allowed_amount": 863.2, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 4160.56, "npi": [1790174860]}, {"billed_charge": 3962.43, "npi": [1790174860]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["59"], "providers": [{"billed_charge": 1133.0, "npi": [1790174860]}]}, {"allowed_amount": 122.22, "billing_code_modifier": [""], "providers": [{"billed_charge": 656.0, "npi": [1790174860]}]}, {"allowed_amount": 604.81, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 1926.75, "npi": [1790174860]}, {"billed_charge": 1835.0, "npi": [1790174860]}]}, {"allowed_amount": 1197.29, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 3449.05, "npi": [1790174860]}]}]}]}, {"name": "Emergency Room - General", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0450", "description": "Emergency Room", "allowed_amounts": [{"tin": {"type": "ein", "value": "752890358"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 308.31, "billing_code_modifier": [""], "providers": [{"billed_charge": 333.25, "npi": [1548291883]}, {"billed_charge": 779.25, "npi": [1548291883]}]}, {"allowed_amount": 222.56, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 537.75, "npi": [1548291883]}]}, {"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 542.5, "npi": [1548291883]}, {"billed_charge": 636.375, "npi": [1548291883]}, {"billed_charge": 333.25, "npi": [1548291883]}, {"billed_charge": 103.5, "npi": [1548291883]}, {"billed_charge": 634.45, "npi": [1548291883]}, {"billed_charge": 889.3056, "npi": [1548291883]}, {"billed_charge": 254.75, "npi": [1548291883]}]}, {"allowed_amount": 67.875, "billing_code_modifier": [""], "providers": [{"billed_charge": 333.25, "npi": [1548291883]}]}, {"allowed_amount": 604.81, "billing_code_modifier": [""], "providers": [{"billed_charge": 1521.25, "npi": [1548291883]}]}, {"allowed_amount": 67.875, "billing_code_modifier": ["59"], "providers": [{"billed_charge": 333.25, "npi": [1548291883]}]}, {"allowed_amount": 222.56, "billing_code_modifier": [""], "providers": [{"billed_charge": 537.75, "npi": [1548291883]}]}, {"allowed_amount": 67.8733, "billing_code_modifier": ["59"], "providers": [{"billed_charge": 333.25, "npi": [1548291883]}]}, {"allowed_amount": 3791.1, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 1521.25, "npi": [1548291883]}]}, {"allowed_amount": 67.87, "billing_code_modifier": [""], "providers": [{"billed_charge": 333.25, "npi": [1548291883]}, {"billed_charge": 103.5, "npi": [1548291883]}]}, {"allowed_amount": 67.8733, "billing_code_modifier": [""], "providers": [{"billed_charge": 103.5, "npi": [1548291883]}]}, {"allowed_amount": 395.66, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 1042.5, "npi": [1548291883]}]}, {"allowed_amount": 395.66, "billing_code_modifier": [""], "providers": [{"billed_charge": 1042.5, "npi": [1548291883]}]}, {"allowed_amount": 863.2, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 2758.25, "npi": [1548291883]}]}, {"allowed_amount": 308.31, "billing_code_modifier": ["59"], "providers": [{"billed_charge": 333.25, "npi": [1548291883]}]}, {"allowed_amount": 122.22, "billing_code_modifier": [""], "providers": [{"billed_charge": 332.25, "npi": [1548291883]}]}, {"allowed_amount": 67.87, "billing_code_modifier": ["59"], "providers": [{"billed_charge": 333.25, "npi": [1548291883]}, {"billed_charge": 103.5, "npi": [1548291883]}]}, {"allowed_amount": 604.81, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 1521.25, "npi": [1548291883]}]}]}]}, {"name": "Laboratory - Chemistry", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0301", "description": "Laboratory", "allowed_amounts": [{"tin": {"type": "ein", "value": "452694620"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 6.05, "billing_code_modifier": ["91"], "providers": [{"billed_charge": 70.38, "npi": [1033120423]}]}, {"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 255.2, "npi": [1033120423]}, {"billed_charge": 715.04, "npi": [1033120423]}, {"billed_charge": 161.97, "npi": [1033120423]}, {"billed_charge": 212.63, "npi": [1033120423]}, {"billed_charge": 272.4, "npi": [1033120423]}, {"billed_charge": 303.5, "npi": [1033120423]}, {"billed_charge": 426.5, "npi": [1033120423]}, {"billed_charge": 180.8155, "npi": [1033120423]}, {"billed_charge": 247.89, "npi": [1033120423]}, {"billed_charge": 242.0848, "npi": [1033120423]}, {"billed_charge": 453.13, "npi": [1033120423]}, {"billed_charge": 411.736, "npi": [1033120423]}, {"billed_charge": 183.38, "npi": [1033120423]}, {"billed_charge": 220.4932, "npi": [1033120423]}, {"billed_charge": 243.1297, "npi": [1033120423]}, {"billed_charge": 536.89, "npi": [1033120423]}, {"billed_charge": 222.29, "npi": [1033120423]}, {"billed_charge": 146.2, "npi": [1033120423]}, {"billed_charge": 360.09, "npi": [1033120423]}, {"billed_charge": 300.766, "npi": [1033120423]}, {"billed_charge": 170.57, "npi": [1033120423]}, {"billed_charge": 423.32, "npi": [1033120423]}]}, {"allowed_amount": 5.7, "billing_code_modifier": ["91"], "providers": [{"billed_charge": 70.38, "npi": [1033120423]}]}, {"allowed_amount": 19.42, "billing_code_modifier": [""], "providers": [{"billed_charge": 452.61, "npi": [1033120423]}]}, {"allowed_amount": 20.62, "billing_code_modifier": [""], "providers": [{"billed_charge": 452.61, "npi": [1033120423]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["QW"], "providers": [{"billed_charge": 255.2, "npi": [1033120423]}, {"billed_charge": 715.04, "npi": [1033120423]}, {"billed_charge": 247.89, "npi": [1033120423]}, {"billed_charge": 423.32, "npi": [1033120423]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["91"], "providers": [{"billed_charge": 272.4, "npi": [1033120423]}]}]}]}, {"name": "Laboratory - Hematology", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0305", "description": "Laboratory", "allowed_amounts": [{"tin": {"type": "ein", "value": "824052186"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 93.56, "npi": [1801826839]}, {"billed_charge": 248.29, "npi": [1801826839]}, {"billed_charge": 146.11, "npi": [1801826839]}, {"billed_charge": 183.63, "npi": [1801826839]}, {"billed_charge": 140.91, "npi": [1801826839]}, {"billed_charge": 149.84, "npi": [1801826839]}]}]}]}, {"name": "Medical/Surgical Supplies and Devices - Sterile Supply", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0272", "description": "Med/Surg Supplies &Devices (also see 062x, extension of 027x", "allowed_amounts": [{"tin": {"type": "ein", "value": "472177648"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 5.5, "npi": [1790174860]}, {"billed_charge": 116.25, "npi": [1790174860]}, {"billed_charge": 35.83, "npi": [1790174860]}, {"billed_charge": 21.95, "npi": [1790174860]}, {"billed_charge": 5.0, "npi": [1790174860]}, {"billed_charge": 41.625, "npi": [1790174860]}, {"billed_charge": 7.65, "npi": [1790174860]}, {"billed_charge": 32.36, "npi": [1790174860]}, {"billed_charge": 26.4658, "npi": [1790174860]}, {"billed_charge": 10.7833, "npi": [1790174860]}, {"billed_charge": 168.6067, "npi": [1790174860]}, {"billed_charge": 497.0605, "npi": [1790174860]}, {"billed_charge": 496.6211, "npi": [1790174860]}, {"billed_charge": 21.45, "npi": [1790174860]}, {"billed_charge": 8.05, "npi": [1790174860]}, {"billed_charge": 75.115, "npi": [1790174860]}, {"billed_charge": 58.8268, "npi": [1790174860]}, {"billed_charge": 28.7, "npi": [1790174860]}, {"billed_charge": 10.3357, "npi": [1790174860]}, {"billed_charge": 39.6333, "npi": [1790174860]}, {"billed_charge": 56.95, "npi": [1790174860]}, {"billed_charge": 12.9, "npi": [1790174860]}, {"billed_charge": 318.8489, "npi": [1790174860]}, {"billed_charge": 51.6871, "npi": [1790174860]}, {"billed_charge": 20.7, "npi": [1790174860]}, {"billed_charge": 184.9944, "npi": [1790174860]}, {"billed_charge": 17.1125, "npi": [1790174860]}, {"billed_charge": 15.9667, "npi": [1790174860]}, {"billed_charge": 39.8167, "npi": [1790174860]}, {"billed_charge": 22.35, "npi": [1790174860]}, {"billed_charge": 20.55, "npi": [1790174860]}, {"billed_charge": 24.9, "npi": [1790174860]}, {"billed_charge": 36.24, "npi": [1790174860]}]}]}]}, {"name": "Radiology - Diagnostic - General", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0320", "description": "Radiology - Diagnostic", "allowed_amounts": [{"tin": {"type": "ein", "value": "751047527"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 701.0, "npi": [1396779948]}, {"billed_charge": 1044.25, "npi": [1396779948]}, {"billed_charge": 620.6786, "npi": [1396779948]}, {"billed_charge": 1371.6875, "npi": [1396779948]}, {"billed_charge": 909.0, "npi": [1396779948]}, {"billed_charge": 677.75, "npi": [1396779948]}, {"billed_charge": 792.25, "npi": [1396779948]}, {"billed_charge": 664.25, "npi": [1396779948]}, {"billed_charge": 1011.7778, "npi": [1396779948]}, {"billed_charge": 644.75, "npi": [1396779948]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["LT76"], "providers": [{"billed_charge": 489.25, "npi": [1396779948]}]}, {"allowed_amount": 126.14, "billing_code_modifier": [""], "providers": [{"billed_charge": 792.25, "npi": [1396779948]}, {"billed_charge": 664.25, "npi": [1396779948]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["RT"], "providers": [{"billed_charge": 701.0, "npi": [1396779948]}, {"billed_charge": 664.25, "npi": [1396779948]}, {"billed_charge": 644.75, "npi": [1396779948]}, {"billed_charge": 489.25, "npi": [1396779948]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["LT"], "providers": [{"billed_charge": 701.0, "npi": [1396779948]}, {"billed_charge": 599.5, "npi": [1396779948]}, {"billed_charge": 870.25, "npi": [1396779948]}, {"billed_charge": 608.5, "npi": [1396779948]}, {"billed_charge": 644.75, "npi": [1396779948]}, {"billed_charge": 489.25, "npi": [1396779948]}]}]}]}, {"name": "Pharmacy - General", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0250", "description": "Pharmacy (also see 063x, an extension of 025x)", "allowed_amounts": [{"tin": {"type": "ein", "value": "752770738"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 1.5, "npi": [1770514077]}, {"billed_charge": 8.6695, "npi": [1770514077]}, {"billed_charge": 49.55, "npi": [1770514077]}, {"billed_charge": 5.645, "npi": [1770514077]}, {"billed_charge": 2.0, "npi": [1770514077]}, {"billed_charge": 13.5, "npi": [1770514077]}, {"billed_charge": 3.6, "npi": [1770514077]}, {"billed_charge": 1.975, "npi": [1770514077]}, {"billed_charge": 52.08, "npi": [1770514077]}, {"billed_charge": 1.0, "npi": [1770514077]}, {"billed_charge": 0.5, "npi": [1770514077]}, {"billed_charge": 0.25, "npi": [1770514077]}, {"billed_charge": 1.6375, "npi": [1770514077]}, {"billed_charge": 10.0, "npi": [1770514077]}, {"billed_charge": 16.015, "npi": [1770514077]}, {"billed_charge": 2.39, "npi": [1770514077]}, {"billed_charge": 22.23, "npi": [1770514077]}, {"billed_charge": 1.15, "npi": [1770514077]}, {"billed_charge": 13.075, "npi": [1770514077]}, {"billed_charge": 6.0401, "npi": [1770514077]}, {"billed_charge": 50.0, "npi": [1770514077]}, {"billed_charge": 69.73, "npi": [1770514077]}, {"billed_charge": 3.4067, "npi": [1770514077]}, {"billed_charge": 2.2, "npi": [1770514077]}, {"billed_charge": 8.3571, "npi": [1770514077]}, {"billed_charge": 0.875, "npi": [1770514077]}]}]}]}, {"name": "Unlisted ambulance service", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "A0999", "description": "Unlisted ambulance service", "allowed_amounts": [{"tin": {"type": "ein", "value": "756000566"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": ["PH"], "providers": [{"billed_charge": 5.0, "npi": [1962432930]}]}, {"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 5.0, "npi": [1962432930]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["RH"], "providers": [{"billed_charge": 5.0, "npi": [1962432930]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["SH"], "providers": [{"billed_charge": 5.0, "npi": [1962432930]}]}]}]}, {"name": "Laboratory - General", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0300", "description": "Laboratory", "allowed_amounts": [{"tin": {"type": "ein", "value": "751748586"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 41.5, "npi": [1508899204]}]}]}]}, {"name": "Intensive Care - Intermediate  (ICU)", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0206", "description": "Intensive Care Unit", "allowed_amounts": [{"tin": {"type": "ein", "value": "751837454"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 3838.53, "npi": [1447250253]}, {"billed_charge": 2565.3, "npi": [1447250253]}]}, {"allowed_amount": 5023.04, "billing_code_modifier": [""], "providers": [{"billed_charge": 3838.53, "npi": [1447250253]}]}, {"allowed_amount": 4017.52, "billing_code_modifier": [""], "providers": [{"billed_charge": 2565.3, "npi": [1447250253]}]}, {"allowed_amount": 10831.09, "billing_code_modifier": [""], "providers": [{"billed_charge": 2565.3, "npi": [1447250253]}]}, {"allowed_amount": 2166.218, "billing_code_modifier": [""], "providers": [{"billed_charge": 2565.3, "npi": [1447250253]}]}, {"allowed_amount": 2165.274, "billing_code_modifier": [""], "providers": [{"billed_charge": 2565.3, "npi": [1447250253]}]}, {"allowed_amount": 3746.47, "billing_code_modifier": [""], "providers": [{"billed_charge": 2565.3, "npi": [1447250253]}]}]}]}, {"name": "Laboratory - Chemistry", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0301", "description": "Laboratory", "allowed_amounts": [{"tin": {"type": "ein", "value": "752678857"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 278.25, "npi": [1417980202]}, {"billed_charge": 229.25, "npi": [1417980202]}, {"billed_charge": 335.75, "npi": [1417980202]}, {"billed_charge": 123.25, "npi": [1417980202]}, {"billed_charge": 473.75, "npi": [1417980202]}, {"billed_charge": 411.9167, "npi": [1417980202]}, {"billed_charge": 49.25, "npi": [1417980202]}, {"billed_charge": 210.75, "npi": [1417980202]}, {"billed_charge": 231.0, "npi": [1417980202]}, {"billed_charge": 257.75, "npi": [1417980202]}, {"billed_charge": 402.9643, "npi": [1417980202]}, {"billed_charge": 153.5, "npi": [1417980202]}, {"billed_charge": 463.25, "npi": [1417980202]}, {"billed_charge": 120.75, "npi": [1417980202]}, {"billed_charge": 225.75, "npi": [1417980202]}, {"billed_charge": 328.75, "npi": [1417980202]}, {"billed_charge": 324.5, "npi": [1417980202]}, {"billed_charge": 348.5, "npi": [1417980202]}, {"billed_charge": 611.0, "npi": [1417980202]}, {"billed_charge": 679.25, "npi": [1417980202]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["91"], "providers": [{"billed_charge": 274.25, "npi": [1417980202]}, {"billed_charge": 611.0, "npi": [1417980202]}]}]}]}, {"name": "Laboratory - Bacteriology & Microbiology", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0306", "description": "Laboratory", "allowed_amounts": [{"tin": {"type": "ein", "value": "751037591"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 282.44, "npi": [1124305065]}, {"billed_charge": 307.62, "npi": [1124305065]}, {"billed_charge": 448.72, "npi": [1124305065]}, {"billed_charge": 340.52, "npi": [1124305065]}, {"billed_charge": 403.065, "npi": [1124305065]}, {"billed_charge": 245.6013, "npi": [1124305065]}, {"billed_charge": 120.7, "npi": [1124305065]}, {"billed_charge": 123.65, "npi": [1124305065]}, {"billed_charge": 285.48, "npi": [1124305065]}, {"billed_charge": 433.21, "npi": [1124305065]}, {"billed_charge": 146.91, "npi": [1124305065]}, {"billed_charge": 465.18, "npi": [1124305065]}, {"billed_charge": 199.2472, "npi": [1124305065]}, {"billed_charge": 357.84, "npi": [1124305065]}, {"billed_charge": 142.75, "npi": [1124305065]}, {"billed_charge": 215.5, "npi": [1124305065]}]}, {"allowed_amount": 148.49, "billing_code_modifier": [""], "providers": [{"billed_charge": 102.41, "npi": [1124305065]}]}]}]}, {"name": "Laboratory - Hematology", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0305", "description": "Laboratory", "allowed_amounts": [{"tin": {"type": "ein", "value": "751777119"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 147.7473, "npi": [1073511762]}, {"billed_charge": 146.11, "npi": [1073511762]}, {"billed_charge": 111.76, "npi": [1073511762]}, {"billed_charge": 248.29, "npi": [1073511762]}, {"billed_charge": 140.91, "npi": [1073511762]}, {"billed_charge": 183.63, "npi": [1073511762]}, {"billed_charge": 149.84, "npi": [1073511762]}, {"billed_charge": 161.398, "npi": [1073511762]}]}]}]}, {"name": "Emergency Room - General", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0450", "description": "Emergency Room", "allowed_amounts": [{"tin": {"type": "ein", "value": "751977850"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 230.24, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 537.75, "npi": [1396778064]}]}, {"allowed_amount": 625.67, "billing_code_modifier": [""], "providers": [{"billed_charge": 1521.25, "npi": [1396778064]}]}, {"allowed_amount": 409.31, "billing_code_modifier": [""], "providers": [{"billed_charge": 1042.5, "npi": [1396778064]}]}, {"allowed_amount": 230.24, "billing_code_modifier": [""], "providers": [{"billed_charge": 537.75, "npi": [1396778064]}]}, {"allowed_amount": 625.67, "billing_code_modifier": ["2725"], "providers": [{"billed_charge": 1521.25, "npi": [1396778064]}]}, {"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 254.75, "npi": [1396778064]}, {"billed_charge": 542.5, "npi": [1396778064]}, {"billed_charge": 524.9, "npi": [1396778064]}, {"billed_charge": 408.0, "npi": [1396778064]}]}, {"allowed_amount": 318.95, "billing_code_modifier": ["59"], "providers": [{"billed_charge": 333.25, "npi": [1396778064]}]}, {"allowed_amount": 3921.83, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 1521.25, "npi": [1396778064]}]}, {"allowed_amount": 892.97, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 2758.25, "npi": [1396778064]}]}, {"allowed_amount": 126.44, "billing_code_modifier": [""], "providers": [{"billed_charge": 332.25, "npi": [1396778064]}]}, {"allowed_amount": 318.95, "billing_code_modifier": [""], "providers": [{"billed_charge": 779.25, "npi": [1396778064]}, {"billed_charge": 333.25, "npi": [1396778064]}]}, {"allowed_amount": 625.67, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 1521.25, "npi": [1396778064]}]}, {"allowed_amount": 126.44, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 332.25, "npi": [1396778064]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 2758.25, "npi": [1396778064]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["59"], "providers": [{"billed_charge": 254.75, "npi": [1396778064]}]}, {"allowed_amount": 70.22, "billing_code_modifier": [""], "providers": [{"billed_charge": 103.5, "npi": [1396778064]}, {"billed_charge": 333.25, "npi": [1396778064]}]}, {"allowed_amount": 70.215, "billing_code_modifier": [""], "providers": [{"billed_charge": 333.25, "npi": [1396778064]}]}, {"allowed_amount": 70.2167, "billing_code_modifier": [""], "providers": [{"billed_charge": 333.25, "npi": [1396778064]}]}, {"allowed_amount": 409.31, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 1042.5, "npi": [1396778064]}]}]}]}, {"name": "Other Imaging Services - Ultrasound", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0402", "description": "Other Imaging Services", "allowed_amounts": [{"tin": {"type": "ein", "value": "752586857"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 151.54, "billing_code_modifier": [""], "providers": [{"billed_charge": 1101.64, "npi": [1992700983]}, {"billed_charge": 674.97, "npi": [1992700983]}, {"billed_charge": 1269.06, "npi": [1992700983]}, {"billed_charge": 1049.03, "npi": [1992700983]}, {"billed_charge": 1152.88, "npi": [1992700983]}, {"billed_charge": 1072.02, "npi": [1992700983]}]}, {"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 765.0, "npi": [1992700983]}, {"billed_charge": 1101.64, "npi": [1992700983]}, {"billed_charge": 1020.91, "npi": [1992700983]}, {"billed_charge": 864.66, "npi": [1992700983]}, {"billed_charge": 1053.25, "npi": [1992700983]}, {"billed_charge": 1049.03, "npi": [1992700983]}, {"billed_charge": 1152.88, "npi": [1992700983]}, {"billed_charge": 848.33, "npi": [1992700983]}]}, {"allowed_amount": 151.54, "billing_code_modifier": ["U6"], "providers": [{"billed_charge": 1049.03, "npi": [1992700983]}]}]}]}, {"name": "Other Diagnostic Services - Peripheral Vascular Lab", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0921", "description": "Other Diagnostic Services", "allowed_amounts": [{"tin": {"type": "ein", "value": "751837454"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 151.54, "billing_code_modifier": ["RT"], "providers": [{"billed_charge": 1338.82, "npi": [1447250253]}]}, {"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 1468.77, "npi": [1447250253]}, {"billed_charge": 2001.42, "npi": [1447250253]}, {"billed_charge": 832.87, "npi": [1447250253]}, {"billed_charge": 1338.82, "npi": [1447250253]}, {"billed_charge": 1670.12, "npi": [1447250253]}, {"billed_charge": 1741.09, "npi": [1447250253]}]}, {"allowed_amount": 151.54, "billing_code_modifier": ["LT"], "providers": [{"billed_charge": 1338.82, "npi": [1447250253]}]}, {"allowed_amount": 345.85, "billing_code_modifier": [""], "providers": [{"billed_charge": 1961.81, "npi": [1447250253]}, {"billed_charge": 2001.42, "npi": [1447250253]}, {"billed_charge": 1741.09, "npi": [1447250253]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["RT"], "providers": [{"billed_charge": 1338.82, "npi": [1447250253]}]}]}]}, {"name": "SBSQ HOSPITAL IP/OBS CARE MOD MDM 35 MINUTES", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "99232", "description": "SBSQ HOSPITAL IP/OBS CARE MOD MDM 35 MINUTES", "allowed_amounts": [{"tin": {"type": "ein", "value": "752848392"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 84.4, "billing_code_modifier": [""], "providers": [{"billed_charge": 247.0, "npi": [1285677138]}]}]}]}, {"name": "CT Scan - Head Scan", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0351", "description": "CT Scan", "allowed_amounts": [{"tin": {"type": "ein", "value": "752586857"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 151.54, "billing_code_modifier": [""], "providers": [{"billed_charge": 2840.9, "npi": [1992700983]}, {"billed_charge": 3178.59, "npi": [1992700983]}]}, {"allowed_amount": 622.69, "billing_code_modifier": [""], "providers": [{"billed_charge": 3178.59, "npi": [1992700983]}]}, {"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 11751.19, "npi": [1992700983]}, {"billed_charge": 3306.97, "npi": [1992700983]}, {"billed_charge": 3178.59, "npi": [1992700983]}]}, {"allowed_amount": 254.23, "billing_code_modifier": [""], "providers": [{"billed_charge": 3340.68, "npi": [1992700983]}, {"billed_charge": 3306.97, "npi": [1992700983]}]}]}]}, {"name": "CT Scan - Body Scan", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0352", "description": "CT Scan", "allowed_amounts": [{"tin": {"type": "ein", "value": "752586857"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 151.54, "billing_code_modifier": [""], "providers": [{"billed_charge": 2800.19, "npi": [1992700983]}]}, {"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 5896.8, "npi": [1992700983]}, {"billed_charge": 6387.66, "npi": [1992700983]}, {"billed_charge": 3339.84, "npi": [1992700983]}, {"billed_charge": 7792.97, "npi": [1992700983]}, {"billed_charge": 6484.35, "npi": [1992700983]}, {"billed_charge": 7694.4275, "npi": [1992700983]}, {"billed_charge": 2800.19, "npi": [1992700983]}]}, {"allowed_amount": 254.23, "billing_code_modifier": [""], "providers": [{"billed_charge": 3339.84, "npi": [1992700983]}, {"billed_charge": 3665.78, "npi": [1992700983]}]}, {"allowed_amount": 345.85, "billing_code_modifier": [""], "providers": [{"billed_charge": 5896.8, "npi": [1992700983]}]}, {"allowed_amount": 505.67, "billing_code_modifier": [""], "providers": [{"billed_charge": 6484.35, "npi": [1992700983]}]}]}]}, {"name": "Emergency Room - General", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0450", "description": "Emergency Room", "allowed_amounts": [{"tin": {"type": "ein", "value": "751037591"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 308.31, "billing_code_modifier": [""], "providers": [{"billed_charge": 524.33, "npi": [1124305065]}, {"billed_charge": 814.34, "npi": [1124305065]}]}, {"allowed_amount": 222.56, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 782.31, "npi": [1124305065]}]}, {"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 321.2, "npi": [1124305065]}, {"billed_charge": 392.06, "npi": [1124305065]}, {"billed_charge": 1461.415, "npi": [1124305065]}, {"billed_charge": 1788.61, "npi": [1124305065]}, {"billed_charge": 919.1475, "npi": [1124305065]}, {"billed_charge": 2122.8, "npi": [1124305065]}, {"billed_charge": 2379.02, "npi": [1124305065]}, {"billed_charge": 500.62, "npi": [1124305065]}, {"billed_charge": 1760.79, "npi": [1124305065]}, {"billed_charge": 361.12, "npi": [1124305065]}]}, {"allowed_amount": 67.875, "billing_code_modifier": [""], "providers": [{"billed_charge": 392.06, "npi": [1124305065]}, {"billed_charge": 317.78, "npi": [1124305065]}]}, {"allowed_amount": 604.81, "billing_code_modifier": [""], "providers": [{"billed_charge": 2122.8, "npi": [1124305065]}]}, {"allowed_amount": 67.875, "billing_code_modifier": ["XU"], "providers": [{"billed_charge": 392.06, "npi": [1124305065]}]}, {"allowed_amount": 67.87, "billing_code_modifier": ["XU"], "providers": [{"billed_charge": 392.06, "npi": [1124305065]}]}, {"allowed_amount": 222.56, "billing_code_modifier": [""], "providers": [{"billed_charge": 782.31, "npi": [1124305065]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["XU"], "providers": [{"billed_charge": 524.33, "npi": [1124305065]}, {"billed_charge": 321.2, "npi": [1124305065]}]}, {"allowed_amount": 444.92, "billing_code_modifier": ["LT"], "providers": [{"billed_charge": 1313.52, "npi": [1124305065]}]}, {"allowed_amount": 3791.1, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 3879.67, "npi": [1124305065]}]}, {"allowed_amount": 67.87, "billing_code_modifier": [""], "providers": [{"billed_charge": 392.06, "npi": [1124305065]}, {"billed_charge": 317.78, "npi": [1124305065]}]}, {"allowed_amount": 67.8733, "billing_code_modifier": [""], "providers": [{"billed_charge": 392.06, "npi": [1124305065]}, {"billed_charge": 317.78, "npi": [1124305065]}]}, {"allowed_amount": 395.66, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 1283.4, "npi": [1124305065]}]}, {"allowed_amount": 395.66, "billing_code_modifier": [""], "providers": [{"billed_charge": 1283.4, "npi": [1124305065]}]}, {"allowed_amount": 308.31, "billing_code_modifier": ["XU"], "providers": [{"billed_charge": 524.33, "npi": [1124305065]}, {"billed_charge": 814.34, "npi": [1124305065]}]}, {"allowed_amount": 863.2, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 3879.67, "npi": [1124305065]}]}, {"allowed_amount": 604.81, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 3276.53, "npi": [1124305065]}, {"billed_charge": 2122.8, "npi": [1124305065]}]}, {"allowed_amount": 1197.29, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 4233.71, "npi": [1124305065]}]}]}]}, {"name": "Emergency Room - General", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0450", "description": "Emergency Room", "allowed_amounts": [{"tin": {"type": "ein", "value": "752586857"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 308.31, "billing_code_modifier": [""], "providers": [{"billed_charge": 902.11, "npi": [1992700983]}, {"billed_charge": 545.3, "npi": [1992700983]}, {"billed_charge": 524.33, "npi": [1992700983]}, {"billed_charge": 814.34, "npi": [1992700983]}]}, {"allowed_amount": 222.56, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 782.31, "npi": [1992700983]}]}, {"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 1291.778, "npi": [1992700983]}, {"billed_charge": 902.11, "npi": [1992700983]}, {"billed_charge": 500.62, "npi": [1992700983]}, {"billed_charge": 1203.19, "npi": [1992700983]}, {"billed_charge": 1394.9275, "npi": [1992700983]}, {"billed_charge": 468.18, "npi": [1992700983]}, {"billed_charge": 806.34, "npi": [1992700983]}, {"billed_charge": 321.2, "npi": [1992700983]}, {"billed_charge": 392.06, "npi": [1992700983]}, {"billed_charge": 1716.7, "npi": [1992700983]}, {"billed_charge": 1171.988, "npi": [1992700983]}, {"billed_charge": 1573.9267, "npi": [1992700983]}, {"billed_charge": 1366.97, "npi": [1992700983]}, {"billed_charge": 321.05, "npi": [1992700983]}, {"billed_charge": 317.78, "npi": [1992700983]}, {"billed_charge": 361.12, "npi": [1992700983]}, {"billed_charge": 862.0, "npi": [1992700983]}]}, {"allowed_amount": 67.875, "billing_code_modifier": [""], "providers": [{"billed_charge": 392.06, "npi": [1992700983]}, {"billed_charge": 317.78, "npi": [1992700983]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["XS"], "providers": [{"billed_charge": 524.33, "npi": [1992700983]}]}, {"allowed_amount": 604.81, "billing_code_modifier": [""], "providers": [{"billed_charge": 2122.8, "npi": [1992700983]}]}, {"allowed_amount": 362.15, "billing_code_modifier": [""], "providers": [{"billed_charge": 1375.24, "npi": [1992700983]}]}, {"allowed_amount": 67.87, "billing_code_modifier": ["XU"], "providers": [{"billed_charge": 392.06, "npi": [1992700983]}]}, {"allowed_amount": 222.56, "billing_code_modifier": [""], "providers": [{"billed_charge": 782.31, "npi": [1992700983]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["XU"], "providers": [{"billed_charge": 321.2, "npi": [1992700983]}, {"billed_charge": 392.06, "npi": [1992700983]}, {"billed_charge": 361.12, "npi": [1992700983]}]}, {"allowed_amount": 781.74, "billing_code_modifier": [""], "providers": [{"billed_charge": 2911.14, "npi": [1992700983]}]}, {"allowed_amount": 441.68, "billing_code_modifier": [""], "providers": [{"billed_charge": 805.59, "npi": [1992700983]}]}, {"allowed_amount": 3791.1, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 4233.71, "npi": [1992700983]}, {"billed_charge": 3879.67, "npi": [1992700983]}, {"billed_charge": 2122.8, "npi": [1992700983]}]}, {"allowed_amount": 589.22, "billing_code_modifier": [""], "providers": [{"billed_charge": 1075.22, "npi": [1992700983]}, {"billed_charge": 1358.12, "npi": [1992700983]}]}, {"allowed_amount": 67.87, "billing_code_modifier": [""], "providers": [{"billed_charge": 330.49, "npi": [1992700983]}, {"billed_charge": 392.06, "npi": [1992700983]}, {"billed_charge": 317.78, "npi": [1992700983]}]}, {"allowed_amount": 863.2, "billing_code_modifier": [""], "providers": [{"billed_charge": 3879.67, "npi": [1992700983]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 4233.71, "npi": [1992700983]}, {"billed_charge": 3879.67, "npi": [1992700983]}]}, {"allowed_amount": 67.8733, "billing_code_modifier": [""], "providers": [{"billed_charge": 392.06, "npi": [1992700983]}, {"billed_charge": 317.78, "npi": [1992700983]}]}, {"allowed_amount": 395.66, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 1334.74, "npi": [1992700983]}, {"billed_charge": 1807.73, "npi": [1992700983]}, {"billed_charge": 1283.4, "npi": [1992700983]}]}, {"allowed_amount": 395.66, "billing_code_modifier": [""], "providers": [{"billed_charge": 1283.4, "npi": [1992700983]}]}, {"allowed_amount": 308.31, "billing_code_modifier": ["XU"], "providers": [{"billed_charge": 524.33, "npi": [1992700983]}, {"billed_charge": 814.34, "npi": [1992700983]}]}, {"allowed_amount": 863.2, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 3879.67, "npi": [1992700983]}]}, {"allowed_amount": 104.36, "billing_code_modifier": [""], "providers": [{"billed_charge": 468.18, "npi": [1992700983]}]}, {"allowed_amount": 604.81, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 2207.71, "npi": [1992700983]}, {"billed_charge": 2122.8, "npi": [1992700983]}]}, {"allowed_amount": 1197.29, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 4233.71, "npi": [1992700983]}]}]}]}, {"name": "Laboratory - Chemistry", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0301", "description": "Laboratory", "allowed_amounts": [{"tin": {"type": "ein", "value": "751047527"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 319.475, "npi": [1396779948]}, {"billed_charge": 410.0, "npi": [1396779948]}, {"billed_charge": 348.5, "npi": [1396779948]}, {"billed_charge": 231.0, "npi": [1396779948]}, {"billed_charge": 112.75, "npi": [1396779948]}, {"billed_charge": 679.25, "npi": [1396779948]}, {"billed_charge": 328.8375, "npi": [1396779948]}, {"billed_charge": 229.25, "npi": [1396779948]}, {"billed_charge": 328.75, "npi": [1396779948]}, {"billed_charge": 561.75, "npi": [1396779948]}, {"billed_charge": 343.8026, "npi": [1396779948]}, {"billed_charge": 278.25, "npi": [1396779948]}, {"billed_charge": 324.5, "npi": [1396779948]}, {"billed_charge": 49.25, "npi": [1396779948]}, {"billed_charge": 335.75, "npi": [1396779948]}, {"billed_charge": 392.75, "npi": [1396779948]}, {"billed_charge": 497.2143, "npi": [1396779948]}, {"billed_charge": 226.5, "npi": [1396779948]}, {"billed_charge": 153.5, "npi": [1396779948]}, {"billed_charge": 291.25, "npi": [1396779948]}, {"billed_charge": 274.25, "npi": [1396779948]}, {"billed_charge": 209.6111, "npi": [1396779948]}, {"billed_charge": 408.9035, "npi": [1396779948]}, {"billed_charge": 288.25, "npi": [1396779948]}, {"billed_charge": 442.5, "npi": [1396779948]}, {"billed_charge": 671.0, "npi": [1396779948]}, {"billed_charge": 235.0, "npi": [1396779948]}, {"billed_charge": 334.25, "npi": [1396779948]}, {"billed_charge": 185.5, "npi": [1396779948]}, {"billed_charge": 161.0, "npi": [1396779948]}, {"billed_charge": 668.5, "npi": [1396779948]}, {"billed_charge": 225.75, "npi": [1396779948]}, {"billed_charge": 236.755, "npi": [1396779948]}, {"billed_charge": 323.0, "npi": [1396779948]}, {"billed_charge": 183.6842, "npi": [1396779948]}, {"billed_charge": 565.0, "npi": [1396779948]}, {"billed_charge": 340.0, "npi": [1396779948]}, {"billed_charge": 477.25, "npi": [1396779948]}]}, {"allowed_amount": 19.42, "billing_code_modifier": [""], "providers": [{"billed_charge": 679.25, "npi": [1396779948]}]}, {"allowed_amount": 5.7, "billing_code_modifier": [""], "providers": [{"billed_charge": 106.25, "npi": [1396779948]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["91"], "providers": [{"billed_charge": 49.25, "npi": [1396779948]}, {"billed_charge": 335.75, "npi": [1396779948]}, {"billed_charge": 247.0, "npi": [1396779948]}]}]}]}]}