{"reporting_entity_name":"Capital Health Plan Inc.","reporting_entity_type":"health insurance issuer","plan_name":"Commercial","plan_id_type":"ein","plan_id":"59-1830622","plan_market_type":"group","last_updated_on":"2026-11-04","version":"1.0.0","out_of_network":[{"name":"Digitize image of specimen","billing_code_type":"CPT","billing_code_type_version":"2023","billing_code":"0753T","description":"dgtz gls mcrscp sld level iv","allowed_amounts":[{"tin":{"Type":"ein","value":"590714831"},"billing_class":"institutional","setting":"outpatient","payments":[{"allowed_amount":0.00,"providers":[{"billed_charge":0.01,"npi":[1891782470]}]}]},{"tin":{"Type":"ein","value":"590714831"},"billing_class":"institutional","setting":"outpatient","payments":[{"allowed_amount":0.01,"providers":[{"billed_charge":0.01,"npi":[1891782470]}]}]}]},{"name":"Blood draw from vein","billing_code_type":"CPT","billing_code_type_version":"2005","billing_code":"36415","description":"coll venous bld venipuncture","allowed_amounts":[{"tin":{"Type":"ein","value":"590714831"},"billing_class":"institutional","setting":"outpatient","payments":[{"allowed_amount":0.00,"providers":[{"billed_charge":42.00,"npi":[1891782470]}]}]},{"tin":{"Type":"ein","value":"590714831"},"billing_class":"institutional","setting":"outpatient","payments":[{"allowed_amount":10.74,"providers":[{"billed_charge":42.00,"npi":[1891782470]}]}]},{"tin":{"Type":"ein","value":"590714831"},"billing_class":"institutional","setting":"outpatient","payments":[{"allowed_amount":16.87,"providers":[{"billed_charge":42.00,"npi":[1891782470]}]}]},{"tin":{"Type":"ein","value":"590714831"},"billing_class":"institutional","setting":"outpatient","payments":[{"allowed_amount":22.43,"providers":[{"billed_charge":42.00,"npi":[1891782470]}]}]},{"tin":{"Type":"ein","value":"590714831"},"billing_class":"institutional","setting":"outpatient","payments":[{"allowed_amount":31.50,"providers":[{"billed_charge":42.00,"npi":[1891782470]}]}]},{"tin":{"Type":"ein","value":"596001321"},"billing_class":"institutional","setting":"outpatient","payments":[{"allowed_amount":0.00,"providers":[{"billed_charge":23.00,"npi":[1538108725]}]}]}]},{"name":"Elbow nerve surgery","billing_code_type":"CPT","billing_code_type_version":"2005","billing_code":"64718","description":"revise ulnar nerve at elbow","allowed_amounts":[{"tin":{"Type":"ein","value":"591286000"},"service_code":["22"],"billing_class":"professional","setting":"outpatient","payments":[{"allowed_amount":444.08,"billing_code_modifier":["51","59","LT","RT"],"providers":[{"billed_charge":2645.00,"npi":[1972570885]}]}]},{"tin":{"Type":"ein","value":"591286000"},"service_code":["22"],"billing_class":"professional","setting":"outpatient","payments":[{"allowed_amount":445.66,"billing_code_modifier":["78","RT"],"providers":[{"billed_charge":2645.00,"npi":[1972570885]}]}]},{"tin":{"Type":"ein","value":"591286000"},"service_code":["22"],"billing_class":"professional","setting":"outpatient","payments":[{"allowed_amount":674.99,"billing_code_modifier":["78","LT","RT"],"providers":[{"billed_charge":2645.00,"npi":[1972570885]}]}]},{"tin":{"Type":"ein","value":"591286000"},"service_code":["22"],"billing_class":"professional","setting":"outpatient","payments":[{"allowed_amount":888.15,"billing_code_modifier":["LT","RT"],"providers":[{"billed_charge":2645.00,"npi":[1972570885]}]}]}]},{"name":"CT scan of head or brain","billing_code_type":"CPT","billing_code_type_version":"2005","billing_code":"70450","description":"ct head/brain w/o dye","allowed_amounts":[{"tin":{"Type":"ein","value":"591226176"},"service_code":["23"],"billing_class":"professional","setting":"outpatient","payments":[{"allowed_amount":53.18,"billing_code_modifier":["26"],"providers":[{"billed_charge":637.00,"npi":[1972577856]}]}]},{"tin":{"Type":"ein","value":"591226176"},"service_code":["23"],"billing_class":"professional","setting":"outpatient","payments":[{"allowed_amount":54.54,"billing_code_modifier":["26"],"providers":[{"billed_charge":733.00,"npi":[1972577856]}]}]}]},{"name":"Chest x-ray","billing_code_type":"CPT","billing_code_type_version":"2018","billing_code":"71045","description":"x-ray exam chest 1 view","allowed_amounts":[{"tin":{"Type":"ein","value":"591226176"},"service_code":["21","23"],"billing_class":"professional","setting":"inpatient","payments":[{"allowed_amount":10.54,"billing_code_modifier":["26"],"providers":[{"billed_charge":176.00,"npi":[1598785594]}]},{"allowed_amount":10.54,"billing_code_modifier":["26"],"providers":[{"billed_charge":202.00,"npi":[1598785594]}]}]},{"tin":{"Type":"ein","value":"591226176"},"service_code":["21","23"],"billing_class":"professional","setting":"inpatient","payments":[{"allowed_amount":11.55,"billing_code_modifier":["26"],"providers":[{"billed_charge":176.00,"npi":[1093706145,1972577856]}]},{"allowed_amount":11.55,"billing_code_modifier":["26"],"providers":[{"billed_charge":202.00,"npi":[1972577856]}]}]}]},{"name":"CT scan of abdomen and pelvis","billing_code_type":"CPT","billing_code_type_version":"2011","billing_code":"74176","description":"ct abd & pelvis w/o contrast","allowed_amounts":[{"tin":{"Type":"ein","value":"591226176"},"service_code":["23"],"billing_class":"professional","setting":"outpatient","payments":[{"allowed_amount":108.55,"billing_code_modifier":["26"],"providers":[{"billed_charge":1617.00,"npi":[1972577856]}]}]},{"tin":{"Type":"ein","value":"591226176"},"service_code":["23"],"billing_class":"professional","setting":"outpatient","payments":[{"allowed_amount":110.23,"billing_code_modifier":["26"],"providers":[{"billed_charge":1860.00,"npi":[1972577856]}]}]}]},{"name":"CT scan of abdomen and pelvis","billing_code_type":"CPT","billing_code_type_version":"2011","billing_code":"74177","description":"ct abd & pelvis w/contrast","allowed_amounts":[{"tin":{"Type":"ein","value":"591226176"},"service_code":["23"],"billing_class":"professional","setting":"outpatient","payments":[{"allowed_amount":114.64,"billing_code_modifier":["26"],"providers":[{"billed_charge":1692.00,"npi":[1972577856]}]}]},{"tin":{"Type":"ein","value":"591226176"},"service_code":["23"],"billing_class":"professional","setting":"outpatient","payments":[{"allowed_amount":116.12,"billing_code_modifier":["26"],"providers":[{"billed_charge":1946.00,"npi":[1972577856]}]}]}]},{"name":"Metabolic blood tests","billing_code_type":"CPT","billing_code_type_version":"2005","billing_code":"80048","description":"basic metabolic pnl total ca","allowed_amounts":[{"tin":{"Type":"ein","value":"593337028"},"service_code":["81"],"billing_class":"professional","setting":"outpatient","payments":[{"allowed_amount":10.58,"providers":[{"billed_charge":345.00,"npi":[1841351566]}]}]},{"tin":{"Type":"ein","value":"593337028"},"service_code":["81"],"billing_class":"professional","setting":"outpatient","payments":[{"allowed_amount":16.60,"providers":[{"billed_charge":345.00,"npi":[1841351566]}]}]},{"tin":{"Type":"ein","value":"596001321"},"billing_class":"institutional","setting":"outpatient","payments":[{"allowed_amount":0.00,"providers":[{"billed_charge":61.00,"npi":[1538108725]}]}]}]},{"name":"Metabolic blood tests","billing_code_type":"CPT","billing_code_type_version":"2005","billing_code":"80053","description":"comprehen metabolic panel","allowed_amounts":[{"tin":{"Type":"ein","value":"590714831"},"billing_class":"institutional","setting":"outpatient","payments":[{"allowed_amount":0.00,"providers":[{"billed_charge":525.00,"npi":[1891782470]}]}]},{"tin":{"Type":"ein","value":"590714831"},"billing_class":"institutional","setting":"outpatient","payments":[{"allowed_amount":156.26,"providers":[{"billed_charge":525.00,"npi":[1891782470]}]}]},{"tin":{"Type":"ein","value":"590714831"},"billing_class":"institutional","setting":"outpatient","payments":[{"allowed_amount":280.35,"providers":[{"billed_charge":525.00,"npi":[1891782470]}]}]},{"tin":{"Type":"ein","value":"590714831"},"billing_class":"institutional","setting":"outpatient","payments":[{"allowed_amount":393.75,"providers":[{"billed_charge":525.00,"npi":[1891782470]}]}]},{"tin":{"Type":"ein","value":"593337028"},"service_code":["81"],"billing_class":"professional","setting":"outpatient","payments":[{"allowed_amount":16.60,"providers":[{"billed_charge":525.00,"npi":[1841351566]}]}]},{"tin":{"Type":"ein","value":"593337028"},"service_code":["81"],"billing_class":"professional","setting":"outpatient","payments":[{"allowed_amount":18.62,"providers":[{"billed_charge":525.00,"npi":[1841351566]}]}]},{"tin":{"Type":"ein","value":"593337028"},"service_code":["81"],"billing_class":"professional","setting":"outpatient","payments":[{"allowed_amount":20.74,"providers":[{"billed_charge":525.00,"npi":[1841351566]}]}]},{"tin":{"Type":"ein","value":"593337028"},"service_code":["81"],"billing_class":"professional","setting":"outpatient","payments":[{"allowed_amount":21.04,"providers":[{"billed_charge":544.00,"npi":[1841351566]}]}]},{"tin":{"Type":"ein","value":"593337028"},"service_code":["81"],"billing_class":"professional","setting":"outpatient","payments":[{"allowed_amount":393.75,"providers":[{"billed_charge":525.00,"npi":[1285621631]}]}]}]},{"name":"Immune suppressant monitoring","billing_code_type":"CPT","billing_code_type_version":"2005","billing_code":"80197","description":"assay of tacrolimus","allowed_amounts":[{"tin":{"Type":"ein","value":"593337028"},"service_code":["81"],"billing_class":"professional","setting":"outpatient","payments":[{"allowed_amount":229.50,"providers":[{"billed_charge":306.00,"npi":[1285621631]}]}]}]},{"name":"Urine analysis","billing_code_type":"CPT","billing_code_type_version":"2005","billing_code":"81001","description":"urinalysis auto w/scope","allowed_amounts":[{"tin":{"Type":"ein","value":"593337028"},"service_code":["81"],"billing_class":"professional","setting":"outpatient","payments":[{"allowed_amount":5.58,"providers":[{"billed_charge":59.00,"npi":[1841351566]}]}]},{"tin":{"Type":"ein","value":"593337028"},"service_code":["81"],"billing_class":"professional","setting":"outpatient","payments":[{"allowed_amount":6.12,"providers":[{"billed_charge":59.00,"npi":[1841351566]}]}]},{"tin":{"Type":"ein","value":"593337028"},"service_code":["81"],"billing_class":"professional","setting":"outpatient","payments":[{"allowed_amount":6.22,"providers":[{"billed_charge":59.00,"npi":[1841351566]}]}]},{"tin":{"Type":"ein","value":"593337028"},"service_code":["81"],"billing_class":"professional","setting":"outpatient","payments":[{"allowed_amount":6.31,"providers":[{"billed_charge":61.00,"npi":[1841351566]}]}]},{"tin":{"Type":"ein","value":"593337028"},"service_code":["81"],"billing_class":"professional","setting":"outpatient","payments":[{"allowed_amount":44.25,"providers":[{"billed_charge":59.00,"npi":[1285621631]}]}]},{"tin":{"Type":"ein","value":"596001321"},"billing_class":"institutional","setting":"outpatient","payments":[{"allowed_amount":0.00,"billing_code_modifier":["59","XU"],"providers":[{"billed_charge":36.00,"npi":[1538108725]}]}]}]},{"name":"Genetic test on breast tissue","billing_code_type":"CPT","billing_code_type_version":"2015","billing_code":"81519","description":"oncology breast mrna","allowed_amounts":[{"tin":{"Type":"ein","value":"770552594"},"service_code":["81"],"billing_class":"professional","setting":"outpatient","payments":[{"allowed_amount":3863.00,"providers":[{"billed_charge":4620.00,"npi":[1215003603]}]}]}]},{"name":"Colon cancer screening","billing_code_type":"CPT","billing_code_type_version":"2016","billing_code":"81528","description":"oncology colorectal scr","allowed_amounts":[{"tin":{"Type":"ein","value":"463095174"},"service_code":["81"],"billing_class":"professional","setting":"outpatient","payments":[{"allowed_amount":524.00,"providers":[{"billed_charge":681.00,"npi":[1629407069]}]}]},{"tin":{"Type":"ein","value":"463095174"},"service_code":["81"],"billing_class":"professional","setting":"outpatient","payments":[{"allowed_amount":526.00,"providers":[{"billed_charge":681.00,"npi":[1629407069]}]}]},{"tin":{"Type":"ein","value":"463095174"},"service_code":["81"],"billing_class":"professional","setting":"outpatient","payments":[{"allowed_amount":636.09,"providers":[{"billed_charge":681.00,"npi":[1629407069]}]}]}]},{"name":"Blood test for bilirubin","billing_code_type":"CPT","billing_code_type_version":"2005","billing_code":"82248","description":"bilirubin direct","allowed_amounts":[{"tin":{"Type":"ein","value":"590714831"},"billing_class":"institutional","setting":"outpatient","payments":[{"allowed_amount":0.00,"providers":[{"billed_charge":63.00,"npi":[1891782470]}]}]},{"tin":{"Type":"ein","value":"590714831"},"billing_class":"institutional","setting":"outpatient","payments":[{"allowed_amount":18.75,"providers":[{"billed_charge":63.00,"npi":[1891782470]}]}]},{"tin":{"Type":"ein","value":"590714831"},"billing_class":"institutional","setting":"outpatient","payments":[{"allowed_amount":33.64,"providers":[{"billed_charge":63.00,"npi":[1891782470]}]}]},{"tin":{"Type":"ein","value":"590714831"},"billing_class":"institutional","setting":"outpatient","payments":[{"allowed_amount":47.25,"providers":[{"billed_charge":63.00,"npi":[1891782470]}]}]},{"tin":{"Type":"ein","value":"593337028"},"service_code":["81"],"billing_class":"professional","setting":"outpatient","payments":[{"allowed_amount":9.85,"providers":[{"billed_charge":63.00,"npi":[1841351566]}]}]},{"tin":{"Type":"ein","value":"593337028"},"service_code":["81"],"billing_class":"professional","setting":"outpatient","payments":[{"allowed_amount":9.99,"providers":[{"billed_charge":66.00,"npi":[1841351566]}]}]},{"tin":{"Type":"ein","value":"593337028"},"service_code":["81"],"billing_class":"professional","setting":"outpatient","payments":[{"allowed_amount":47.25,"providers":[{"billed_charge":63.00,"npi":[1285621631]}]}]}]},{"name":"Test for vitamin D deficiency","billing_code_type":"CPT","billing_code_type_version":"2005","billing_code":"82306","description":"vitamin d 25 hydroxy","allowed_amounts":[{"tin":{"Type":"ein","value":"593337028"},"service_code":["81"],"billing_class":"professional","setting":"outpatient","payments":[{"allowed_amount":58.09,"providers":[{"billed_charge":362.00,"npi":[1841351566]}]}]},{"tin":{"Type":"ein","value":"593337028"},"service_code":["81"],"billing_class":"professional","setting":"outpatient","payments":[{"allowed_amount":58.94,"providers":[{"billed_charge":362.00,"npi":[1841351566]}]}]}]},{"name":"Kidney function test","billing_code_type":"CPT","billing_code_type_version":"2005","billing_code":"82570","description":"assay of urine creatinine","allowed_amounts":[{"tin":{"Type":"ein","value":"593337028"},"service_code":["81"],"billing_class":"professional","setting":"outpatient","payments":[{"allowed_amount":9.11,"billing_code_modifier":["90","91"],"providers":[{"billed_charge":101.00,"npi":[1841351566]}]}]},{"tin":{"Type":"ein","value":"593337028"},"service_code":["81"],"billing_class":"professional","setting":"outpatient","payments":[{"allowed_amount":10.15,"billing_code_modifier":["59","90","91"],"providers":[{"billed_charge":101.00,"npi":[1841351566]}]}]},{"tin":{"Type":"ein","value":"593337028"},"service_code":["81"],"billing_class":"professional","setting":"outpatient","payments":[{"allowed_amount":10.30,"billing_code_modifier":["90"],"providers":[{"billed_charge":105.00,"npi":[1841351566]}]}]},{"tin":{"Type":"ein","value":"593337028"},"service_code":["81"],"billing_class":"professional","setting":"outpatient","payments":[{"allowed_amount":101.00,"billing_code_modifier":["90","91"],"providers":[{"billed_charge":101.00,"npi":[1841351566]}]}]}]},{"name":"Fasting blood sugar test","billing_code_type":"CPT","billing_code_type_version":"2005","billing_code":"82947","description":"assay glucose blood quant","allowed_amounts":[{"tin":{"Type":"ein","value":"590714831"},"billing_class":"institutional","setting":"outpatient","payments":[{"allowed_amount":0.00,"billing_code_modifier":["91","QW"],"providers":[{"billed_charge":43.00,"npi":[1891782470]}]}]},{"tin":{"Type":"ein","value":"590714831"},"billing_class":"institutional","setting":"outpatient","payments":[{"allowed_amount":4.91,"billing_code_modifier":["91","QW"],"providers":[{"billed_charge":43.00,"npi":[1891782470]}]}]},{"tin":{"Type":"ein","value":"590714831"},"billing_class":"institutional","setting":"outpatient","payments":[{"allowed_amount":32.25,"billing_code_modifier":["91","QW"],"providers":[{"billed_charge":43.00,"npi":[1891782470]}]}]}]},{"name":"Test for tissue damage","billing_code_type":"CPT","billing_code_type_version":"2005","billing_code":"83615","description":"lactate (ld) (ldh) enzyme","allowed_amounts":[{"tin":{"Type":"ein","value":"593337028"},"service_code":["81"],"billing_class":"professional","setting":"outpatient","payments":[{"allowed_amount":56.25,"providers":[{"billed_charge":75.00,"npi":[1285621631]}]}]}]},{"name":"Magnesium testing","billing_code_type":"CPT","billing_code_type_version":"2005","billing_code":"83735","description":"assay of magnesium","allowed_amounts":[{"tin":{"Type":"ein","value":"590714831"},"billing_class":"institutional","setting":"outpatient","payments":[{"allowed_amount":0.00,"providers":[{"billed_charge":100.00,"npi":[1891782470]}]}]},{"tin":{"Type":"ein","value":"590714831"},"billing_class":"institutional","setting":"outpatient","payments":[{"allowed_amount":25.56,"providers":[{"billed_charge":100.00,"npi":[1891782470]}]}]},{"tin":{"Type":"ein","value":"590714831"},"billing_class":"institutional","setting":"outpatient","payments":[{"allowed_amount":29.76,"providers":[{"billed_charge":100.00,"npi":[1891782470]}]}]},{"tin":{"Type":"ein","value":"590714831"},"billing_class":"institutional","setting":"outpatient","payments":[{"allowed_amount":53.40,"providers":[{"billed_charge":100.00,"npi":[1891782470]}]}]},{"tin":{"Type":"ein","value":"590714831"},"billing_class":"institutional","setting":"outpatient","payments":[{"allowed_amount":55.00,"providers":[{"billed_charge":103.00,"npi":[1891782470]}]}]},{"tin":{"Type":"ein","value":"590714831"},"billing_class":"institutional","setting":"outpatient","payments":[{"allowed_amount":75.00,"providers":[{"billed_charge":100.00,"npi":[1891782470]}]}]},{"tin":{"Type":"ein","value":"593337028"},"service_code":["81"],"billing_class":"professional","setting":"outpatient","payments":[{"allowed_amount":75.00,"providers":[{"billed_charge":100.00,"npi":[1285621631]}]}]}]},{"name":"Phosphorus trace element test","billing_code_type":"CPT","billing_code_type_version":"2005","billing_code":"84100","description":"assay of phosphorus","allowed_amounts":[{"tin":{"Type":"ein","value":"593337028"},"service_code":["81"],"billing_class":"professional","setting":"outpatient","payments":[{"allowed_amount":41.25,"providers":[{"billed_charge":55.00,"npi":[1285621631]}]}]}]},{"name":"Thyroid hormone (T4) test","billing_code_type":"CPT","billing_code_type_version":"2005","billing_code":"84439","description":"assay of free thyroxine","allowed_amounts":[{"tin":{"Type":"ein","value":"593337028"},"service_code":["81"],"billing_class":"professional","setting":"outpatient","payments":[{"allowed_amount":17.70,"providers":[{"billed_charge":180.00,"npi":[1841351566]}]}]},{"tin":{"Type":"ein","value":"593337028"},"service_code":["81"],"billing_class":"professional","setting":"outpatient","payments":[{"allowed_amount":17.96,"providers":[{"billed_charge":180.00,"npi":[1841351566]}]},{"allowed_amount":17.96,"providers":[{"billed_charge":185.00,"npi":[1841351566]}]}]}]},{"name":"Thyroid hormone test","billing_code_type":"CPT","billing_code_type_version":"2005","billing_code":"84443","description":"assay thyroid stim hormone","allowed_amounts":[{"tin":{"Type":"ein","value":"593337028"},"service_code":["81"],"billing_class":"professional","setting":"outpatient","payments":[{"allowed_amount":32.96,"providers":[{"billed_charge":276.00,"npi":[1841351566]}]}]},{"tin":{"Type":"ein","value":"593337028"},"service_code":["81"],"billing_class":"professional","setting":"outpatient","payments":[{"allowed_amount":33.44,"providers":[{"billed_charge":282.00,"npi":[1841351566]}]}]}]},{"name":"Complete blood count (CBC)","billing_code_type":"CPT","billing_code_type_version":"2005","billing_code":"85025","description":"complete cbc w/auto diff wbc","allowed_amounts":[{"tin":{"Type":"ein","value":"590714831"},"billing_class":"institutional","setting":"outpatient","payments":[{"allowed_amount":0.00,"providers":[{"billed_charge":99.00,"npi":[1891782470]}]}]},{"tin":{"Type":"ein","value":"590714831"},"billing_class":"institutional","setting":"outpatient","payments":[{"allowed_amount":25.31,"providers":[{"billed_charge":99.00,"npi":[1891782470]}]}]},{"tin":{"Type":"ein","value":"590714831"},"billing_class":"institutional","setting":"outpatient","payments":[{"allowed_amount":74.25,"providers":[{"billed_charge":99.00,"npi":[1891782470]}]}]},{"tin":{"Type":"ein","value":"593337028"},"service_code":["81"],"billing_class":"professional","setting":"outpatient","payments":[{"allowed_amount":9.71,"providers":[{"billed_charge":99.00,"npi":[1841351566]}]}]},{"tin":{"Type":"ein","value":"593337028"},"service_code":["81"],"billing_class":"professional","setting":"outpatient","payments":[{"allowed_amount":13.70,"providers":[{"billed_charge":99.00,"npi":[1841351566]}]}]},{"tin":{"Type":"ein","value":"593337028"},"service_code":["81"],"billing_class":"professional","setting":"outpatient","payments":[{"allowed_amount":15.26,"providers":[{"billed_charge":99.00,"npi":[1841351566]}]}]},{"tin":{"Type":"ein","value":"593337028"},"service_code":["81"],"billing_class":"professional","setting":"outpatient","payments":[{"allowed_amount":74.25,"providers":[{"billed_charge":99.00,"npi":[1285621631]}]}]},{"tin":{"Type":"ein","value":"596001321"},"billing_class":"institutional","setting":"outpatient","payments":[{"allowed_amount":0.00,"providers":[{"billed_charge":48.00,"npi":[1538108725]}]}]}]},{"name":"Complete blood count (CBC)","billing_code_type":"CPT","billing_code_type_version":"2005","billing_code":"85027","description":"complete cbc automated","allowed_amounts":[{"tin":{"Type":"ein","value":"590714831"},"billing_class":"institutional","setting":"outpatient","payments":[{"allowed_amount":0.00,"providers":[{"billed_charge":108.00,"npi":[1891782470]}]}]},{"tin":{"Type":"ein","value":"590714831"},"billing_class":"institutional","setting":"outpatient","payments":[{"allowed_amount":32.14,"providers":[{"billed_charge":108.00,"npi":[1891782470]}]}]},{"tin":{"Type":"ein","value":"590714831"},"billing_class":"institutional","setting":"outpatient","payments":[{"allowed_amount":43.38,"providers":[{"billed_charge":108.00,"npi":[1891782470]}]}]},{"tin":{"Type":"ein","value":"590714831"},"billing_class":"institutional","setting":"outpatient","payments":[{"allowed_amount":57.67,"providers":[{"billed_charge":108.00,"npi":[1891782470]}]}]},{"tin":{"Type":"ein","value":"590714831"},"billing_class":"institutional","setting":"outpatient","payments":[{"allowed_amount":59.81,"providers":[{"billed_charge":112.00,"npi":[1891782470]}]}]},{"tin":{"Type":"ein","value":"590714831"},"billing_class":"institutional","setting":"outpatient","payments":[{"allowed_amount":61.10,"providers":[{"billed_charge":108.00,"npi":[1891782470]}]}]},{"tin":{"Type":"ein","value":"593337028"},"service_code":["81"],"billing_class":"professional","setting":"outpatient","payments":[{"allowed_amount":12.70,"providers":[{"billed_charge":108.00,"npi":[1841351566]}]}]},{"tin":{"Type":"ein","value":"593337028"},"service_code":["81"],"billing_class":"professional","setting":"outpatient","payments":[{"allowed_amount":12.89,"providers":[{"billed_charge":112.00,"npi":[1841351566]}]}]}]},{"name":"Test prothrombin clotting time","billing_code_type":"CPT","billing_code_type_version":"2005","billing_code":"85610","description":"prothrombin time","allowed_amounts":[{"tin":{"Type":"ein","value":"593337028"},"service_code":["11"],"billing_class":"professional","setting":"outpatient","payments":[{"allowed_amount":7.70,"providers":[{"billed_charge":76.00,"npi":[1841351566]}]}]},{"tin":{"Type":"ein","value":"593337028"},"service_code":["11"],"billing_class":"professional","setting":"outpatient","payments":[{"allowed_amount":57.00,"providers":[{"billed_charge":76.00,"npi":[1841351566]}]}]}]},{"name":"Blood test for inflammation","billing_code_type":"CPT","billing_code_type_version":"2005","billing_code":"86140","description":"c-reactive protein","allowed_amounts":[{"tin":{"Type":"ein","value":"593337028"},"service_code":["81"],"billing_class":"professional","setting":"outpatient","payments":[{"allowed_amount":10.15,"providers":[{"billed_charge":103.00,"npi":[1841351566]}]}]},{"tin":{"Type":"ein","value":"593337028"},"service_code":["81"],"billing_class":"professional","setting":"outpatient","payments":[{"allowed_amount":10.30,"providers":[{"billed_charge":103.00,"npi":[1841351566]}]}]}]},{"name":"Blood autoimmune test","billing_code_type":"CPT","billing_code_type_version":"2005","billing_code":"86850","description":"rbc antibody screen","allowed_amounts":[{"tin":{"Type":"ein","value":"593337028"},"service_code":["81"],"billing_class":"professional","setting":"outpatient","payments":[{"allowed_amount":30.40,"billing_code_modifier":["91"],"providers":[{"billed_charge":103.00,"npi":[1841351566]}]}]},{"tin":{"Type":"ein","value":"593337028"},"service_code":["81"],"billing_class":"professional","setting":"outpatient","payments":[{"allowed_amount":31.00,"billing_code_modifier":["91"],"providers":[{"billed_charge":103.00,"npi":[1841351566]}]}]}]},{"name":"Blood typing","billing_code_type":"CPT","billing_code_type_version":"2005","billing_code":"86900","description":"blood typing serologic abo","allowed_amounts":[{"tin":{"Type":"ein","value":"593337028"},"service_code":["81"],"billing_class":"professional","setting":"outpatient","payments":[{"allowed_amount":5.85,"providers":[{"billed_charge":66.00,"npi":[1841351566]}]}]}]},{"name":"Rh blood typing","billing_code_type":"CPT","billing_code_type_version":"2005","billing_code":"86901","description":"blood typing serologic rh(d)","allowed_amounts":[{"tin":{"Type":"ein","value":"593337028"},"service_code":["81"],"billing_class":"professional","setting":"outpatient","payments":[{"allowed_amount":5.85,"providers":[{"billed_charge":94.00,"npi":[1841351566]}]}]},{"tin":{"Type":"ein","value":"593337028"},"service_code":["81"],"billing_class":"professional","setting":"outpatient","payments":[{"allowed_amount":5.94,"billing_code_modifier":["59"],"providers":[{"billed_charge":94.00,"npi":[1841351566]}]}]}]},{"name":"Urine test for bacteria","billing_code_type":"CPT","billing_code_type_version":"2005","billing_code":"87086","description":"urine culture/colony count","allowed_amounts":[{"tin":{"Type":"ein","value":"382084239"},"service_code":["81"],"billing_class":"professional","setting":"outpatient","payments":[{"allowed_amount":6.14,"providers":[{"billed_charge":69.50,"npi":[1891731626]}]},{"allowed_amount":6.14,"providers":[{"billed_charge":72.98,"npi":[1891731626]}]}]}]},{"name":"Cytomegalovirus (CMV) test","billing_code_type":"CPT","billing_code_type_version":"2005","billing_code":"87497","description":"cytomeg dna quant","allowed_amounts":[{"tin":{"Type":"ein","value":"593337028"},"service_code":["81"],"billing_class":"professional","setting":"outpatient","payments":[{"allowed_amount":588.00,"billing_code_modifier":["59"],"providers":[{"billed_charge":784.00,"npi":[1285621631]}]}]}]},{"name":"Pathology exam of body tissue","billing_code_type":"CPT","billing_code_type_version":"2005","billing_code":"88304","description":"tissue exam by pathologist","allowed_amounts":[{"tin":{"Type":"ein","value":"800564919"},"service_code":["22"],"billing_class":"professional","setting":"outpatient","payments":[{"allowed_amount":12.99,"billing_code_modifier":["26"],"providers":[{"billed_charge":192.00,"npi":[1154309680]}]}]},{"tin":{"Type":"ein","value":"800564919"},"service_code":["22"],"billing_class":"professional","setting":"outpatient","payments":[{"allowed_amount":13.29,"billing_code_modifier":["26"],"providers":[{"billed_charge":192.00,"npi":[1154309680,1184782500]}]}]}]},{"name":"Pathology exam of body tissue","billing_code_type":"CPT","billing_code_type_version":"2005","billing_code":"88305","description":"tissue exam by pathologist","allowed_amounts":[{"tin":{"Type":"ein","value":"590714831"},"billing_class":"institutional","setting":"outpatient","payments":[{"allowed_amount":0.00,"providers":[{"billed_charge":714.00,"npi":[1891782470]}]}]},{"tin":{"Type":"ein","value":"590714831"},"billing_class":"institutional","setting":"outpatient","payments":[{"allowed_amount":182.52,"providers":[{"billed_charge":714.00,"npi":[1891782470]}]}]},{"tin":{"Type":"ein","value":"590714831"},"billing_class":"institutional","setting":"outpatient","payments":[{"allowed_amount":535.50,"providers":[{"billed_charge":714.00,"npi":[1891782470]}]}]},{"tin":{"Type":"ein","value":"800564919"},"service_code":["21","22"],"billing_class":"professional","setting":"inpatient","payments":[{"allowed_amount":43.08,"billing_code_modifier":["26"],"providers":[{"billed_charge":260.00,"npi":[1154309680,1184782500]}]}]}]},{"name":"Prep for tissue study","billing_code_type":"CPT","billing_code_type_version":"2005","billing_code":"88311","description":"decalcify tissue","allowed_amounts":[{"tin":{"Type":"ein","value":"800564919"},"service_code":["22"],"billing_class":"professional","setting":"outpatient","payments":[{"allowed_amount":14.48,"billing_code_modifier":["26"],"providers":[{"billed_charge":88.00,"npi":[1154309680,1184782500]}]}]}]},{"name":"Typing of diseased cells","billing_code_type":"CPT","billing_code_type_version":"2005","billing_code":"88342","description":"imhchem/imcytchm 1st antb","allowed_amounts":[{"tin":{"Type":"ein","value":"590714831"},"billing_class":"institutional","setting":"outpatient","payments":[{"allowed_amount":0.00,"billing_code_modifier":["59"],"providers":[{"billed_charge":443.00,"npi":[1891782470]}]}]},{"tin":{"Type":"ein","value":"590714831"},"billing_class":"institutional","setting":"outpatient","payments":[{"allowed_amount":109.99,"billing_code_modifier":["59"],"providers":[{"billed_charge":443.00,"npi":[1891782470]}]}]},{"tin":{"Type":"ein","value":"590714831"},"billing_class":"institutional","setting":"outpatient","payments":[{"allowed_amount":113.24,"providers":[{"billed_charge":443.00,"npi":[1891782470]}]}]},{"tin":{"Type":"ein","value":"590714831"},"billing_class":"institutional","setting":"outpatient","payments":[{"allowed_amount":332.25,"providers":[{"billed_charge":443.00,"npi":[1891782470]}]}]}]},{"name":"Mental health eval w/services","billing_code_type":"CPT","billing_code_type_version":"2013","billing_code":"90792","description":"psych diag eval w/med srvcs","allowed_amounts":[{"tin":{"Type":"ein","value":"475240597"},"service_code":["31"],"billing_class":"professional","setting":"inpatient","payments":[{"allowed_amount":174.94,"providers":[{"billed_charge":341.41,"npi":[1295445914]}]}]}]},{"name":"Psychotherapy session 60 mins","billing_code_type":"CPT","billing_code_type_version":"2013","billing_code":"90837","description":"psytx w pt 60 minutes","allowed_amounts":[{"tin":{"Type":"ein","value":"842706066"},"service_code":["02"],"billing_class":"professional","setting":"outpatient","payments":[{"allowed_amount":75.00,"billing_code_modifier":["AJ","GT"],"providers":[{"billed_charge":150.00,"npi":[1437534237]}]}]},{"tin":{"Type":"ein","value":"842706066"},"service_code":["02"],"billing_class":"professional","setting":"outpatient","payments":[{"allowed_amount":94.43,"billing_code_modifier":["AJ","GT"],"providers":[{"billed_charge":150.00,"npi":[1437534237]}]}]}]},{"name":"Heart test (ECG)","billing_code_type":"CPT","billing_code_type_version":"2005","billing_code":"93000","description":"electrocardiogram complete","allowed_amounts":[{"tin":{"Type":"ein","value":"593337028"},"service_code":["11"],"billing_class":"professional","setting":"outpatient","payments":[{"allowed_amount":17.19,"providers":[{"billed_charge":120.00,"npi":[1174596324]}]}]},{"tin":{"Type":"ein","value":"593337028"},"service_code":["11"],"billing_class":"professional","setting":"outpatient","payments":[{"allowed_amount":81.14,"providers":[{"billed_charge":120.00,"npi":[1174596324]}]}]},{"tin":{"Type":"ein","value":"593337028"},"service_code":["11"],"billing_class":"professional","setting":"outpatient","payments":[{"allowed_amount":90.00,"providers":[{"billed_charge":120.00,"npi":[1174596324]}]}]}]},{"name":"Heart test review and report","billing_code_type":"CPT","billing_code_type_version":"2005","billing_code":"93010","description":"electrocardiogram report","allowed_amounts":[{"tin":{"Type":"ein","value":"810584939"},"service_code":["23"],"billing_class":"professional","setting":"outpatient","payments":[{"allowed_amount":8.29,"billing_code_modifier":["76"],"providers":[{"billed_charge":65.00,"npi":[1033744610,1124789805]}]},{"allowed_amount":8.29,"billing_code_modifier":["76"],"providers":[{"billed_charge":67.00,"npi":[1033744610,1124789805]}]}]},{"tin":{"Type":"ein","value":"810584939"},"service_code":["23"],"billing_class":"professional","setting":"outpatient","payments":[{"allowed_amount":9.75,"billing_code_modifier":["59","76","77"],"providers":[{"billed_charge":65.00,"npi":[1013189224,1306824693,1508917105,1588124333,1629174917,1710379920,1982021846]}]},{"allowed_amount":9.75,"billing_code_modifier":["59","76","77"],"providers":[{"billed_charge":67.00,"npi":[1013189224,1306824693,1588124333,1629174917,1710379920,1982021846]}]}]},{"tin":{"Type":"ein","value":"810584939"},"service_code":["23"],"billing_class":"professional","setting":"outpatient","payments":[{"allowed_amount":10.53,"providers":[{"billed_charge":67.00,"npi":[1013189224,1710379920]}]}]}]},{"name":"Ultrasound of heart","billing_code_type":"CPT","billing_code_type_version":"2008","billing_code":"93306","description":"tte w/doppler complete","allowed_amounts":[{"tin":{"Type":"ein","value":"590714831"},"billing_class":"institutional","setting":"outpatient","payments":[{"allowed_amount":2079.75,"providers":[{"billed_charge":2773.00,"npi":[1891782470]}]}]},{"tin":{"Type":"ein","value":"590714831"},"billing_class":"institutional","setting":"outpatient","payments":[{"allowed_amount":2773.00,"providers":[{"billed_charge":2773.00,"npi":[1891782470]}]}]},{"tin":{"Type":"ein","value":"590714831"},"billing_class":"institutional","setting":"outpatient","payments":[{"allowed_amount":3355.90,"providers":[{"billed_charge":2773.00,"npi":[1891782470]}]}]}]},{"name":"Group intervention 30 mins","billing_code_type":"CPT","billing_code_type_version":"2020","billing_code":"96164","description":"hlth bhv ivntj grp 1st 30","allowed_amounts":[{"tin":{"Type":"ein","value":"590714831"},"billing_class":"institutional","setting":"outpatient","payments":[{"allowed_amount":139.10,"providers":[{"billed_charge":252.00,"npi":[1891782470]}]}]},{"tin":{"Type":"ein","value":"590714831"},"billing_class":"institutional","setting":"outpatient","payments":[{"allowed_amount":139.11,"providers":[{"billed_charge":252.00,"npi":[1891782470]}]}]},{"tin":{"Type":"ein","value":"590714831"},"billing_class":"institutional","setting":"outpatient","payments":[{"allowed_amount":426.14,"providers":[{"billed_charge":252.00,"npi":[1891782470]}]}]}]},{"name":"Group intervention 15 mins","billing_code_type":"CPT","billing_code_type_version":"2020","billing_code":"96165","description":"hlth bhv ivntj grp ea addl","allowed_amounts":[{"tin":{"Type":"ein","value":"590714831"},"billing_class":"institutional","setting":"outpatient","payments":[{"allowed_amount":0.00,"providers":[{"billed_charge":130.00,"npi":[1891782470]}]}]},{"tin":{"Type":"ein","value":"590714831"},"billing_class":"institutional","setting":"outpatient","payments":[{"allowed_amount":71.76,"providers":[{"billed_charge":130.00,"npi":[1891782470]}]}]}]},{"name":"Assessment of behavior 15 min","billing_code_type":"CPT","billing_code_type_version":"2018","billing_code":"97151","description":"bhv id assmt by phys/qhp","allowed_amounts":[{"tin":{"Type":"ein","value":"994055213"},"service_code":["11"],"billing_class":"professional","setting":"outpatient","payments":[{"allowed_amount":17.50,"providers":[{"billed_charge":17.50,"npi":[1801325741]}]}]}]},{"name":"Behavior therapy 15 mins","billing_code_type":"CPT","billing_code_type_version":"2018","billing_code":"97153","description":"adaptive behavior tx by tech","allowed_amounts":[{"tin":{"Type":"ein","value":"994055213"},"service_code":["03","11","12"],"billing_class":"professional","setting":"outpatient","payments":[{"allowed_amount":9.38,"providers":[{"billed_charge":9.38,"npi":[1801325741]}]}]},{"tin":{"Type":"ein","value":"994055213"},"service_code":["03","11","12"],"billing_class":"professional","setting":"outpatient","payments":[{"allowed_amount":12.50,"providers":[{"billed_charge":12.50,"npi":[1376980532,1801325741]}]},{"allowed_amount":12.50,"providers":[{"billed_charge":13.00,"npi":[1376980532]}]},{"allowed_amount":12.50,"providers":[{"billed_charge":13.54,"npi":[1376980532]}]},{"allowed_amount":12.50,"providers":[{"billed_charge":14.20,"npi":[1801325741]}]}]}]},{"name":"Behavior therapy 15 mins","billing_code_type":"CPT","billing_code_type_version":"2018","billing_code":"97155","description":"adapt behavior tx phys/qhp","allowed_amounts":[{"tin":{"Type":"ein","value":"994055213"},"service_code":["03"],"billing_class":"professional","setting":"outpatient","payments":[{"allowed_amount":25.00,"providers":[{"billed_charge":25.00,"npi":[1376980532,1801325741]}]}]}]},{"name":"New doctor visit 45+ minutes","billing_code_type":"CPT","billing_code_type_version":"2005","billing_code":"99204","description":"office o/p new mod 45 min","allowed_amounts":[{"tin":{"Type":"ein","value":"591286000"},"service_code":["11"],"billing_class":"professional","setting":"outpatient","payments":[{"allowed_amount":215.66,"billing_code_modifier":["57"],"providers":[{"billed_charge":553.00,"npi":[1164764445,1184859530,1316236045,1730251943,1972570885]}]}]}]},{"name":"Doctor's office visit","billing_code_type":"CPT","billing_code_type_version":"2005","billing_code":"99213","description":"office o/p est low 20 min","allowed_amounts":[{"tin":{"Type":"ein","value":"591286000"},"service_code":["11"],"billing_class":"professional","setting":"outpatient","payments":[{"allowed_amount":66.61,"billing_code_modifier":["24","25"],"providers":[{"billed_charge":378.00,"npi":[1164764445,1184859530,1730251943,1972570885]}]}]}]},{"name":"Doctor's office visit long","billing_code_type":"CPT","billing_code_type_version":"2005","billing_code":"99214","description":"office o/p est mod 30 min","allowed_amounts":[{"tin":{"Type":"ein","value":"591286000"},"service_code":["11"],"billing_class":"professional","setting":"outpatient","payments":[{"allowed_amount":77.63,"billing_code_modifier":["24"],"providers":[{"billed_charge":553.00,"npi":[1164764445,1184859530,1316236045,1972570885]}]}]}]},{"name":"Admission day doctor service","billing_code_type":"CPT","billing_code_type_version":"2005","billing_code":"99223","description":"1st hosp ip/obs high 75","allowed_amounts":[{"tin":{"Type":"ein","value":"812660368"},"service_code":["21"],"billing_class":"professional","setting":"inpatient","payments":[{"allowed_amount":169.68,"billing_code_modifier":["AI"],"providers":[{"billed_charge":729.00,"npi":[1518385913,1689459307]}]}]},{"tin":{"Type":"ein","value":"812660368"},"service_code":["21"],"billing_class":"professional","setting":"inpatient","payments":[{"allowed_amount":179.31,"billing_code_modifier":["FS"],"providers":[{"billed_charge":694.00,"npi":[1518385913,1659045318,1689459307]}]},{"allowed_amount":179.31,"billing_code_modifier":["FS"],"providers":[{"billed_charge":729.00,"npi":[1518385913,1659045318,1689459307]}]}]},{"tin":{"Type":"ein","value":"812660368"},"service_code":["21"],"billing_class":"professional","setting":"inpatient","payments":[{"allowed_amount":210.95,"billing_code_modifier":["25","AI"],"providers":[{"billed_charge":694.00,"npi":[1235459355,1518385913,1659045318,1689459307,1700445533,1801537337,1992190631]}]},{"allowed_amount":210.95,"billing_code_modifier":["25","AI"],"providers":[{"billed_charge":729.00,"npi":[1235459355,1700445533,1992190631]}]}]},{"tin":{"Type":"ein","value":"814723941"},"service_code":["21"],"billing_class":"professional","setting":"inpatient","payments":[{"allowed_amount":210.95,"providers":[{"billed_charge":310.00,"npi":[1225327380]}]}]}]},{"name":"Doctor care in hospital","billing_code_type":"CPT","billing_code_type_version":"2005","billing_code":"99232","description":"sbsq hosp ip/obs moderate 35","allowed_amounts":[{"tin":{"Type":"ein","value":"474464147"},"service_code":["61"],"billing_class":"professional","setting":"inpatient","payments":[{"allowed_amount":65.81,"providers":[{"billed_charge":151.00,"npi":[1588910343]}]}]},{"tin":{"Type":"ein","value":"591286000"},"service_code":["21"],"billing_class":"professional","setting":"inpatient","payments":[{"allowed_amount":67.95,"billing_code_modifier":["57"],"providers":[{"billed_charge":195.00,"npi":[1346934577,1356931067]}]}]},{"tin":{"Type":"ein","value":"591286000"},"service_code":["21"],"billing_class":"professional","setting":"inpatient","payments":[{"allowed_amount":79.94,"providers":[{"billed_charge":195.00,"npi":[1164764445]}]}]},{"tin":{"Type":"ein","value":"593337028"},"service_code":["21"],"billing_class":"professional","setting":"inpatient","payments":[{"allowed_amount":282.82,"providers":[{"billed_charge":322.00,"npi":[1306171871]}]}]},{"tin":{"Type":"ein","value":"812660368"},"service_code":["21"],"billing_class":"professional","setting":"inpatient","payments":[{"allowed_amount":76.39,"providers":[{"billed_charge":263.00,"npi":[1922705524]}]}]},{"tin":{"Type":"ein","value":"812660368"},"service_code":["21"],"billing_class":"professional","setting":"inpatient","payments":[{"allowed_amount":81.88,"providers":[{"billed_charge":250.00,"npi":[1467734681,1922705524]}]},{"allowed_amount":81.88,"providers":[{"billed_charge":263.00,"npi":[1922705524]}]}]},{"tin":{"Type":"ein","value":"812660368"},"service_code":["21"],"billing_class":"professional","setting":"inpatient","payments":[{"allowed_amount":89.88,"providers":[{"billed_charge":263.00,"npi":[1023670833,1063552396,1285383372,1699171538]}]}]},{"tin":{"Type":"ein","value":"812660368"},"service_code":["21"],"billing_class":"professional","setting":"inpatient","payments":[{"allowed_amount":96.33,"providers":[{"billed_charge":250.00,"npi":[1003548116,1023670833,1033615208,1033791942,1063552396,1073174314,1083766687,1285383372,1508509092,1548902307,1578021689,1699171538,1700517893,1750802930,1801458435,1801537337,1902922727,1932773793,1932841806]}]},{"allowed_amount":96.33,"providers":[{"billed_charge":263.00,"npi":[1003548116,1023670833,1033615208,1033791942,1073174314,1285383372,1578021689,1699171538,1700517893,1750802930,1801458435,1902922727,1932773793]}]}]},{"tin":{"Type":"ein","value":"814723941"},"service_code":["21"],"billing_class":"professional","setting":"inpatient","payments":[{"allowed_amount":96.33,"providers":[{"billed_charge":111.00,"npi":[1225327380]}]}]},{"tin":{"Type":"ein","value":"823032998"},"service_code":["21"],"billing_class":"professional","setting":"inpatient","payments":[{"allowed_amount":89.88,"providers":[{"billed_charge":111.00,"npi":[1811302771]}]}]},{"tin":{"Type":"ein","value":"823032998"},"service_code":["21"],"billing_class":"professional","setting":"inpatient","payments":[{"allowed_amount":96.33,"providers":[{"billed_charge":111.00,"npi":[1811302771]}]}]},{"tin":{"Type":"ein","value":"863247242"},"service_code":["21"],"billing_class":"professional","setting":"inpatient","payments":[{"allowed_amount":96.33,"billing_code_modifier":["FS"],"providers":[{"billed_charge":120.00,"npi":[1154562593,1376528380]}]}]}]},{"name":"Doctor care in hospital","billing_code_type":"CPT","billing_code_type_version":"2005","billing_code":"99233","description":"sbsq hosp ip/obs high 50","allowed_amounts":[{"tin":{"Type":"ein","value":"812660368"},"service_code":["21"],"billing_class":"professional","setting":"inpatient","payments":[{"allowed_amount":136.25,"providers":[{"billed_charge":377.00,"npi":[1023670833,1285383372]}]}]},{"tin":{"Type":"ein","value":"812660368"},"service_code":["21"],"billing_class":"professional","setting":"inpatient","payments":[{"allowed_amount":143.23,"billing_code_modifier":["25"],"providers":[{"billed_charge":359.00,"npi":[1023670833,1033615208,1033791942,1063552396,1073174314,1285383372,1578021689,1750802930,1801458435,1902922727,1932773793]}]},{"allowed_amount":143.23,"billing_code_modifier":["25"],"providers":[{"billed_charge":377.00,"npi":[1023670833,1063552396,1073174314,1578021689,1750802930,1801458435,1902922727,1932773793]}]}]},{"tin":{"Type":"ein","value":"814723941"},"service_code":["21"],"billing_class":"professional","setting":"inpatient","payments":[{"allowed_amount":143.23,"providers":[{"billed_charge":160.00,"npi":[1225327380]}]}]},{"tin":{"Type":"ein","value":"863247242"},"service_code":["21"],"billing_class":"professional","setting":"inpatient","payments":[{"allowed_amount":143.23,"billing_code_modifier":["FS"],"providers":[{"billed_charge":160.00,"npi":[1154562593,1376528380]}]}]}]},{"name":"Physician hospital discharge","billing_code_type":"CPT","billing_code_type_version":"2005","billing_code":"99238","description":"hosp ip/obs dschrg mgmt 30/<","allowed_amounts":[{"tin":{"Type":"ein","value":"812660368"},"service_code":["21"],"billing_class":"professional","setting":"inpatient","payments":[{"allowed_amount":98.18,"providers":[{"billed_charge":252.00,"npi":[1548902307,1699171538,1750802930,1902922727,1932773793,1932841806]}]},{"allowed_amount":98.18,"providers":[{"billed_charge":265.00,"npi":[1750802930,1902922727,1932773793]}]}]}]},{"name":"Physician hospital discharge","billing_code_type":"CPT","billing_code_type_version":"2005","billing_code":"99239","description":"hosp ip/obs dschrg mgmt >30","allowed_amounts":[{"tin":{"Type":"ein","value":"812660368"},"service_code":["21"],"billing_class":"professional","setting":"inpatient","payments":[{"allowed_amount":134.93,"billing_code_modifier":["25"],"providers":[{"billed_charge":386.00,"npi":[1285383372]}]}]},{"tin":{"Type":"ein","value":"812660368"},"service_code":["21"],"billing_class":"professional","setting":"inpatient","payments":[{"allowed_amount":138.61,"providers":[{"billed_charge":368.00,"npi":[1003548116,1063552396,1073174314,1285383372,1578021689]}]},{"allowed_amount":138.61,"providers":[{"billed_charge":386.00,"npi":[1003548116,1063552396,1073174314,1285383372,1578021689]}]}]}]},{"name":"ER visit doctor services","billing_code_type":"CPT","billing_code_type_version":"2005","billing_code":"99283","description":"emergency dept visit low mdm","allowed_amounts":[{"tin":{"Type":"ein","value":"596001321"},"billing_class":"institutional","setting":"outpatient","payments":[{"allowed_amount":372.09,"billing_code_modifier":["25"],"providers":[{"billed_charge":679.00,"npi":[1538108725]}]}]},{"tin":{"Type":"ein","value":"810584939"},"service_code":["23"],"billing_class":"professional","setting":"outpatient","payments":[{"allowed_amount":74.36,"billing_code_modifier":["25"],"providers":[{"billed_charge":594.00,"npi":[1467932152]}]},{"allowed_amount":74.36,"billing_code_modifier":["25"],"providers":[{"billed_charge":612.00,"npi":[1467932152]}]}]},{"tin":{"Type":"ein","value":"810584939"},"service_code":["23"],"billing_class":"professional","setting":"outpatient","payments":[{"allowed_amount":76.95,"providers":[{"billed_charge":612.00,"npi":[1467932152]}]}]},{"tin":{"Type":"ein","value":"810584939"},"service_code":["23"],"billing_class":"professional","setting":"outpatient","payments":[{"allowed_amount":87.49,"billing_code_modifier":["25"],"providers":[{"billed_charge":594.00,"npi":[1780640599]}]},{"allowed_amount":87.49,"billing_code_modifier":["25"],"providers":[{"billed_charge":612.00,"npi":[1780640599]}]}]}]},{"name":"Doctor visit ER","billing_code_type":"CPT","billing_code_type_version":"2005","billing_code":"99284","description":"emergency dept visit mod mdm","allowed_amounts":[{"tin":{"Type":"ein","value":"810584939"},"service_code":["23"],"billing_class":"professional","setting":"outpatient","payments":[{"allowed_amount":127.20,"billing_code_modifier":["25"],"providers":[{"billed_charge":1024.00,"npi":[1023605912,1033744610,1063998235,1124789805,1164032330,1295019925,1467932152,1649806175,1700241023,1740022086,1821593252,1841263142,1942385901,1972802510]}]},{"allowed_amount":127.20,"billing_code_modifier":["25"],"providers":[{"billed_charge":994.00,"npi":[1023605912,1033744610,1063998235,1124789805,1164032330,1295019925,1467932152,1649806175,1700241023,1740022086,1821593252,1841263142,1942385901,1972802510]}]}]},{"tin":{"Type":"ein","value":"810584939"},"service_code":["23"],"billing_class":"professional","setting":"outpatient","payments":[{"allowed_amount":131.18,"billing_code_modifier":["25"],"providers":[{"billed_charge":1024.00,"npi":[1063998235,1124789805,1164032330,1295019925,1467932152,1649806175,1700241023,1740022086,1841263142]}]}]},{"tin":{"Type":"ein","value":"810584939"},"service_code":["23"],"billing_class":"professional","setting":"outpatient","payments":[{"allowed_amount":149.65,"billing_code_modifier":["25","SA"],"providers":[{"billed_charge":1024.00,"npi":[1013189224,1194068247,1265474019,1306824693,1508492158,1508917105,1568925527,1588124333,1629174917,1639676059,1649477993,1659588762,1679525463,1710379920,1780640599,1821016361,1891012845,1912274481,1932197076,1932563145,1972025310,1982021846]}]},{"allowed_amount":149.65,"billing_code_modifier":["25","SA"],"providers":[{"billed_charge":994.00,"npi":[1013189224,1174086110,1194068247,1265474019,1306824693,1437252657,1508492158,1508917105,1568925527,1588124333,1629174917,1639676059,1649477993,1659588762,1679525463,1710379920,1780640599,1821016361,1891012845,1912274481,1932197076,1932563145,1972025310,1982021846]}]}]},{"tin":{"Type":"ein","value":"810584939"},"service_code":["23"],"billing_class":"professional","setting":"outpatient","payments":[{"allowed_amount":154.33,"billing_code_modifier":["25"],"providers":[{"billed_charge":1024.00,"npi":[1013189224,1194068247,1265474019,1508492158,1508917105,1568925527,1588124333,1639676059,1659588762,1679525463,1710379920,1821016361,1972025310]}]}]}]},{"name":"Doctor visit ER","billing_code_type":"CPT","billing_code_type_version":"2005","billing_code":"99285","description":"emergency dept visit hi mdm","allowed_amounts":[{"tin":{"Type":"ein","value":"810584939"},"service_code":["23"],"billing_class":"professional","setting":"outpatient","payments":[{"allowed_amount":184.67,"billing_code_modifier":["25"],"providers":[{"billed_charge":1451.00,"npi":[1023605912,1033744610,1063998235,1124789805,1164032330,1467932152,1558032045,1649806175,1700241023,1740022086,1972802510]}]},{"allowed_amount":184.67,"billing_code_modifier":["25"],"providers":[{"billed_charge":1495.00,"npi":[1023605912,1033744610,1063998235,1124789805,1164032330,1467932152,1558032045,1649806175,1700241023,1740022086,1972802510]}]}]},{"tin":{"Type":"ein","value":"810584939"},"service_code":["23"],"billing_class":"professional","setting":"outpatient","payments":[{"allowed_amount":189.61,"providers":[{"billed_charge":1495.00,"npi":[1023605912,1063998235,1467932152,1649806175,1700241023]}]}]},{"tin":{"Type":"ein","value":"810584939"},"service_code":["23"],"billing_class":"professional","setting":"outpatient","payments":[{"allowed_amount":217.26,"billing_code_modifier":["25","57"],"providers":[{"billed_charge":1451.00,"npi":[1013189224,1194068247,1265474019,1306824693,1447713979,1508492158,1508917105,1568925527,1588124333,1629174917,1639676059,1649477993,1659588762,1679525463,1710379920,1740922061,1912274481,1932563145,1972025310,1982021846]}]},{"allowed_amount":217.26,"billing_code_modifier":["25","57"],"providers":[{"billed_charge":1495.00,"npi":[1013189224,1194068247,1265474019,1306824693,1447713979,1508492158,1508917105,1568925527,1588124333,1629174917,1639676059,1649477993,1659588762,1679525463,1710379920,1912274481,1932563145,1972025310,1982021846]}]}]},{"tin":{"Type":"ein","value":"810584939"},"service_code":["23"],"billing_class":"professional","setting":"outpatient","payments":[{"allowed_amount":223.08,"providers":[{"billed_charge":1495.00,"npi":[1013189224,1194068247,1588124333,1629174917,1639676059,1679525463,1710379920,1972025310]}]}]},{"tin":{"Type":"ein","value":"810584939"},"service_code":["23"],"billing_class":"professional","setting":"outpatient","payments":[{"allowed_amount":553.91,"providers":[{"billed_charge":1451.00,"npi":[1447713979]}]}]}]},{"name":"Critical care doctor services","billing_code_type":"CPT","billing_code_type_version":"2005","billing_code":"99291","description":"critical care first hour","allowed_amounts":[{"tin":{"Type":"ein","value":"202252101"},"service_code":["21"],"billing_class":"professional","setting":"inpatient","payments":[{"allowed_amount":256.66,"providers":[{"billed_charge":1217.00,"npi":[1265452791]}]}]},{"tin":{"Type":"ein","value":"202252101"},"service_code":["21"],"billing_class":"professional","setting":"inpatient","payments":[{"allowed_amount":262.01,"billing_code_modifier":["25","GC"],"providers":[{"billed_charge":1217.00,"npi":[1265452791,1730539990]}]}]}]},{"name":"Doctor care nursing home","billing_code_type":"CPT","billing_code_type_version":"2006","billing_code":"99305","description":"1st nf care moderate mdm 35","allowed_amounts":[{"tin":{"Type":"ein","value":"883526640"},"service_code":["31"],"billing_class":"professional","setting":"inpatient","payments":[{"allowed_amount":160.36,"providers":[{"billed_charge":251.56,"npi":[1114928603]}]}]}]},{"name":"Doctor care nursing home","billing_code_type":"CPT","billing_code_type_version":"2006","billing_code":"99306","description":"1st nf care high mdm 50","allowed_amounts":[{"tin":{"Type":"ein","value":"472590836"},"service_code":["31"],"billing_class":"professional","setting":"inpatient","payments":[{"allowed_amount":186.30,"providers":[{"billed_charge":566.00,"npi":[1790257756]}]}]},{"tin":{"Type":"ein","value":"843784979"},"service_code":["31"],"billing_class":"professional","setting":"inpatient","payments":[{"allowed_amount":219.18,"billing_code_modifier":["25"],"providers":[{"billed_charge":255.00,"npi":[1457558132]}]}]},{"tin":{"Type":"ein","value":"883526640"},"service_code":["31"],"billing_class":"professional","setting":"inpatient","payments":[{"allowed_amount":219.18,"providers":[{"billed_charge":343.66,"npi":[1114928603]}]}]}]},{"name":"Doctor care nursing home","billing_code_type":"CPT","billing_code_type_version":"2006","billing_code":"99308","description":"sbsq nf care low mdm 20","allowed_amounts":[{"tin":{"Type":"ein","value":"843784979"},"service_code":["31"],"billing_class":"professional","setting":"inpatient","payments":[{"allowed_amount":75.85,"providers":[{"billed_charge":105.00,"npi":[1558248120]}]}]},{"tin":{"Type":"ein","value":"883526640"},"service_code":["31"],"billing_class":"professional","setting":"inpatient","payments":[{"allowed_amount":89.24,"providers":[{"billed_charge":140.16,"npi":[1114928603]}]}]}]},{"name":"Doctor care nursing home","billing_code_type":"CPT","billing_code_type_version":"2006","billing_code":"99309","description":"sbsq nf care moderate mdm 30","allowed_amounts":[{"tin":{"Type":"ein","value":"550893915"},"service_code":["31"],"billing_class":"professional","setting":"inpatient","payments":[{"allowed_amount":110.34,"providers":[{"billed_charge":160.00,"npi":[1255956934]}]}]},{"tin":{"Type":"ein","value":"814723941"},"service_code":["31"],"billing_class":"professional","setting":"inpatient","payments":[{"allowed_amount":110.34,"providers":[{"billed_charge":141.00,"npi":[1235128869]}]}]},{"tin":{"Type":"ein","value":"843784979"},"service_code":["31"],"billing_class":"professional","setting":"inpatient","payments":[{"allowed_amount":105.80,"providers":[{"billed_charge":138.00,"npi":[1306585351,1558248120]}]}]},{"tin":{"Type":"ein","value":"843784979"},"service_code":["31"],"billing_class":"professional","setting":"inpatient","payments":[{"allowed_amount":110.34,"providers":[{"billed_charge":138.00,"npi":[1306585351,1508667379,1558248120]}]}]},{"tin":{"Type":"ein","value":"843784979"},"service_code":["31"],"billing_class":"professional","setting":"inpatient","payments":[{"allowed_amount":124.48,"providers":[{"billed_charge":138.00,"npi":[1457558132]}]}]},{"tin":{"Type":"ein","value":"843784979"},"service_code":["31"],"billing_class":"professional","setting":"inpatient","payments":[{"allowed_amount":129.81,"providers":[{"billed_charge":138.00,"npi":[1457558132]}]}]},{"tin":{"Type":"ein","value":"883526640"},"service_code":["31"],"billing_class":"professional","setting":"inpatient","payments":[{"allowed_amount":129.81,"providers":[{"billed_charge":203.84,"npi":[1114928603]}]}]},{"tin":{"Type":"ein","value":"920548864"},"service_code":["31"],"billing_class":"professional","setting":"inpatient","payments":[{"allowed_amount":110.34,"providers":[{"billed_charge":124.00,"npi":[1184951436,1609623032]}]}]}]},{"name":"Doctor care nursing home","billing_code_type":"CPT","billing_code_type_version":"2006","billing_code":"99310","description":"sbsq nf care high mdm 45","allowed_amounts":[{"tin":{"Type":"ein","value":"843784979"},"service_code":["31"],"billing_class":"professional","setting":"inpatient","payments":[{"allowed_amount":157.69,"billing_code_modifier":["25"],"providers":[{"billed_charge":204.00,"npi":[1306585351,1508667379,1558248120]}]}]}]},{"name":"Discharge care nursing home","billing_code_type":"CPT","billing_code_type_version":"2005","billing_code":"99315","description":"nf dschrg mgmt 30 min/less","allowed_amounts":[{"tin":{"Type":"ein","value":"883526640"},"service_code":["31"],"billing_class":"professional","setting":"inpatient","payments":[{"allowed_amount":98.13,"billing_code_modifier":["FS"],"providers":[{"billed_charge":154.00,"npi":[1114928603]}]}]}]},{"name":"Discharge care nursing home","billing_code_type":"CPT","billing_code_type_version":"2005","billing_code":"99316","description":"nf dschrg mgmt 30 min+","allowed_amounts":[{"tin":{"Type":"ein","value":"843784979"},"service_code":["31"],"billing_class":"professional","setting":"inpatient","payments":[{"allowed_amount":133.73,"providers":[{"billed_charge":160.00,"npi":[1306585351]}]}]},{"tin":{"Type":"ein","value":"883526640"},"service_code":["31"],"billing_class":"professional","setting":"inpatient","payments":[{"allowed_amount":157.33,"billing_code_modifier":["FS"],"providers":[{"billed_charge":246.70,"npi":[1114928603]}]}]}]},{"name":"Doctor service newborn ICU","billing_code_type":"CPT","billing_code_type_version":"2008","billing_code":"99480","description":"sbsq ic inf pbw 2501-5000","allowed_amounts":[{"tin":{"Type":"ein","value":"593214635"},"service_code":["21"],"billing_class":"professional","setting":"inpatient","payments":[{"allowed_amount":409.45,"providers":[{"billed_charge":473.00,"npi":[1447446984]}]}]}]},{"name":"Ambulance mileage","billing_code_type":"CPT","billing_code_type_version":"2005","billing_code":"A0425","description":"Ground mileage","allowed_amounts":[{"tin":{"Type":"ein","value":"596000616"},"service_code":["41"],"billing_class":"professional","setting":"outpatient","payments":[{"allowed_amount":13.07,"billing_code_modifier":["EH","HH","NH","RH","SH"],"providers":[{"billed_charge":13.07,"npi":[1700856754]}]}]},{"tin":{"Type":"ein","value":"596000690"},"service_code":["41"],"billing_class":"professional","setting":"outpatient","payments":[{"allowed_amount":22.50,"billing_code_modifier":["EH","PH","RH","SH"],"providers":[{"billed_charge":22.50,"npi":[1396880654]}]}]},{"tin":{"Type":"ein","value":"596000690"},"service_code":["41"],"billing_class":"professional","setting":"outpatient","payments":[{"allowed_amount":22.95,"billing_code_modifier":["RH","SH"],"providers":[{"billed_charge":22.95,"npi":[1396880654]}]}]},{"tin":{"Type":"ein","value":"596031875"},"service_code":["41"],"billing_class":"professional","setting":"outpatient","payments":[{"allowed_amount":12.50,"billing_code_modifier":["EH","NH","PH","RH","SH"],"providers":[{"billed_charge":12.50,"npi":[1952448383]}]}]}]},{"name":"Ambulance transport","billing_code_type":"CPT","billing_code_type_version":"2005","billing_code":"A0427","description":"ALS1-emergency","allowed_amounts":[{"tin":{"Type":"ein","value":"596000616"},"service_code":["41"],"billing_class":"professional","setting":"outpatient","payments":[{"allowed_amount":739.50,"billing_code_modifier":["EH","HH","NH","RH","SH"],"providers":[{"billed_charge":739.50,"npi":[1700856754]}]}]},{"tin":{"Type":"ein","value":"596000690"},"service_code":["41"],"billing_class":"professional","setting":"outpatient","payments":[{"allowed_amount":1169.52,"billing_code_modifier":["RH","SH"],"providers":[{"billed_charge":1169.52,"npi":[1396880654]}]}]},{"tin":{"Type":"ein","value":"596000690"},"service_code":["41"],"billing_class":"professional","setting":"outpatient","payments":[{"allowed_amount":1192.91,"billing_code_modifier":["RH"],"providers":[{"billed_charge":1192.91,"npi":[1396880654]}]}]},{"tin":{"Type":"ein","value":"596031875"},"service_code":["41"],"billing_class":"professional","setting":"outpatient","payments":[{"allowed_amount":821.00,"billing_code_modifier":["EH","NH","RH","SH"],"providers":[{"billed_charge":821.00,"npi":[1952448383]}]}]}]},{"name":"Ambulance transport","billing_code_type":"CPT","billing_code_type_version":"2005","billing_code":"A0429","description":"BLS-emergency","allowed_amounts":[{"tin":{"Type":"ein","value":"596000616"},"service_code":["41"],"billing_class":"professional","setting":"outpatient","payments":[{"allowed_amount":622.74,"billing_code_modifier":["RH","SH"],"providers":[{"billed_charge":622.74,"npi":[1700856754]}]}]},{"tin":{"Type":"ein","value":"596000690"},"service_code":["41"],"billing_class":"professional","setting":"outpatient","payments":[{"allowed_amount":950.95,"billing_code_modifier":["EH","PH","RH","SH"],"providers":[{"billed_charge":950.95,"npi":[1396880654]}]}]},{"tin":{"Type":"ein","value":"596000690"},"service_code":["41"],"billing_class":"professional","setting":"outpatient","payments":[{"allowed_amount":969.97,"billing_code_modifier":["RH","SH"],"providers":[{"billed_charge":969.97,"npi":[1396880654]}]}]},{"tin":{"Type":"ein","value":"596031875"},"service_code":["41"],"billing_class":"professional","setting":"outpatient","payments":[{"allowed_amount":684.00,"billing_code_modifier":["PH","RH","SH"],"providers":[{"billed_charge":684.00,"npi":[1952448383]}]}]}]},{"name":"Emergency medical services","billing_code_type":"CPT","billing_code_type_version":"2006","billing_code":"A0998","description":"Ambulance response/treatment","allowed_amounts":[{"tin":{"Type":"ein","value":"596031875"},"service_code":["41"],"billing_class":"professional","setting":"outpatient","payments":[{"allowed_amount":100.00,"billing_code_modifier":["RR","SS"],"providers":[{"billed_charge":100.00,"npi":[1952448383]}]}]}]},{"name":"Spinal bone growth stimulator","billing_code_type":"CPT","billing_code_type_version":"2005","billing_code":"E0748","description":"Elec osteogen stim spinal","allowed_amounts":[{"tin":{"Type":"ein","value":"752608036"},"service_code":["12"],"billing_class":"professional","setting":"outpatient","payments":[{"allowed_amount":5995.00,"billing_code_modifier":["KF","NU"],"providers":[{"billed_charge":5995.00,"npi":[1235136060]}]}]}]},{"name":"Nursing home care extra time","billing_code_type":"CPT","billing_code_type_version":"2005","billing_code":"G0317","description":"Prolong nursin fac eval 15m","allowed_amounts":[{"tin":{"Type":"ein","value":"843784979"},"service_code":["31"],"billing_class":"professional","setting":"inpatient","payments":[{"allowed_amount":36.54,"providers":[{"billed_charge":47.00,"npi":[1457558132]}]}]}]},{"name":"Cefazolin sodium shot/infusion","billing_code_type":"CPT","billing_code_type_version":"2005","billing_code":"J0690","description":"Cefazolin sodium injection","allowed_amounts":[{"tin":{"Type":"ein","value":"590714831"},"billing_class":"institutional","setting":"outpatient","payments":[{"allowed_amount":0.00,"providers":[{"billed_charge":10.08,"npi":[1891782470]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":13.45,"npi":[1891782470]}]}]},{"tin":{"Type":"ein","value":"590714831"},"billing_class":"institutional","setting":"outpatient","payments":[{"allowed_amount":0.92,"providers":[{"billed_charge":2.28,"npi":[1891782470]}]}]},{"tin":{"Type":"ein","value":"590714831"},"billing_class":"institutional","setting":"outpatient","payments":[{"allowed_amount":3.34,"providers":[{"billed_charge":13.45,"npi":[1891782470]}]}]},{"tin":{"Type":"ein","value":"590714831"},"billing_class":"institutional","setting":"outpatient","payments":[{"allowed_amount":5.40,"providers":[{"billed_charge":13.45,"npi":[1891782470]}]}]}]},{"name":"Dexamethasone shot or infusion","billing_code_type":"CPT","billing_code_type_version":"2005","billing_code":"J1100","description":"Dexamethasone sodium phos","allowed_amounts":[{"tin":{"Type":"ein","value":"590714831"},"billing_class":"institutional","setting":"outpatient","payments":[{"allowed_amount":0.00,"billing_code_modifier":["JW"],"providers":[{"billed_charge":0.54,"npi":[1891782470]}]},{"allowed_amount":0.00,"billing_code_modifier":["JW"],"providers":[{"billed_charge":3.85,"npi":[1891782470]}]},{"allowed_amount":0.00,"billing_code_modifier":["JW"],"providers":[{"billed_charge":4.03,"npi":[1891782470]}]},{"allowed_amount":0.00,"billing_code_modifier":["JW"],"providers":[{"billed_charge":4.73,"npi":[1891782470]}]},{"allowed_amount":0.00,"billing_code_modifier":["JW"],"providers":[{"billed_charge":4.89,"npi":[1891782470]}]},{"allowed_amount":0.00,"billing_code_modifier":["JW"],"providers":[{"billed_charge":6.36,"npi":[1891782470]}]},{"allowed_amount":0.00,"billing_code_modifier":["JW"],"providers":[{"billed_charge":7.54,"npi":[1891782470]}]},{"allowed_amount":0.00,"billing_code_modifier":["JW"],"providers":[{"billed_charge":9.10,"npi":[1891782470]}]},{"allowed_amount":0.00,"billing_code_modifier":["JW"],"providers":[{"billed_charge":9.28,"npi":[1891782470]}]}]},{"tin":{"Type":"ein","value":"590714831"},"billing_class":"institutional","setting":"outpatient","payments":[{"allowed_amount":0.96,"providers":[{"billed_charge":3.85,"npi":[1891782470]}]}]},{"tin":{"Type":"ein","value":"590714831"},"billing_class":"institutional","setting":"outpatient","payments":[{"allowed_amount":1.96,"providers":[{"billed_charge":4.89,"npi":[1891782470]}]}]},{"tin":{"Type":"ein","value":"590714831"},"billing_class":"institutional","setting":"outpatient","payments":[{"allowed_amount":2.61,"providers":[{"billed_charge":9.10,"npi":[1891782470]}]}]},{"tin":{"Type":"ein","value":"590714831"},"billing_class":"institutional","setting":"outpatient","payments":[{"allowed_amount":3.73,"providers":[{"billed_charge":9.28,"npi":[1891782470]}]}]},{"tin":{"Type":"ein","value":"590714831"},"billing_class":"institutional","setting":"outpatient","payments":[{"allowed_amount":4.03,"providers":[{"billed_charge":4.03,"npi":[1891782470]}]}]},{"tin":{"Type":"ein","value":"590714831"},"billing_class":"institutional","setting":"outpatient","payments":[{"allowed_amount":6.83,"providers":[{"billed_charge":9.10,"npi":[1891782470]}]}]},{"tin":{"Type":"ein","value":"590714831"},"billing_class":"institutional","setting":"outpatient","payments":[{"allowed_amount":6.96,"providers":[{"billed_charge":9.28,"npi":[1891782470]}]}]}]},{"name":"Hydromorphone injection","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"J1171","description":"Inj hydromorphone 0.1 mg","allowed_amounts":[{"tin":{"Type":"ein","value":"590714831"},"billing_class":"institutional","setting":"outpatient","payments":[{"allowed_amount":0.00,"billing_code_modifier":["JW"],"providers":[{"billed_charge":0.62,"npi":[1891782470]}]},{"allowed_amount":0.00,"billing_code_modifier":["JW"],"providers":[{"billed_charge":14.62,"npi":[1891782470]}]},{"allowed_amount":0.00,"billing_code_modifier":["JW"],"providers":[{"billed_charge":15.10,"npi":[1891782470]}]},{"allowed_amount":0.00,"billing_code_modifier":["JW"],"providers":[{"billed_charge":15.80,"npi":[1891782470]}]},{"allowed_amount":0.00,"billing_code_modifier":["JW"],"providers":[{"billed_charge":35.65,"npi":[1891782470]}]},{"allowed_amount":0.00,"billing_code_modifier":["JW"],"providers":[{"billed_charge":36.10,"npi":[1891782470]}]},{"allowed_amount":0.00,"billing_code_modifier":["JW"],"providers":[{"billed_charge":4.59,"npi":[1891782470]}]},{"allowed_amount":0.00,"billing_code_modifier":["JW"],"providers":[{"billed_charge":7.61,"npi":[1891782470]}]},{"allowed_amount":0.00,"billing_code_modifier":["JW"],"providers":[{"billed_charge":8.09,"npi":[1891782470]}]}]},{"tin":{"Type":"ein","value":"590714831"},"billing_class":"institutional","setting":"outpatient","payments":[{"allowed_amount":6.07,"providers":[{"billed_charge":8.09,"npi":[1891782470]}]}]}]},{"name":"Midazolam shot or infusion","billing_code_type":"CPT","billing_code_type_version":"2005","billing_code":"J2250","description":"Inj midazolam hydrochloride","allowed_amounts":[{"tin":{"Type":"ein","value":"590714831"},"billing_class":"institutional","setting":"outpatient","payments":[{"allowed_amount":0.00,"providers":[{"billed_charge":36.00,"npi":[1891782470]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":36.35,"npi":[1891782470]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":70.60,"npi":[1891782470]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":71.00,"npi":[1891782470]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":71.40,"npi":[1891782470]}]}]},{"tin":{"Type":"ein","value":"590714831"},"billing_class":"institutional","setting":"outpatient","payments":[{"allowed_amount":8.94,"providers":[{"billed_charge":36.00,"npi":[1891782470]}]}]},{"tin":{"Type":"ein","value":"590714831"},"billing_class":"institutional","setting":"outpatient","payments":[{"allowed_amount":10.39,"providers":[{"billed_charge":36.20,"npi":[1891782470]}]}]},{"tin":{"Type":"ein","value":"590714831"},"billing_class":"institutional","setting":"outpatient","payments":[{"allowed_amount":14.46,"providers":[{"billed_charge":36.00,"npi":[1891782470]}]}]}]},{"name":"Ondansetron shot or infusion","billing_code_type":"CPT","billing_code_type_version":"2005","billing_code":"J2405","description":"Ondansetron hcl injection","allowed_amounts":[{"tin":{"Type":"ein","value":"590714831"},"billing_class":"institutional","setting":"outpatient","payments":[{"allowed_amount":0.00,"providers":[{"billed_charge":4.81,"npi":[1891782470]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":9.00,"npi":[1891782470]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":9.20,"npi":[1891782470]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":9.40,"npi":[1891782470]}]}]},{"tin":{"Type":"ein","value":"590714831"},"billing_class":"institutional","setting":"outpatient","payments":[{"allowed_amount":2.30,"providers":[{"billed_charge":9.00,"npi":[1891782470]}]}]},{"tin":{"Type":"ein","value":"590714831"},"billing_class":"institutional","setting":"outpatient","payments":[{"allowed_amount":2.34,"providers":[{"billed_charge":9.40,"npi":[1891782470]}]}]},{"tin":{"Type":"ein","value":"590714831"},"billing_class":"institutional","setting":"outpatient","payments":[{"allowed_amount":2.64,"providers":[{"billed_charge":9.20,"npi":[1891782470]}]}]},{"tin":{"Type":"ein","value":"590714831"},"billing_class":"institutional","setting":"outpatient","payments":[{"allowed_amount":2.68,"providers":[{"billed_charge":9.00,"npi":[1891782470]}]}]},{"tin":{"Type":"ein","value":"590714831"},"billing_class":"institutional","setting":"outpatient","payments":[{"allowed_amount":4.81,"providers":[{"billed_charge":9.00,"npi":[1891782470]}]}]},{"tin":{"Type":"ein","value":"590714831"},"billing_class":"institutional","setting":"outpatient","payments":[{"allowed_amount":5.09,"providers":[{"billed_charge":9.00,"npi":[1891782470]}]}]},{"tin":{"Type":"ein","value":"590714831"},"billing_class":"institutional","setting":"outpatient","payments":[{"allowed_amount":6.90,"providers":[{"billed_charge":9.20,"npi":[1891782470]}]}]},{"tin":{"Type":"ein","value":"590714831"},"billing_class":"institutional","setting":"outpatient","payments":[{"allowed_amount":7.05,"providers":[{"billed_charge":9.40,"npi":[1891782470]}]}]}]},{"name":"Propofol infusion or injection","billing_code_type":"CPT","billing_code_type_version":"2015","billing_code":"J2704","description":"Inj propofol 10 MG","allowed_amounts":[{"tin":{"Type":"ein","value":"590714831"},"billing_class":"institutional","setting":"outpatient","payments":[{"allowed_amount":0.00,"billing_code_modifier":["JW"],"providers":[{"billed_charge":0.42,"npi":[1891782470]}]},{"allowed_amount":0.00,"billing_code_modifier":["JW"],"providers":[{"billed_charge":0.43,"npi":[1891782470]}]},{"allowed_amount":0.00,"billing_code_modifier":["JW"],"providers":[{"billed_charge":0.44,"npi":[1891782470]}]},{"allowed_amount":0.00,"billing_code_modifier":["JW"],"providers":[{"billed_charge":0.45,"npi":[1891782470]}]},{"allowed_amount":0.00,"billing_code_modifier":["JW"],"providers":[{"billed_charge":0.46,"npi":[1891782470]}]},{"allowed_amount":0.00,"billing_code_modifier":["JW"],"providers":[{"billed_charge":0.47,"npi":[1891782470]}]},{"allowed_amount":0.00,"billing_code_modifier":["JW"],"providers":[{"billed_charge":0.48,"npi":[1891782470]}]},{"allowed_amount":0.00,"billing_code_modifier":["JW"],"providers":[{"billed_charge":0.49,"npi":[1891782470]}]},{"allowed_amount":0.00,"billing_code_modifier":["JW"],"providers":[{"billed_charge":0.50,"npi":[1891782470]}]},{"allowed_amount":0.00,"billing_code_modifier":["JW"],"providers":[{"billed_charge":0.51,"npi":[1891782470]}]},{"allowed_amount":0.00,"billing_code_modifier":["JW"],"providers":[{"billed_charge":0.52,"npi":[1891782470]}]},{"allowed_amount":0.00,"billing_code_modifier":["JW"],"providers":[{"billed_charge":0.53,"npi":[1891782470]}]},{"allowed_amount":0.00,"billing_code_modifier":["JW"],"providers":[{"billed_charge":0.54,"npi":[1891782470]}]},{"allowed_amount":0.00,"billing_code_modifier":["JW"],"providers":[{"billed_charge":0.55,"npi":[1891782470]}]},{"allowed_amount":0.00,"billing_code_modifier":["JW"],"providers":[{"billed_charge":0.60,"npi":[1891782470]}]},{"allowed_amount":0.00,"billing_code_modifier":["JW"],"providers":[{"billed_charge":0.70,"npi":[1891782470]}]},{"allowed_amount":0.00,"billing_code_modifier":["JW"],"providers":[{"billed_charge":0.75,"npi":[1891782470]}]},{"allowed_amount":0.00,"billing_code_modifier":["JW"],"providers":[{"billed_charge":0.76,"npi":[1891782470]}]},{"allowed_amount":0.00,"billing_code_modifier":["JW"],"providers":[{"billed_charge":0.77,"npi":[1891782470]}]},{"allowed_amount":0.00,"billing_code_modifier":["JW"],"providers":[{"billed_charge":0.78,"npi":[1891782470]}]},{"allowed_amount":0.00,"billing_code_modifier":["JW"],"providers":[{"billed_charge":0.80,"npi":[1891782470]}]},{"allowed_amount":0.00,"billing_code_modifier":["JW"],"providers":[{"billed_charge":0.82,"npi":[1891782470]}]},{"allowed_amount":0.00,"billing_code_modifier":["JW"],"providers":[{"billed_charge":1.05,"npi":[1891782470]}]},{"allowed_amount":0.00,"billing_code_modifier":["JW"],"providers":[{"billed_charge":1.13,"npi":[1891782470]}]},{"allowed_amount":0.00,"billing_code_modifier":["JW"],"providers":[{"billed_charge":1.20,"npi":[1891782470]}]},{"allowed_amount":0.00,"billing_code_modifier":["JW"],"providers":[{"billed_charge":1.23,"npi":[1891782470]}]},{"allowed_amount":0.00,"billing_code_modifier":["JW"],"providers":[{"billed_charge":1.25,"npi":[1891782470]}]},{"allowed_amount":0.00,"billing_code_modifier":["JW"],"providers":[{"billed_charge":1.28,"npi":[1891782470]}]},{"allowed_amount":0.00,"billing_code_modifier":["JW"],"providers":[{"billed_charge":1.29,"npi":[1891782470]}]},{"allowed_amount":0.00,"billing_code_modifier":["JW"],"providers":[{"billed_charge":1.30,"npi":[1891782470]}]},{"allowed_amount":0.00,"billing_code_modifier":["JW"],"providers":[{"billed_charge":1.32,"npi":[1891782470]}]},{"allowed_amount":0.00,"billing_code_modifier":["JW"],"providers":[{"billed_charge":1.48,"npi":[1891782470]}]},{"allowed_amount":0.00,"billing_code_modifier":["JW"],"providers":[{"billed_charge":1.64,"npi":[1891782470]}]},{"allowed_amount":0.00,"billing_code_modifier":["JW"],"providers":[{"billed_charge":1.70,"npi":[1891782470]}]},{"allowed_amount":0.00,"billing_code_modifier":["JW"],"providers":[{"billed_charge":1.71,"npi":[1891782470]}]},{"allowed_amount":0.00,"billing_code_modifier":["JW"],"providers":[{"billed_charge":1.82,"npi":[1891782470]}]},{"allowed_amount":0.00,"billing_code_modifier":["JW"],"providers":[{"billed_charge":2.09,"npi":[1891782470]}]},{"allowed_amount":0.00,"billing_code_modifier":["JW"],"providers":[{"billed_charge":2.18,"npi":[1891782470]}]},{"allowed_amount":0.00,"billing_code_modifier":["JW"],"providers":[{"billed_charge":2.22,"npi":[1891782470]}]},{"allowed_amount":0.00,"billing_code_modifier":["JW"],"providers":[{"billed_charge":2.26,"npi":[1891782470]}]},{"allowed_amount":0.00,"billing_code_modifier":["JW"],"providers":[{"billed_charge":2.27,"npi":[1891782470]}]},{"allowed_amount":0.00,"billing_code_modifier":["JW"],"providers":[{"billed_charge":2.37,"npi":[1891782470]}]},{"allowed_amount":0.00,"billing_code_modifier":["JW"],"providers":[{"billed_charge":2.40,"npi":[1891782470]}]},{"allowed_amount":0.00,"billing_code_modifier":["JW"],"providers":[{"billed_charge":2.52,"npi":[1891782470]}]},{"allowed_amount":0.00,"billing_code_modifier":["JW"],"providers":[{"billed_charge":2.61,"npi":[1891782470]}]},{"allowed_amount":0.00,"billing_code_modifier":["JW"],"providers":[{"billed_charge":2.76,"npi":[1891782470]}]},{"allowed_amount":0.00,"billing_code_modifier":["JW"],"providers":[{"billed_charge":2.81,"npi":[1891782470]}]},{"allowed_amount":0.00,"billing_code_modifier":["JW"],"providers":[{"billed_charge":2.91,"npi":[1891782470]}]},{"allowed_amount":0.00,"billing_code_modifier":["JW"],"providers":[{"billed_charge":2.92,"npi":[1891782470]}]},{"allowed_amount":0.00,"billing_code_modifier":["JW"],"providers":[{"billed_charge":3.10,"npi":[1891782470]}]},{"allowed_amount":0.00,"billing_code_modifier":["JW"],"providers":[{"billed_charge":3.34,"npi":[1891782470]}]},{"allowed_amount":0.00,"billing_code_modifier":["JW"],"providers":[{"billed_charge":3.61,"npi":[1891782470]}]},{"allowed_amount":0.00,"billing_code_modifier":["JW"],"providers":[{"billed_charge":3.62,"npi":[1891782470]}]},{"allowed_amount":0.00,"billing_code_modifier":["JW"],"providers":[{"billed_charge":3.97,"npi":[1891782470]}]},{"allowed_amount":0.00,"billing_code_modifier":["JW"],"providers":[{"billed_charge":4.34,"npi":[1891782470]}]},{"allowed_amount":0.00,"billing_code_modifier":["JW"],"providers":[{"billed_charge":4.58,"npi":[1891782470]}]},{"allowed_amount":0.00,"billing_code_modifier":["JW"],"providers":[{"billed_charge":4.85,"npi":[1891782470]}]},{"allowed_amount":0.00,"billing_code_modifier":["JW"],"providers":[{"billed_charge":5.47,"npi":[1891782470]}]},{"allowed_amount":0.00,"billing_code_modifier":["JW"],"providers":[{"billed_charge":5.48,"npi":[1891782470]}]}]},{"tin":{"Type":"ein","value":"590714831"},"billing_class":"institutional","setting":"outpatient","payments":[{"allowed_amount":0.11,"billing_code_modifier":["JW"],"providers":[{"billed_charge":0.43,"npi":[1891782470]}]}]},{"tin":{"Type":"ein","value":"590714831"},"billing_class":"institutional","setting":"outpatient","payments":[{"allowed_amount":0.12,"billing_code_modifier":["JW"],"providers":[{"billed_charge":0.44,"npi":[1891782470]}]}]},{"tin":{"Type":"ein","value":"590714831"},"billing_class":"institutional","setting":"outpatient","payments":[{"allowed_amount":0.14,"billing_code_modifier":["JW"],"providers":[{"billed_charge":0.48,"npi":[1891782470]}]},{"allowed_amount":0.14,"billing_code_modifier":["JW"],"providers":[{"billed_charge":0.56,"npi":[1891782470]}]}]},{"tin":{"Type":"ein","value":"590714831"},"billing_class":"institutional","setting":"outpatient","payments":[{"allowed_amount":0.19,"providers":[{"billed_charge":0.65,"npi":[1891782470]}]}]},{"tin":{"Type":"ein","value":"590714831"},"billing_class":"institutional","setting":"outpatient","payments":[{"allowed_amount":0.20,"billing_code_modifier":["JW"],"providers":[{"billed_charge":0.50,"npi":[1891782470]}]}]},{"tin":{"Type":"ein","value":"590714831"},"billing_class":"institutional","setting":"outpatient","payments":[{"allowed_amount":0.32,"billing_code_modifier":["JW"],"providers":[{"billed_charge":0.42,"npi":[1891782470]}]},{"allowed_amount":0.32,"billing_code_modifier":["JW"],"providers":[{"billed_charge":0.43,"npi":[1891782470]}]}]},{"tin":{"Type":"ein","value":"590714831"},"billing_class":"institutional","setting":"outpatient","payments":[{"allowed_amount":0.33,"billing_code_modifier":["JW"],"providers":[{"billed_charge":0.44,"npi":[1891782470]}]}]},{"tin":{"Type":"ein","value":"590714831"},"billing_class":"institutional","setting":"outpatient","payments":[{"allowed_amount":0.34,"billing_code_modifier":["JW"],"providers":[{"billed_charge":0.45,"npi":[1891782470]}]}]},{"tin":{"Type":"ein","value":"590714831"},"billing_class":"institutional","setting":"outpatient","payments":[{"allowed_amount":0.41,"providers":[{"billed_charge":1.64,"npi":[1891782470]}]}]},{"tin":{"Type":"ein","value":"590714831"},"billing_class":"institutional","setting":"outpatient","payments":[{"allowed_amount":0.54,"providers":[{"billed_charge":1.87,"npi":[1891782470]}]}]},{"tin":{"Type":"ein","value":"590714831"},"billing_class":"institutional","setting":"outpatient","payments":[{"allowed_amount":0.61,"providers":[{"billed_charge":1.53,"npi":[1891782470]}]}]},{"tin":{"Type":"ein","value":"590714831"},"billing_class":"institutional","setting":"outpatient","payments":[{"allowed_amount":0.88,"providers":[{"billed_charge":1.18,"npi":[1891782470]}]}]},{"tin":{"Type":"ein","value":"590714831"},"billing_class":"institutional","setting":"outpatient","payments":[{"allowed_amount":0.94,"providers":[{"billed_charge":1.25,"npi":[1891782470]}]}]},{"tin":{"Type":"ein","value":"590714831"},"billing_class":"institutional","setting":"outpatient","payments":[{"allowed_amount":1.29,"providers":[{"billed_charge":1.72,"npi":[1891782470]}]}]},{"tin":{"Type":"ein","value":"590714831"},"billing_class":"institutional","setting":"outpatient","payments":[{"allowed_amount":1.63,"providers":[{"billed_charge":2.18,"npi":[1891782470]}]}]},{"tin":{"Type":"ein","value":"590714831"},"billing_class":"institutional","setting":"outpatient","payments":[{"allowed_amount":2.19,"providers":[{"billed_charge":2.92,"npi":[1891782470]}]}]}]},{"name":"Ropivacaine shot or infusion","billing_code_type":"CPT","billing_code_type_version":"2005","billing_code":"J2795","description":"Ropivacaine HCl injection","allowed_amounts":[{"tin":{"Type":"ein","value":"590714831"},"billing_class":"institutional","setting":"outpatient","payments":[{"allowed_amount":0.00,"billing_code_modifier":["JW"],"providers":[{"billed_charge":0.16,"npi":[1891782470]}]},{"allowed_amount":0.00,"billing_code_modifier":["JW"],"providers":[{"billed_charge":0.38,"npi":[1891782470]}]},{"allowed_amount":0.00,"billing_code_modifier":["JW"],"providers":[{"billed_charge":0.51,"npi":[1891782470]}]},{"allowed_amount":0.00,"billing_code_modifier":["JW"],"providers":[{"billed_charge":0.68,"npi":[1891782470]}]},{"allowed_amount":0.00,"billing_code_modifier":["JW"],"providers":[{"billed_charge":5.06,"npi":[1891782470]}]}]},{"tin":{"Type":"ein","value":"590714831"},"billing_class":"institutional","setting":"outpatient","payments":[{"allowed_amount":0.06,"billing_code_modifier":["JW"],"providers":[{"billed_charge":0.15,"npi":[1891782470]}]},{"allowed_amount":0.06,"billing_code_modifier":["JW"],"providers":[{"billed_charge":0.23,"npi":[1891782470]}]}]},{"tin":{"Type":"ein","value":"590714831"},"billing_class":"institutional","setting":"outpatient","payments":[{"allowed_amount":0.14,"providers":[{"billed_charge":0.56,"npi":[1891782470]}]}]},{"tin":{"Type":"ein","value":"590714831"},"billing_class":"institutional","setting":"outpatient","payments":[{"allowed_amount":0.34,"providers":[{"billed_charge":0.85,"npi":[1891782470]}]}]}]},{"name":"Vest with heart pacer","billing_code_type":"CPT","billing_code_type_version":"2005","billing_code":"K0606","description":"AED garment w elec analysis","allowed_amounts":[{"tin":{"Type":"ein","value":"201121194"},"service_code":["12"],"billing_class":"professional","setting":"outpatient","payments":[{"allowed_amount":3534.00,"billing_code_modifier":["KF","KJ","KX","RR"],"providers":[{"billed_charge":4960.00,"npi":[1164535274]}]}]},{"tin":{"Type":"ein","value":"201121194"},"service_code":["12"],"billing_class":"professional","setting":"outpatient","payments":[{"allowed_amount":4712.00,"billing_code_modifier":["KF","RR"],"providers":[{"billed_charge":4960.00,"npi":[1164535274]}]}]},{"tin":{"Type":"ein","value":"201121194"},"service_code":["12"],"billing_class":"professional","setting":"outpatient","payments":[{"allowed_amount":4806.05,"billing_code_modifier":["KF","RR"],"providers":[{"billed_charge":4960.00,"npi":[1164535274]}]}]}]},{"name":"Contrast material for scan","billing_code_type":"CPT","billing_code_type_version":"2008","billing_code":"Q9967","description":"LOCM 300-399mg/ml iodine1ml","allowed_amounts":[{"tin":{"Type":"ein","value":"590714831"},"billing_class":"institutional","setting":"outpatient","payments":[{"allowed_amount":0.00,"billing_code_modifier":["JW"],"providers":[{"billed_charge":0.70,"npi":[1891782470]}]},{"allowed_amount":0.00,"billing_code_modifier":["JW"],"providers":[{"billed_charge":0.75,"npi":[1891782470]}]},{"allowed_amount":0.00,"billing_code_modifier":["JW"],"providers":[{"billed_charge":0.79,"npi":[1891782470]}]},{"allowed_amount":0.00,"billing_code_modifier":["JW"],"providers":[{"billed_charge":0.94,"npi":[1891782470]}]},{"allowed_amount":0.00,"billing_code_modifier":["JW"],"providers":[{"billed_charge":1.45,"npi":[1891782470]}]},{"allowed_amount":0.00,"billing_code_modifier":["JW"],"providers":[{"billed_charge":1.49,"npi":[1891782470]}]},{"allowed_amount":0.00,"billing_code_modifier":["JW"],"providers":[{"billed_charge":1.87,"npi":[1891782470]}]},{"allowed_amount":0.00,"billing_code_modifier":["JW"],"providers":[{"billed_charge":10.81,"npi":[1891782470]}]},{"allowed_amount":0.00,"billing_code_modifier":["JW"],"providers":[{"billed_charge":11.77,"npi":[1891782470]}]},{"allowed_amount":0.00,"billing_code_modifier":["JW"],"providers":[{"billed_charge":18.30,"npi":[1891782470]}]},{"allowed_amount":0.00,"billing_code_modifier":["JW"],"providers":[{"billed_charge":2.26,"npi":[1891782470]}]},{"allowed_amount":0.00,"billing_code_modifier":["JW"],"providers":[{"billed_charge":3.03,"npi":[1891782470]}]},{"allowed_amount":0.00,"billing_code_modifier":["JW"],"providers":[{"billed_charge":37.60,"npi":[1891782470]}]},{"allowed_amount":0.00,"billing_code_modifier":["JW"],"providers":[{"billed_charge":48.00,"npi":[1891782470]}]}]},{"tin":{"Type":"ein","value":"590714831"},"billing_class":"institutional","setting":"outpatient","payments":[{"allowed_amount":0.29,"providers":[{"billed_charge":0.97,"npi":[1891782470]}]}]},{"tin":{"Type":"ein","value":"590714831"},"billing_class":"institutional","setting":"outpatient","payments":[{"allowed_amount":1.01,"billing_code_modifier":["JW"],"providers":[{"billed_charge":1.35,"npi":[1891782470]}]}]},{"tin":{"Type":"ein","value":"590714831"},"billing_class":"institutional","setting":"outpatient","payments":[{"allowed_amount":2.76,"providers":[{"billed_charge":3.68,"npi":[1891782470]}]}]},{"tin":{"Type":"ein","value":"590714831"},"billing_class":"institutional","setting":"outpatient","payments":[{"allowed_amount":3.64,"providers":[{"billed_charge":4.85,"npi":[1891782470]}]}]},{"tin":{"Type":"ein","value":"590714831"},"billing_class":"institutional","setting":"outpatient","payments":[{"allowed_amount":10.81,"billing_code_modifier":["JW"],"providers":[{"billed_charge":10.81,"npi":[1891782470]}]}]},{"tin":{"Type":"ein","value":"590714831"},"billing_class":"institutional","setting":"outpatient","payments":[{"allowed_amount":48.00,"providers":[{"billed_charge":48.00,"npi":[1891782470]}]}]}]},{"name":"In-home immune therapy","billing_code_type":"CPT","billing_code_type_version":"2005","billing_code":"S9338","description":"HIT immunotherapy diem","allowed_amounts":[{"tin":{"Type":"ein","value":"204881413"},"service_code":["12"],"billing_class":"universalc","setting":"outpatient","payments":[{"allowed_amount":0.00,"providers":[{"billed_charge":400.00,"npi":[1700975802]}]}]},{"tin":{"Type":"ein","value":"204881413"},"service_code":["12"],"billing_class":"universalc","setting":"outpatient","payments":[{"allowed_amount":25.00,"providers":[{"billed_charge":400.00,"npi":[1700975802]}]}]},{"tin":{"Type":"ein","value":"204881413"},"service_code":["12"],"billing_class":"universalc","setting":"outpatient","payments":[{"allowed_amount":50.00,"providers":[{"billed_charge":400.00,"npi":[1700975802]}]}]},{"tin":{"Type":"ein","value":"204881413"},"service_code":["12"],"billing_class":"universalc","setting":"outpatient","payments":[{"allowed_amount":400.00,"providers":[{"billed_charge":400.00,"npi":[1700975802]}]}]}]},{"name":"Medical/Surgical/Gyn","billing_code_type":"REV","billing_code_type_version":"2005","billing_code":"0111","description":"MED-SUR-GY/PVT","allowed_amounts":[{"tin":{"Type":"ein","value":"590714831"},"billing_class":"institutional","setting":"inpatient","payments":[{"allowed_amount":0.00,"providers":[{"billed_charge":3612.00,"npi":[1891782470]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":3767.00,"npi":[1891782470]}]}]},{"tin":{"Type":"ein","value":"590714831"},"billing_class":"institutional","setting":"inpatient","payments":[{"allowed_amount":1864.38,"providers":[{"billed_charge":3172.00,"npi":[1891782470]}]}]},{"tin":{"Type":"ein","value":"590714831"},"billing_class":"institutional","setting":"inpatient","payments":[{"allowed_amount":1868.64,"providers":[{"billed_charge":3277.00,"npi":[1891782470]}]}]},{"tin":{"Type":"ein","value":"590714831"},"billing_class":"institutional","setting":"inpatient","payments":[{"allowed_amount":1913.41,"providers":[{"billed_charge":3612.00,"npi":[1891782470]}]}]},{"tin":{"Type":"ein","value":"590714831"},"billing_class":"institutional","setting":"inpatient","payments":[{"allowed_amount":2038.67,"providers":[{"billed_charge":3172.00,"npi":[1891782470]}]}]},{"tin":{"Type":"ein","value":"590714831"},"billing_class":"institutional","setting":"inpatient","payments":[{"allowed_amount":2988.25,"providers":[{"billed_charge":3172.00,"npi":[1891782470]}]}]},{"tin":{"Type":"ein","value":"590714831"},"billing_class":"institutional","setting":"inpatient","payments":[{"allowed_amount":4286.33,"providers":[{"billed_charge":1.00,"npi":[1891782470]}]}]},{"tin":{"Type":"ein","value":"590714831"},"billing_class":"institutional","setting":"inpatient","payments":[{"allowed_amount":4438.90,"providers":[{"billed_charge":3612.00,"npi":[1891782470]}]}]},{"tin":{"Type":"ein","value":"590714831"},"billing_class":"institutional","setting":"inpatient","payments":[{"allowed_amount":7559.73,"providers":[{"billed_charge":3172.00,"npi":[1891782470]}]}]},{"tin":{"Type":"ein","value":"590714831"},"billing_class":"institutional","setting":"inpatient","payments":[{"allowed_amount":7770.18,"providers":[{"billed_charge":3860.00,"npi":[1891782470]}]}]},{"tin":{"Type":"ein","value":"590714831"},"billing_class":"institutional","setting":"inpatient","payments":[{"allowed_amount":8192.48,"providers":[{"billed_charge":3612.00,"npi":[1891782470]}]}]},{"tin":{"Type":"ein","value":"590714831"},"billing_class":"institutional","setting":"inpatient","payments":[{"allowed_amount":8623.05,"providers":[{"billed_charge":3612.00,"npi":[1891782470]}]}]},{"tin":{"Type":"ein","value":"590714831"},"billing_class":"institutional","setting":"inpatient","payments":[{"allowed_amount":8799.62,"providers":[{"billed_charge":1.00,"npi":[1891782470]}]}]},{"tin":{"Type":"ein","value":"590714831"},"billing_class":"institutional","setting":"inpatient","payments":[{"allowed_amount":10380.92,"providers":[{"billed_charge":3172.00,"npi":[1891782470]}]}]},{"tin":{"Type":"ein","value":"590714831"},"billing_class":"institutional","setting":"inpatient","payments":[{"allowed_amount":10987.36,"providers":[{"billed_charge":3172.00,"npi":[1891782470]}]}]},{"tin":{"Type":"ein","value":"590714831"},"billing_class":"institutional","setting":"inpatient","payments":[{"allowed_amount":11156.11,"providers":[{"billed_charge":3172.00,"npi":[1891782470]}]}]},{"tin":{"Type":"ein","value":"590714831"},"billing_class":"institutional","setting":"inpatient","payments":[{"allowed_amount":11497.40,"providers":[{"billed_charge":3612.00,"npi":[1891782470]}]}]},{"tin":{"Type":"ein","value":"590714831"},"billing_class":"institutional","setting":"inpatient","payments":[{"allowed_amount":11985.85,"providers":[{"billed_charge":3612.00,"npi":[1891782470]}]}]},{"tin":{"Type":"ein","value":"590714831"},"billing_class":"institutional","setting":"inpatient","payments":[{"allowed_amount":24924.80,"providers":[{"billed_charge":3172.00,"npi":[1891782470]}]}]},{"tin":{"Type":"ein","value":"590714831"},"billing_class":"institutional","setting":"inpatient","payments":[{"allowed_amount":29136.77,"providers":[{"billed_charge":3172.00,"npi":[1891782470]}]}]},{"tin":{"Type":"ein","value":"590714831"},"billing_class":"institutional","setting":"inpatient","payments":[{"allowed_amount":43501.96,"providers":[{"billed_charge":3612.00,"npi":[1891782470]}]}]},{"tin":{"Type":"ein","value":"590714831"},"billing_class":"institutional","setting":"inpatient","payments":[{"allowed_amount":52215.84,"providers":[{"billed_charge":3860.00,"npi":[1891782470]}]}]},{"tin":{"Type":"ein","value":"590714831"},"billing_class":"institutional","setting":"inpatient","payments":[{"allowed_amount":83866.36,"providers":[{"billed_charge":3612.00,"npi":[1891782470]}]}]}]},{"name":"Psychiatric","billing_code_type":"REV","billing_code_type_version":"2005","billing_code":"0124","description":"PSYCH/SEMI-PVT","allowed_amounts":[{"tin":{"Type":"ein","value":"621091430"},"billing_class":"institutional","setting":"inpatient","payments":[{"allowed_amount":0.00,"providers":[{"billed_charge":3854.80,"npi":[1912396326]}]}]},{"tin":{"Type":"ein","value":"621091430"},"billing_class":"institutional","setting":"inpatient","payments":[{"allowed_amount":1037.40,"providers":[{"billed_charge":3854.80,"npi":[1912396326]}]}]},{"tin":{"Type":"ein","value":"621091430"},"billing_class":"institutional","setting":"inpatient","payments":[{"allowed_amount":1142.41,"providers":[{"billed_charge":3854.80,"npi":[1912396326]}]}]},{"tin":{"Type":"ein","value":"621091430"},"billing_class":"institutional","setting":"inpatient","payments":[{"allowed_amount":1214.73,"providers":[{"billed_charge":3854.80,"npi":[1912396326]}]}]},{"tin":{"Type":"ein","value":"621091430"},"billing_class":"institutional","setting":"inpatient","payments":[{"allowed_amount":1239.03,"providers":[{"billed_charge":3854.80,"npi":[1912396326]}]}]},{"tin":{"Type":"ein","value":"621091430"},"billing_class":"institutional","setting":"inpatient","payments":[{"allowed_amount":1392.76,"providers":[{"billed_charge":3854.80,"npi":[1912396326]}]}]},{"tin":{"Type":"ein","value":"621091430"},"billing_class":"institutional","setting":"inpatient","payments":[{"allowed_amount":1392.78,"providers":[{"billed_charge":3854.80,"npi":[1912396326]}]}]},{"tin":{"Type":"ein","value":"621091430"},"billing_class":"institutional","setting":"inpatient","payments":[{"allowed_amount":1510.35,"providers":[{"billed_charge":3854.80,"npi":[1912396326]}]}]},{"tin":{"Type":"ein","value":"621091430"},"billing_class":"institutional","setting":"inpatient","payments":[{"allowed_amount":1759.06,"providers":[{"billed_charge":3854.80,"npi":[1912396326]}]}]},{"tin":{"Type":"ein","value":"621091430"},"billing_class":"institutional","setting":"inpatient","payments":[{"allowed_amount":2478.05,"providers":[{"billed_charge":3854.80,"npi":[1912396326]}]}]}]},{"name":"General Classification","billing_code_type":"REV","billing_code_type_version":"2005","billing_code":"0250","description":"PHARMACY","allowed_amounts":[{"tin":{"Type":"ein","value":"300577249"},"billing_class":"institutional","setting":"inpatient","payments":[{"allowed_amount":0.00,"providers":[{"billed_charge":0.30,"npi":[1083941678]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":0.40,"npi":[1083941678]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":1.56,"npi":[1083941678]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":103.97,"npi":[1083941678]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":11.55,"npi":[1083941678]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":12.92,"npi":[1083941678]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":2.10,"npi":[1083941678]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":20.29,"npi":[1083941678]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":42.50,"npi":[1083941678]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":5.55,"npi":[1083941678]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":5.68,"npi":[1083941678]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":52.70,"npi":[1083941678]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":6.15,"npi":[1083941678]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":7.78,"npi":[1083941678]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":8.09,"npi":[1083941678]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":9.97,"npi":[1083941678]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":93.65,"npi":[1083941678]}]}]},{"tin":{"Type":"ein","value":"590714831"},"billing_class":"institutional","setting":"inpatient","payments":[{"allowed_amount":0.00,"providers":[{"billed_charge":0.50,"npi":[1891782470]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":0.89,"npi":[1891782470]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":1.25,"npi":[1891782470]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":1.43,"npi":[1891782470]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":1.60,"npi":[1891782470]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":1.61,"npi":[1891782470]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":10.34,"npi":[1891782470]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":107.14,"npi":[1891782470]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":11.09,"npi":[1891782470]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":11.57,"npi":[1891782470]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":11.74,"npi":[1891782470]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":11.86,"npi":[1891782470]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":110.63,"npi":[1891782470]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":12.54,"npi":[1891782470]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":13.79,"npi":[1891782470]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":15.30,"npi":[1891782470]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":16.19,"npi":[1891782470]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":18.45,"npi":[1891782470]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":19.12,"npi":[1891782470]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":19.14,"npi":[1891782470]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":19.22,"npi":[1891782470]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":19.57,"npi":[1891782470]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":19.69,"npi":[1891782470]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":2.27,"npi":[1891782470]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":20.18,"npi":[1891782470]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":20.44,"npi":[1891782470]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":20.70,"npi":[1891782470]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":20.98,"npi":[1891782470]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":21.30,"npi":[1891782470]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":26.33,"npi":[1891782470]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":26.69,"npi":[1891782470]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":3.75,"npi":[1891782470]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":31.80,"npi":[1891782470]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":32.00,"npi":[1891782470]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":33.88,"npi":[1891782470]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":34.00,"npi":[1891782470]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":37.53,"npi":[1891782470]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":37.68,"npi":[1891782470]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":39.18,"npi":[1891782470]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":39.80,"npi":[1891782470]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":39.88,"npi":[1891782470]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":4.35,"npi":[1891782470]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":4.70,"npi":[1891782470]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":41.52,"npi":[1891782470]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":43.32,"npi":[1891782470]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":44.80,"npi":[1891782470]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":45.30,"npi":[1891782470]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":47.20,"npi":[1891782470]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":49.17,"npi":[1891782470]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":5.08,"npi":[1891782470]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":5.95,"npi":[1891782470]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":50.46,"npi":[1891782470]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":50.53,"npi":[1891782470]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":52.88,"npi":[1891782470]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":55.05,"npi":[1891782470]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":56.18,"npi":[1891782470]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":57.70,"npi":[1891782470]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":58.86,"npi":[1891782470]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":59.14,"npi":[1891782470]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":59.94,"npi":[1891782470]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":6.60,"npi":[1891782470]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":60.64,"npi":[1891782470]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":61.28,"npi":[1891782470]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":67.50,"npi":[1891782470]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":7.05,"npi":[1891782470]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":7.17,"npi":[1891782470]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":7.54,"npi":[1891782470]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":7.62,"npi":[1891782470]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":7.87,"npi":[1891782470]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":72.90,"npi":[1891782470]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":73.70,"npi":[1891782470]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":74.33,"npi":[1891782470]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":74.90,"npi":[1891782470]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":75.83,"npi":[1891782470]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":76.58,"npi":[1891782470]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":77.95,"npi":[1891782470]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":8.57,"npi":[1891782470]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":80.30,"npi":[1891782470]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":81.73,"npi":[1891782470]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":82.00,"npi":[1891782470]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":83.75,"npi":[1891782470]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":84.80,"npi":[1891782470]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":9.66,"npi":[1891782470]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":94.66,"npi":[1891782470]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":95.75,"npi":[1891782470]}]}]},{"tin":{"Type":"ein","value":"590714831"},"billing_class":"institutional","setting":"inpatient","payments":[{"allowed_amount":1.60,"providers":[{"billed_charge":1.60,"npi":[1891782470]}]}]},{"tin":{"Type":"ein","value":"590714831"},"billing_class":"institutional","setting":"inpatient","payments":[{"allowed_amount":1.95,"providers":[{"billed_charge":7.62,"npi":[1891782470]}]}]},{"tin":{"Type":"ein","value":"590714831"},"billing_class":"institutional","setting":"inpatient","payments":[{"allowed_amount":3.03,"providers":[{"billed_charge":11.86,"npi":[1891782470]}]}]},{"tin":{"Type":"ein","value":"590714831"},"billing_class":"institutional","setting":"inpatient","payments":[{"allowed_amount":4.25,"providers":[{"billed_charge":10.59,"npi":[1891782470]}]}]},{"tin":{"Type":"ein","value":"590714831"},"billing_class":"institutional","setting":"inpatient","payments":[{"allowed_amount":4.66,"providers":[{"billed_charge":11.61,"npi":[1891782470]}]}]},{"tin":{"Type":"ein","value":"590714831"},"billing_class":"institutional","setting":"inpatient","payments":[{"allowed_amount":5.98,"providers":[{"billed_charge":11.20,"npi":[1891782470]}]}]},{"tin":{"Type":"ein","value":"590714831"},"billing_class":"institutional","setting":"inpatient","payments":[{"allowed_amount":7.08,"providers":[{"billed_charge":12.02,"npi":[1891782470]}]}]},{"tin":{"Type":"ein","value":"590714831"},"billing_class":"institutional","setting":"inpatient","payments":[{"allowed_amount":8.44,"providers":[{"billed_charge":20.73,"npi":[1891782470]}]}]},{"tin":{"Type":"ein","value":"590714831"},"billing_class":"institutional","setting":"inpatient","payments":[{"allowed_amount":10.32,"providers":[{"billed_charge":41.57,"npi":[1891782470]}]}]},{"tin":{"Type":"ein","value":"590714831"},"billing_class":"institutional","setting":"inpatient","payments":[{"allowed_amount":11.10,"providers":[{"billed_charge":27.27,"npi":[1891782470]}]}]},{"tin":{"Type":"ein","value":"590714831"},"billing_class":"institutional","setting":"inpatient","payments":[{"allowed_amount":13.69,"providers":[{"billed_charge":25.64,"npi":[1891782470]}]}]},{"tin":{"Type":"ein","value":"590714831"},"billing_class":"institutional","setting":"inpatient","payments":[{"allowed_amount":14.65,"providers":[{"billed_charge":51.07,"npi":[1891782470]}]}]},{"tin":{"Type":"ein","value":"590714831"},"billing_class":"institutional","setting":"inpatient","payments":[{"allowed_amount":18.44,"providers":[{"billed_charge":24.59,"npi":[1891782470]}]}]},{"tin":{"Type":"ein","value":"590714831"},"billing_class":"institutional","setting":"inpatient","payments":[{"allowed_amount":24.00,"providers":[{"billed_charge":32.00,"npi":[1891782470]}]}]},{"tin":{"Type":"ein","value":"590714831"},"billing_class":"institutional","setting":"inpatient","payments":[{"allowed_amount":24.27,"providers":[{"billed_charge":81.53,"npi":[1891782470]}]}]},{"tin":{"Type":"ein","value":"590714831"},"billing_class":"institutional","setting":"inpatient","payments":[{"allowed_amount":43.79,"providers":[{"billed_charge":82.00,"npi":[1891782470]}]}]},{"tin":{"Type":"ein","value":"590714831"},"billing_class":"institutional","setting":"inpatient","payments":[{"allowed_amount":44.04,"providers":[{"billed_charge":79.80,"npi":[1891782470]}]}]},{"tin":{"Type":"ein","value":"590714831"},"billing_class":"institutional","setting":"inpatient","payments":[{"allowed_amount":101.71,"providers":[{"billed_charge":135.61,"npi":[1891782470]}]}]},{"tin":{"Type":"ein","value":"590714831"},"billing_class":"institutional","setting":"inpatient","payments":[{"allowed_amount":173.67,"providers":[{"billed_charge":231.56,"npi":[1891782470]}]}]},{"tin":{"Type":"ein","value":"590714831"},"billing_class":"institutional","setting":"inpatient","payments":[{"allowed_amount":173.95,"providers":[{"billed_charge":231.94,"npi":[1891782470]}]}]},{"tin":{"Type":"ein","value":"590714831"},"billing_class":"institutional","setting":"inpatient","payments":[{"allowed_amount":325.65,"providers":[{"billed_charge":27.27,"npi":[1891782470]}]}]},{"tin":{"Type":"ein","value":"593238634"},"billing_class":"institutional","setting":"inpatient","payments":[{"allowed_amount":0.00,"providers":[{"billed_charge":0.50,"npi":[1780653618]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":11.41,"npi":[1780653618]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":17.65,"npi":[1780653618]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":198.00,"npi":[1780653618]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":22.86,"npi":[1780653618]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":3.00,"npi":[1780653618]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":4.52,"npi":[1780653618]}]}]},{"tin":{"Type":"ein","value":"593238634"},"billing_class":"institutional","setting":"inpatient","payments":[{"allowed_amount":0.13,"providers":[{"billed_charge":0.50,"npi":[1780653618]}]}]},{"tin":{"Type":"ein","value":"593238634"},"billing_class":"institutional","setting":"inpatient","payments":[{"allowed_amount":0.25,"providers":[{"billed_charge":0.50,"npi":[1780653618]}]}]},{"tin":{"Type":"ein","value":"593238634"},"billing_class":"institutional","setting":"inpatient","payments":[{"allowed_amount":0.26,"providers":[{"billed_charge":1.00,"npi":[1780653618]}]}]},{"tin":{"Type":"ein","value":"593238634"},"billing_class":"institutional","setting":"inpatient","payments":[{"allowed_amount":0.50,"providers":[{"billed_charge":1.00,"npi":[1780653618]}]}]},{"tin":{"Type":"ein","value":"593238634"},"billing_class":"institutional","setting":"inpatient","payments":[{"allowed_amount":0.78,"providers":[{"billed_charge":3.00,"npi":[1780653618]}]}]},{"tin":{"Type":"ein","value":"593238634"},"billing_class":"institutional","setting":"inpatient","payments":[{"allowed_amount":1.04,"providers":[{"billed_charge":4.00,"npi":[1780653618]}]}]},{"tin":{"Type":"ein","value":"593238634"},"billing_class":"institutional","setting":"inpatient","payments":[{"allowed_amount":1.50,"providers":[{"billed_charge":3.00,"npi":[1780653618]}]}]},{"tin":{"Type":"ein","value":"593238634"},"billing_class":"institutional","setting":"inpatient","payments":[{"allowed_amount":1.51,"providers":[{"billed_charge":3.00,"npi":[1780653618]}]}]},{"tin":{"Type":"ein","value":"593238634"},"billing_class":"institutional","setting":"inpatient","payments":[{"allowed_amount":2.00,"providers":[{"billed_charge":4.00,"npi":[1780653618]}]}]},{"tin":{"Type":"ein","value":"593238634"},"billing_class":"institutional","setting":"inpatient","payments":[{"allowed_amount":2.01,"providers":[{"billed_charge":4.00,"npi":[1780653618]}]}]},{"tin":{"Type":"ein","value":"593238634"},"billing_class":"institutional","setting":"inpatient","payments":[{"allowed_amount":3.51,"providers":[{"billed_charge":7.00,"npi":[1780653618]}]}]},{"tin":{"Type":"ein","value":"593238634"},"billing_class":"institutional","setting":"inpatient","payments":[{"allowed_amount":4.01,"providers":[{"billed_charge":8.00,"npi":[1780653618]}]}]},{"tin":{"Type":"ein","value":"593238634"},"billing_class":"institutional","setting":"inpatient","payments":[{"allowed_amount":5.72,"providers":[{"billed_charge":22.00,"npi":[1780653618]}]}]},{"tin":{"Type":"ein","value":"593238634"},"billing_class":"institutional","setting":"inpatient","payments":[{"allowed_amount":9.02,"providers":[{"billed_charge":18.00,"npi":[1780653618]}]}]},{"tin":{"Type":"ein","value":"593238634"},"billing_class":"institutional","setting":"inpatient","payments":[{"allowed_amount":11.03,"providers":[{"billed_charge":22.00,"npi":[1780653618]}]}]},{"tin":{"Type":"ein","value":"593238634"},"billing_class":"institutional","setting":"inpatient","payments":[{"allowed_amount":51.48,"providers":[{"billed_charge":198.00,"npi":[1780653618]}]}]},{"tin":{"Type":"ein","value":"593238634"},"billing_class":"institutional","setting":"inpatient","payments":[{"allowed_amount":99.22,"providers":[{"billed_charge":198.00,"npi":[1780653618]}]}]},{"tin":{"Type":"ein","value":"593238634"},"billing_class":"institutional","setting":"inpatient","payments":[{"allowed_amount":592.20,"providers":[{"billed_charge":987.00,"npi":[1780653618]}]}]},{"tin":{"Type":"ein","value":"596001321"},"billing_class":"institutional","setting":"inpatient","payments":[{"allowed_amount":0.00,"providers":[{"billed_charge":0.59,"npi":[1538108725]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":0.94,"npi":[1538108725]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":108.88,"npi":[1538108725]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":139.25,"npi":[1538108725]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":20.00,"npi":[1538108725]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":33.10,"npi":[1538108725]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":33.67,"npi":[1538108725]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":38.67,"npi":[1538108725]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":39.00,"npi":[1538108725]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":42.58,"npi":[1538108725]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":48.00,"npi":[1538108725]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":5.00,"npi":[1538108725]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":5.67,"npi":[1538108725]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":50.81,"npi":[1538108725]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":52.75,"npi":[1538108725]}]}]},{"tin":{"Type":"ein","value":"621091430"},"billing_class":"institutional","setting":"inpatient","payments":[{"allowed_amount":0.00,"providers":[{"billed_charge":23.56,"npi":[1912396326]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":29.70,"npi":[1912396326]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":31.02,"npi":[1912396326]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":32.47,"npi":[1912396326]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":36.00,"npi":[1912396326]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":41.50,"npi":[1912396326]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":43.76,"npi":[1912396326]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":43.98,"npi":[1912396326]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":44.50,"npi":[1912396326]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":61.35,"npi":[1912396326]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":63.24,"npi":[1912396326]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":77.08,"npi":[1912396326]}]}]}]},{"name":"Drugs Incident to Radiology","billing_code_type":"REV","billing_code_type_version":"2005","billing_code":"0255","description":"DRUGS/INCIDENT RAD","allowed_amounts":[{"tin":{"Type":"ein","value":"590714831"},"billing_class":"institutional","setting":"inpatient","payments":[{"allowed_amount":0.00,"providers":[{"billed_charge":0.94,"npi":[1891782470]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":0.97,"npi":[1891782470]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":1.14,"npi":[1891782470]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":1.28,"npi":[1891782470]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":1.47,"npi":[1891782470]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":1.49,"npi":[1891782470]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":1.71,"npi":[1891782470]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":2.26,"npi":[1891782470]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":255.65,"npi":[1891782470]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":4527.50,"npi":[1891782470]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":676.70,"npi":[1891782470]}]}]},{"tin":{"Type":"ein","value":"593238634"},"billing_class":"institutional","setting":"inpatient","payments":[{"allowed_amount":0.00,"providers":[{"billed_charge":5.00,"npi":[1780653618]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":8.52,"npi":[1780653618]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":9.12,"npi":[1780653618]}]}]},{"tin":{"Type":"ein","value":"593238634"},"billing_class":"institutional","setting":"inpatient","payments":[{"allowed_amount":0.86,"providers":[{"billed_charge":9.00,"npi":[1780653618]}]}]},{"tin":{"Type":"ein","value":"593238634"},"billing_class":"institutional","setting":"inpatient","payments":[{"allowed_amount":2.51,"providers":[{"billed_charge":5.00,"npi":[1780653618]}]}]},{"tin":{"Type":"ein","value":"593238634"},"billing_class":"institutional","setting":"inpatient","payments":[{"allowed_amount":4.50,"providers":[{"billed_charge":9.00,"npi":[1780653618]}]}]},{"tin":{"Type":"ein","value":"593238634"},"billing_class":"institutional","setting":"inpatient","payments":[{"allowed_amount":4.51,"providers":[{"billed_charge":9.00,"npi":[1780653618]}]}]},{"tin":{"Type":"ein","value":"593238634"},"billing_class":"institutional","setting":"inpatient","payments":[{"allowed_amount":5.01,"providers":[{"billed_charge":10.00,"npi":[1780653618]}]}]},{"tin":{"Type":"ein","value":"593238634"},"billing_class":"institutional","setting":"inpatient","payments":[{"allowed_amount":16.04,"providers":[{"billed_charge":32.00,"npi":[1780653618]}]}]},{"tin":{"Type":"ein","value":"593238634"},"billing_class":"institutional","setting":"inpatient","payments":[{"allowed_amount":22.05,"providers":[{"billed_charge":44.00,"npi":[1780653618]}]}]},{"tin":{"Type":"ein","value":"593238634"},"billing_class":"institutional","setting":"inpatient","payments":[{"allowed_amount":465.26,"providers":[{"billed_charge":9.00,"npi":[1780653618]}]}]}]},{"name":"IV Solutions","billing_code_type":"REV","billing_code_type_version":"2005","billing_code":"0258","description":"IV SOLUTIONS","allowed_amounts":[{"tin":{"Type":"ein","value":"593238634"},"billing_class":"institutional","setting":"inpatient","payments":[{"allowed_amount":0.00,"providers":[{"billed_charge":18.00,"npi":[1780653618]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":19.00,"npi":[1780653618]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":20.50,"npi":[1780653618]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":21.50,"npi":[1780653618]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":23.67,"npi":[1780653618]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":25.17,"npi":[1780653618]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":32.00,"npi":[1780653618]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":33.00,"npi":[1780653618]}]}]},{"tin":{"Type":"ein","value":"593238634"},"billing_class":"institutional","setting":"inpatient","payments":[{"allowed_amount":1.37,"providers":[{"billed_charge":33.00,"npi":[1780653618]}]}]},{"tin":{"Type":"ein","value":"593238634"},"billing_class":"institutional","setting":"inpatient","payments":[{"allowed_amount":4.10,"providers":[{"billed_charge":32.00,"npi":[1780653618]}]}]},{"tin":{"Type":"ein","value":"593238634"},"billing_class":"institutional","setting":"inpatient","payments":[{"allowed_amount":9.02,"providers":[{"billed_charge":18.00,"npi":[1780653618]}]}]},{"tin":{"Type":"ein","value":"593238634"},"billing_class":"institutional","setting":"inpatient","payments":[{"allowed_amount":9.52,"providers":[{"billed_charge":19.00,"npi":[1780653618]}]}]},{"tin":{"Type":"ein","value":"593238634"},"billing_class":"institutional","setting":"inpatient","payments":[{"allowed_amount":999.85,"providers":[{"billed_charge":32.00,"npi":[1780653618]}]}]}]},{"name":"General Classification","billing_code_type":"REV","billing_code_type_version":"2005","billing_code":"0260","description":"IV THERAPY","allowed_amounts":[{"tin":{"Type":"ein","value":"593238634"},"billing_class":"institutional","setting":"inpatient","payments":[{"allowed_amount":0.00,"providers":[{"billed_charge":318.00,"npi":[1780653618]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":430.60,"npi":[1780653618]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":649.00,"npi":[1780653618]}]}]},{"tin":{"Type":"ein","value":"593238634"},"billing_class":"institutional","setting":"inpatient","payments":[{"allowed_amount":82.68,"providers":[{"billed_charge":318.00,"npi":[1780653618]}]}]},{"tin":{"Type":"ein","value":"593238634"},"billing_class":"institutional","setting":"inpatient","payments":[{"allowed_amount":159.35,"billing_code_modifier":["XE","XS"],"providers":[{"billed_charge":318.00,"npi":[1780653618]}]}]},{"tin":{"Type":"ein","value":"593238634"},"billing_class":"institutional","setting":"inpatient","payments":[{"allowed_amount":277.80,"providers":[{"billed_charge":463.00,"npi":[1780653618]}]}]},{"tin":{"Type":"ein","value":"593238634"},"billing_class":"institutional","setting":"inpatient","payments":[{"allowed_amount":588.00,"providers":[{"billed_charge":980.00,"npi":[1780653618]}]}]}]},{"name":"General Classification","billing_code_type":"REV","billing_code_type_version":"2005","billing_code":"0270","description":"MED-SUR SUPPLIES","allowed_amounts":[{"tin":{"Type":"ein","value":"590714831"},"billing_class":"institutional","setting":"inpatient","payments":[{"allowed_amount":0.00,"providers":[{"billed_charge":28.00,"npi":[1891782470]}]}]},{"tin":{"Type":"ein","value":"590714831"},"billing_class":"institutional","setting":"inpatient","payments":[{"allowed_amount":7.16,"providers":[{"billed_charge":28.00,"npi":[1891782470]}]}]},{"tin":{"Type":"ein","value":"590714831"},"billing_class":"institutional","setting":"inpatient","payments":[{"allowed_amount":11.63,"providers":[{"billed_charge":28.00,"npi":[1891782470]}]}]}]},{"name":"Sterile Supply","billing_code_type":"REV","billing_code_type_version":"2005","billing_code":"0272","description":"STERILE SUPPLY","allowed_amounts":[{"tin":{"Type":"ein","value":"590714831"},"billing_class":"institutional","setting":"inpatient","payments":[{"allowed_amount":0.00,"providers":[{"billed_charge":10191.12,"npi":[1891782470]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":1530.39,"npi":[1891782470]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":1557.00,"npi":[1891782470]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":1708.22,"npi":[1891782470]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":173.88,"npi":[1891782470]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":254.97,"npi":[1891782470]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":282.97,"npi":[1891782470]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":287.30,"npi":[1891782470]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":287.79,"npi":[1891782470]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":311.64,"npi":[1891782470]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":313.20,"npi":[1891782470]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":315.66,"npi":[1891782470]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":328.52,"npi":[1891782470]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":331.61,"npi":[1891782470]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":351.23,"npi":[1891782470]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":378.37,"npi":[1891782470]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":390.00,"npi":[1891782470]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":398.09,"npi":[1891782470]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":430.33,"npi":[1891782470]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":469.98,"npi":[1891782470]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":477.36,"npi":[1891782470]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":501.80,"npi":[1891782470]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":502.05,"npi":[1891782470]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":504.00,"npi":[1891782470]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":508.66,"npi":[1891782470]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":524.04,"npi":[1891782470]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":558.49,"npi":[1891782470]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":570.83,"npi":[1891782470]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":588.50,"npi":[1891782470]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":609.98,"npi":[1891782470]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":618.80,"npi":[1891782470]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":624.89,"npi":[1891782470]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":626.91,"npi":[1891782470]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":630.74,"npi":[1891782470]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":685.40,"npi":[1891782470]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":718.68,"npi":[1891782470]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":819.82,"npi":[1891782470]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":831.04,"npi":[1891782470]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":856.37,"npi":[1891782470]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":884.69,"npi":[1891782470]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":902.61,"npi":[1891782470]}]}]},{"tin":{"Type":"ein","value":"590714831"},"billing_class":"institutional","setting":"inpatient","payments":[{"allowed_amount":71.82,"providers":[{"billed_charge":289.27,"npi":[1891782470]}]}]},{"tin":{"Type":"ein","value":"590714831"},"billing_class":"institutional","setting":"inpatient","payments":[{"allowed_amount":73.57,"providers":[{"billed_charge":287.79,"npi":[1891782470]}]}]},{"tin":{"Type":"ein","value":"590714831"},"billing_class":"institutional","setting":"inpatient","payments":[{"allowed_amount":125.21,"providers":[{"billed_charge":436.44,"npi":[1891782470]}]}]},{"tin":{"Type":"ein","value":"590714831"},"billing_class":"institutional","setting":"inpatient","payments":[{"allowed_amount":167.84,"providers":[{"billed_charge":417.85,"npi":[1891782470]}]}]},{"tin":{"Type":"ein","value":"590714831"},"billing_class":"institutional","setting":"inpatient","payments":[{"allowed_amount":509.19,"providers":[{"billed_charge":678.92,"npi":[1891782470]}]}]},{"tin":{"Type":"ein","value":"590714831"},"billing_class":"institutional","setting":"inpatient","payments":[{"allowed_amount":1544.07,"providers":[{"billed_charge":2058.75,"npi":[1891782470]}]}]}]},{"name":"General Classification","billing_code_type":"REV","billing_code_type_version":"2005","billing_code":"0300","description":"LAB","allowed_amounts":[{"tin":{"Type":"ein","value":"590714831"},"billing_class":"institutional","setting":"inpatient","payments":[{"allowed_amount":0.00,"providers":[{"billed_charge":42.00,"npi":[1891782470]}]}]},{"tin":{"Type":"ein","value":"590714831"},"billing_class":"institutional","setting":"inpatient","payments":[{"allowed_amount":353.90,"providers":[{"billed_charge":544.92,"npi":[1891782470]}]}]},{"tin":{"Type":"ein","value":"593238634"},"billing_class":"institutional","setting":"inpatient","payments":[{"allowed_amount":0.00,"providers":[{"billed_charge":203.00,"npi":[1780653618]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":335.00,"npi":[1780653618]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":410.00,"npi":[1780653618]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":49.00,"npi":[1780653618]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":707.86,"npi":[1780653618]}]}]},{"tin":{"Type":"ein","value":"593238634"},"billing_class":"institutional","setting":"inpatient","payments":[{"allowed_amount":12.74,"providers":[{"billed_charge":49.00,"npi":[1780653618]}]}]},{"tin":{"Type":"ein","value":"593238634"},"billing_class":"institutional","setting":"inpatient","payments":[{"allowed_amount":24.55,"providers":[{"billed_charge":49.00,"npi":[1780653618]}]}]},{"tin":{"Type":"ein","value":"593238634"},"billing_class":"institutional","setting":"inpatient","payments":[{"allowed_amount":24.56,"providers":[{"billed_charge":49.00,"npi":[1780653618]}]}]},{"tin":{"Type":"ein","value":"593238634"},"billing_class":"institutional","setting":"inpatient","payments":[{"allowed_amount":68.15,"providers":[{"billed_charge":136.00,"npi":[1780653618]}]}]},{"tin":{"Type":"ein","value":"593238634"},"billing_class":"institutional","setting":"inpatient","payments":[{"allowed_amount":76.17,"providers":[{"billed_charge":152.00,"npi":[1780653618]}]}]},{"tin":{"Type":"ein","value":"593238634"},"billing_class":"institutional","setting":"inpatient","payments":[{"allowed_amount":87.19,"providers":[{"billed_charge":174.00,"npi":[1780653618]}]}]},{"tin":{"Type":"ein","value":"593238634"},"billing_class":"institutional","setting":"inpatient","payments":[{"allowed_amount":87.69,"providers":[{"billed_charge":175.00,"npi":[1780653618]}]}]},{"tin":{"Type":"ein","value":"593238634"},"billing_class":"institutional","setting":"inpatient","payments":[{"allowed_amount":138.80,"providers":[{"billed_charge":277.00,"npi":[1780653618]}]}]},{"tin":{"Type":"ein","value":"593238634"},"billing_class":"institutional","setting":"inpatient","payments":[{"allowed_amount":180.40,"providers":[{"billed_charge":360.00,"npi":[1780653618]}]}]},{"tin":{"Type":"ein","value":"593238634"},"billing_class":"institutional","setting":"inpatient","payments":[{"allowed_amount":2104.20,"providers":[{"billed_charge":3507.00,"npi":[1780653618]}]}]}]},{"name":"Chemistry","billing_code_type":"REV","billing_code_type_version":"2005","billing_code":"0301","description":"CHEMISTRY TESTS","allowed_amounts":[{"tin":{"Type":"ein","value":"590714831"},"billing_class":"institutional","setting":"inpatient","payments":[{"allowed_amount":0.00,"providers":[{"billed_charge":153.67,"npi":[1891782470]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":165.00,"npi":[1891782470]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":166.75,"npi":[1891782470]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":168.64,"npi":[1891782470]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":169.60,"npi":[1891782470]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":171.14,"npi":[1891782470]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":171.64,"npi":[1891782470]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":172.71,"npi":[1891782470]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":181.77,"npi":[1891782470]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":182.41,"npi":[1891782470]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":182.88,"npi":[1891782470]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":192.75,"npi":[1891782470]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":197.83,"npi":[1891782470]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":200.05,"npi":[1891782470]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":211.16,"npi":[1891782470]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":239.90,"npi":[1891782470]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":254.50,"npi":[1891782470]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":281.62,"npi":[1891782470]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":345.00,"npi":[1891782470]}]}]},{"tin":{"Type":"ein","value":"590714831"},"billing_class":"institutional","setting":"inpatient","payments":[{"allowed_amount":55.06,"providers":[{"billed_charge":129.77,"npi":[1891782470]}]}]},{"tin":{"Type":"ein","value":"593238634"},"billing_class":"institutional","setting":"inpatient","payments":[{"allowed_amount":0.00,"billing_code_modifier":["XE"],"providers":[{"billed_charge":123.95,"npi":[1780653618]}]},{"allowed_amount":0.00,"billing_code_modifier":["XE"],"providers":[{"billed_charge":142.00,"npi":[1780653618]}]},{"allowed_amount":0.00,"billing_code_modifier":["XE"],"providers":[{"billed_charge":190.00,"npi":[1780653618]}]},{"allowed_amount":0.00,"billing_code_modifier":["XE"],"providers":[{"billed_charge":202.00,"npi":[1780653618]}]},{"allowed_amount":0.00,"billing_code_modifier":["XE"],"providers":[{"billed_charge":228.67,"npi":[1780653618]}]},{"allowed_amount":0.00,"billing_code_modifier":["XE"],"providers":[{"billed_charge":248.00,"npi":[1780653618]}]},{"allowed_amount":0.00,"billing_code_modifier":["XE"],"providers":[{"billed_charge":313.60,"npi":[1780653618]}]},{"allowed_amount":0.00,"billing_code_modifier":["XE"],"providers":[{"billed_charge":333.31,"npi":[1780653618]}]},{"allowed_amount":0.00,"billing_code_modifier":["XE"],"providers":[{"billed_charge":359.00,"npi":[1780653618]}]},{"allowed_amount":0.00,"billing_code_modifier":["XE"],"providers":[{"billed_charge":37.00,"npi":[1780653618]}]},{"allowed_amount":0.00,"billing_code_modifier":["XE"],"providers":[{"billed_charge":433.00,"npi":[1780653618]}]},{"allowed_amount":0.00,"billing_code_modifier":["XE"],"providers":[{"billed_charge":447.00,"npi":[1780653618]}]},{"allowed_amount":0.00,"billing_code_modifier":["XE"],"providers":[{"billed_charge":482.00,"npi":[1780653618]}]},{"allowed_amount":0.00,"billing_code_modifier":["XE"],"providers":[{"billed_charge":551.00,"npi":[1780653618]}]},{"allowed_amount":0.00,"billing_code_modifier":["XE"],"providers":[{"billed_charge":58.00,"npi":[1780653618]}]},{"allowed_amount":0.00,"billing_code_modifier":["XE"],"providers":[{"billed_charge":591.00,"npi":[1780653618]}]},{"allowed_amount":0.00,"billing_code_modifier":["XE"],"providers":[{"billed_charge":68.00,"npi":[1780653618]}]},{"allowed_amount":0.00,"billing_code_modifier":["XE"],"providers":[{"billed_charge":806.00,"npi":[1780653618]}]}]},{"tin":{"Type":"ein","value":"593238634"},"billing_class":"institutional","setting":"inpatient","payments":[{"allowed_amount":2.60,"providers":[{"billed_charge":10.00,"npi":[1780653618]}]}]},{"tin":{"Type":"ein","value":"593238634"},"billing_class":"institutional","setting":"inpatient","payments":[{"allowed_amount":5.01,"providers":[{"billed_charge":10.00,"npi":[1780653618]}]}]},{"tin":{"Type":"ein","value":"593238634"},"billing_class":"institutional","setting":"inpatient","payments":[{"allowed_amount":6.00,"providers":[{"billed_charge":10.00,"npi":[1780653618]}]}]},{"tin":{"Type":"ein","value":"593238634"},"billing_class":"institutional","setting":"inpatient","payments":[{"allowed_amount":17.54,"providers":[{"billed_charge":35.00,"npi":[1780653618]}]}]},{"tin":{"Type":"ein","value":"593238634"},"billing_class":"institutional","setting":"inpatient","payments":[{"allowed_amount":18.54,"providers":[{"billed_charge":37.00,"npi":[1780653618]}]}]},{"tin":{"Type":"ein","value":"593238634"},"billing_class":"institutional","setting":"inpatient","payments":[{"allowed_amount":28.56,"providers":[{"billed_charge":57.00,"npi":[1780653618]}]}]},{"tin":{"Type":"ein","value":"593238634"},"billing_class":"institutional","setting":"inpatient","payments":[{"allowed_amount":29.56,"providers":[{"billed_charge":59.00,"npi":[1780653618]}]}]},{"tin":{"Type":"ein","value":"593238634"},"billing_class":"institutional","setting":"inpatient","payments":[{"allowed_amount":36.58,"providers":[{"billed_charge":73.00,"npi":[1780653618]}]}]},{"tin":{"Type":"ein","value":"593238634"},"billing_class":"institutional","setting":"inpatient","payments":[{"allowed_amount":37.18,"providers":[{"billed_charge":143.00,"npi":[1780653618]}]}]},{"tin":{"Type":"ein","value":"593238634"},"billing_class":"institutional","setting":"inpatient","payments":[{"allowed_amount":59.40,"providers":[{"billed_charge":99.00,"npi":[1780653618]}]}]},{"tin":{"Type":"ein","value":"593238634"},"billing_class":"institutional","setting":"inpatient","payments":[{"allowed_amount":71.16,"providers":[{"billed_charge":142.00,"npi":[1780653618]}]}]},{"tin":{"Type":"ein","value":"593238634"},"billing_class":"institutional","setting":"inpatient","payments":[{"allowed_amount":71.66,"providers":[{"billed_charge":143.00,"npi":[1780653618]}]}]},{"tin":{"Type":"ein","value":"593238634"},"billing_class":"institutional","setting":"inpatient","payments":[{"allowed_amount":72.66,"providers":[{"billed_charge":145.00,"npi":[1780653618]}]}]},{"tin":{"Type":"ein","value":"593238634"},"billing_class":"institutional","setting":"inpatient","payments":[{"allowed_amount":78.42,"providers":[{"billed_charge":156.50,"npi":[1780653618]}]}]},{"tin":{"Type":"ein","value":"593238634"},"billing_class":"institutional","setting":"inpatient","payments":[{"allowed_amount":85.20,"providers":[{"billed_charge":142.00,"npi":[1780653618]}]}]},{"tin":{"Type":"ein","value":"593238634"},"billing_class":"institutional","setting":"inpatient","payments":[{"allowed_amount":88.69,"providers":[{"billed_charge":177.00,"npi":[1780653618]}]}]},{"tin":{"Type":"ein","value":"593238634"},"billing_class":"institutional","setting":"inpatient","payments":[{"allowed_amount":95.21,"providers":[{"billed_charge":190.00,"npi":[1780653618]}]}]},{"tin":{"Type":"ein","value":"593238634"},"billing_class":"institutional","setting":"inpatient","payments":[{"allowed_amount":101.22,"providers":[{"billed_charge":202.00,"npi":[1780653618]}]}]},{"tin":{"Type":"ein","value":"593238634"},"billing_class":"institutional","setting":"inpatient","payments":[{"allowed_amount":106.20,"providers":[{"billed_charge":177.00,"npi":[1780653618]}]}]},{"tin":{"Type":"ein","value":"593238634"},"billing_class":"institutional","setting":"inpatient","payments":[{"allowed_amount":109.24,"providers":[{"billed_charge":218.00,"npi":[1780653618]}]}]},{"tin":{"Type":"ein","value":"593238634"},"billing_class":"institutional","setting":"inpatient","payments":[{"allowed_amount":114.00,"providers":[{"billed_charge":190.00,"npi":[1780653618]}]}]},{"tin":{"Type":"ein","value":"593238634"},"billing_class":"institutional","setting":"inpatient","payments":[{"allowed_amount":121.20,"providers":[{"billed_charge":202.00,"npi":[1780653618]}]}]},{"tin":{"Type":"ein","value":"593238634"},"billing_class":"institutional","setting":"inpatient","payments":[{"allowed_amount":121.27,"providers":[{"billed_charge":242.00,"npi":[1780653618]}]}]},{"tin":{"Type":"ein","value":"593238634"},"billing_class":"institutional","setting":"inpatient","payments":[{"allowed_amount":126.78,"providers":[{"billed_charge":253.00,"npi":[1780653618]}]}]},{"tin":{"Type":"ein","value":"593238634"},"billing_class":"institutional","setting":"inpatient","payments":[{"allowed_amount":130.80,"providers":[{"billed_charge":218.00,"npi":[1780653618]}]}]},{"tin":{"Type":"ein","value":"593238634"},"billing_class":"institutional","setting":"inpatient","payments":[{"allowed_amount":153.34,"providers":[{"billed_charge":306.00,"npi":[1780653618]}]}]},{"tin":{"Type":"ein","value":"593238634"},"billing_class":"institutional","setting":"inpatient","payments":[{"allowed_amount":157.35,"providers":[{"billed_charge":314.00,"npi":[1780653618]}]}]},{"tin":{"Type":"ein","value":"593238634"},"billing_class":"institutional","setting":"inpatient","payments":[{"allowed_amount":202.95,"providers":[{"billed_charge":405.00,"npi":[1780653618]}]}]},{"tin":{"Type":"ein","value":"593238634"},"billing_class":"institutional","setting":"inpatient","payments":[{"allowed_amount":203.45,"providers":[{"billed_charge":406.00,"npi":[1780653618]}]}]},{"tin":{"Type":"ein","value":"593238634"},"billing_class":"institutional","setting":"inpatient","payments":[{"allowed_amount":216.50,"providers":[{"billed_charge":433.00,"npi":[1780653618]}]}]},{"tin":{"Type":"ein","value":"593238634"},"billing_class":"institutional","setting":"inpatient","payments":[{"allowed_amount":216.98,"providers":[{"billed_charge":433.00,"npi":[1780653618]}]}]},{"tin":{"Type":"ein","value":"593238634"},"billing_class":"institutional","setting":"inpatient","payments":[{"allowed_amount":223.99,"providers":[{"billed_charge":447.00,"npi":[1780653618]}]}]},{"tin":{"Type":"ein","value":"593238634"},"billing_class":"institutional","setting":"inpatient","payments":[{"allowed_amount":227.40,"providers":[{"billed_charge":379.00,"npi":[1780653618]}]}]},{"tin":{"Type":"ein","value":"593238634"},"billing_class":"institutional","setting":"inpatient","payments":[{"allowed_amount":241.53,"providers":[{"billed_charge":482.00,"npi":[1780653618]}]}]},{"tin":{"Type":"ein","value":"593238634"},"billing_class":"institutional","setting":"inpatient","payments":[{"allowed_amount":245.83,"providers":[{"billed_charge":806.00,"npi":[1780653618]}]}]},{"tin":{"Type":"ein","value":"593238634"},"billing_class":"institutional","setting":"inpatient","payments":[{"allowed_amount":256.06,"providers":[{"billed_charge":511.00,"npi":[1780653618]}]}]},{"tin":{"Type":"ein","value":"593238634"},"billing_class":"institutional","setting":"inpatient","payments":[{"allowed_amount":268.20,"providers":[{"billed_charge":447.00,"npi":[1780653618]}]}]},{"tin":{"Type":"ein","value":"593238634"},"billing_class":"institutional","setting":"inpatient","payments":[{"allowed_amount":270.59,"providers":[{"billed_charge":540.00,"npi":[1780653618]}]}]},{"tin":{"Type":"ein","value":"593238634"},"billing_class":"institutional","setting":"inpatient","payments":[{"allowed_amount":274.60,"providers":[{"billed_charge":548.00,"npi":[1780653618]}]}]},{"tin":{"Type":"ein","value":"593238634"},"billing_class":"institutional","setting":"inpatient","payments":[{"allowed_amount":276.11,"providers":[{"billed_charge":551.00,"npi":[1780653618]}]}]},{"tin":{"Type":"ein","value":"593238634"},"billing_class":"institutional","setting":"inpatient","payments":[{"allowed_amount":289.20,"providers":[{"billed_charge":482.00,"npi":[1780653618]}]}]},{"tin":{"Type":"ein","value":"593238634"},"billing_class":"institutional","setting":"inpatient","payments":[{"allowed_amount":330.60,"providers":[{"billed_charge":551.00,"npi":[1780653618]}]}]},{"tin":{"Type":"ein","value":"593238634"},"billing_class":"institutional","setting":"inpatient","payments":[{"allowed_amount":339.00,"providers":[{"billed_charge":565.00,"npi":[1780653618]}]}]},{"tin":{"Type":"ein","value":"593238634"},"billing_class":"institutional","setting":"inpatient","payments":[{"allowed_amount":403.87,"providers":[{"billed_charge":806.00,"npi":[1780653618]}]}]},{"tin":{"Type":"ein","value":"593238634"},"billing_class":"institutional","setting":"inpatient","payments":[{"allowed_amount":403.88,"providers":[{"billed_charge":806.00,"npi":[1780653618]}]}]},{"tin":{"Type":"ein","value":"593238634"},"billing_class":"institutional","setting":"inpatient","payments":[{"allowed_amount":403.89,"providers":[{"billed_charge":806.00,"npi":[1780653618]}]}]},{"tin":{"Type":"ein","value":"593238634"},"billing_class":"institutional","setting":"inpatient","payments":[{"allowed_amount":483.60,"providers":[{"billed_charge":806.00,"npi":[1780653618]}]}]},{"tin":{"Type":"ein","value":"621091430"},"billing_class":"institutional","setting":"inpatient","payments":[{"allowed_amount":0.00,"providers":[{"billed_charge":1041.37,"npi":[1912396326]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":1100.95,"npi":[1912396326]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":1104.99,"npi":[1912396326]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":1151.55,"npi":[1912396326]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":1595.60,"npi":[1912396326]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":353.28,"npi":[1912396326]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":431.70,"npi":[1912396326]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":636.74,"npi":[1912396326]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":733.41,"npi":[1912396326]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":745.19,"npi":[1912396326]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":907.43,"npi":[1912396326]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":998.65,"npi":[1912396326]}]}]}]},{"name":"Immunology","billing_code_type":"REV","billing_code_type_version":"2005","billing_code":"0302","description":"IMMUNOLOGY TESTS","allowed_amounts":[{"tin":{"Type":"ein","value":"590714831"},"billing_class":"institutional","setting":"inpatient","payments":[{"allowed_amount":0.00,"providers":[{"billed_charge":101.60,"npi":[1891782470]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":103.00,"npi":[1891782470]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":105.57,"npi":[1891782470]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":134.00,"npi":[1891782470]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":167.00,"npi":[1891782470]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":220.00,"npi":[1891782470]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":383.00,"npi":[1891782470]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":87.67,"npi":[1891782470]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":91.50,"npi":[1891782470]}]}]},{"tin":{"Type":"ein","value":"590714831"},"billing_class":"institutional","setting":"inpatient","payments":[{"allowed_amount":228.08,"providers":[{"billed_charge":340.93,"npi":[1891782470]}]}]},{"tin":{"Type":"ein","value":"593238634"},"billing_class":"institutional","setting":"inpatient","payments":[{"allowed_amount":0.00,"providers":[{"billed_charge":153.25,"npi":[1780653618]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":206.00,"npi":[1780653618]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":364.00,"npi":[1780653618]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":496.00,"npi":[1780653618]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":59.00,"npi":[1780653618]}]}]},{"tin":{"Type":"ein","value":"593238634"},"billing_class":"institutional","setting":"inpatient","payments":[{"allowed_amount":40.09,"providers":[{"billed_charge":80.00,"npi":[1780653618]}]}]},{"tin":{"Type":"ein","value":"593238634"},"billing_class":"institutional","setting":"inpatient","payments":[{"allowed_amount":48.11,"providers":[{"billed_charge":96.00,"npi":[1780653618]}]}]},{"tin":{"Type":"ein","value":"593238634"},"billing_class":"institutional","setting":"inpatient","payments":[{"allowed_amount":79.17,"providers":[{"billed_charge":158.00,"npi":[1780653618]}]}]},{"tin":{"Type":"ein","value":"593238634"},"billing_class":"institutional","setting":"inpatient","payments":[{"allowed_amount":87.69,"providers":[{"billed_charge":175.00,"npi":[1780653618]}]}]},{"tin":{"Type":"ein","value":"593238634"},"billing_class":"institutional","setting":"inpatient","payments":[{"allowed_amount":87.70,"providers":[{"billed_charge":175.00,"npi":[1780653618]}]}]},{"tin":{"Type":"ein","value":"593238634"},"billing_class":"institutional","setting":"inpatient","payments":[{"allowed_amount":103.23,"providers":[{"billed_charge":206.00,"npi":[1780653618]}]}]},{"tin":{"Type":"ein","value":"593238634"},"billing_class":"institutional","setting":"inpatient","payments":[{"allowed_amount":136.80,"providers":[{"billed_charge":273.00,"npi":[1780653618]}]}]},{"tin":{"Type":"ein","value":"593238634"},"billing_class":"institutional","setting":"inpatient","payments":[{"allowed_amount":160.20,"providers":[{"billed_charge":267.00,"npi":[1780653618]}]}]},{"tin":{"Type":"ein","value":"593238634"},"billing_class":"institutional","setting":"inpatient","payments":[{"allowed_amount":182.40,"providers":[{"billed_charge":364.00,"npi":[1780653618]}]}]},{"tin":{"Type":"ein","value":"593238634"},"billing_class":"institutional","setting":"inpatient","payments":[{"allowed_amount":220.48,"providers":[{"billed_charge":440.00,"npi":[1780653618]}]}]},{"tin":{"Type":"ein","value":"593238634"},"billing_class":"institutional","setting":"inpatient","payments":[{"allowed_amount":248.55,"providers":[{"billed_charge":496.00,"npi":[1780653618]}]}]},{"tin":{"Type":"ein","value":"593238634"},"billing_class":"institutional","setting":"inpatient","payments":[{"allowed_amount":311.40,"providers":[{"billed_charge":519.00,"npi":[1780653618]}]}]}]},{"name":"Hematology","billing_code_type":"REV","billing_code_type_version":"2005","billing_code":"0305","description":"HEMATOLOGY TESTS","allowed_amounts":[{"tin":{"Type":"ein","value":"590714831"},"billing_class":"institutional","setting":"inpatient","payments":[{"allowed_amount":0.00,"providers":[{"billed_charge":101.00,"npi":[1891782470]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":104.67,"npi":[1891782470]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":104.80,"npi":[1891782470]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":105.00,"npi":[1891782470]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":108.00,"npi":[1891782470]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":201.09,"npi":[1891782470]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":221.96,"npi":[1891782470]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":66.90,"npi":[1891782470]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":67.73,"npi":[1891782470]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":72.58,"npi":[1891782470]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":73.21,"npi":[1891782470]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":84.17,"npi":[1891782470]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":85.94,"npi":[1891782470]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":87.50,"npi":[1891782470]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":88.85,"npi":[1891782470]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":93.50,"npi":[1891782470]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":98.43,"npi":[1891782470]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":99.00,"npi":[1891782470]}]}]},{"tin":{"Type":"ein","value":"590714831"},"billing_class":"institutional","setting":"inpatient","payments":[{"allowed_amount":40.81,"providers":[{"billed_charge":90.84,"npi":[1891782470]}]}]},{"tin":{"Type":"ein","value":"593238634"},"billing_class":"institutional","setting":"inpatient","payments":[{"allowed_amount":0.00,"providers":[{"billed_charge":103.00,"npi":[1780653618]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":142.00,"npi":[1780653618]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":161.00,"npi":[1780653618]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":162.52,"npi":[1780653618]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":236.70,"npi":[1780653618]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":24.67,"npi":[1780653618]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":389.00,"npi":[1780653618]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":63.00,"npi":[1780653618]}]}]},{"tin":{"Type":"ein","value":"593238634"},"billing_class":"institutional","setting":"inpatient","payments":[{"allowed_amount":7.54,"providers":[{"billed_charge":29.00,"npi":[1780653618]}]}]},{"tin":{"Type":"ein","value":"593238634"},"billing_class":"institutional","setting":"inpatient","payments":[{"allowed_amount":14.53,"providers":[{"billed_charge":29.00,"npi":[1780653618]}]}]},{"tin":{"Type":"ein","value":"593238634"},"billing_class":"institutional","setting":"inpatient","payments":[{"allowed_amount":19.22,"providers":[{"billed_charge":63.00,"npi":[1780653618]}]}]},{"tin":{"Type":"ein","value":"593238634"},"billing_class":"institutional","setting":"inpatient","payments":[{"allowed_amount":31.57,"providers":[{"billed_charge":63.00,"npi":[1780653618]}]}]},{"tin":{"Type":"ein","value":"593238634"},"billing_class":"institutional","setting":"inpatient","payments":[{"allowed_amount":85.20,"providers":[{"billed_charge":142.00,"npi":[1780653618]}]}]},{"tin":{"Type":"ein","value":"593238634"},"billing_class":"institutional","setting":"inpatient","payments":[{"allowed_amount":119.61,"providers":[{"billed_charge":389.00,"npi":[1780653618]}]}]},{"tin":{"Type":"ein","value":"593238634"},"billing_class":"institutional","setting":"inpatient","payments":[{"allowed_amount":194.93,"providers":[{"billed_charge":389.00,"npi":[1780653618]}]}]},{"tin":{"Type":"ein","value":"593238634"},"billing_class":"institutional","setting":"inpatient","payments":[{"allowed_amount":205.95,"providers":[{"billed_charge":411.00,"npi":[1780653618]}]}]},{"tin":{"Type":"ein","value":"593238634"},"billing_class":"institutional","setting":"inpatient","payments":[{"allowed_amount":233.40,"providers":[{"billed_charge":389.00,"npi":[1780653618]}]}]},{"tin":{"Type":"ein","value":"593238634"},"billing_class":"institutional","setting":"inpatient","payments":[{"allowed_amount":289.64,"providers":[{"billed_charge":578.00,"npi":[1780653618]}]}]},{"tin":{"Type":"ein","value":"593238634"},"billing_class":"institutional","setting":"inpatient","payments":[{"allowed_amount":666.60,"providers":[{"billed_charge":1111.00,"npi":[1780653618]}]}]},{"tin":{"Type":"ein","value":"621091430"},"billing_class":"institutional","setting":"inpatient","payments":[{"allowed_amount":0.00,"providers":[{"billed_charge":112.09,"npi":[1912396326]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":119.86,"npi":[1912396326]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":132.82,"npi":[1912396326]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":81.00,"npi":[1912396326]}]}]}]},{"name":"Bacteriology & Microbiology","billing_code_type":"REV","billing_code_type_version":"2005","billing_code":"0306","description":"BACT & MICRO TESTS","allowed_amounts":[{"tin":{"Type":"ein","value":"590714831"},"billing_class":"institutional","setting":"inpatient","payments":[{"allowed_amount":0.00,"providers":[{"billed_charge":108.44,"npi":[1891782470]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":115.80,"npi":[1891782470]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":123.52,"npi":[1891782470]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":166.88,"npi":[1891782470]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":187.48,"npi":[1891782470]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":201.50,"npi":[1891782470]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":217.50,"npi":[1891782470]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":338.71,"npi":[1891782470]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":357.44,"npi":[1891782470]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":442.40,"npi":[1891782470]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":834.00,"npi":[1891782470]}]}]},{"tin":{"Type":"ein","value":"590714831"},"billing_class":"institutional","setting":"inpatient","payments":[{"allowed_amount":111.22,"providers":[{"billed_charge":184.50,"npi":[1891782470]}]}]},{"tin":{"Type":"ein","value":"593238634"},"billing_class":"institutional","setting":"inpatient","payments":[{"allowed_amount":0.00,"providers":[{"billed_charge":199.00,"npi":[1780653618]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":233.00,"npi":[1780653618]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":296.00,"npi":[1780653618]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":311.00,"npi":[1780653618]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":385.57,"npi":[1780653618]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":737.00,"npi":[1780653618]}]}]},{"tin":{"Type":"ein","value":"593238634"},"billing_class":"institutional","setting":"inpatient","payments":[{"allowed_amount":9.00,"providers":[{"billed_charge":15.00,"npi":[1780653618]}]}]},{"tin":{"Type":"ein","value":"593238634"},"billing_class":"institutional","setting":"inpatient","payments":[{"allowed_amount":12.00,"providers":[{"billed_charge":20.00,"npi":[1780653618]}]}]},{"tin":{"Type":"ein","value":"593238634"},"billing_class":"institutional","setting":"inpatient","payments":[{"allowed_amount":17.54,"providers":[{"billed_charge":35.00,"npi":[1780653618]}]}]},{"tin":{"Type":"ein","value":"593238634"},"billing_class":"institutional","setting":"inpatient","payments":[{"allowed_amount":19.54,"providers":[{"billed_charge":39.00,"npi":[1780653618]}]}]},{"tin":{"Type":"ein","value":"593238634"},"billing_class":"institutional","setting":"inpatient","payments":[{"allowed_amount":19.55,"providers":[{"billed_charge":39.00,"npi":[1780653618]}]}]},{"tin":{"Type":"ein","value":"593238634"},"billing_class":"institutional","setting":"inpatient","payments":[{"allowed_amount":23.40,"providers":[{"billed_charge":39.00,"npi":[1780653618]}]}]},{"tin":{"Type":"ein","value":"593238634"},"billing_class":"institutional","setting":"inpatient","payments":[{"allowed_amount":26.40,"providers":[{"billed_charge":44.00,"npi":[1780653618]}]}]},{"tin":{"Type":"ein","value":"593238634"},"billing_class":"institutional","setting":"inpatient","payments":[{"allowed_amount":30.60,"providers":[{"billed_charge":51.00,"npi":[1780653618]}]}]},{"tin":{"Type":"ein","value":"593238634"},"billing_class":"institutional","setting":"inpatient","payments":[{"allowed_amount":34.80,"providers":[{"billed_charge":58.00,"npi":[1780653618]}]}]},{"tin":{"Type":"ein","value":"593238634"},"billing_class":"institutional","setting":"inpatient","payments":[{"allowed_amount":99.72,"providers":[{"billed_charge":199.00,"npi":[1780653618]}]}]},{"tin":{"Type":"ein","value":"593238634"},"billing_class":"institutional","setting":"inpatient","payments":[{"allowed_amount":116.76,"providers":[{"billed_charge":233.00,"npi":[1780653618]}]}]},{"tin":{"Type":"ein","value":"593238634"},"billing_class":"institutional","setting":"inpatient","payments":[{"allowed_amount":238.20,"providers":[{"billed_charge":397.00,"npi":[1780653618]}]}]},{"tin":{"Type":"ein","value":"593238634"},"billing_class":"institutional","setting":"inpatient","payments":[{"allowed_amount":570.00,"providers":[{"billed_charge":950.00,"npi":[1780653618]}]}]}]},{"name":"Urology","billing_code_type":"REV","billing_code_type_version":"2005","billing_code":"0307","description":"UROLOGY TESTS","allowed_amounts":[{"tin":{"Type":"ein","value":"621091430"},"billing_class":"institutional","setting":"inpatient","payments":[{"allowed_amount":0.00,"providers":[{"billed_charge":306.00,"npi":[1912396326]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":326.55,"npi":[1912396326]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":347.10,"npi":[1912396326]}]}]}]},{"name":"General Classification","billing_code_type":"REV","billing_code_type_version":"2005","billing_code":"0310","description":"PATHOLOGY LAB","allowed_amounts":[{"tin":{"Type":"ein","value":"593238634"},"billing_class":"institutional","setting":"inpatient","payments":[{"allowed_amount":0.00,"providers":[{"billed_charge":797.09,"npi":[1780653618]}]}]},{"tin":{"Type":"ein","value":"593238634"},"billing_class":"institutional","setting":"inpatient","payments":[{"allowed_amount":136.80,"providers":[{"billed_charge":273.00,"npi":[1780653618]}]}]},{"tin":{"Type":"ein","value":"593238634"},"billing_class":"institutional","setting":"inpatient","payments":[{"allowed_amount":165.36,"providers":[{"billed_charge":330.00,"npi":[1780653618]}]}]},{"tin":{"Type":"ein","value":"593238634"},"billing_class":"institutional","setting":"inpatient","payments":[{"allowed_amount":320.40,"providers":[{"billed_charge":534.00,"npi":[1780653618]}]}]},{"tin":{"Type":"ein","value":"593238634"},"billing_class":"institutional","setting":"inpatient","payments":[{"allowed_amount":366.00,"providers":[{"billed_charge":610.00,"npi":[1780653618]}]}]},{"tin":{"Type":"ein","value":"593238634"},"billing_class":"institutional","setting":"inpatient","payments":[{"allowed_amount":1124.40,"billing_code_modifier":["XE"],"providers":[{"billed_charge":1874.00,"npi":[1780653618]}]}]},{"tin":{"Type":"ein","value":"593238634"},"billing_class":"institutional","setting":"inpatient","payments":[{"allowed_amount":1405.80,"billing_code_modifier":["XS"],"providers":[{"billed_charge":2343.00,"npi":[1780653618]}]}]},{"tin":{"Type":"ein","value":"593238634"},"billing_class":"institutional","setting":"inpatient","payments":[{"allowed_amount":5805.24,"providers":[{"billed_charge":11585.00,"npi":[1780653618]}]}]},{"tin":{"Type":"ein","value":"593238634"},"billing_class":"institutional","setting":"inpatient","payments":[{"allowed_amount":7229.40,"providers":[{"billed_charge":12049.00,"npi":[1780653618]}]}]}]},{"name":"Histology","billing_code_type":"REV","billing_code_type_version":"2005","billing_code":"0312","description":"HISTOLOGY TESTS","allowed_amounts":[{"tin":{"Type":"ein","value":"593238634"},"billing_class":"institutional","setting":"inpatient","payments":[{"allowed_amount":0.00,"providers":[{"billed_charge":135.00,"npi":[1780653618]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":565.76,"npi":[1780653618]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":882.25,"npi":[1780653618]}]}]},{"tin":{"Type":"ein","value":"593238634"},"billing_class":"institutional","setting":"inpatient","payments":[{"allowed_amount":167.44,"providers":[{"billed_charge":644.00,"npi":[1780653618]}]}]},{"tin":{"Type":"ein","value":"593238634"},"billing_class":"institutional","setting":"inpatient","payments":[{"allowed_amount":267.60,"providers":[{"billed_charge":446.00,"npi":[1780653618]}]}]},{"tin":{"Type":"ein","value":"593238634"},"billing_class":"institutional","setting":"inpatient","payments":[{"allowed_amount":322.71,"providers":[{"billed_charge":644.00,"npi":[1780653618]}]}]},{"tin":{"Type":"ein","value":"593238634"},"billing_class":"institutional","setting":"inpatient","payments":[{"allowed_amount":336.60,"providers":[{"billed_charge":561.00,"npi":[1780653618]}]}]},{"tin":{"Type":"ein","value":"593238634"},"billing_class":"institutional","setting":"inpatient","payments":[{"allowed_amount":386.40,"providers":[{"billed_charge":644.00,"npi":[1780653618]}]}]},{"tin":{"Type":"ein","value":"593238634"},"billing_class":"institutional","setting":"inpatient","payments":[{"allowed_amount":418.42,"providers":[{"billed_charge":835.00,"npi":[1780653618]}]}]},{"tin":{"Type":"ein","value":"593238634"},"billing_class":"institutional","setting":"inpatient","payments":[{"allowed_amount":501.80,"providers":[{"billed_charge":1930.00,"npi":[1780653618]}]}]},{"tin":{"Type":"ein","value":"593238634"},"billing_class":"institutional","setting":"inpatient","payments":[{"allowed_amount":515.13,"billing_code_modifier":["XU"],"providers":[{"billed_charge":1028.00,"npi":[1780653618]}]}]},{"tin":{"Type":"ein","value":"593238634"},"billing_class":"institutional","setting":"inpatient","payments":[{"allowed_amount":709.05,"providers":[{"billed_charge":1415.00,"npi":[1780653618]}]}]},{"tin":{"Type":"ein","value":"593238634"},"billing_class":"institutional","setting":"inpatient","payments":[{"allowed_amount":709.06,"providers":[{"billed_charge":1415.00,"npi":[1780653618]}]}]},{"tin":{"Type":"ein","value":"593238634"},"billing_class":"institutional","setting":"inpatient","payments":[{"allowed_amount":835.00,"providers":[{"billed_charge":835.00,"npi":[1780653618]}]}]},{"tin":{"Type":"ein","value":"593238634"},"billing_class":"institutional","setting":"inpatient","payments":[{"allowed_amount":967.12,"providers":[{"billed_charge":1930.00,"npi":[1780653618]}]}]},{"tin":{"Type":"ein","value":"593238634"},"billing_class":"institutional","setting":"inpatient","payments":[{"allowed_amount":1016.73,"providers":[{"billed_charge":2029.00,"npi":[1780653618]}]}]}]},{"name":"Chest X-Ray","billing_code_type":"REV","billing_code_type_version":"2005","billing_code":"0324","description":"DX X-RAY/CHEST","allowed_amounts":[{"tin":{"Type":"ein","value":"590714831"},"billing_class":"institutional","setting":"inpatient","payments":[{"allowed_amount":0.00,"providers":[{"billed_charge":217.00,"npi":[1891782470]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":239.50,"npi":[1891782470]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":262.00,"npi":[1891782470]}]}]},{"tin":{"Type":"ein","value":"590714831"},"billing_class":"institutional","setting":"inpatient","payments":[{"allowed_amount":78.86,"providers":[{"billed_charge":219.65,"npi":[1891782470]}]}]}]},{"name":"Radiation Therapy","billing_code_type":"REV","billing_code_type_version":"2005","billing_code":"0333","description":"RAD-RADIATION","allowed_amounts":[{"tin":{"Type":"ein","value":"593238634"},"billing_class":"institutional","setting":"inpatient","payments":[{"allowed_amount":0.00,"providers":[{"billed_charge":2963.00,"npi":[1780653618]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":3776.00,"npi":[1780653618]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":8790.00,"npi":[1780653618]}]}]},{"tin":{"Type":"ein","value":"593238634"},"billing_class":"institutional","setting":"inpatient","payments":[{"allowed_amount":645.92,"providers":[{"billed_charge":1289.00,"npi":[1780653618]}]}]},{"tin":{"Type":"ein","value":"593238634"},"billing_class":"institutional","setting":"inpatient","payments":[{"allowed_amount":1484.76,"providers":[{"billed_charge":2963.00,"npi":[1780653618]}]}]},{"tin":{"Type":"ein","value":"593238634"},"billing_class":"institutional","setting":"inpatient","payments":[{"allowed_amount":1892.15,"providers":[{"billed_charge":3776.00,"npi":[1780653618]}]}]},{"tin":{"Type":"ein","value":"593238634"},"billing_class":"institutional","setting":"inpatient","payments":[{"allowed_amount":2923.92,"providers":[{"billed_charge":5835.00,"npi":[1780653618]}]}]},{"tin":{"Type":"ein","value":"593238634"},"billing_class":"institutional","setting":"inpatient","payments":[{"allowed_amount":4404.67,"providers":[{"billed_charge":8790.00,"npi":[1780653618]}]}]}]},{"name":"General Classification","billing_code_type":"REV","billing_code_type_version":"2005","billing_code":"0350","description":"CT SCAN","allowed_amounts":[{"tin":{"Type":"ein","value":"593238634"},"billing_class":"institutional","setting":"inpatient","payments":[{"allowed_amount":0.00,"providers":[{"billed_charge":4975.00,"npi":[1780653618]}]}]},{"tin":{"Type":"ein","value":"593238634"},"billing_class":"institutional","setting":"inpatient","payments":[{"allowed_amount":105.84,"billing_code_modifier":["XE"],"providers":[{"billed_charge":347.00,"npi":[1780653618]}]}]},{"tin":{"Type":"ein","value":"593238634"},"billing_class":"institutional","setting":"inpatient","payments":[{"allowed_amount":173.88,"billing_code_modifier":["XU"],"providers":[{"billed_charge":347.00,"npi":[1780653618]}]}]},{"tin":{"Type":"ein","value":"593238634"},"billing_class":"institutional","setting":"inpatient","payments":[{"allowed_amount":250.10,"billing_code_modifier":["XE"],"providers":[{"billed_charge":820.00,"npi":[1780653618]}]}]},{"tin":{"Type":"ein","value":"593238634"},"billing_class":"institutional","setting":"inpatient","payments":[{"allowed_amount":2019.43,"providers":[{"billed_charge":4030.00,"npi":[1780653618]}]}]},{"tin":{"Type":"ein","value":"593238634"},"billing_class":"institutional","setting":"inpatient","payments":[{"allowed_amount":2418.00,"providers":[{"billed_charge":4030.00,"npi":[1780653618]}]}]},{"tin":{"Type":"ein","value":"593238634"},"billing_class":"institutional","setting":"inpatient","payments":[{"allowed_amount":2458.77,"providers":[{"billed_charge":4975.00,"npi":[1780653618]}]}]},{"tin":{"Type":"ein","value":"593238634"},"billing_class":"institutional","setting":"inpatient","payments":[{"allowed_amount":2492.97,"providers":[{"billed_charge":4975.00,"npi":[1780653618]}]}]},{"tin":{"Type":"ein","value":"593238634"},"billing_class":"institutional","setting":"inpatient","payments":[{"allowed_amount":4006.80,"providers":[{"billed_charge":7996.00,"npi":[1780653618]}]}]}]},{"name":"Body Scan","billing_code_type":"REV","billing_code_type_version":"2005","billing_code":"0352","description":"CT SCAN/BODY","allowed_amounts":[{"tin":{"Type":"ein","value":"593238634"},"billing_class":"institutional","setting":"inpatient","payments":[{"allowed_amount":0.00,"providers":[{"billed_charge":10406.00,"npi":[1780653618]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":13003.00,"npi":[1780653618]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":8114.50,"npi":[1780653618]}]}]},{"tin":{"Type":"ein","value":"593238634"},"billing_class":"institutional","setting":"inpatient","payments":[{"allowed_amount":3911.59,"providers":[{"billed_charge":7806.00,"npi":[1780653618]}]}]},{"tin":{"Type":"ein","value":"593238634"},"billing_class":"institutional","setting":"inpatient","payments":[{"allowed_amount":5214.45,"providers":[{"billed_charge":10406.00,"npi":[1780653618]}]}]},{"tin":{"Type":"ein","value":"593238634"},"billing_class":"institutional","setting":"inpatient","payments":[{"allowed_amount":6501.50,"providers":[{"billed_charge":13003.00,"npi":[1780653618]}]}]},{"tin":{"Type":"ein","value":"593238634"},"billing_class":"institutional","setting":"inpatient","payments":[{"allowed_amount":6515.80,"providers":[{"billed_charge":13003.00,"npi":[1780653618]}]}]},{"tin":{"Type":"ein","value":"593238634"},"billing_class":"institutional","setting":"inpatient","payments":[{"allowed_amount":7745.00,"providers":[{"billed_charge":15456.00,"npi":[1780653618]}]}]}]},{"name":"General Classification","billing_code_type":"REV","billing_code_type_version":"2005","billing_code":"0370","description":"ANESTHESIA","allowed_amounts":[{"tin":{"Type":"ein","value":"590714831"},"billing_class":"institutional","setting":"inpatient","payments":[{"allowed_amount":0.00,"providers":[{"billed_charge":11405.00,"npi":[1891782470]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":210.00,"npi":[1891782470]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":330.00,"npi":[1891782470]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":3970.00,"npi":[1891782470]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":4093.00,"npi":[1891782470]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":412.50,"npi":[1891782470]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":4120.00,"npi":[1891782470]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":4167.00,"npi":[1891782470]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":4197.00,"npi":[1891782470]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":4224.00,"npi":[1891782470]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":4243.00,"npi":[1891782470]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":4277.00,"npi":[1891782470]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":4283.50,"npi":[1891782470]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":4447.00,"npi":[1891782470]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":6431.00,"npi":[1891782470]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":660.00,"npi":[1891782470]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":7414.00,"npi":[1891782470]}]}]},{"tin":{"Type":"ein","value":"590714831"},"billing_class":"institutional","setting":"inpatient","payments":[{"allowed_amount":1211.81,"providers":[{"billed_charge":4224.00,"npi":[1891782470]}]}]},{"tin":{"Type":"ein","value":"590714831"},"billing_class":"institutional","setting":"inpatient","payments":[{"allowed_amount":1704.32,"providers":[{"billed_charge":4243.00,"npi":[1891782470]}]}]},{"tin":{"Type":"ein","value":"590714831"},"billing_class":"institutional","setting":"inpatient","payments":[{"allowed_amount":1840.75,"providers":[{"billed_charge":7414.00,"npi":[1891782470]}]}]},{"tin":{"Type":"ein","value":"590714831"},"billing_class":"institutional","setting":"inpatient","payments":[{"allowed_amount":1942.71,"providers":[{"billed_charge":3101.50,"npi":[1891782470]}]}]},{"tin":{"Type":"ein","value":"590714831"},"billing_class":"institutional","setting":"inpatient","payments":[{"allowed_amount":3125.25,"providers":[{"billed_charge":4167.00,"npi":[1891782470]}]}]},{"tin":{"Type":"ein","value":"590714831"},"billing_class":"institutional","setting":"inpatient","payments":[{"allowed_amount":3168.00,"providers":[{"billed_charge":4224.00,"npi":[1891782470]}]}]},{"tin":{"Type":"ein","value":"590714831"},"billing_class":"institutional","setting":"inpatient","payments":[{"allowed_amount":4486.00,"providers":[{"billed_charge":4167.00,"npi":[1891782470]}]}]},{"tin":{"Type":"ein","value":"593238634"},"billing_class":"institutional","setting":"inpatient","payments":[{"allowed_amount":0.00,"providers":[{"billed_charge":0.01,"npi":[1780653618]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":361.93,"npi":[1780653618]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":380.47,"npi":[1780653618]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":382.50,"npi":[1780653618]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":779.00,"npi":[1780653618]}]}]},{"tin":{"Type":"ein","value":"593238634"},"billing_class":"institutional","setting":"inpatient","payments":[{"allowed_amount":0.01,"providers":[{"billed_charge":0.01,"npi":[1780653618]}]}]},{"tin":{"Type":"ein","value":"593238634"},"billing_class":"institutional","setting":"inpatient","payments":[{"allowed_amount":97.36,"providers":[{"billed_charge":374.47,"npi":[1780653618]}]}]},{"tin":{"Type":"ein","value":"593238634"},"billing_class":"institutional","setting":"inpatient","payments":[{"allowed_amount":187.65,"providers":[{"billed_charge":374.47,"npi":[1780653618]}]}]},{"tin":{"Type":"ein","value":"593238634"},"billing_class":"institutional","setting":"inpatient","payments":[{"allowed_amount":188.27,"providers":[{"billed_charge":375.72,"npi":[1780653618]}]}]},{"tin":{"Type":"ein","value":"593238634"},"billing_class":"institutional","setting":"inpatient","payments":[{"allowed_amount":247.71,"providers":[{"billed_charge":494.33,"npi":[1780653618]}]}]},{"tin":{"Type":"ein","value":"593238634"},"billing_class":"institutional","setting":"inpatient","payments":[{"allowed_amount":283.37,"providers":[{"billed_charge":565.50,"npi":[1780653618]}]}]},{"tin":{"Type":"ein","value":"593238634"},"billing_class":"institutional","setting":"inpatient","payments":[{"allowed_amount":339.30,"providers":[{"billed_charge":565.50,"npi":[1780653618]}]}]}]},{"name":"Ultrasound","billing_code_type":"REV","billing_code_type_version":"2005","billing_code":"0402","description":"ULTRASOUND","allowed_amounts":[{"tin":{"Type":"ein","value":"593238634"},"billing_class":"institutional","setting":"inpatient","payments":[{"allowed_amount":0.00,"providers":[{"billed_charge":3253.00,"npi":[1780653618]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":3420.00,"npi":[1780653618]}]}]},{"tin":{"Type":"ein","value":"593238634"},"billing_class":"institutional","setting":"inpatient","payments":[{"allowed_amount":608.84,"billing_code_modifier":["LT"],"providers":[{"billed_charge":1215.00,"npi":[1780653618]}]}]},{"tin":{"Type":"ein","value":"593238634"},"billing_class":"institutional","setting":"inpatient","payments":[{"allowed_amount":968.63,"providers":[{"billed_charge":1933.00,"npi":[1780653618]}]}]},{"tin":{"Type":"ein","value":"593238634"},"billing_class":"institutional","setting":"inpatient","payments":[{"allowed_amount":992.17,"providers":[{"billed_charge":3253.00,"npi":[1780653618]}]}]},{"tin":{"Type":"ein","value":"593238634"},"billing_class":"institutional","setting":"inpatient","payments":[{"allowed_amount":1158.04,"providers":[{"billed_charge":2311.00,"npi":[1780653618]}]}]},{"tin":{"Type":"ein","value":"593238634"},"billing_class":"institutional","setting":"inpatient","payments":[{"allowed_amount":1630.08,"providers":[{"billed_charge":3253.00,"npi":[1780653618]}]}]},{"tin":{"Type":"ein","value":"593238634"},"billing_class":"institutional","setting":"inpatient","payments":[{"allowed_amount":1713.76,"providers":[{"billed_charge":3420.00,"npi":[1780653618]}]}]},{"tin":{"Type":"ein","value":"593238634"},"billing_class":"institutional","setting":"inpatient","payments":[{"allowed_amount":2248.94,"billing_code_modifier":["LT"],"providers":[{"billed_charge":4488.00,"npi":[1780653618]}]}]}]},{"name":"General Classification","billing_code_type":"REV","billing_code_type_version":"2005","billing_code":"0420","description":"PHYSICAL THERP","allowed_amounts":[{"tin":{"Type":"ein","value":"590714831"},"billing_class":"institutional","setting":"inpatient","payments":[{"allowed_amount":0.00,"providers":[{"billed_charge":176.29,"npi":[1891782470]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":177.80,"npi":[1891782470]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":183.14,"npi":[1891782470]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":209.00,"npi":[1891782470]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":213.67,"npi":[1891782470]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":249.00,"npi":[1891782470]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":257.50,"npi":[1891782470]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":258.00,"npi":[1891782470]}]}]},{"tin":{"Type":"ein","value":"590714831"},"billing_class":"institutional","setting":"inpatient","payments":[{"allowed_amount":109.25,"providers":[{"billed_charge":162.82,"npi":[1891782470]}]}]}]},{"name":"General Classification","billing_code_type":"REV","billing_code_type_version":"2005","billing_code":"0430","description":"OCCUPATIONAL THER","allowed_amounts":[{"tin":{"Type":"ein","value":"590714831"},"billing_class":"institutional","setting":"inpatient","payments":[{"allowed_amount":0.00,"providers":[{"billed_charge":183.73,"npi":[1891782470]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":190.50,"npi":[1891782470]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":209.75,"npi":[1891782470]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":259.00,"npi":[1891782470]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":262.00,"npi":[1891782470]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":363.00,"npi":[1891782470]}]}]},{"tin":{"Type":"ein","value":"590714831"},"billing_class":"institutional","setting":"inpatient","payments":[{"allowed_amount":116.53,"providers":[{"billed_charge":173.67,"npi":[1891782470]}]}]}]},{"name":"General Classification","billing_code_type":"REV","billing_code_type_version":"2005","billing_code":"0450","description":"EMERG ROOM","allowed_amounts":[{"tin":{"Type":"ein","value":"621091430"},"billing_class":"institutional","setting":"inpatient","payments":[{"allowed_amount":0.00,"providers":[{"billed_charge":6261.85,"npi":[1912396326]}]}]},{"tin":{"Type":"ein","value":"621091430"},"billing_class":"institutional","setting":"inpatient","payments":[{"allowed_amount":3656.06,"providers":[{"billed_charge":6261.85,"npi":[1912396326]}]}]}]},{"name":"General Classification","billing_code_type":"REV","billing_code_type_version":"2005","billing_code":"0510","description":"CLINIC","allowed_amounts":[{"tin":{"Type":"ein","value":"593238634"},"billing_class":"institutional","setting":"inpatient","payments":[{"allowed_amount":0.00,"billing_code_modifier":["25"],"providers":[{"billed_charge":309.00,"npi":[1780653618]}]}]},{"tin":{"Type":"ein","value":"593238634"},"billing_class":"institutional","setting":"inpatient","payments":[{"allowed_amount":154.84,"billing_code_modifier":["25"],"providers":[{"billed_charge":309.00,"npi":[1780653618]}]}]},{"tin":{"Type":"ein","value":"593238634"},"billing_class":"institutional","setting":"inpatient","payments":[{"allowed_amount":185.40,"billing_code_modifier":["25"],"providers":[{"billed_charge":309.00,"npi":[1780653618]}]}]},{"tin":{"Type":"ein","value":"593238634"},"billing_class":"institutional","setting":"inpatient","payments":[{"allowed_amount":1199.13,"billing_code_modifier":["25"],"providers":[{"billed_charge":309.00,"npi":[1780653618]}]}]},{"tin":{"Type":"ein","value":"593238634"},"billing_class":"institutional","setting":"inpatient","payments":[{"allowed_amount":1909.69,"billing_code_modifier":["25"],"providers":[{"billed_charge":309.00,"npi":[1780653618]}]}]}]},{"name":"Drugs Requiring Detailed Coding","billing_code_type":"REV","billing_code_type_version":"2005","billing_code":"0636","description":"DRUGS/DETAIL CODE","allowed_amounts":[{"tin":{"Type":"ein","value":"593238634"},"billing_class":"institutional","setting":"inpatient","payments":[{"allowed_amount":0.00,"providers":[{"billed_charge":0.50,"npi":[1780653618]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":1.00,"npi":[1780653618]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":1013.00,"npi":[1780653618]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":14.00,"npi":[1780653618]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":2.00,"npi":[1780653618]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":3.00,"npi":[1780653618]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":3.46,"npi":[1780653618]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":36.00,"npi":[1780653618]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":4.16,"npi":[1780653618]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":43.00,"npi":[1780653618]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":5.04,"npi":[1780653618]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":53.00,"npi":[1780653618]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":56.00,"npi":[1780653618]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":6.00,"npi":[1780653618]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":6.50,"npi":[1780653618]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":60.00,"npi":[1780653618]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":66.00,"npi":[1780653618]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":674.00,"npi":[1780653618]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":7.00,"npi":[1780653618]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":8.00,"npi":[1780653618]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":81.00,"npi":[1780653618]}]}]},{"tin":{"Type":"ein","value":"593238634"},"billing_class":"institutional","setting":"inpatient","payments":[{"allowed_amount":0.02,"providers":[{"billed_charge":1.00,"npi":[1780653618]}]}]},{"tin":{"Type":"ein","value":"593238634"},"billing_class":"institutional","setting":"inpatient","payments":[{"allowed_amount":0.11,"providers":[{"billed_charge":1.00,"npi":[1780653618]}]}]},{"tin":{"Type":"ein","value":"593238634"},"billing_class":"institutional","setting":"inpatient","payments":[{"allowed_amount":0.13,"providers":[{"billed_charge":0.50,"npi":[1780653618]}]}]},{"tin":{"Type":"ein","value":"593238634"},"billing_class":"institutional","setting":"inpatient","payments":[{"allowed_amount":0.19,"providers":[{"billed_charge":1.00,"npi":[1780653618]}]},{"allowed_amount":0.19,"providers":[{"billed_charge":3.00,"npi":[1780653618]}]},{"allowed_amount":0.19,"providers":[{"billed_charge":6.00,"npi":[1780653618]}]}]},{"tin":{"Type":"ein","value":"593238634"},"billing_class":"institutional","setting":"inpatient","payments":[{"allowed_amount":0.21,"providers":[{"billed_charge":6.00,"npi":[1780653618]}]}]},{"tin":{"Type":"ein","value":"593238634"},"billing_class":"institutional","setting":"inpatient","payments":[{"allowed_amount":0.25,"providers":[{"billed_charge":0.50,"npi":[1780653618]}]},{"allowed_amount":0.25,"providers":[{"billed_charge":2.00,"npi":[1780653618]}]}]},{"tin":{"Type":"ein","value":"593238634"},"billing_class":"institutional","setting":"inpatient","payments":[{"allowed_amount":0.26,"providers":[{"billed_charge":1.00,"npi":[1780653618]}]}]},{"tin":{"Type":"ein","value":"593238634"},"billing_class":"institutional","setting":"inpatient","payments":[{"allowed_amount":0.29,"providers":[{"billed_charge":1.00,"npi":[1780653618]}]}]},{"tin":{"Type":"ein","value":"593238634"},"billing_class":"institutional","setting":"inpatient","payments":[{"allowed_amount":0.30,"providers":[{"billed_charge":0.50,"npi":[1780653618]}]}]},{"tin":{"Type":"ein","value":"593238634"},"billing_class":"institutional","setting":"inpatient","payments":[{"allowed_amount":0.32,"providers":[{"billed_charge":3.00,"npi":[1780653618]}]}]},{"tin":{"Type":"ein","value":"593238634"},"billing_class":"institutional","setting":"inpatient","payments":[{"allowed_amount":0.44,"providers":[{"billed_charge":23.00,"npi":[1780653618]}]},{"allowed_amount":0.44,"providers":[{"billed_charge":3.00,"npi":[1780653618]}]},{"allowed_amount":0.44,"providers":[{"billed_charge":7.00,"npi":[1780653618]}]}]},{"tin":{"Type":"ein","value":"593238634"},"billing_class":"institutional","setting":"inpatient","payments":[{"allowed_amount":0.50,"providers":[{"billed_charge":1.00,"npi":[1780653618]}]}]},{"tin":{"Type":"ein","value":"593238634"},"billing_class":"institutional","setting":"inpatient","payments":[{"allowed_amount":0.60,"providers":[{"billed_charge":1.00,"npi":[1780653618]}]}]},{"tin":{"Type":"ein","value":"593238634"},"billing_class":"institutional","setting":"inpatient","payments":[{"allowed_amount":0.63,"providers":[{"billed_charge":3.00,"npi":[1780653618]}]}]},{"tin":{"Type":"ein","value":"593238634"},"billing_class":"institutional","setting":"inpatient","payments":[{"allowed_amount":0.76,"providers":[{"billed_charge":81.00,"npi":[1780653618]}]}]},{"tin":{"Type":"ein","value":"593238634"},"billing_class":"institutional","setting":"inpatient","payments":[{"allowed_amount":0.78,"providers":[{"billed_charge":3.00,"npi":[1780653618]}]}]},{"tin":{"Type":"ein","value":"593238634"},"billing_class":"institutional","setting":"inpatient","payments":[{"allowed_amount":0.90,"providers":[{"billed_charge":60.00,"npi":[1780653618]}]}]},{"tin":{"Type":"ein","value":"593238634"},"billing_class":"institutional","setting":"inpatient","payments":[{"allowed_amount":0.92,"providers":[{"billed_charge":3.00,"npi":[1780653618]}]}]},{"tin":{"Type":"ein","value":"593238634"},"billing_class":"institutional","setting":"inpatient","payments":[{"allowed_amount":0.97,"providers":[{"billed_charge":9.00,"npi":[1780653618]}]}]},{"tin":{"Type":"ein","value":"593238634"},"billing_class":"institutional","setting":"inpatient","payments":[{"allowed_amount":1.00,"providers":[{"billed_charge":2.00,"npi":[1780653618]}]}]},{"tin":{"Type":"ein","value":"593238634"},"billing_class":"institutional","setting":"inpatient","payments":[{"allowed_amount":1.32,"providers":[{"billed_charge":8.00,"npi":[1780653618]}]}]},{"tin":{"Type":"ein","value":"593238634"},"billing_class":"institutional","setting":"inpatient","payments":[{"allowed_amount":1.50,"providers":[{"billed_charge":3.00,"npi":[1780653618]}]}]},{"tin":{"Type":"ein","value":"593238634"},"billing_class":"institutional","setting":"inpatient","payments":[{"allowed_amount":1.56,"providers":[{"billed_charge":6.00,"npi":[1780653618]}]}]},{"tin":{"Type":"ein","value":"593238634"},"billing_class":"institutional","setting":"inpatient","payments":[{"allowed_amount":1.68,"providers":[{"billed_charge":7.00,"npi":[1780653618]}]}]},{"tin":{"Type":"ein","value":"593238634"},"billing_class":"institutional","setting":"inpatient","payments":[{"allowed_amount":1.82,"providers":[{"billed_charge":7.00,"npi":[1780653618]}]}]},{"tin":{"Type":"ein","value":"593238634"},"billing_class":"institutional","setting":"inpatient","payments":[{"allowed_amount":1.97,"providers":[{"billed_charge":7.00,"npi":[1780653618]}]}]},{"tin":{"Type":"ein","value":"593238634"},"billing_class":"institutional","setting":"inpatient","payments":[{"allowed_amount":2.31,"providers":[{"billed_charge":14.00,"npi":[1780653618]}]}]},{"tin":{"Type":"ein","value":"593238634"},"billing_class":"institutional","setting":"inpatient","payments":[{"allowed_amount":2.34,"providers":[{"billed_charge":9.00,"npi":[1780653618]}]}]},{"tin":{"Type":"ein","value":"593238634"},"billing_class":"institutional","setting":"inpatient","payments":[{"allowed_amount":3.64,"providers":[{"billed_charge":14.00,"npi":[1780653618]}]}]},{"tin":{"Type":"ein","value":"593238634"},"billing_class":"institutional","setting":"inpatient","payments":[{"allowed_amount":3.80,"providers":[{"billed_charge":10.00,"npi":[1780653618]}]}]},{"tin":{"Type":"ein","value":"593238634"},"billing_class":"institutional","setting":"inpatient","payments":[{"allowed_amount":4.13,"providers":[{"billed_charge":14.00,"npi":[1780653618]}]}]},{"tin":{"Type":"ein","value":"593238634"},"billing_class":"institutional","setting":"inpatient","payments":[{"allowed_amount":4.51,"providers":[{"billed_charge":9.00,"npi":[1780653618]}]}]},{"tin":{"Type":"ein","value":"593238634"},"billing_class":"institutional","setting":"inpatient","payments":[{"allowed_amount":4.64,"providers":[{"billed_charge":6.00,"npi":[1780653618]}]}]},{"tin":{"Type":"ein","value":"593238634"},"billing_class":"institutional","setting":"inpatient","payments":[{"allowed_amount":5.01,"providers":[{"billed_charge":10.00,"npi":[1780653618]}]}]},{"tin":{"Type":"ein","value":"593238634"},"billing_class":"institutional","setting":"inpatient","payments":[{"allowed_amount":5.20,"providers":[{"billed_charge":20.00,"npi":[1780653618]}]}]},{"tin":{"Type":"ein","value":"593238634"},"billing_class":"institutional","setting":"inpatient","payments":[{"allowed_amount":5.71,"providers":[{"billed_charge":66.00,"npi":[1780653618]}]}]},{"tin":{"Type":"ein","value":"593238634"},"billing_class":"institutional","setting":"inpatient","payments":[{"allowed_amount":5.92,"providers":[{"billed_charge":9.00,"npi":[1780653618]}]}]},{"tin":{"Type":"ein","value":"593238634"},"billing_class":"institutional","setting":"inpatient","payments":[{"allowed_amount":6.34,"providers":[{"billed_charge":43.00,"npi":[1780653618]}]}]},{"tin":{"Type":"ein","value":"593238634"},"billing_class":"institutional","setting":"inpatient","payments":[{"allowed_amount":7.00,"providers":[{"billed_charge":14.00,"npi":[1780653618]}]}]},{"tin":{"Type":"ein","value":"593238634"},"billing_class":"institutional","setting":"inpatient","payments":[{"allowed_amount":7.02,"providers":[{"billed_charge":14.00,"npi":[1780653618]}]},{"allowed_amount":7.02,"providers":[{"billed_charge":23.00,"npi":[1780653618]}]}]},{"tin":{"Type":"ein","value":"593238634"},"billing_class":"institutional","setting":"inpatient","payments":[{"allowed_amount":10.02,"providers":[{"billed_charge":20.00,"npi":[1780653618]}]}]},{"tin":{"Type":"ein","value":"593238634"},"billing_class":"institutional","setting":"inpatient","payments":[{"allowed_amount":10.63,"providers":[{"billed_charge":287.00,"npi":[1780653618]}]}]},{"tin":{"Type":"ein","value":"593238634"},"billing_class":"institutional","setting":"inpatient","payments":[{"allowed_amount":10.80,"providers":[{"billed_charge":18.00,"npi":[1780653618]}]}]},{"tin":{"Type":"ein","value":"593238634"},"billing_class":"institutional","setting":"inpatient","payments":[{"allowed_amount":11.53,"providers":[{"billed_charge":23.00,"npi":[1780653618]}]}]},{"tin":{"Type":"ein","value":"593238634"},"billing_class":"institutional","setting":"inpatient","payments":[{"allowed_amount":11.70,"providers":[{"billed_charge":45.00,"npi":[1780653618]}]}]},{"tin":{"Type":"ein","value":"593238634"},"billing_class":"institutional","setting":"inpatient","payments":[{"allowed_amount":14.03,"providers":[{"billed_charge":28.00,"npi":[1780653618]}]}]},{"tin":{"Type":"ein","value":"593238634"},"billing_class":"institutional","setting":"inpatient","payments":[{"allowed_amount":14.13,"providers":[{"billed_charge":210.00,"npi":[1780653618]}]}]},{"tin":{"Type":"ein","value":"593238634"},"billing_class":"institutional","setting":"inpatient","payments":[{"allowed_amount":14.56,"providers":[{"billed_charge":56.00,"npi":[1780653618]}]}]},{"tin":{"Type":"ein","value":"593238634"},"billing_class":"institutional","setting":"inpatient","payments":[{"allowed_amount":17.16,"providers":[{"billed_charge":66.00,"npi":[1780653618]}]}]},{"tin":{"Type":"ein","value":"593238634"},"billing_class":"institutional","setting":"inpatient","payments":[{"allowed_amount":17.26,"providers":[{"billed_charge":53.00,"npi":[1780653618]}]}]},{"tin":{"Type":"ein","value":"593238634"},"billing_class":"institutional","setting":"inpatient","payments":[{"allowed_amount":19.00,"providers":[{"billed_charge":19.00,"npi":[1780653618]}]}]},{"tin":{"Type":"ein","value":"593238634"},"billing_class":"institutional","setting":"inpatient","payments":[{"allowed_amount":28.06,"providers":[{"billed_charge":56.00,"npi":[1780653618]}]}]},{"tin":{"Type":"ein","value":"593238634"},"billing_class":"institutional","setting":"inpatient","payments":[{"allowed_amount":60.00,"providers":[{"billed_charge":100.00,"npi":[1780653618]}]}]},{"tin":{"Type":"ein","value":"593238634"},"billing_class":"institutional","setting":"inpatient","payments":[{"allowed_amount":61.70,"providers":[{"billed_charge":508.00,"npi":[1780653618]}]}]},{"tin":{"Type":"ein","value":"593238634"},"billing_class":"institutional","setting":"inpatient","payments":[{"allowed_amount":175.24,"providers":[{"billed_charge":674.00,"npi":[1780653618]}]}]},{"tin":{"Type":"ein","value":"593238634"},"billing_class":"institutional","setting":"inpatient","payments":[{"allowed_amount":223.29,"providers":[{"billed_charge":1601.00,"npi":[1780653618]}]}]},{"tin":{"Type":"ein","value":"593238634"},"billing_class":"institutional","setting":"inpatient","payments":[{"allowed_amount":312.88,"providers":[{"billed_charge":985.00,"npi":[1780653618]}]}]},{"tin":{"Type":"ein","value":"593238634"},"billing_class":"institutional","setting":"inpatient","payments":[{"allowed_amount":337.74,"providers":[{"billed_charge":674.00,"npi":[1780653618]}]}]},{"tin":{"Type":"ein","value":"593238634"},"billing_class":"institutional","setting":"inpatient","payments":[{"allowed_amount":511.79,"providers":[{"billed_charge":1013.00,"npi":[1780653618]}]}]},{"tin":{"Type":"ein","value":"593238634"},"billing_class":"institutional","setting":"inpatient","payments":[{"allowed_amount":726.60,"providers":[{"billed_charge":1211.00,"npi":[1780653618]}]}]},{"tin":{"Type":"ein","value":"621091430"},"billing_class":"institutional","setting":"inpatient","payments":[{"allowed_amount":0.00,"providers":[{"billed_charge":17.00,"npi":[1912396326]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":448.00,"npi":[1912396326]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":64.75,"npi":[1912396326]}]}]}]},{"name":"General Classification","billing_code_type":"REV","billing_code_type_version":"2005","billing_code":"0710","description":"RECOVERY ROOM","allowed_amounts":[{"tin":{"Type":"ein","value":"590714831"},"billing_class":"institutional","setting":"inpatient","payments":[{"allowed_amount":0.00,"providers":[{"billed_charge":1123.00,"npi":[1891782470]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":224.67,"npi":[1891782470]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":265.33,"npi":[1891782470]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":269.90,"npi":[1891782470]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":272.15,"npi":[1891782470]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":272.26,"npi":[1891782470]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":274.89,"npi":[1891782470]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":284.87,"npi":[1891782470]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":304.13,"npi":[1891782470]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":306.64,"npi":[1891782470]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":316.00,"npi":[1891782470]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":331.83,"npi":[1891782470]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":353.29,"npi":[1891782470]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":354.00,"npi":[1891782470]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":368.78,"npi":[1891782470]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":374.67,"npi":[1891782470]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":387.25,"npi":[1891782470]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":397.25,"npi":[1891782470]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":404.60,"npi":[1891782470]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":442.67,"npi":[1891782470]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":449.50,"npi":[1891782470]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":524.33,"npi":[1891782470]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":584.33,"npi":[1891782470]}]}]},{"tin":{"Type":"ein","value":"590714831"},"billing_class":"institutional","setting":"inpatient","payments":[{"allowed_amount":78.46,"providers":[{"billed_charge":316.00,"npi":[1891782470]}]}]},{"tin":{"Type":"ein","value":"590714831"},"billing_class":"institutional","setting":"inpatient","payments":[{"allowed_amount":90.31,"providers":[{"billed_charge":314.80,"npi":[1891782470]}]}]},{"tin":{"Type":"ein","value":"590714831"},"billing_class":"institutional","setting":"inpatient","payments":[{"allowed_amount":180.55,"providers":[{"billed_charge":449.50,"npi":[1891782470]}]}]},{"tin":{"Type":"ein","value":"590714831"},"billing_class":"institutional","setting":"inpatient","payments":[{"allowed_amount":199.00,"providers":[{"billed_charge":265.33,"npi":[1891782470]}]}]},{"tin":{"Type":"ein","value":"590714831"},"billing_class":"institutional","setting":"inpatient","payments":[{"allowed_amount":266.25,"providers":[{"billed_charge":396.80,"npi":[1891782470]}]}]},{"tin":{"Type":"ein","value":"590714831"},"billing_class":"institutional","setting":"inpatient","payments":[{"allowed_amount":279.39,"providers":[{"billed_charge":257.94,"npi":[1891782470]}]}]},{"tin":{"Type":"ein","value":"590714831"},"billing_class":"institutional","setting":"inpatient","payments":[{"allowed_amount":290.44,"providers":[{"billed_charge":387.25,"npi":[1891782470]}]}]},{"tin":{"Type":"ein","value":"590714831"},"billing_class":"institutional","setting":"inpatient","payments":[{"allowed_amount":328.50,"providers":[{"billed_charge":438.00,"npi":[1891782470]}]}]},{"tin":{"Type":"ein","value":"590714831"},"billing_class":"institutional","setting":"inpatient","payments":[{"allowed_amount":625.40,"providers":[{"billed_charge":354.00,"npi":[1891782470]}]}]},{"tin":{"Type":"ein","value":"590714831"},"billing_class":"institutional","setting":"inpatient","payments":[{"allowed_amount":1042.33,"providers":[{"billed_charge":442.67,"npi":[1891782470]}]}]},{"tin":{"Type":"ein","value":"590714831"},"billing_class":"institutional","setting":"inpatient","payments":[{"allowed_amount":1257.25,"providers":[{"billed_charge":387.25,"npi":[1891782470]}]}]}]},{"name":"General Classification","billing_code_type":"REV","billing_code_type_version":"2005","billing_code":"0730","description":"EKG/ECG","allowed_amounts":[{"tin":{"Type":"ein","value":"590714831"},"billing_class":"institutional","setting":"inpatient","payments":[{"allowed_amount":0.00,"providers":[{"billed_charge":307.00,"npi":[1891782470]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":314.20,"npi":[1891782470]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":325.00,"npi":[1891782470]}]}]},{"tin":{"Type":"ein","value":"590714831"},"billing_class":"institutional","setting":"inpatient","payments":[{"allowed_amount":168.54,"providers":[{"billed_charge":307.00,"npi":[1891782470]}]}]},{"tin":{"Type":"ein","value":"621091430"},"billing_class":"institutional","setting":"inpatient","payments":[{"allowed_amount":0.00,"providers":[{"billed_charge":1944.55,"npi":[1912396326]}]}]}]},{"name":"Residential Treatment - Psychiatric","billing_code_type":"REV","billing_code_type_version":"2005","billing_code":"1001","description":"BH R&B RES/PSYCH","allowed_amounts":[{"tin":{"Type":"ein","value":"581791069"},"billing_class":"institutional","setting":"inpatient","payments":[{"allowed_amount":0.00,"providers":[{"billed_charge":1400.00,"npi":[1811964737]}]}]},{"tin":{"Type":"ein","value":"581791069"},"billing_class":"institutional","setting":"inpatient","payments":[{"allowed_amount":670.00,"providers":[{"billed_charge":1400.00,"npi":[1811964737]}]}]}]}]}
