{"reporting_entity_name": "Molina-Healthcare-of-Ohio", "reporting_entity_type": "health insurance issuer", "last_updated_on": "2026-06-22", "version": "2.0.0", "out_of_network": [{"name": "Pharmacy - Extension of 25X - Drug Requiring Detailed Coding", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0636", "description": "Pharmacy - Extension of 25x", "allowed_amounts": [{"tin": {"type": "ein", "value": "340714684"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 40.5146, "billing_code_modifier": ["JZ"], "providers": [{"billed_charge": 113.475, "npi": [1194763045]}]}, {"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 0.615, "npi": [1194763045]}, {"billed_charge": 2.8, "npi": [1194763045]}, {"billed_charge": 8.575, "npi": [1194763045]}, {"billed_charge": 1.4125, "npi": [1194763045]}, {"billed_charge": 5.25, "npi": [1194763045]}, {"billed_charge": 19.0, "npi": [1194763045]}, {"billed_charge": 0.04, "npi": [1194763045]}, {"billed_charge": 0.0531, "npi": [1194763045]}, {"billed_charge": 11.575, "npi": [1194763045]}, {"billed_charge": 0.9532, "npi": [1194763045]}, {"billed_charge": 0.69, "npi": [1194763045]}, {"billed_charge": 1.9071, "npi": [1194763045]}, {"billed_charge": 12.65, "npi": [1194763045]}, {"billed_charge": 1.425, "npi": [1194763045]}, {"billed_charge": 40.575, "npi": [1194763045]}, {"billed_charge": 10.05, "npi": [1194763045]}, {"billed_charge": 0.765, "npi": [1194763045]}, {"billed_charge": 0.055, "npi": [1194763045]}, {"billed_charge": 1.1165, "npi": [1194763045]}, {"billed_charge": 5.5, "npi": [1194763045]}, {"billed_charge": 24.6833, "npi": [1194763045]}, {"billed_charge": 13.65, "npi": [1194763045]}, {"billed_charge": 1.66, "npi": [1194763045]}, {"billed_charge": 0.465, "npi": [1194763045]}, {"billed_charge": 0.5, "npi": [1194763045]}, {"billed_charge": 0.1, "npi": [1194763045]}, {"billed_charge": 1.9, "npi": [1194763045]}, {"billed_charge": 14.0, "npi": [1194763045]}, {"billed_charge": 3.48, "npi": [1194763045]}, {"billed_charge": 18.2325, "npi": [1194763045]}, {"billed_charge": 16.525, "npi": [1194763045]}, {"billed_charge": 0.95, "npi": [1194763045]}, {"billed_charge": 0.05, "npi": [1194763045]}, {"billed_charge": 1.13, "npi": [1194763045]}, {"billed_charge": 0.3625, "npi": [1194763045]}, {"billed_charge": 14.2, "npi": [1194763045]}, {"billed_charge": 5.7751, "npi": [1194763045]}, {"billed_charge": 8.39, "npi": [1194763045]}, {"billed_charge": 1.7, "npi": [1194763045]}, {"billed_charge": 1.0, "npi": [1194763045]}, {"billed_charge": 2.25, "npi": [1194763045]}, {"billed_charge": 1.1733, "npi": [1194763045]}, {"billed_charge": 0.2, "npi": [1194763045]}, {"billed_charge": 1.57, "npi": [1194763045]}, {"billed_charge": 4.625, "npi": [1194763045]}, {"billed_charge": 62.35, "npi": [1194763045]}, {"billed_charge": 3.34, "npi": [1194763045]}, {"billed_charge": 1.3, "npi": [1194763045]}, {"billed_charge": 39.3, "npi": [1194763045]}]}, {"allowed_amount": 0.41, "billing_code_modifier": ["JZ"], "providers": [{"billed_charge": 9.5, "npi": [1194763045]}, {"billed_charge": 14.5, "npi": [1194763045]}]}, {"allowed_amount": 0.47, "billing_code_modifier": ["JZ"], "providers": [{"billed_charge": 9.5, "npi": [1194763045]}, {"billed_charge": 10.775, "npi": [1194763045]}, {"billed_charge": 14.5, "npi": [1194763045]}]}, {"allowed_amount": 0.46, "billing_code_modifier": ["JZ"], "providers": [{"billed_charge": 14.5, "npi": [1194763045]}]}, {"allowed_amount": 0.4667, "billing_code_modifier": ["JZ"], "providers": [{"billed_charge": 14.5, "npi": [1194763045]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["JZ"], "providers": [{"billed_charge": 23.9, "npi": [1194763045]}, {"billed_charge": 1.542, "npi": [1194763045]}, {"billed_charge": 1.7208, "npi": [1194763045]}]}, {"allowed_amount": 71.66, "billing_code_modifier": ["JZ"], "providers": [{"billed_charge": 168.25, "npi": [1194763045]}]}]}]}, {"name": "Emergency Room - General", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0450", "description": "Emergency Room", "allowed_amounts": [{"tin": {"type": "ein", "value": "344428256"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 366.2, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 1743.0, "npi": [1407854771]}, {"billed_charge": 1835.0, "npi": [1407854771]}]}, {"allowed_amount": 207.8, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 1117.0, "npi": [1407854771]}]}, {"allowed_amount": 810.85, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 3513.0, "npi": [1407854771]}]}, {"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 3699.0, "npi": [1407854771]}, {"billed_charge": 3123.0, "npi": [1407854771]}, {"billed_charge": 16812.0, "npi": [1407854771]}, {"billed_charge": 3513.0, "npi": [1407854771]}, {"billed_charge": 2966.0, "npi": [1407854771]}, {"billed_charge": 8925.0, "npi": [1407854771]}]}, {"allowed_amount": 207.8, "billing_code_modifier": [""], "providers": [{"billed_charge": 1117.0, "npi": [1407854771]}]}, {"allowed_amount": 194.58, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 1743.0, "npi": [1407854771]}]}, {"allowed_amount": 366.2, "billing_code_modifier": [""], "providers": [{"billed_charge": 1743.0, "npi": [1407854771]}]}, {"allowed_amount": 1117.91, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 8925.0, "npi": [1407854771]}]}, {"allowed_amount": 209.44, "billing_code_modifier": [""], "providers": [{"billed_charge": 1061.0, "npi": [1407854771]}]}, {"allowed_amount": 564.7, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 3123.0, "npi": [1407854771]}]}, {"allowed_amount": 369.43, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 1835.0, "npi": [1407854771]}]}, {"allowed_amount": 369.43, "billing_code_modifier": [""], "providers": [{"billed_charge": 1835.0, "npi": [1407854771]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 3699.0, "npi": [1407854771]}, {"billed_charge": 8925.0, "npi": [1407854771]}]}, {"allowed_amount": 805.98, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 3699.0, "npi": [1407854771]}]}, {"allowed_amount": 563.16, "billing_code_modifier": [""], "providers": [{"billed_charge": 2966.0, "npi": [1407854771]}]}, {"allowed_amount": 3501.76, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 3123.0, "npi": [1407854771]}, {"billed_charge": 3513.0, "npi": [1407854771]}, {"billed_charge": 2966.0, "npi": [1407854771]}]}, {"allowed_amount": 3539.75, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 3699.0, "npi": [1407854771]}]}, {"allowed_amount": 563.16, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 2966.0, "npi": [1407854771]}]}, {"allowed_amount": 11075.02, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 8925.0, "npi": [1407854771]}]}]}]}, {"name": "Emergency Room - General", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0450", "description": "Emergency Room", "allowed_amounts": [{"tin": {"type": "ein", "value": "264827222"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 202.37, "billing_code_modifier": [""], "providers": [{"billed_charge": 680.0, "npi": [1609189604]}]}, {"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 2796.0, "npi": [1609189604]}, {"billed_charge": 225.0, "npi": [1609189604]}, {"billed_charge": 218.0, "npi": [1609189604]}, {"billed_charge": 3766.0, "npi": [1609189604]}, {"billed_charge": 216.0, "npi": [1609189604]}]}, {"allowed_amount": 359.79, "billing_code_modifier": [""], "providers": [{"billed_charge": 1134.0, "npi": [1609189604]}]}, {"allowed_amount": 795.72, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 2796.0, "npi": [1609189604]}]}, {"allowed_amount": 767.3, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 2688.0, "npi": [1609189604]}]}, {"allowed_amount": 532.91, "billing_code_modifier": [""], "providers": [{"billed_charge": 1711.0, "npi": [1609189604]}]}, {"allowed_amount": 784.92, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 2796.0, "npi": [1609189604]}]}, {"allowed_amount": 3447.28, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 2796.0, "npi": [1609189604]}]}, {"allowed_amount": 359.37, "billing_code_modifier": [""], "providers": [{"billed_charge": 1134.0, "npi": [1609189604]}]}, {"allowed_amount": 532.91, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 1711.0, "npi": [1609189604]}]}, {"allowed_amount": 111.15, "billing_code_modifier": [""], "providers": [{"billed_charge": 416.0, "npi": [1609189604]}]}, {"allowed_amount": 404.56, "billing_code_modifier": ["RT"], "providers": [{"billed_charge": 1071.0, "npi": [1609189604]}]}, {"allowed_amount": 3313.64, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 2688.0, "npi": [1609189604]}]}, {"allowed_amount": 346.53, "billing_code_modifier": [""], "providers": [{"billed_charge": 1090.0, "npi": [1609189604]}]}, {"allowed_amount": 549.96, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 1779.0, "npi": [1609189604]}]}, {"allowed_amount": 784.92, "billing_code_modifier": [""], "providers": [{"billed_charge": 2796.0, "npi": [1609189604]}]}, {"allowed_amount": 549.96, "billing_code_modifier": [""], "providers": [{"billed_charge": 1779.0, "npi": [1609189604]}]}]}]}, {"name": "Laboratory - General", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0300", "description": "Laboratory", "allowed_amounts": [{"tin": {"type": "ein", "value": "340714456"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 1081.0, "npi": [1790837235]}, {"billed_charge": 133.0, "npi": [1790837235]}, {"billed_charge": 146.1667, "npi": [1790837235]}, {"billed_charge": 612.0, "npi": [1790837235]}, {"billed_charge": 18.0, "npi": [1790837235]}, {"billed_charge": 40.0, "npi": [1790837235]}, {"billed_charge": 86.5, "npi": [1790837235]}, {"billed_charge": 140.2, "npi": [1790837235]}]}]}]}, {"name": "Laboratory - Hematology", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0305", "description": "Laboratory", "allowed_amounts": [{"tin": {"type": "ein", "value": "314446959"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 69.0, "npi": [1710913462]}, {"billed_charge": 35.0, "npi": [1710913462]}, {"billed_charge": 219.0, "npi": [1710913462]}, {"billed_charge": 110.0, "npi": [1710913462]}, {"billed_charge": 65.6, "npi": [1710913462]}, {"billed_charge": 10.0, "npi": [1710913462]}, {"billed_charge": 32.0, "npi": [1710913462]}, {"billed_charge": 35.2222, "npi": [1710913462]}, {"billed_charge": 44.0, "npi": [1710913462]}]}, {"allowed_amount": 10.49, "billing_code_modifier": [""], "providers": [{"billed_charge": 35.0, "npi": [1710913462]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["XU"], "providers": [{"billed_charge": 10.0, "npi": [1710913462]}]}]}]}, {"name": "RADIOLOGIC EXAM CHEST 2 VIEWS", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "71046", "description": "RADIOLOGIC EXAM CHEST 2 VIEWS", "allowed_amounts": [{"tin": {"type": "ein", "value": "310745303"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 9.81, "billing_code_modifier": ["2677"], "providers": [{"billed_charge": 196.0, "npi": [1669408159]}]}, {"allowed_amount": 9.84, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 216.0, "npi": [1669408159]}]}, {"allowed_amount": 9.81, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 196.0, "npi": [1669408159]}, {"billed_charge": 216.0, "npi": [1669408159]}]}, {"allowed_amount": 9.81, "billing_code_modifier": ["26XP"], "providers": [{"billed_charge": 196.0, "npi": [1669408159]}]}]}]}, {"name": "Pharmacy - Extension of 25X - Drug Requiring Detailed Coding", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0636", "description": "Pharmacy - Extension of 25x", "allowed_amounts": [{"tin": {"type": "ein", "value": "461393755"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 6.05, "npi": [1457243586]}, {"billed_charge": 0.92, "npi": [1457243586]}, {"billed_charge": 0.12, "npi": [1457243586]}, {"billed_charge": 138.94, "npi": [1457243586]}, {"billed_charge": 0.05, "npi": [1457243586]}, {"billed_charge": 32.63, "npi": [1457243586]}, {"billed_charge": 0.1, "npi": [1457243586]}, {"billed_charge": 0.35, "npi": [1457243586]}, {"billed_charge": 2.1, "npi": [1457243586]}, {"billed_charge": 1.54, "npi": [1457243586]}, {"billed_charge": 4.19, "npi": [1457243586]}, {"billed_charge": 34.35, "npi": [1457243586]}, {"billed_charge": 0.18, "npi": [1457243586]}, {"billed_charge": 60.25, "npi": [1457243586]}, {"billed_charge": 1.6, "npi": [1457243586]}, {"billed_charge": 3.35, "npi": [1457243586]}]}, {"allowed_amount": 41.9692, "billing_code_modifier": [""], "providers": [{"billed_charge": 71.9, "npi": [1457243586]}]}, {"allowed_amount": 41.9692, "billing_code_modifier": ["JW"], "providers": [{"billed_charge": 71.9, "npi": [1457243586]}]}, {"allowed_amount": 0.46, "billing_code_modifier": ["JZ"], "providers": [{"billed_charge": 11.9, "npi": [1457243586]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["JZ"], "providers": [{"billed_charge": 5.55, "npi": [1457243586]}, {"billed_charge": 128.55, "npi": [1457243586]}, {"billed_charge": 104.5, "npi": [1457243586]}, {"billed_charge": 0.26, "npi": [1457243586]}]}]}]}, {"name": "Laboratory - Bacteriology & Microbiology", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0306", "description": "Laboratory", "allowed_amounts": [{"tin": {"type": "ein", "value": "340714458"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 192.55, "billing_code_modifier": [""], "providers": [{"billed_charge": 925.0, "npi": [1942248737]}]}, {"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 71.0, "npi": [1942248737]}, {"billed_charge": 228.0, "npi": [1942248737]}, {"billed_charge": 56.0, "npi": [1942248737]}, {"billed_charge": 925.0, "npi": [1942248737]}, {"billed_charge": 187.0, "npi": [1942248737]}, {"billed_charge": 29.0, "npi": [1942248737]}, {"billed_charge": 277.0, "npi": [1942248737]}, {"billed_charge": 147.5, "npi": [1942248737]}, {"billed_charge": 65.0, "npi": [1942248737]}, {"billed_charge": 302.25, "npi": [1942248737]}, {"billed_charge": 60.0, "npi": [1942248737]}, {"billed_charge": 111.0, "npi": [1942248737]}, {"billed_charge": 469.6667, "npi": [1942248737]}, {"billed_charge": 1071.25, "npi": [1942248737]}, {"billed_charge": 355.6667, "npi": [1942248737]}, {"billed_charge": 242.0, "npi": [1942248737]}, {"billed_charge": 832.0, "npi": [1942248737]}, {"billed_charge": 59.0, "npi": [1942248737]}, {"billed_charge": 484.0, "npi": [1942248737]}, {"billed_charge": 90.1818, "npi": [1942248737]}, {"billed_charge": 53.0, "npi": [1942248737]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["59"], "providers": [{"billed_charge": 242.0, "npi": [1942248737]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["91"], "providers": [{"billed_charge": 71.0, "npi": [1942248737]}]}]}]}, {"name": "Pulmonary Function - General", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0460", "description": "Pulmonary Function", "allowed_amounts": [{"tin": {"type": "ein", "value": "340714593"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 338.25, "npi": [1235183542]}, {"billed_charge": 322.0, "npi": [1235183542]}, {"billed_charge": 348.0, "npi": [1235183542]}]}]}]}, {"name": "Laboratory - Urology", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0307", "description": "Laboratory", "allowed_amounts": [{"tin": {"type": "ein", "value": "344428256"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 96.0, "npi": [1407854771]}, {"billed_charge": 58.0, "npi": [1407854771]}, {"billed_charge": 183.0, "npi": [1407854771]}, {"billed_charge": 91.0, "npi": [1407854771]}, {"billed_charge": 55.0, "npi": [1407854771]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["QW"], "providers": [{"billed_charge": 58.0, "npi": [1407854771]}, {"billed_charge": 55.0, "npi": [1407854771]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["59"], "providers": [{"billed_charge": 58.0, "npi": [1407854771]}, {"billed_charge": 91.0, "npi": [1407854771]}]}]}]}, {"name": "Laboratory - General", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0300", "description": "Laboratory", "allowed_amounts": [{"tin": {"type": "ein", "value": "314394942"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 178.72, "billing_code_modifier": [""], "providers": [{"billed_charge": 133.0, "npi": [1255377149]}]}, {"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 40.0, "npi": [1255377149]}, {"billed_charge": 20.0, "npi": [1255377149]}, {"billed_charge": 86.5, "npi": [1255377149]}, {"billed_charge": 46.6, "npi": [1255377149]}, {"billed_charge": 133.0, "npi": [1255377149]}]}]}]}, {"name": "CT Scan - Body Scan", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0352", "description": "CT Scan", "allowed_amounts": [{"tin": {"type": "ein", "value": "340714458"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 231.18, "billing_code_modifier": [""], "providers": [{"billed_charge": 1228.0, "npi": [1942248737]}]}, {"allowed_amount": 222.79, "billing_code_modifier": [""], "providers": [{"billed_charge": 1135.0, "npi": [1942248737]}]}, {"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 981.0, "npi": [1942248737]}, {"billed_charge": 2375.0, "npi": [1942248737]}, {"billed_charge": 1668.0, "npi": [1942248737]}, {"billed_charge": 679.0, "npi": [1942248737]}, {"billed_charge": 2464.0, "npi": [1942248737]}, {"billed_charge": 1513.0, "npi": [1942248737]}, {"billed_charge": 1228.0, "npi": [1942248737]}, {"billed_charge": 734.0, "npi": [1942248737]}]}, {"allowed_amount": 459.82, "billing_code_modifier": [""], "providers": [{"billed_charge": 2464.0, "npi": [1942248737]}]}, {"allowed_amount": 446.94, "billing_code_modifier": [""], "providers": [{"billed_charge": 2375.0, "npi": [1942248737]}]}]}]}, {"name": "Emergency Room - General", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0450", "description": "Emergency Room", "allowed_amounts": [{"tin": {"type": "ein", "value": "340714458"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 202.37, "billing_code_modifier": [""], "providers": [{"billed_charge": 1093.0, "npi": [1942248737]}]}, {"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 5814.0, "npi": [1942248737]}, {"billed_charge": 5073.0, "npi": [1942248737]}, {"billed_charge": 4230.0, "npi": [1942248737]}, {"billed_charge": 413.0, "npi": [1942248737]}, {"billed_charge": 3672.0, "npi": [1942248737]}]}, {"allowed_amount": 359.79, "billing_code_modifier": [""], "providers": [{"billed_charge": 1911.0, "npi": [1942248737]}]}, {"allowed_amount": 767.3, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 3672.0, "npi": [1942248737]}]}, {"allowed_amount": 111.15, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 608.0, "npi": [1942248737]}]}, {"allowed_amount": 346.53, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 1632.0, "npi": [1942248737]}]}, {"allowed_amount": 198.19, "billing_code_modifier": [""], "providers": [{"billed_charge": 935.0, "npi": [1942248737]}]}, {"allowed_amount": 300.21, "billing_code_modifier": ["LT"], "providers": [{"billed_charge": 971.0, "npi": [1942248737]}]}, {"allowed_amount": 532.91, "billing_code_modifier": [""], "providers": [{"billed_charge": 2533.0, "npi": [1942248737]}]}, {"allowed_amount": 784.92, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 4230.0, "npi": [1942248737]}]}, {"allowed_amount": 325.12, "billing_code_modifier": ["RT"], "providers": [{"billed_charge": 1103.0, "npi": [1942248737]}]}, {"allowed_amount": 3447.28, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 2938.0, "npi": [1942248737]}, {"billed_charge": 5814.0, "npi": [1942248737]}]}, {"allowed_amount": 532.91, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 2533.0, "npi": [1942248737]}]}, {"allowed_amount": 111.15, "billing_code_modifier": [""], "providers": [{"billed_charge": 608.0, "npi": [1942248737]}]}, {"allowed_amount": 3313.64, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 3672.0, "npi": [1942248737]}]}, {"allowed_amount": 767.3, "billing_code_modifier": [""], "providers": [{"billed_charge": 3672.0, "npi": [1942248737]}]}, {"allowed_amount": 346.53, "billing_code_modifier": [""], "providers": [{"billed_charge": 1632.0, "npi": [1942248737]}]}, {"allowed_amount": 549.96, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 2938.0, "npi": [1942248737]}]}, {"allowed_amount": 784.92, "billing_code_modifier": [""], "providers": [{"billed_charge": 4230.0, "npi": [1942248737]}]}, {"allowed_amount": 110.2, "billing_code_modifier": [""], "providers": [{"billed_charge": 508.0, "npi": [1942248737]}]}]}]}, {"name": "Laboratory - Hematology", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0305", "description": "Laboratory", "allowed_amounts": [{"tin": {"type": "ein", "value": "314391798"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 85.0, "npi": [1346247350]}, {"billed_charge": 60.0, "npi": [1346247350]}, {"billed_charge": 44.0, "npi": [1346247350]}, {"billed_charge": 37.0, "npi": [1346247350]}, {"billed_charge": 149.0, "npi": [1346247350]}, {"billed_charge": 61.0, "npi": [1346247350]}, {"billed_charge": 51.0, "npi": [1346247350]}, {"billed_charge": 60.3333, "npi": [1346247350]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["XU"], "providers": [{"billed_charge": 26.0, "npi": [1346247350]}]}]}]}, {"name": "CT Scan - Body Scan", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0352", "description": "CT Scan", "allowed_amounts": [{"tin": {"type": "ein", "value": "341105619"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 593.36, "billing_code_modifier": [""], "providers": [{"billed_charge": 7592.0, "npi": [1811939887]}]}, {"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 3237.0, "npi": [1811939887]}, {"billed_charge": 3817.0, "npi": [1811939887]}, {"billed_charge": 2108.0, "npi": [1811939887]}, {"billed_charge": 1814.5, "npi": [1811939887]}, {"billed_charge": 5704.5, "npi": [1811939887]}, {"billed_charge": 2213.0, "npi": [1811939887]}, {"billed_charge": 3658.3333, "npi": [1811939887]}, {"billed_charge": 2253.0, "npi": [1811939887]}, {"billed_charge": 3272.5, "npi": [1811939887]}, {"billed_charge": 1910.0, "npi": [1811939887]}, {"billed_charge": 2518.0, "npi": [1811939887]}, {"billed_charge": 4975.0, "npi": [1811939887]}, {"billed_charge": 4439.6667, "npi": [1811939887]}, {"billed_charge": 2598.0, "npi": [1811939887]}, {"billed_charge": 1905.0, "npi": [1811939887]}]}, {"allowed_amount": 242.27, "billing_code_modifier": [""], "providers": [{"billed_charge": 3237.0, "npi": [1811939887]}, {"billed_charge": 2213.0, "npi": [1811939887]}]}, {"allowed_amount": 469.48, "billing_code_modifier": [""], "providers": [{"billed_charge": 7592.0, "npi": [1811939887]}, {"billed_charge": 7230.0, "npi": [1811939887]}]}, {"allowed_amount": 481.87, "billing_code_modifier": [""], "providers": [{"billed_charge": 2518.0, "npi": [1811939887]}, {"billed_charge": 7592.0, "npi": [1811939887]}]}, {"allowed_amount": 572.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 7230.0, "npi": [1811939887]}]}, {"allowed_amount": 234.02, "billing_code_modifier": [""], "providers": [{"billed_charge": 1814.0, "npi": [1811939887]}, {"billed_charge": 2213.0, "npi": [1811939887]}, {"billed_charge": 3083.0, "npi": [1811939887]}]}, {"allowed_amount": 144.41, "billing_code_modifier": ["LT"], "providers": [{"billed_charge": 2728.0, "npi": [1811939887]}]}]}]}, {"name": "CT LUMBAR SPINE W/O CONTRAST MATERIAL", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "72131", "description": "CT LUMBAR SPINE W/O CONTRAST MATERIAL", "allowed_amounts": [{"tin": {"type": "ein", "value": "310745303"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 42.07, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 681.0, "npi": [1669408159]}, {"billed_charge": 715.0, "npi": [1669408159]}]}, {"allowed_amount": 42.08, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 715.0, "npi": [1669408159]}]}, {"allowed_amount": 44.29, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 681.0, "npi": [1669408159]}, {"billed_charge": 715.0, "npi": [1669408159]}]}, {"allowed_amount": 45.65, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 715.0, "npi": [1669408159]}]}, {"allowed_amount": 43.37, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 715.0, "npi": [1669408159]}]}, {"allowed_amount": 41.82, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 715.0, "npi": [1669408159]}]}]}]}, {"name": "RADIOLOGIC EXAM CHEST SINGLE VIEW", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "71045", "description": "RADIOLOGIC EXAM CHEST SINGLE VIEW", "allowed_amounts": [{"tin": {"type": "ein", "value": "310983140"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 8.22, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 41.0, "npi": [1093718496]}, {"billed_charge": 45.0, "npi": [1093718496]}, {"billed_charge": 39.0, "npi": [1093718496]}]}, {"allowed_amount": 8.22, "billing_code_modifier": ["2676"], "providers": [{"billed_charge": 41.0, "npi": [1093718496]}]}, {"allowed_amount": 8.22, "billing_code_modifier": ["2677"], "providers": [{"billed_charge": 41.0, "npi": [1093718496]}]}]}]}, {"name": "ALCOHOL  AND OR OTH DRUG TREATMENT PROGRAM PER DIEM", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "H2036", "description": "ALCOHOL  AND OR OTH DRUG TREATMENT PROGRAM PER DIEM", "allowed_amounts": [{"tin": {"type": "ein", "value": "813606655"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 1483.5, "billing_code_modifier": [""], "providers": [{"billed_charge": 4945.0, "npi": [1457755811]}, {"billed_charge": 4945.0, "npi": [1740264720]}]}]}]}, {"name": "Laboratory - Bacteriology & Microbiology", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0306", "description": "Laboratory", "allowed_amounts": [{"tin": {"type": "ein", "value": "340714618"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 469.6667, "npi": [1215989611]}, {"billed_charge": 56.0, "npi": [1215989611]}, {"billed_charge": 59.0, "npi": [1215989611]}, {"billed_charge": 29.0, "npi": [1215989611]}, {"billed_charge": 228.0, "npi": [1215989611]}, {"billed_charge": 60.0, "npi": [1215989611]}, {"billed_charge": 484.0, "npi": [1215989611]}, {"billed_charge": 114.2, "npi": [1215989611]}, {"billed_charge": 151.8667, "npi": [1215989611]}, {"billed_charge": 136.4, "npi": [1215989611]}, {"billed_charge": 925.0, "npi": [1215989611]}, {"billed_charge": 242.0, "npi": [1215989611]}, {"billed_charge": 353.0, "npi": [1215989611]}, {"billed_charge": 71.0, "npi": [1215989611]}, {"billed_charge": 105.0, "npi": [1215989611]}, {"billed_charge": 111.0, "npi": [1215989611]}, {"billed_charge": 65.0, "npi": [1215989611]}, {"billed_charge": 67.0, "npi": [1215989611]}]}, {"allowed_amount": 199.68, "billing_code_modifier": [""], "providers": [{"billed_charge": 925.0, "npi": [1215989611]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["59"], "providers": [{"billed_charge": 242.0, "npi": [1215989611]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["91"], "providers": [{"billed_charge": 56.0, "npi": [1215989611]}]}]}]}, {"name": "IV Therapy -General", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0260", "description": "IV Therapy", "allowed_amounts": [{"tin": {"type": "ein", "value": "340714538"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 482.3333, "npi": [1356366991]}, {"billed_charge": 382.3846, "npi": [1356366991]}, {"billed_charge": 337.0, "npi": [1356366991]}, {"billed_charge": 280.0, "npi": [1356366991]}, {"billed_charge": 284.125, "npi": [1356366991]}]}, {"allowed_amount": 59.68, "billing_code_modifier": ["XU"], "providers": [{"billed_charge": 301.0, "npi": [1356366991]}, {"billed_charge": 362.0, "npi": [1356366991]}, {"billed_charge": 200.0, "npi": [1356366991]}]}, {"allowed_amount": 94.89, "billing_code_modifier": ["XU"], "providers": [{"billed_charge": 379.0, "npi": [1356366991]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["XU"], "providers": [{"billed_charge": 482.0, "npi": [1356366991]}, {"billed_charge": 580.0, "npi": [1356366991]}]}, {"allowed_amount": 61.73, "billing_code_modifier": ["XU"], "providers": [{"billed_charge": 241.0, "npi": [1356366991]}, {"billed_charge": 362.0, "npi": [1356366991]}]}, {"allowed_amount": 280.35, "billing_code_modifier": [""], "providers": [{"billed_charge": 536.0, "npi": [1356366991]}]}, {"allowed_amount": 272.54, "billing_code_modifier": ["XU"], "providers": [{"billed_charge": 446.0, "npi": [1356366991]}, {"billed_charge": 902.0, "npi": [1356366991]}, {"billed_charge": 536.0, "npi": [1356366991]}]}, {"allowed_amount": 280.35, "billing_code_modifier": ["XU"], "providers": [{"billed_charge": 1085.0, "npi": [1356366991]}, {"billed_charge": 536.0, "npi": [1356366991]}]}, {"allowed_amount": 61.73, "billing_code_modifier": [""], "providers": [{"billed_charge": 241.0, "npi": [1356366991]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["59"], "providers": [{"billed_charge": 362.0, "npi": [1356366991]}, {"billed_charge": 580.0, "npi": [1356366991]}, {"billed_charge": 1085.0, "npi": [1356366991]}, {"billed_charge": 337.0, "npi": [1356366991]}]}, {"allowed_amount": 61.725, "billing_code_modifier": ["XU"], "providers": [{"billed_charge": 241.0, "npi": [1356366991]}, {"billed_charge": 362.0, "npi": [1356366991]}]}, {"allowed_amount": 61.7267, "billing_code_modifier": ["XU"], "providers": [{"billed_charge": 362.0, "npi": [1356366991]}]}]}]}, {"name": "Treatment or Observation Room - Treatment Room", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0761", "description": "Specialty Services", "allowed_amounts": [{"tin": {"type": "ein", "value": "344428256"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 63.38, "billing_code_modifier": ["59"], "providers": [{"billed_charge": 394.0, "npi": [1407854771]}]}, {"allowed_amount": 198.44, "billing_code_modifier": [""], "providers": [{"billed_charge": 147.0, "npi": [1407854771]}]}, {"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 374.0, "npi": [1407854771]}, {"billed_charge": 481.0, "npi": [1407854771]}, {"billed_charge": 558.3333, "npi": [1407854771]}, {"billed_charge": 622.0, "npi": [1407854771]}, {"billed_charge": 394.0, "npi": [1407854771]}, {"billed_charge": 292.0, "npi": [1407854771]}, {"billed_charge": 1180.0, "npi": [1407854771]}, {"billed_charge": 354.6, "npi": [1407854771]}, {"billed_charge": 391.8571, "npi": [1407854771]}, {"billed_charge": 1121.0, "npi": [1407854771]}, {"billed_charge": 341.6667, "npi": [1407854771]}, {"billed_charge": 3008.0, "npi": [1407854771]}, {"billed_charge": 349.75, "npi": [1407854771]}, {"billed_charge": 457.0, "npi": [1407854771]}, {"billed_charge": 277.0, "npi": [1407854771]}]}, {"allowed_amount": 278.64, "billing_code_modifier": ["59"], "providers": [{"billed_charge": 1121.0, "npi": [1407854771]}]}, {"allowed_amount": 287.87, "billing_code_modifier": ["59"], "providers": [{"billed_charge": 1180.0, "npi": [1407854771]}]}, {"allowed_amount": 63.38, "billing_code_modifier": [""], "providers": [{"billed_charge": 394.0, "npi": [1407854771]}]}, {"allowed_amount": 61.03, "billing_code_modifier": ["59"], "providers": [{"billed_charge": 374.0, "npi": [1407854771]}]}, {"allowed_amount": 287.87, "billing_code_modifier": [""], "providers": [{"billed_charge": 1180.0, "npi": [1407854771]}]}, {"allowed_amount": 63.3767, "billing_code_modifier": ["59"], "providers": [{"billed_charge": 394.0, "npi": [1407854771]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["59"], "providers": [{"billed_charge": 374.0, "npi": [1407854771]}, {"billed_charge": 481.0, "npi": [1407854771]}, {"billed_charge": 394.0, "npi": [1407854771]}, {"billed_charge": 292.0, "npi": [1407854771]}, {"billed_charge": 1180.0, "npi": [1407854771]}, {"billed_charge": 1121.0, "npi": [1407854771]}, {"billed_charge": 457.0, "npi": [1407854771]}, {"billed_charge": 277.0, "npi": [1407854771]}]}, {"allowed_amount": 147.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 147.0, "npi": [1407854771]}]}, {"allowed_amount": 278.64, "billing_code_modifier": [""], "providers": [{"billed_charge": 1121.0, "npi": [1407854771]}]}, {"allowed_amount": 61.03, "billing_code_modifier": [""], "providers": [{"billed_charge": 374.0, "npi": [1407854771]}]}, {"allowed_amount": 61.025, "billing_code_modifier": [""], "providers": [{"billed_charge": 374.0, "npi": [1407854771]}]}]}]}, {"name": "Radiology - Diagnostic - Chest X-ray", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0324", "description": "Radiology - Diagnostic", "allowed_amounts": [{"tin": {"type": "ein", "value": "341105619"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 356.0, "npi": [1811939887]}, {"billed_charge": 711.0, "npi": [1811939887]}, {"billed_charge": 540.0, "npi": [1811939887]}, {"billed_charge": 677.0, "npi": [1811939887]}, {"billed_charge": 533.5, "npi": [1811939887]}, {"billed_charge": 339.0, "npi": [1811939887]}, {"billed_charge": 349.625, "npi": [1811939887]}]}, {"allowed_amount": 115.75, "billing_code_modifier": [""], "providers": [{"billed_charge": 356.0, "npi": [1811939887]}, {"billed_charge": 711.0, "npi": [1811939887]}, {"billed_charge": 540.0, "npi": [1811939887]}, {"billed_charge": 677.0, "npi": [1811939887]}, {"billed_charge": 339.0, "npi": [1811939887]}]}, {"allowed_amount": 120.19, "billing_code_modifier": [""], "providers": [{"billed_charge": 356.0, "npi": [1811939887]}, {"billed_charge": 711.0, "npi": [1811939887]}]}]}]}, {"name": "Pulmonary Function - General", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0460", "description": "Pulmonary Function", "allowed_amounts": [{"tin": {"type": "ein", "value": "340714585"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 491.82, "billing_code_modifier": [""], "providers": [{"billed_charge": 1432.0, "npi": [1679525919]}]}, {"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 348.0, "npi": [1679525919]}, {"billed_charge": 361.7143, "npi": [1679525919]}, {"billed_charge": 473.8, "npi": [1679525919]}, {"billed_charge": 593.0, "npi": [1679525919]}, {"billed_charge": 394.5, "npi": [1679525919]}, {"billed_charge": 324.8889, "npi": [1679525919]}, {"billed_charge": 605.0, "npi": [1679525919]}, {"billed_charge": 322.0, "npi": [1679525919]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["59"], "providers": [{"billed_charge": 322.0, "npi": [1679525919]}]}, {"allowed_amount": 284.59, "billing_code_modifier": [""], "providers": [{"billed_charge": 720.0, "npi": [1679525919]}]}]}]}, {"name": "Laboratory - Urology", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0307", "description": "Laboratory", "allowed_amounts": [{"tin": {"type": "ein", "value": "340714458"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 56.0, "npi": [1942248737]}, {"billed_charge": 16.0, "npi": [1942248737]}, {"billed_charge": 34.3333, "npi": [1942248737]}, {"billed_charge": 59.0, "npi": [1942248737]}, {"billed_charge": 21.0, "npi": [1942248737]}, {"billed_charge": 38.5, "npi": [1942248737]}, {"billed_charge": 39.5, "npi": [1942248737]}, {"billed_charge": 22.0, "npi": [1942248737]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["59"], "providers": [{"billed_charge": 21.0, "npi": [1942248737]}, {"billed_charge": 22.0, "npi": [1942248737]}]}]}]}, {"name": "IV Therapy -General", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0260", "description": "IV Therapy", "allowed_amounts": [{"tin": {"type": "ein", "value": "340827442"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 61.7267, "billing_code_modifier": [""], "providers": [{"billed_charge": 357.0, "npi": [1164481677]}]}, {"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 581.0, "npi": [1164481677]}, {"billed_charge": 331.0, "npi": [1164481677]}, {"billed_charge": 843.0, "npi": [1164481677]}, {"billed_charge": 345.0, "npi": [1164481677]}, {"billed_charge": 359.0, "npi": [1164481677]}, {"billed_charge": 811.0, "npi": [1164481677]}, {"billed_charge": 343.0, "npi": [1164481677]}, {"billed_charge": 487.0, "npi": [1164481677]}, {"billed_charge": 379.0, "npi": [1164481677]}]}, {"allowed_amount": 61.725, "billing_code_modifier": [""], "providers": [{"billed_charge": 506.0, "npi": [1164481677]}, {"billed_charge": 357.0, "npi": [1164481677]}]}, {"allowed_amount": 280.35, "billing_code_modifier": [""], "providers": [{"billed_charge": 394.0, "npi": [1164481677]}, {"billed_charge": 843.0, "npi": [1164481677]}, {"billed_charge": 920.0, "npi": [1164481677]}]}, {"allowed_amount": 280.35, "billing_code_modifier": ["59"], "providers": [{"billed_charge": 394.0, "npi": [1164481677]}, {"billed_charge": 843.0, "npi": [1164481677]}]}, {"allowed_amount": 263.68, "billing_code_modifier": [""], "providers": [{"billed_charge": 885.0, "npi": [1164481677]}]}, {"allowed_amount": 61.73, "billing_code_modifier": [""], "providers": [{"billed_charge": 506.0, "npi": [1164481677]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["59"], "providers": [{"billed_charge": 359.0, "npi": [1164481677]}, {"billed_charge": 225.0, "npi": [1164481677]}]}, {"allowed_amount": 94.89, "billing_code_modifier": [""], "providers": [{"billed_charge": 486.0, "npi": [1164481677]}]}, {"allowed_amount": 61.73, "billing_code_modifier": ["59"], "providers": [{"billed_charge": 357.0, "npi": [1164481677]}]}]}]}, {"name": "EKG/ECG (Electrocardiogram) - General", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0730", "description": "EKG/ECG (Electrocardiogram)", "allowed_amounts": [{"tin": {"type": "ein", "value": "340714538"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 320.0, "npi": [1356366991]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["59"], "providers": [{"billed_charge": 320.0, "npi": [1356366991]}]}]}]}, {"name": "Laboratory - Bacteriology & Microbiology", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0306", "description": "Laboratory", "allowed_amounts": [{"tin": {"type": "ein", "value": "344428218"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 366.7, "npi": [1801884655]}, {"billed_charge": 350.9, "npi": [1801884655]}, {"billed_charge": 90.4, "npi": [1801884655]}, {"billed_charge": 84.5, "npi": [1801884655]}, {"billed_charge": 80.9, "npi": [1801884655]}, {"billed_charge": 84.4, "npi": [1801884655]}, {"billed_charge": 84.3, "npi": [1801884655]}, {"billed_charge": 90.1, "npi": [1801884655]}, {"billed_charge": 86.5, "npi": [1801884655]}, {"billed_charge": 80.7, "npi": [1801884655]}, {"billed_charge": 103.2, "npi": [1801884655]}, {"billed_charge": 42.7, "npi": [1801884655]}, {"billed_charge": 58.2, "npi": [1801884655]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["QW"], "providers": [{"billed_charge": 172.7, "npi": [1801884655]}]}]}]}, {"name": "EMERGENCY DEPARTMENT VISIT MODERATE MDM", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "99284", "description": "EMERGENCY DEPARTMENT VISIT MODERATE MDM", "allowed_amounts": [{"tin": {"type": "ein", "value": "463160463"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 147.01, "billing_code_modifier": ["UD"], "providers": [{"billed_charge": 1186.31, "npi": [1154763944]}]}, {"allowed_amount": 138.14, "billing_code_modifier": ["UD"], "providers": [{"billed_charge": 1186.31, "npi": [1154763944]}, {"billed_charge": 1151.76, "npi": [1154763944]}]}, {"allowed_amount": 138.14, "billing_code_modifier": ["57"], "providers": [{"billed_charge": 1186.31, "npi": [1154763944]}]}, {"allowed_amount": 147.01, "billing_code_modifier": [""], "providers": [{"billed_charge": 1186.31, "npi": [1154763944]}]}, {"allowed_amount": 339.46, "billing_code_modifier": [""], "providers": [{"billed_charge": 1151.76, "npi": [1154763944]}]}, {"allowed_amount": 138.14, "billing_code_modifier": ["SA"], "providers": [{"billed_charge": 1186.31, "npi": [1154763944]}]}, {"allowed_amount": 138.14, "billing_code_modifier": [""], "providers": [{"billed_charge": 1186.31, "npi": [1154763944]}, {"billed_charge": 1151.76, "npi": [1154763944]}]}, {"allowed_amount": 339.46, "billing_code_modifier": ["UD"], "providers": [{"billed_charge": 1186.31, "npi": [1154763944]}, {"billed_charge": 1151.76, "npi": [1154763944]}]}, {"allowed_amount": 339.46, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 1151.76, "npi": [1154763944]}]}, {"allowed_amount": 138.14, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 1186.31, "npi": [1154763944]}, {"billed_charge": 1151.76, "npi": [1154763944]}]}, {"allowed_amount": 138.14, "billing_code_modifier": ["UD25"], "providers": [{"billed_charge": 1186.31, "npi": [1154763944]}]}]}]}, {"name": "Pharmacy - Extension of 25X - Drug Requiring Detailed Coding", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0636", "description": "Pharmacy - Extension of 25x", "allowed_amounts": [{"tin": {"type": "ein", "value": "341260978"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 3.98, "npi": [1841264868]}, {"billed_charge": 17.26, "npi": [1841264868]}, {"billed_charge": 6.91, "npi": [1841264868]}, {"billed_charge": 8.23, "npi": [1841264868]}, {"billed_charge": 14.79, "npi": [1841264868]}, {"billed_charge": 7.82, "npi": [1841264868]}, {"billed_charge": 0.1248, "npi": [1841264868]}, {"billed_charge": 2.675, "npi": [1841264868]}, {"billed_charge": 10.28, "npi": [1841264868]}, {"billed_charge": 0.8075, "npi": [1841264868]}, {"billed_charge": 9.86, "npi": [1841264868]}, {"billed_charge": 0.0404, "npi": [1841264868]}, {"billed_charge": 5.37, "npi": [1841264868]}, {"billed_charge": 3.23, "npi": [1841264868]}, {"billed_charge": 7.96, "npi": [1841264868]}]}, {"allowed_amount": 0.41, "billing_code_modifier": ["JZ"], "providers": [{"billed_charge": 3.23, "npi": [1841264868]}]}, {"allowed_amount": 0.47, "billing_code_modifier": ["JZ"], "providers": [{"billed_charge": 1.615, "npi": [1841264868]}]}, {"allowed_amount": 0.46, "billing_code_modifier": ["JZ"], "providers": [{"billed_charge": 3.23, "npi": [1841264868]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["JZ"], "providers": [{"billed_charge": 5.03, "npi": [1841264868]}, {"billed_charge": 0.8075, "npi": [1841264868]}]}]}]}, {"name": "Laboratory - Bacteriology & Microbiology", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0306", "description": "Laboratory", "allowed_amounts": [{"tin": {"type": "ein", "value": "314391798"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 94.0, "npi": [1346247350]}, {"billed_charge": 175.0, "npi": [1346247350]}, {"billed_charge": 55.0, "npi": [1346247350]}, {"billed_charge": 65.0, "npi": [1346247350]}, {"billed_charge": 101.0, "npi": [1346247350]}, {"billed_charge": 526.0, "npi": [1346247350]}, {"billed_charge": 47.0, "npi": [1346247350]}, {"billed_charge": 599.0, "npi": [1346247350]}, {"billed_charge": 227.0, "npi": [1346247350]}, {"billed_charge": 96.0, "npi": [1346247350]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["XU"], "providers": [{"billed_charge": 71.0, "npi": [1346247350]}]}]}]}, {"name": "Laboratory - General", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0300", "description": "Laboratory", "allowed_amounts": [{"tin": {"type": "ein", "value": "340714593"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 49.25, "npi": [1902858152]}, {"billed_charge": 64.0, "npi": [1598719346]}, {"billed_charge": 21.0, "npi": [1902858152]}, {"billed_charge": 51.375, "npi": [1598719346]}, {"billed_charge": 63.0, "npi": [1902858152]}, {"billed_charge": 58.0, "npi": [1235183542]}, {"billed_charge": 51.0, "npi": [1902858152]}, {"billed_charge": 64.0, "npi": [1235183542]}, {"billed_charge": 1055.0, "npi": [1598719346]}, {"billed_charge": 49.0, "npi": [1598719346]}, {"billed_charge": 58.0, "npi": [1902858152]}, {"billed_charge": 93.0, "npi": [1598719346]}, {"billed_charge": 59.4286, "npi": [1902858152]}, {"billed_charge": 52.6667, "npi": [1902858152]}, {"billed_charge": 64.0, "npi": [1902858152]}, {"billed_charge": 20.0, "npi": [1598719346]}, {"billed_charge": 52.0, "npi": [1235183542]}, {"billed_charge": 21.0, "npi": [1598719346]}, {"billed_charge": 110.6875, "npi": [1902858152]}, {"billed_charge": 63.0, "npi": [1235183542]}, {"billed_charge": 67.0, "npi": [1598719346]}, {"billed_charge": 63.0, "npi": [1598719346]}, {"billed_charge": 53.0, "npi": [1235183542]}, {"billed_charge": 58.0, "npi": [1598719346]}, {"billed_charge": 67.0, "npi": [1235183542]}, {"billed_charge": 21.0, "npi": [1235183542]}, {"billed_charge": 115.9375, "npi": [1902858152]}, {"billed_charge": 20.0, "npi": [1235183542]}, {"billed_charge": 54.0, "npi": [1235183542]}, {"billed_charge": 57.1111, "npi": [1235183542]}, {"billed_charge": 20.0, "npi": [1902858152]}, {"billed_charge": 67.0, "npi": [1902858152]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["91"], "providers": [{"billed_charge": 32.0, "npi": [1235183542]}, {"billed_charge": 30.0, "npi": [1235183542]}, {"billed_charge": 30.0, "npi": [1598719346]}, {"billed_charge": 32.0, "npi": [1598719346]}]}, {"allowed_amount": 13.08, "billing_code_modifier": [""], "providers": [{"billed_charge": 63.0, "npi": [1902858152]}]}]}]}, {"name": "Occupational Therapy - General", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0430", "description": "Occupational Therapy", "allowed_amounts": [{"tin": {"type": "ein", "value": "340714585"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": ["GO59"], "providers": [{"billed_charge": 254.0, "npi": [1679525919]}]}, {"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 247.6, "npi": [1679525919]}, {"billed_charge": 252.1, "npi": [1679525919]}, {"billed_charge": 272.0952, "npi": [1679525919]}, {"billed_charge": 274.0, "npi": [1679525919]}, {"billed_charge": 251.0, "npi": [1679525919]}, {"billed_charge": 254.0, "npi": [1679525919]}, {"billed_charge": 252.75, "npi": [1679525919]}, {"billed_charge": 222.0, "npi": [1679525919]}]}, {"allowed_amount": 30.27, "billing_code_modifier": ["GO"], "providers": [{"billed_charge": 258.0, "npi": [1679525919]}]}, {"allowed_amount": 28.66, "billing_code_modifier": ["GO"], "providers": [{"billed_charge": 239.0, "npi": [1679525919]}]}, {"allowed_amount": 33.1833, "billing_code_modifier": ["GO"], "providers": [{"billed_charge": 258.0, "npi": [1679525919]}]}, {"allowed_amount": 43.29, "billing_code_modifier": ["GO"], "providers": [{"billed_charge": 274.0, "npi": [1679525919]}]}, {"allowed_amount": 36.0267, "billing_code_modifier": ["GO"], "providers": [{"billed_charge": 274.0, "npi": [1679525919]}]}]}]}, {"name": "Laboratory - Hematology", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0305", "description": "Laboratory", "allowed_amounts": [{"tin": {"type": "ein", "value": "474442902"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 42.0, "npi": [1346607017]}, {"billed_charge": 30.0, "npi": [1346607017]}, {"billed_charge": 66.0, "npi": [1346607017]}, {"billed_charge": 43.2308, "npi": [1346607017]}, {"billed_charge": 70.0, "npi": [1346607017]}, {"billed_charge": 51.0, "npi": [1346607017]}, {"billed_charge": 45.0, "npi": [1346607017]}, {"billed_charge": 54.0, "npi": [1346607017]}, {"billed_charge": 46.2857, "npi": [1346607017]}]}]}]}, {"name": "Laboratory - Chemistry", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0301", "description": "Laboratory", "allowed_amounts": [{"tin": {"type": "ein", "value": "341425870"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 189.0, "npi": [1972689172]}, {"billed_charge": 71.0, "npi": [1972689172]}, {"billed_charge": 417.0, "npi": [1972689172]}, {"billed_charge": 316.0, "npi": [1972689172]}, {"billed_charge": 837.0, "npi": [1972689172]}, {"billed_charge": 152.0, "npi": [1972689172]}, {"billed_charge": 49.0, "npi": [1972689172]}, {"billed_charge": 128.9852, "npi": [1972689172]}, {"billed_charge": 103.0, "npi": [1972689172]}, {"billed_charge": 219.0, "npi": [1972689172]}, {"billed_charge": 805.0, "npi": [1972689172]}, {"billed_charge": 136.125, "npi": [1972689172]}, {"billed_charge": 59.0, "npi": [1972689172]}, {"billed_charge": 81.0, "npi": [1972689172]}, {"billed_charge": 153.0, "npi": [1972689172]}, {"billed_charge": 93.0, "npi": [1972689172]}, {"billed_charge": 120.0, "npi": [1972689172]}, {"billed_charge": 115.0, "npi": [1972689172]}, {"billed_charge": 179.0, "npi": [1972689172]}, {"billed_charge": 108.0, "npi": [1972689172]}, {"billed_charge": 77.0, "npi": [1972689172]}, {"billed_charge": 211.0, "npi": [1972689172]}, {"billed_charge": 151.4167, "npi": [1972689172]}, {"billed_charge": 175.0, "npi": [1972689172]}, {"billed_charge": 164.0, "npi": [1972689172]}, {"billed_charge": 172.0, "npi": [1972689172]}, {"billed_charge": 104.0, "npi": [1972689172]}, {"billed_charge": 116.5149, "npi": [1972689172]}, {"billed_charge": 101.0, "npi": [1972689172]}, {"billed_charge": 97.0, "npi": [1972689172]}, {"billed_charge": 264.0, "npi": [1972689172]}, {"billed_charge": 78.0, "npi": [1972689172]}, {"billed_charge": 109.175, "npi": [1972689172]}, {"billed_charge": 146.0, "npi": [1972689172]}, {"billed_charge": 329.0, "npi": [1972689172]}, {"billed_charge": 99.125, "npi": [1972689172]}, {"billed_charge": 158.0, "npi": [1972689172]}, {"billed_charge": 80.0, "npi": [1972689172]}, {"billed_charge": 209.5455, "npi": [1972689172]}, {"billed_charge": 434.0, "npi": [1972689172]}, {"billed_charge": 254.0, "npi": [1972689172]}, {"billed_charge": 275.0, "npi": [1972689172]}, {"billed_charge": 92.0, "npi": [1972689172]}, {"billed_charge": 121.9314, "npi": [1972689172]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["59"], "providers": [{"billed_charge": 108.0, "npi": [1972689172]}, {"billed_charge": 104.0, "npi": [1972689172]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["91"], "providers": [{"billed_charge": 179.0, "npi": [1972689172]}, {"billed_charge": 172.0, "npi": [1972689172]}]}, {"allowed_amount": 5.11, "billing_code_modifier": ["91"], "providers": [{"billed_charge": 60.0, "npi": [1972689172]}]}, {"allowed_amount": 5.11, "billing_code_modifier": ["59"], "providers": [{"billed_charge": 60.0, "npi": [1972689172]}]}, {"allowed_amount": 17.41, "billing_code_modifier": [""], "providers": [{"billed_charge": 191.0, "npi": [1972689172]}]}]}]}, {"name": "Pharmacy - General", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0250", "description": "Pharmacy (also see 063x, an extension of 025x)", "allowed_amounts": [{"tin": {"type": "ein", "value": "344430849"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 3.0, "npi": [1851338149]}, {"billed_charge": 11.5843, "npi": [1851338149]}, {"billed_charge": 0.6667, "npi": [1851338149]}, {"billed_charge": 0.5, "npi": [1851338149]}, {"billed_charge": 4.6667, "npi": [1851338149]}, {"billed_charge": 6.0, "npi": [1851338149]}, {"billed_charge": 0.7857, "npi": [1851338149]}, {"billed_charge": 1.75, "npi": [1851338149]}, {"billed_charge": 1.25, "npi": [1851338149]}, {"billed_charge": 2.0, "npi": [1851338149]}, {"billed_charge": 2.4, "npi": [1851338149]}, {"billed_charge": 7.4525, "npi": [1851338149]}, {"billed_charge": 17.5, "npi": [1851338149]}, {"billed_charge": 5.3049, "npi": [1851338149]}, {"billed_charge": 1.0, "npi": [1851338149]}]}]}]}, {"name": "Radiology - Diagnostic - Chest X-ray", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0324", "description": "Radiology - Diagnostic", "allowed_amounts": [{"tin": {"type": "ein", "value": "340714593"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 608.0, "npi": [1235183542]}, {"billed_charge": 592.6667, "npi": [1235183542]}, {"billed_charge": 608.0, "npi": [1902858152]}, {"billed_charge": 562.0, "npi": [1902858152]}, {"billed_charge": 608.0, "npi": [1598719346]}, {"billed_charge": 562.0, "npi": [1598719346]}, {"billed_charge": 562.0, "npi": [1235183542]}]}, {"allowed_amount": 114.69, "billing_code_modifier": [""], "providers": [{"billed_charge": 608.0, "npi": [1235183542]}, {"billed_charge": 608.0, "npi": [1902858152]}, {"billed_charge": 608.0, "npi": [1598719346]}]}, {"allowed_amount": 110.2, "billing_code_modifier": [""], "providers": [{"billed_charge": 562.0, "npi": [1902858152]}, {"billed_charge": 562.0, "npi": [1598719346]}, {"billed_charge": 562.0, "npi": [1235183542]}]}]}]}, {"name": "Laboratory - General", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0300", "description": "Laboratory", "allowed_amounts": [{"tin": {"type": "ein", "value": "310537504"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 236.0, "npi": [1073688354]}, {"billed_charge": 303.0, "npi": [1073688354]}, {"billed_charge": 34.0, "npi": [1073688354]}, {"billed_charge": 33.0, "npi": [1073688354]}, {"billed_charge": 293.6, "npi": [1073688354]}, {"billed_charge": 36.0, "npi": [1073688354]}, {"billed_charge": 28.0, "npi": [1073688354]}, {"billed_charge": 499.0, "npi": [1073688354]}]}]}]}, {"name": "Laboratory - Immunology", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0302", "description": "Laboratory", "allowed_amounts": [{"tin": {"type": "ein", "value": "340714585"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 145.0, "npi": [1679525919]}, {"billed_charge": 34.0, "npi": [1679525919]}, {"billed_charge": 84.8, "npi": [1679525919]}, {"billed_charge": 96.0, "npi": [1679525919]}, {"billed_charge": 116.0, "npi": [1679525919]}, {"billed_charge": 89.0, "npi": [1679525919]}, {"billed_charge": 574.6667, "npi": [1679525919]}, {"billed_charge": 53.0, "npi": [1679525919]}, {"billed_charge": 79.3333, "npi": [1679525919]}, {"billed_charge": 144.0, "npi": [1679525919]}, {"billed_charge": 95.5, "npi": [1679525919]}, {"billed_charge": 36.0, "npi": [1679525919]}, {"billed_charge": 84.0, "npi": [1679525919]}, {"billed_charge": 95.0, "npi": [1679525919]}, {"billed_charge": 106.2222, "npi": [1679525919]}, {"billed_charge": 68.0, "npi": [1679525919]}, {"billed_charge": 125.0, "npi": [1679525919]}, {"billed_charge": 87.2857, "npi": [1679525919]}, {"billed_charge": 83.375, "npi": [1679525919]}, {"billed_charge": 108.0, "npi": [1679525919]}, {"billed_charge": 78.0, "npi": [1679525919]}, {"billed_charge": 90.0, "npi": [1679525919]}]}, {"allowed_amount": 17.87, "billing_code_modifier": [""], "providers": [{"billed_charge": 86.0, "npi": [1679525919]}]}, {"allowed_amount": 7.25, "billing_code_modifier": [""], "providers": [{"billed_charge": 36.0, "npi": [1679525919]}]}, {"allowed_amount": 18.54, "billing_code_modifier": [""], "providers": [{"billed_charge": 91.0, "npi": [1679525919]}]}]}]}, {"name": "Laboratory - Hematology", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0305", "description": "Laboratory", "allowed_amounts": [{"tin": {"type": "ein", "value": "340714684"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 40.5, "npi": [1194763045]}, {"billed_charge": 30.0, "npi": [1194763045]}, {"billed_charge": 19.0, "npi": [1194763045]}, {"billed_charge": 51.0, "npi": [1194763045]}, {"billed_charge": 45.0, "npi": [1194763045]}, {"billed_charge": 28.0, "npi": [1194763045]}, {"billed_charge": 70.0, "npi": [1194763045]}, {"billed_charge": 39.0, "npi": [1194763045]}, {"billed_charge": 29.05, "npi": [1194763045]}, {"billed_charge": 42.0, "npi": [1194763045]}, {"billed_charge": 66.0, "npi": [1194763045]}, {"billed_charge": 49.5, "npi": [1194763045]}, {"billed_charge": 54.0, "npi": [1194763045]}, {"billed_charge": 28.6429, "npi": [1194763045]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["91"], "providers": [{"billed_charge": 16.0, "npi": [1194763045]}]}]}]}, {"name": "RADIOLOGIC EXAMINATION KNEE 3 VIEWS", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "73562", "description": "RADIOLOGIC EXAMINATION KNEE 3 VIEWS", "allowed_amounts": [{"tin": {"type": "ein", "value": "310745303"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 8.51, "billing_code_modifier": ["26LT"], "providers": [{"billed_charge": 147.0, "npi": [1669408159]}, {"billed_charge": 140.0, "npi": [1669408159]}]}, {"allowed_amount": 9.14, "billing_code_modifier": ["26LT"], "providers": [{"billed_charge": 147.0, "npi": [1669408159]}]}, {"allowed_amount": 9.14, "billing_code_modifier": ["26RT"], "providers": [{"billed_charge": 147.0, "npi": [1669408159]}]}, {"allowed_amount": 8.51, "billing_code_modifier": ["26RT"], "providers": [{"billed_charge": 147.0, "npi": [1669408159]}, {"billed_charge": 140.0, "npi": [1669408159]}]}]}]}, {"name": "EMERGENCY DEPARTMENT VISIT LOW MDM", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "99283", "description": "EMERGENCY DEPARTMENT VISIT LOW MDM", "allowed_amounts": [{"tin": {"type": "ein", "value": "463160463"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 80.89, "billing_code_modifier": [""], "providers": [{"billed_charge": 625.3, "npi": [1154763944]}, {"billed_charge": 607.09, "npi": [1154763944]}]}, {"allowed_amount": 201.25, "billing_code_modifier": [""], "providers": [{"billed_charge": 625.3, "npi": [1154763944]}, {"billed_charge": 607.09, "npi": [1154763944]}]}, {"allowed_amount": 201.25, "billing_code_modifier": ["UD"], "providers": [{"billed_charge": 625.3, "npi": [1154763944]}, {"billed_charge": 607.09, "npi": [1154763944]}]}, {"allowed_amount": 80.89, "billing_code_modifier": ["UD"], "providers": [{"billed_charge": 625.3, "npi": [1154763944]}, {"billed_charge": 607.09, "npi": [1154763944]}]}, {"allowed_amount": 86.33, "billing_code_modifier": [""], "providers": [{"billed_charge": 625.3, "npi": [1154763944]}]}]}]}, {"name": "OFFICE/OUTPATIENT ESTABLISHED MOD MDM 30 MIN", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "99214", "description": "OFFICE/OUTPATIENT ESTABLISHED MOD MDM 30 MIN", "allowed_amounts": [{"tin": {"type": "ein", "value": "341751703"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 115.68, "billing_code_modifier": ["GTSA"], "providers": [{"billed_charge": 264.0, "npi": [1306612882]}]}, {"allowed_amount": 115.68, "billing_code_modifier": ["SA"], "providers": [{"billed_charge": 264.0, "npi": [1306612882]}]}, {"allowed_amount": 115.68, "billing_code_modifier": [""], "providers": [{"billed_charge": 264.0, "npi": [1306612882]}]}, {"allowed_amount": 115.68, "billing_code_modifier": ["GT"], "providers": [{"billed_charge": 264.0, "npi": [1306612882]}]}]}]}, {"name": "CT ABDOMEN  and  PELVIS W/CONTRAST MATERIAL", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "74177", "description": "CT ABDOMEN  and  PELVIS W/CONTRAST MATERIAL", "allowed_amounts": [{"tin": {"type": "ein", "value": "310745303"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 81.66, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 1692.0, "npi": [1669408159]}, {"billed_charge": 1946.0, "npi": [1669408159]}]}, {"allowed_amount": 77.57, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 1692.0, "npi": [1669408159]}]}, {"allowed_amount": 78.32, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 1946.0, "npi": [1669408159]}]}, {"allowed_amount": 77.3, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 1692.0, "npi": [1669408159]}]}, {"allowed_amount": 82.44, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 1946.0, "npi": [1669408159]}]}, {"allowed_amount": 77.58, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 1946.0, "npi": [1669408159]}]}]}]}, {"name": "Radiology - Diagnostic - Chest X-ray", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0324", "description": "Radiology - Diagnostic", "allowed_amounts": [{"tin": {"type": "ein", "value": "340714585"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 562.0, "npi": [1679525919]}, {"billed_charge": 594.2, "npi": [1679525919]}, {"billed_charge": 586.9714, "npi": [1679525919]}, {"billed_charge": 585.0, "npi": [1679525919]}, {"billed_charge": 608.0, "npi": [1679525919]}]}, {"allowed_amount": 114.69, "billing_code_modifier": [""], "providers": [{"billed_charge": 608.0, "npi": [1679525919]}]}, {"allowed_amount": 110.2, "billing_code_modifier": [""], "providers": [{"billed_charge": 562.0, "npi": [1679525919]}]}]}]}, {"name": "Pharmacy - Extension of 25X - Drug Requiring Detailed Coding", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0636", "description": "Pharmacy - Extension of 25x", "allowed_amounts": [{"tin": {"type": "ein", "value": "341425870"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.39, "billing_code_modifier": ["JZ"], "providers": [{"billed_charge": 3.23, "npi": [1972689172]}]}, {"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 4.87, "npi": [1972689172]}, {"billed_charge": 0.647, "npi": [1972689172]}, {"billed_charge": 25.5, "npi": [1972689172]}, {"billed_charge": 11.16, "npi": [1972689172]}, {"billed_charge": 16.09, "npi": [1972689172]}, {"billed_charge": 3.945, "npi": [1972689172]}, {"billed_charge": 0.652, "npi": [1972689172]}, {"billed_charge": 0.8075, "npi": [1972689172]}, {"billed_charge": 6.47, "npi": [1972689172]}, {"billed_charge": 24.65, "npi": [1972689172]}, {"billed_charge": 6.86, "npi": [1972689172]}, {"billed_charge": 6.8375, "npi": [1972689172]}, {"billed_charge": 17.26, "npi": [1972689172]}, {"billed_charge": 0.0646, "npi": [1972689172]}, {"billed_charge": 0.0404, "npi": [1972689172]}, {"billed_charge": 0.0343, "npi": [1972689172]}, {"billed_charge": 5.37, "npi": [1972689172]}, {"billed_charge": 8.23, "npi": [1972689172]}, {"billed_charge": 174.95, "npi": [1972689172]}, {"billed_charge": 0.646, "npi": [1972689172]}, {"billed_charge": 11.64, "npi": [1972689172]}, {"billed_charge": 7.87, "npi": [1972689172]}, {"billed_charge": 0.1009, "npi": [1972689172]}, {"billed_charge": 0.588, "npi": [1972689172]}, {"billed_charge": 0.0247, "npi": [1972689172]}, {"billed_charge": 5.484, "npi": [1972689172]}, {"billed_charge": 0.0323, "npi": [1972689172]}, {"billed_charge": 0.6212, "npi": [1972689172]}, {"billed_charge": 29.58, "npi": [1972689172]}, {"billed_charge": 9.4, "npi": [1972689172]}, {"billed_charge": 7.9813, "npi": [1972689172]}, {"billed_charge": 3.98, "npi": [1972689172]}, {"billed_charge": 5.4825, "npi": [1972689172]}, {"billed_charge": 0.0479, "npi": [1972689172]}, {"billed_charge": 12.08, "npi": [1972689172]}, {"billed_charge": 22.31, "npi": [1972689172]}, {"billed_charge": 3.23, "npi": [1972689172]}, {"billed_charge": 9.1467, "npi": [1972689172]}, {"billed_charge": 4.16, "npi": [1972689172]}]}, {"allowed_amount": 0.41, "billing_code_modifier": ["JZ"], "providers": [{"billed_charge": 3.23, "npi": [1972689172]}]}, {"allowed_amount": 0.2836, "billing_code_modifier": ["JZ"], "providers": [{"billed_charge": 1.4172, "npi": [1972689172]}]}, {"allowed_amount": 0.43, "billing_code_modifier": ["JZ"], "providers": [{"billed_charge": 3.23, "npi": [1972689172]}]}, {"allowed_amount": 0.395, "billing_code_modifier": ["JZ"], "providers": [{"billed_charge": 1.615, "npi": [1972689172]}]}, {"allowed_amount": 0.2732, "billing_code_modifier": ["JZ"], "providers": [{"billed_charge": 1.4172, "npi": [1972689172]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["JZ"], "providers": [{"billed_charge": 2.194, "npi": [1972689172]}, {"billed_charge": 1.4172, "npi": [1972689172]}, {"billed_charge": 31.3075, "npi": [1972689172]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["JW"], "providers": [{"billed_charge": 0.629, "npi": [1972689172]}]}]}]}, {"name": "Radiology - Diagnostic - General", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0320", "description": "Radiology - Diagnostic", "allowed_amounts": [{"tin": {"type": "ein", "value": "340714593"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 608.0, "npi": [1235183542]}, {"billed_charge": 823.0, "npi": [1235183542]}, {"billed_charge": 608.0, "npi": [1902858152]}, {"billed_charge": 734.0, "npi": [1235183542]}, {"billed_charge": 734.0, "npi": [1598719346]}, {"billed_charge": 562.0, "npi": [1902858152]}, {"billed_charge": 734.0, "npi": [1902858152]}, {"billed_charge": 608.0, "npi": [1598719346]}, {"billed_charge": 562.0, "npi": [1598719346]}, {"billed_charge": 562.0, "npi": [1235183542]}, {"billed_charge": 679.0, "npi": [1235183542]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["RT"], "providers": [{"billed_charge": 608.0, "npi": [1235183542]}, {"billed_charge": 608.0, "npi": [1902858152]}, {"billed_charge": 734.0, "npi": [1598719346]}, {"billed_charge": 562.0, "npi": [1902858152]}, {"billed_charge": 734.0, "npi": [1902858152]}, {"billed_charge": 608.0, "npi": [1598719346]}, {"billed_charge": 679.0, "npi": [1598719346]}, {"billed_charge": 562.0, "npi": [1598719346]}, {"billed_charge": 562.0, "npi": [1235183542]}, {"billed_charge": 679.0, "npi": [1235183542]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["50"], "providers": [{"billed_charge": 1124.0, "npi": [1235183542]}, {"billed_charge": 1124.0, "npi": [1598719346]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["LT"], "providers": [{"billed_charge": 608.0, "npi": [1235183542]}, {"billed_charge": 608.0, "npi": [1902858152]}, {"billed_charge": 734.0, "npi": [1235183542]}, {"billed_charge": 562.0, "npi": [1902858152]}, {"billed_charge": 734.0, "npi": [1902858152]}, {"billed_charge": 608.0, "npi": [1598719346]}, {"billed_charge": 679.0, "npi": [1598719346]}, {"billed_charge": 562.0, "npi": [1598719346]}, {"billed_charge": 562.0, "npi": [1235183542]}]}]}]}, {"name": "Laboratory - Chemistry", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0301", "description": "Laboratory", "allowed_amounts": [{"tin": {"type": "ein", "value": "344428256"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 18.75, "billing_code_modifier": [""], "providers": [{"billed_charge": 437.0, "npi": [1407854771]}, {"billed_charge": 459.0, "npi": [1407854771]}]}, {"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 159.2333, "npi": [1407854771]}, {"billed_charge": 167.0, "npi": [1407854771]}, {"billed_charge": 179.0, "npi": [1407854771]}, {"billed_charge": 159.0, "npi": [1407854771]}, {"billed_charge": 221.0, "npi": [1407854771]}, {"billed_charge": 347.0, "npi": [1407854771]}, {"billed_charge": 306.0, "npi": [1407854771]}, {"billed_charge": 318.0, "npi": [1407854771]}, {"billed_charge": 228.0, "npi": [1407854771]}, {"billed_charge": 265.0, "npi": [1407854771]}, {"billed_charge": 398.0, "npi": [1407854771]}, {"billed_charge": 323.0, "npi": [1407854771]}, {"billed_charge": 405.0, "npi": [1407854771]}, {"billed_charge": 142.0, "npi": [1407854771]}, {"billed_charge": 225.0, "npi": [1407854771]}, {"billed_charge": 424.0, "npi": [1407854771]}, {"billed_charge": 197.6923, "npi": [1407854771]}, {"billed_charge": 252.9333, "npi": [1407854771]}, {"billed_charge": 321.0, "npi": [1407854771]}, {"billed_charge": 181.0, "npi": [1407854771]}, {"billed_charge": 108.0, "npi": [1407854771]}, {"billed_charge": 124.0, "npi": [1407854771]}, {"billed_charge": 146.0, "npi": [1407854771]}, {"billed_charge": 122.0, "npi": [1407854771]}, {"billed_charge": 271.0, "npi": [1407854771]}, {"billed_charge": 120.0, "npi": [1407854771]}, {"billed_charge": 103.0, "npi": [1407854771]}, {"billed_charge": 325.5455, "npi": [1407854771]}, {"billed_charge": 204.5556, "npi": [1407854771]}, {"billed_charge": 131.0, "npi": [1407854771]}, {"billed_charge": 273.0, "npi": [1407854771]}, {"billed_charge": 236.0, "npi": [1407854771]}, {"billed_charge": 213.0, "npi": [1407854771]}, {"billed_charge": 376.0, "npi": [1407854771]}, {"billed_charge": 224.0, "npi": [1407854771]}, {"billed_charge": 395.0, "npi": [1407854771]}, {"billed_charge": 191.35, "npi": [1407854771]}, {"billed_charge": 151.0, "npi": [1407854771]}, {"billed_charge": 218.1429, "npi": [1407854771]}, {"billed_charge": 417.0, "npi": [1407854771]}, {"billed_charge": 161.0, "npi": [1407854771]}, {"billed_charge": 155.0, "npi": [1407854771]}, {"billed_charge": 235.0, "npi": [1407854771]}, {"billed_charge": 128.0, "npi": [1407854771]}, {"billed_charge": 217.0, "npi": [1407854771]}, {"billed_charge": 1023.0, "npi": [1407854771]}, {"billed_charge": 177.6429, "npi": [1407854771]}, {"billed_charge": 127.0, "npi": [1407854771]}, {"billed_charge": 393.0, "npi": [1407854771]}, {"billed_charge": 55.0, "npi": [1407854771]}, {"billed_charge": 121.0, "npi": [1407854771]}, {"billed_charge": 109.0, "npi": [1407854771]}, {"billed_charge": 204.5, "npi": [1407854771]}, {"billed_charge": 169.0, "npi": [1407854771]}, {"billed_charge": 129.0, "npi": [1407854771]}, {"billed_charge": 185.3333, "npi": [1407854771]}, {"billed_charge": 214.0, "npi": [1407854771]}, {"billed_charge": 138.0, "npi": [1407854771]}, {"billed_charge": 69.0, "npi": [1407854771]}, {"billed_charge": 114.0, "npi": [1407854771]}, {"billed_charge": 232.0, "npi": [1407854771]}, {"billed_charge": 386.0, "npi": [1407854771]}, {"billed_charge": 247.0, "npi": [1407854771]}, {"billed_charge": 616.0, "npi": [1407854771]}, {"billed_charge": 334.0, "npi": [1407854771]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["59"], "providers": [{"billed_charge": 103.0, "npi": [1407854771]}, {"billed_charge": 131.0, "npi": [1407854771]}]}]}]}, {"name": "Pharmacy - General", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0250", "description": "Pharmacy (also see 063x, an extension of 025x)", "allowed_amounts": [{"tin": {"type": "ein", "value": "344428218"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 0.916, "npi": [1801884655]}, {"billed_charge": 3.49, "npi": [1801884655]}, {"billed_charge": 7.77, "npi": [1801884655]}, {"billed_charge": 32.31, "npi": [1801884655]}, {"billed_charge": 3.5, "npi": [1801884655]}, {"billed_charge": 0.52, "npi": [1801884655]}, {"billed_charge": 4.93, "npi": [1801884655]}, {"billed_charge": 0.65, "npi": [1801884655]}, {"billed_charge": 0.5, "npi": [1801884655]}, {"billed_charge": 9.76, "npi": [1801884655]}, {"billed_charge": 60.59, "npi": [1801884655]}, {"billed_charge": 8.185, "npi": [1801884655]}, {"billed_charge": 0.71, "npi": [1801884655]}, {"billed_charge": 19.7035, "npi": [1801884655]}, {"billed_charge": 45.47, "npi": [1801884655]}, {"billed_charge": 16.58, "npi": [1801884655]}, {"billed_charge": 72.79, "npi": [1801884655]}, {"billed_charge": 5.83, "npi": [1801884655]}, {"billed_charge": 59.62, "npi": [1801884655]}, {"billed_charge": 0.53, "npi": [1801884655]}, {"billed_charge": 47.1233, "npi": [1801884655]}]}]}]}, {"name": "Radiology - Diagnostic - General", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0320", "description": "Radiology - Diagnostic", "allowed_amounts": [{"tin": {"type": "ein", "value": "340714618"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 608.0, "npi": [1215989611]}, {"billed_charge": 734.0, "npi": [1215989611]}, {"billed_charge": 2464.0, "npi": [1215989611]}, {"billed_charge": 592.6667, "npi": [1215989611]}, {"billed_charge": 562.0, "npi": [1215989611]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["RT"], "providers": [{"billed_charge": 608.0, "npi": [1215989611]}, {"billed_charge": 734.0, "npi": [1215989611]}, {"billed_charge": 562.0, "npi": [1215989611]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["LT"], "providers": [{"billed_charge": 608.0, "npi": [1215989611]}, {"billed_charge": 734.0, "npi": [1215989611]}, {"billed_charge": 562.0, "npi": [1215989611]}]}, {"allowed_amount": 133.08, "billing_code_modifier": ["RT"], "providers": [{"billed_charge": 679.0, "npi": [1215989611]}]}]}]}, {"name": "SCREENING MAMMOGRAPHY BI 2-VIEW BREAST INC CAD", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "77067", "description": "SCREENING MAMMOGRAPHY BI 2-VIEW BREAST INC CAD", "allowed_amounts": [{"tin": {"type": "ein", "value": "310983140"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 37.92, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 221.0, "npi": [1093718496]}]}, {"allowed_amount": 17.24, "billing_code_modifier": ["2652"], "providers": [{"billed_charge": 221.0, "npi": [1093718496]}]}, {"allowed_amount": 37.59, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 221.0, "npi": [1093718496]}]}, {"allowed_amount": 34.47, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 221.0, "npi": [1093718496]}, {"billed_charge": 232.0, "npi": [1093718496]}, {"billed_charge": 255.0, "npi": [1093718496]}]}, {"allowed_amount": 34.17, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 221.0, "npi": [1093718496]}, {"billed_charge": 232.0, "npi": [1093718496]}]}]}]}, {"name": "Pharmacy - General", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0250", "description": "Pharmacy (also see 063x, an extension of 025x)", "allowed_amounts": [{"tin": {"type": "ein", "value": "340714585"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 6.797, "npi": [1679525919]}, {"billed_charge": 8.3462, "npi": [1679525919]}, {"billed_charge": 8.2409, "npi": [1679525919]}, {"billed_charge": 2.0875, "npi": [1679525919]}, {"billed_charge": 2.6167, "npi": [1679525919]}, {"billed_charge": 3.1909, "npi": [1679525919]}, {"billed_charge": 5.1054, "npi": [1679525919]}, {"billed_charge": 12.4806, "npi": [1679525919]}, {"billed_charge": 3.025, "npi": [1679525919]}, {"billed_charge": 2.2625, "npi": [1679525919]}, {"billed_charge": 2.2333, "npi": [1679525919]}, {"billed_charge": 5.45, "npi": [1679525919]}, {"billed_charge": 2.82, "npi": [1679525919]}, {"billed_charge": 1.9, "npi": [1679525919]}, {"billed_charge": 6.645, "npi": [1679525919]}, {"billed_charge": 3.125, "npi": [1679525919]}, {"billed_charge": 2.35, "npi": [1679525919]}, {"billed_charge": 2.25, "npi": [1679525919]}, {"billed_charge": 8.075, "npi": [1679525919]}, {"billed_charge": 14.4, "npi": [1679525919]}, {"billed_charge": 2.21, "npi": [1679525919]}, {"billed_charge": 15.25, "npi": [1679525919]}, {"billed_charge": 12.45, "npi": [1679525919]}, {"billed_charge": 9.177, "npi": [1679525919]}, {"billed_charge": 5.0, "npi": [1679525919]}, {"billed_charge": 20.6091, "npi": [1679525919]}, {"billed_charge": 46.3286, "npi": [1679525919]}, {"billed_charge": 16.31, "npi": [1679525919]}, {"billed_charge": 4.8844, "npi": [1679525919]}, {"billed_charge": 3.4063, "npi": [1679525919]}, {"billed_charge": 3.2375, "npi": [1679525919]}, {"billed_charge": 4.0, "npi": [1679525919]}, {"billed_charge": 2.4303, "npi": [1679525919]}, {"billed_charge": 5.9852, "npi": [1679525919]}, {"billed_charge": 48.2919, "npi": [1679525919]}, {"billed_charge": 26.1648, "npi": [1679525919]}, {"billed_charge": 5.725, "npi": [1679525919]}, {"billed_charge": 70.5847, "npi": [1679525919]}, {"billed_charge": 8.0, "npi": [1679525919]}, {"billed_charge": 2.175, "npi": [1679525919]}, {"billed_charge": 45.95, "npi": [1679525919]}, {"billed_charge": 3.3037, "npi": [1679525919]}, {"billed_charge": 4.45, "npi": [1679525919]}, {"billed_charge": 4.21, "npi": [1679525919]}, {"billed_charge": 3.2071, "npi": [1679525919]}, {"billed_charge": 5.2105, "npi": [1679525919]}, {"billed_charge": 4.068, "npi": [1679525919]}, {"billed_charge": 24.4333, "npi": [1679525919]}, {"billed_charge": 10.566, "npi": [1679525919]}, {"billed_charge": 9.7, "npi": [1679525919]}, {"billed_charge": 7.4375, "npi": [1679525919]}, {"billed_charge": 2.4, "npi": [1679525919]}, {"billed_charge": 3.1, "npi": [1679525919]}, {"billed_charge": 2.634, "npi": [1679525919]}, {"billed_charge": 5.3228, "npi": [1679525919]}, {"billed_charge": 4.35, "npi": [1679525919]}, {"billed_charge": 3.355, "npi": [1679525919]}, {"billed_charge": 10.046, "npi": [1679525919]}, {"billed_charge": 3.2917, "npi": [1679525919]}, {"billed_charge": 3.2333, "npi": [1679525919]}, {"billed_charge": 9.731, "npi": [1679525919]}, {"billed_charge": 13.2664, "npi": [1679525919]}, {"billed_charge": 14.7035, "npi": [1679525919]}, {"billed_charge": 24.4667, "npi": [1679525919]}, {"billed_charge": 3.65, "npi": [1679525919]}, {"billed_charge": 9.1174, "npi": [1679525919]}, {"billed_charge": 3.1515, "npi": [1679525919]}, {"billed_charge": 9.4333, "npi": [1679525919]}, {"billed_charge": 10.52, "npi": [1679525919]}, {"billed_charge": 2.1649, "npi": [1679525919]}, {"billed_charge": 3.25, "npi": [1679525919]}, {"billed_charge": 252.775, "npi": [1679525919]}, {"billed_charge": 3.4375, "npi": [1679525919]}, {"billed_charge": 2.8, "npi": [1679525919]}, {"billed_charge": 3.36, "npi": [1679525919]}, {"billed_charge": 4.9559, "npi": [1679525919]}, {"billed_charge": 4.3883, "npi": [1679525919]}, {"billed_charge": 11.8, "npi": [1679525919]}, {"billed_charge": 3.2875, "npi": [1679525919]}, {"billed_charge": 7.75, "npi": [1679525919]}, {"billed_charge": 5.75, "npi": [1679525919]}, {"billed_charge": 9.8375, "npi": [1679525919]}, {"billed_charge": 2.5, "npi": [1679525919]}, {"billed_charge": 16.2065, "npi": [1679525919]}, {"billed_charge": 2.7, "npi": [1679525919]}, {"billed_charge": 3.6188, "npi": [1679525919]}, {"billed_charge": 2.2, "npi": [1679525919]}, {"billed_charge": 3.3125, "npi": [1679525919]}, {"billed_charge": 14.95, "npi": [1679525919]}, {"billed_charge": 7.5714, "npi": [1679525919]}, {"billed_charge": 2.1625, "npi": [1679525919]}, {"billed_charge": 14.7, "npi": [1679525919]}, {"billed_charge": 2.7694, "npi": [1679525919]}, {"billed_charge": 11.9033, "npi": [1679525919]}, {"billed_charge": 8.4642, "npi": [1679525919]}, {"billed_charge": 14.475, "npi": [1679525919]}, {"billed_charge": 4.05, "npi": [1679525919]}, {"billed_charge": 9.4721, "npi": [1679525919]}, {"billed_charge": 8.3786, "npi": [1679525919]}, {"billed_charge": 2.5167, "npi": [1679525919]}, {"billed_charge": 41.95, "npi": [1679525919]}, {"billed_charge": 2.6833, "npi": [1679525919]}, {"billed_charge": 2.375, "npi": [1679525919]}, {"billed_charge": 2.31, "npi": [1679525919]}, {"billed_charge": 2.7167, "npi": [1679525919]}, {"billed_charge": 49.9423, "npi": [1679525919]}, {"billed_charge": 16.4167, "npi": [1679525919]}, {"billed_charge": 3.1375, "npi": [1679525919]}, {"billed_charge": 3.5, "npi": [1679525919]}, {"billed_charge": 14.498, "npi": [1679525919]}, {"billed_charge": 4.4667, "npi": [1679525919]}, {"billed_charge": 20.6069, "npi": [1679525919]}, {"billed_charge": 3.8, "npi": [1679525919]}, {"billed_charge": 2.0, "npi": [1679525919]}, {"billed_charge": 6.9947, "npi": [1679525919]}, {"billed_charge": 17.7105, "npi": [1679525919]}, {"billed_charge": 24.3557, "npi": [1679525919]}, {"billed_charge": 2.15, "npi": [1679525919]}]}]}]}, {"name": "Laboratory - Bacteriology & Microbiology", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0306", "description": "Laboratory", "allowed_amounts": [{"tin": {"type": "ein", "value": "340714684"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 192.55, "billing_code_modifier": [""], "providers": [{"billed_charge": 925.0, "npi": [1194763045]}]}, {"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 2876.0, "npi": [1194763045]}, {"billed_charge": 402.25, "npi": [1194763045]}, {"billed_charge": 71.0, "npi": [1194763045]}, {"billed_charge": 93.0, "npi": [1194763045]}, {"billed_charge": 242.0, "npi": [1194763045]}, {"billed_charge": 925.0, "npi": [1194763045]}, {"billed_charge": 67.0, "npi": [1194763045]}, {"billed_charge": 228.0, "npi": [1194763045]}, {"billed_charge": 56.0, "npi": [1194763045]}, {"billed_charge": 114.0, "npi": [1194763045]}, {"billed_charge": 57.6667, "npi": [1194763045]}, {"billed_charge": 53.0, "npi": [1194763045]}, {"billed_charge": 484.0, "npi": [1194763045]}, {"billed_charge": 29.0, "npi": [1194763045]}]}, {"allowed_amount": 199.68, "billing_code_modifier": [""], "providers": [{"billed_charge": 925.0, "npi": [1194763045]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["59"], "providers": [{"billed_charge": 242.0, "npi": [1194763045]}, {"billed_charge": 228.0, "npi": [1194763045]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["91"], "providers": [{"billed_charge": 71.0, "npi": [1194763045]}, {"billed_charge": 67.0, "npi": [1194763045]}]}]}]}, {"name": "IV Therapy -General", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0260", "description": "IV Therapy", "allowed_amounts": [{"tin": {"type": "ein", "value": "341924226"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 225.0, "npi": [1669562864]}, {"billed_charge": 357.0, "npi": [1669562864]}, {"billed_charge": 359.0, "npi": [1669562864]}, {"billed_charge": 394.0, "npi": [1669562864]}, {"billed_charge": 216.0, "npi": [1669562864]}, {"billed_charge": 343.0, "npi": [1669562864]}, {"billed_charge": 506.0, "npi": [1669562864]}]}, {"allowed_amount": 263.68, "billing_code_modifier": ["59"], "providers": [{"billed_charge": 379.0, "npi": [1669562864]}]}, {"allowed_amount": 57.74, "billing_code_modifier": ["59"], "providers": [{"billed_charge": 343.0, "npi": [1669562864]}]}, {"allowed_amount": 61.725, "billing_code_modifier": [""], "providers": [{"billed_charge": 344.0, "npi": [1669562864]}, {"billed_charge": 506.0, "npi": [1669562864]}]}, {"allowed_amount": 57.74, "billing_code_modifier": [""], "providers": [{"billed_charge": 487.0, "npi": [1669562864]}, {"billed_charge": 343.0, "npi": [1669562864]}]}, {"allowed_amount": 61.726, "billing_code_modifier": [""], "providers": [{"billed_charge": 506.0, "npi": [1669562864]}]}, {"allowed_amount": 280.35, "billing_code_modifier": [""], "providers": [{"billed_charge": 394.0, "npi": [1669562864]}]}, {"allowed_amount": 280.35, "billing_code_modifier": ["59"], "providers": [{"billed_charge": 843.0, "npi": [1669562864]}, {"billed_charge": 394.0, "npi": [1669562864]}, {"billed_charge": 920.0, "npi": [1669562864]}]}, {"allowed_amount": 61.7267, "billing_code_modifier": ["59"], "providers": [{"billed_charge": 357.0, "npi": [1669562864]}]}, {"allowed_amount": 61.73, "billing_code_modifier": [""], "providers": [{"billed_charge": 506.0, "npi": [1669562864]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["59"], "providers": [{"billed_charge": 379.0, "npi": [1669562864]}, {"billed_charge": 359.0, "npi": [1669562864]}, {"billed_charge": 345.0, "npi": [1669562864]}]}]}]}, {"name": "Laboratory - Immunology", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0302", "description": "Laboratory", "allowed_amounts": [{"tin": {"type": "ein", "value": "340714593"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 20.15, "billing_code_modifier": [""], "providers": [{"billed_charge": 99.0, "npi": [1902858152]}]}, {"allowed_amount": 6.16, "billing_code_modifier": [""], "providers": [{"billed_charge": 30.0, "npi": [1235183542]}]}, {"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 56.0, "npi": [1235183542]}, {"billed_charge": 86.0, "npi": [1902858152]}, {"billed_charge": 36.0, "npi": [1902858152]}, {"billed_charge": 36.0, "npi": [1598719346]}, {"billed_charge": 95.0, "npi": [1902858152]}, {"billed_charge": 139.0, "npi": [1902858152]}, {"billed_charge": 34.0, "npi": [1235183542]}, {"billed_charge": 95.0, "npi": [1598719346]}, {"billed_charge": 2112.0, "npi": [1598719346]}, {"billed_charge": 110.0, "npi": [1902858152]}, {"billed_charge": 77.0, "npi": [1598719346]}, {"billed_charge": 144.0, "npi": [1235183542]}, {"billed_charge": 71.0, "npi": [1235183542]}, {"billed_charge": 95.0, "npi": [1235183542]}, {"billed_charge": 74.0, "npi": [1235183542]}, {"billed_charge": 165.0, "npi": [1902858152]}, {"billed_charge": 67.0, "npi": [1598719346]}, {"billed_charge": 116.0, "npi": [1235183542]}, {"billed_charge": 163.0, "npi": [1598719346]}, {"billed_charge": 89.0, "npi": [1598719346]}, {"billed_charge": 89.0, "npi": [1235183542]}, {"billed_charge": 131.0, "npi": [1598719346]}, {"billed_charge": 157.0, "npi": [1235183542]}, {"billed_charge": 2098.0, "npi": [1598719346]}, {"billed_charge": 153.0, "npi": [1902858152]}, {"billed_charge": 73.0, "npi": [1598719346]}, {"billed_charge": 36.0, "npi": [1235183542]}, {"billed_charge": 89.0, "npi": [1902858152]}, {"billed_charge": 34.0, "npi": [1598719346]}, {"billed_charge": 34.0, "npi": [1902858152]}]}, {"allowed_amount": 17.87, "billing_code_modifier": [""], "providers": [{"billed_charge": 86.0, "npi": [1902858152]}, {"billed_charge": 86.0, "npi": [1235183542]}, {"billed_charge": 86.0, "npi": [1598719346]}]}, {"allowed_amount": 18.54, "billing_code_modifier": [""], "providers": [{"billed_charge": 91.0, "npi": [1598719346]}, {"billed_charge": 91.0, "npi": [1902858152]}, {"billed_charge": 91.0, "npi": [1235183542]}]}, {"allowed_amount": 5.98, "billing_code_modifier": [""], "providers": [{"billed_charge": 29.0, "npi": [1235183542]}]}]}]}, {"name": "Treatment or Observation Room - Observation Hours", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0762", "description": "Specialty Services", "allowed_amounts": [{"tin": {"type": "ein", "value": "340714585"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 127.4185, "npi": [1679525919]}, {"billed_charge": 143.325, "npi": [1679525919]}, {"billed_charge": 165.7895, "npi": [1679525919]}, {"billed_charge": 184.6471, "npi": [1679525919]}, {"billed_charge": 170.8235, "npi": [1679525919]}, {"billed_charge": 139.26, "npi": [1679525919]}, {"billed_charge": 936.0, "npi": [1679525919]}, {"billed_charge": 230.5556, "npi": [1679525919]}, {"billed_charge": 154.4146, "npi": [1679525919]}, {"billed_charge": 159.9545, "npi": [1679525919]}, {"billed_charge": 158.0857, "npi": [1679525919]}, {"billed_charge": 153.9048, "npi": [1679525919]}, {"billed_charge": 224.625, "npi": [1679525919]}, {"billed_charge": 163.65, "npi": [1679525919]}]}]}]}, {"name": "Laboratory - Chemistry", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0301", "description": "Laboratory", "allowed_amounts": [{"tin": {"type": "ein", "value": "340714755"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 240.25, "npi": [1396765681]}, {"billed_charge": 178.75, "npi": [1396765681]}, {"billed_charge": 76.0, "npi": [1396765681]}, {"billed_charge": 56.25, "npi": [1396765681]}, {"billed_charge": 165.25, "npi": [1396765681]}, {"billed_charge": 228.25, "npi": [1396765681]}, {"billed_charge": 174.5, "npi": [1396765681]}, {"billed_charge": 264.5, "npi": [1396765681]}, {"billed_charge": 196.25, "npi": [1396765681]}, {"billed_charge": 169.75, "npi": [1396765681]}, {"billed_charge": 375.5, "npi": [1396765681]}, {"billed_charge": 153.7984, "npi": [1396765681]}, {"billed_charge": 457.75, "npi": [1396765681]}, {"billed_charge": 248.25, "npi": [1396765681]}, {"billed_charge": 945.5, "npi": [1396765681]}, {"billed_charge": 96.75, "npi": [1396765681]}, {"billed_charge": 149.75, "npi": [1396765681]}, {"billed_charge": 108.75, "npi": [1396765681]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["91"], "providers": [{"billed_charge": 248.25, "npi": [1396765681]}]}, {"allowed_amount": 5.5, "billing_code_modifier": ["91"], "providers": [{"billed_charge": 72.25, "npi": [1396765681]}]}]}]}, {"name": "RADEX SHOULDER COMPLETE MINIMUM 2 VIEWS", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "73030", "description": "RADEX SHOULDER COMPLETE MINIMUM 2 VIEWS", "allowed_amounts": [{"tin": {"type": "ein", "value": "310745303"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 8.83, "billing_code_modifier": ["26RT77"], "providers": [{"billed_charge": 161.0, "npi": [1669408159]}]}, {"allowed_amount": 8.51, "billing_code_modifier": ["26RT77"], "providers": [{"billed_charge": 153.0, "npi": [1669408159]}]}, {"allowed_amount": 8.83, "billing_code_modifier": ["26RT"], "providers": [{"billed_charge": 161.0, "npi": [1669408159]}]}, {"allowed_amount": 8.83, "billing_code_modifier": ["26LT"], "providers": [{"billed_charge": 161.0, "npi": [1669408159]}]}, {"allowed_amount": 8.51, "billing_code_modifier": ["26LT"], "providers": [{"billed_charge": 161.0, "npi": [1669408159]}, {"billed_charge": 153.0, "npi": [1669408159]}]}, {"allowed_amount": 8.51, "billing_code_modifier": ["26RT"], "providers": [{"billed_charge": 161.0, "npi": [1669408159]}, {"billed_charge": 153.0, "npi": [1669408159]}]}, {"allowed_amount": 8.51, "billing_code_modifier": ["26LT77"], "providers": [{"billed_charge": 153.0, "npi": [1669408159]}]}]}]}, {"name": "EMERGENCY DEPARTMENT VISIT MODERATE MDM", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "99284", "description": "EMERGENCY DEPARTMENT VISIT MODERATE MDM", "allowed_amounts": [{"tin": {"type": "ein", "value": "453460014"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 141.13, "billing_code_modifier": ["UD"], "providers": [{"billed_charge": 1186.31, "npi": [1528342961]}]}, {"allowed_amount": 126.63, "billing_code_modifier": [""], "providers": [{"billed_charge": 1151.76, "npi": [1528342961]}, {"billed_charge": 1186.31, "npi": [1528342961]}]}, {"allowed_amount": 339.46, "billing_code_modifier": [""], "providers": [{"billed_charge": 1151.76, "npi": [1528342961]}, {"billed_charge": 1186.31, "npi": [1528342961]}]}, {"allowed_amount": 126.63, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 1186.31, "npi": [1528342961]}]}, {"allowed_amount": 126.63, "billing_code_modifier": ["UD"], "providers": [{"billed_charge": 1186.31, "npi": [1528342961]}]}, {"allowed_amount": 141.13, "billing_code_modifier": ["UD57"], "providers": [{"billed_charge": 1186.31, "npi": [1528342961]}]}, {"allowed_amount": 141.13, "billing_code_modifier": [""], "providers": [{"billed_charge": 1186.31, "npi": [1528342961]}]}]}]}, {"name": "Emergency Room - General", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0450", "description": "Emergency Room", "allowed_amounts": [{"tin": {"type": "ein", "value": "332621724"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 342.55, "billing_code_modifier": ["XU"], "providers": [{"billed_charge": 298.99, "npi": [1235940909]}]}, {"allowed_amount": 692.31, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 1012.82, "npi": [1235940909]}]}, {"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 204.52, "npi": [1235940909]}, {"billed_charge": 727.77, "npi": [1235940909]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["XU"], "providers": [{"billed_charge": 379.12, "npi": [1235940909]}, {"billed_charge": 298.99, "npi": [1235940909]}, {"billed_charge": 163.85, "npi": [1235940909]}, {"billed_charge": 583.62, "npi": [1235940909]}]}, {"allowed_amount": 450.17, "billing_code_modifier": [""], "providers": [{"billed_charge": 727.77, "npi": [1235940909]}]}, {"allowed_amount": 450.17, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 727.77, "npi": [1235940909]}]}, {"allowed_amount": 996.78, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 1535.59, "npi": [1235940909]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 1012.82, "npi": [1235940909]}, {"billed_charge": 1535.59, "npi": [1235940909]}]}, {"allowed_amount": 75.02, "billing_code_modifier": [""], "providers": [{"billed_charge": 163.85, "npi": [1235940909]}]}, {"allowed_amount": 687.53, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 1012.82, "npi": [1235940909]}]}, {"allowed_amount": 342.55, "billing_code_modifier": [""], "providers": [{"billed_charge": 591.92, "npi": [1235940909]}, {"billed_charge": 583.62, "npi": [1235940909]}]}]}]}, {"name": "EKG/ECG (Electrocardiogram) - General", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0730", "description": "EKG/ECG (Electrocardiogram)", "allowed_amounts": [{"tin": {"type": "ein", "value": "340714456"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 149.0, "npi": [1790837235]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["XU"], "providers": [{"billed_charge": 149.0, "npi": [1790837235]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["59"], "providers": [{"billed_charge": 149.0, "npi": [1790837235]}]}]}]}, {"name": "Pharmacy - Extension of 25X - Drug Requiring Detailed Coding", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0636", "description": "Pharmacy - Extension of 25x", "allowed_amounts": [{"tin": {"type": "ein", "value": "340827442"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 12.62, "npi": [1164481677]}, {"billed_charge": 7.82, "npi": [1164481677]}, {"billed_charge": 0.3081, "npi": [1164481677]}, {"billed_charge": 622.23, "npi": [1164481677]}, {"billed_charge": 4.155, "npi": [1164481677]}, {"billed_charge": 0.3254, "npi": [1164481677]}, {"billed_charge": 4.23, "npi": [1164481677]}, {"billed_charge": 0.0538, "npi": [1164481677]}, {"billed_charge": 3.98, "npi": [1164481677]}, {"billed_charge": 11.16, "npi": [1164481677]}, {"billed_charge": 22.56, "npi": [1164481677]}, {"billed_charge": 6.76, "npi": [1164481677]}, {"billed_charge": 27.42, "npi": [1164481677]}, {"billed_charge": 0.0404, "npi": [1164481677]}, {"billed_charge": 17.26, "npi": [1164481677]}, {"billed_charge": 12.08, "npi": [1164481677]}, {"billed_charge": 0.7438, "npi": [1164481677]}, {"billed_charge": 1.6175, "npi": [1164481677]}, {"billed_charge": 8.23, "npi": [1164481677]}, {"billed_charge": 0.2906, "npi": [1164481677]}, {"billed_charge": 0.0663, "npi": [1164481677]}, {"billed_charge": 0.0808, "npi": [1164481677]}, {"billed_charge": 0.0323, "npi": [1164481677]}, {"billed_charge": 24.65, "npi": [1164481677]}, {"billed_charge": 3.945, "npi": [1164481677]}, {"billed_charge": 4.605, "npi": [1164481677]}, {"billed_charge": 3.23, "npi": [1164481677]}, {"billed_charge": 14.79, "npi": [1164481677]}, {"billed_charge": 6.47, "npi": [1164481677]}, {"billed_charge": 0.8075, "npi": [1164481677]}, {"billed_charge": 0.1972, "npi": [1164481677]}, {"billed_charge": 7.87, "npi": [1164481677]}, {"billed_charge": 1.58, "npi": [1164481677]}, {"billed_charge": 9.86, "npi": [1164481677]}, {"billed_charge": 0.4635, "npi": [1164481677]}, {"billed_charge": 4.16, "npi": [1164481677]}, {"billed_charge": 1.48, "npi": [1164481677]}, {"billed_charge": 4.93, "npi": [1164481677]}, {"billed_charge": 18.89, "npi": [1164481677]}]}, {"allowed_amount": 0.46, "billing_code_modifier": [""], "providers": [{"billed_charge": 3.23, "npi": [1164481677]}]}, {"allowed_amount": 0.41, "billing_code_modifier": ["JW"], "providers": [{"billed_charge": 1.58, "npi": [1164481677]}]}, {"allowed_amount": 0.41, "billing_code_modifier": [""], "providers": [{"billed_charge": 3.23, "npi": [1164481677]}]}, {"allowed_amount": 0.46, "billing_code_modifier": ["JW"], "providers": [{"billed_charge": 1.58, "npi": [1164481677]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["JZ"], "providers": [{"billed_charge": 2.388, "npi": [1164481677]}, {"billed_charge": 2.534, "npi": [1164481677]}]}]}]}, {"name": "Laboratory - Hematology", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0305", "description": "Laboratory", "allowed_amounts": [{"tin": {"type": "ein", "value": "344428256"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 165.25, "npi": [1407854771]}, {"billed_charge": 194.0, "npi": [1407854771]}, {"billed_charge": 174.0, "npi": [1407854771]}, {"billed_charge": 123.0, "npi": [1407854771]}, {"billed_charge": 104.0, "npi": [1407854771]}, {"billed_charge": 173.0, "npi": [1407854771]}, {"billed_charge": 163.0, "npi": [1407854771]}, {"billed_charge": 143.4333, "npi": [1407854771]}, {"billed_charge": 166.0, "npi": [1407854771]}, {"billed_charge": 155.0, "npi": [1407854771]}, {"billed_charge": 164.0, "npi": [1407854771]}, {"billed_charge": 137.0, "npi": [1407854771]}, {"billed_charge": 171.0, "npi": [1407854771]}, {"billed_charge": 168.6667, "npi": [1407854771]}, {"billed_charge": 65.5, "npi": [1407854771]}, {"billed_charge": 137.9231, "npi": [1407854771]}, {"billed_charge": 204.0, "npi": [1407854771]}, {"billed_charge": 109.0, "npi": [1407854771]}, {"billed_charge": 144.2174, "npi": [1407854771]}, {"billed_charge": 129.0, "npi": [1407854771]}, {"billed_charge": 111.0, "npi": [1407854771]}, {"billed_charge": 184.7143, "npi": [1407854771]}, {"billed_charge": 110.0, "npi": [1407854771]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["QW"], "providers": [{"billed_charge": 104.0, "npi": [1407854771]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["59"], "providers": [{"billed_charge": 174.0, "npi": [1407854771]}, {"billed_charge": 66.0, "npi": [1407854771]}, {"billed_charge": 65.0, "npi": [1407854771]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["91"], "providers": [{"billed_charge": 66.0, "npi": [1407854771]}, {"billed_charge": 65.0, "npi": [1407854771]}]}]}]}, {"name": "RADIOLOGIC EXAM KNEE COMPLETE 4/MORE VIEWS", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "73564", "description": "RADIOLOGIC EXAM KNEE COMPLETE 4/MORE VIEWS", "allowed_amounts": [{"tin": {"type": "ein", "value": "310745303"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 10.4, "billing_code_modifier": ["26LT"], "providers": [{"billed_charge": 192.0, "npi": [1669408159]}, {"billed_charge": 183.0, "npi": [1669408159]}]}, {"allowed_amount": 10.76, "billing_code_modifier": ["26LT"], "providers": [{"billed_charge": 192.0, "npi": [1669408159]}]}, {"allowed_amount": 10.4, "billing_code_modifier": ["26RT"], "providers": [{"billed_charge": 192.0, "npi": [1669408159]}, {"billed_charge": 183.0, "npi": [1669408159]}]}, {"allowed_amount": 10.76, "billing_code_modifier": ["26RT"], "providers": [{"billed_charge": 192.0, "npi": [1669408159]}]}]}]}, {"name": "Medical/Surgical Supplies and Devices - Sterile Supply", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0272", "description": "Med/Surg Supplies &Devices (also see 062x, extension of 027x", "allowed_amounts": [{"tin": {"type": "ein", "value": "340714585"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 105.9133, "npi": [1679525919]}, {"billed_charge": 191.22, "npi": [1679525919]}, {"billed_charge": 198.2053, "npi": [1679525919]}, {"billed_charge": 226.14, "npi": [1679525919]}, {"billed_charge": 236.3067, "npi": [1679525919]}, {"billed_charge": 121.3, "npi": [1679525919]}, {"billed_charge": 605.8747, "npi": [1679525919]}, {"billed_charge": 398.6644, "npi": [1679525919]}, {"billed_charge": 125.5, "npi": [1679525919]}, {"billed_charge": 292.624, "npi": [1679525919]}, {"billed_charge": 277.8425, "npi": [1679525919]}, {"billed_charge": 48.1647, "npi": [1679525919]}, {"billed_charge": 102.25, "npi": [1679525919]}, {"billed_charge": 174.6, "npi": [1679525919]}, {"billed_charge": 305.8585, "npi": [1679525919]}, {"billed_charge": 489.5464, "npi": [1679525919]}, {"billed_charge": 107.8067, "npi": [1679525919]}, {"billed_charge": 148.16, "npi": [1679525919]}, {"billed_charge": 96.95, "npi": [1679525919]}, {"billed_charge": 196.724, "npi": [1679525919]}, {"billed_charge": 675.7387, "npi": [1679525919]}, {"billed_charge": 135.842, "npi": [1679525919]}, {"billed_charge": 392.676, "npi": [1679525919]}, {"billed_charge": 120.25, "npi": [1679525919]}, {"billed_charge": 382.0314, "npi": [1679525919]}, {"billed_charge": 92.0, "npi": [1679525919]}, {"billed_charge": 78.0, "npi": [1679525919]}, {"billed_charge": 72.76, "npi": [1679525919]}]}]}]}, {"name": "Laboratory - Chemistry", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0301", "description": "Laboratory", "allowed_amounts": [{"tin": {"type": "ein", "value": "340714478"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 48.0, "npi": [1821035940]}, {"billed_charge": 93.8571, "npi": [1821035940]}, {"billed_charge": 129.0, "npi": [1821035940]}, {"billed_charge": 86.0, "npi": [1821035940]}, {"billed_charge": 169.0, "npi": [1821035940]}, {"billed_charge": 121.0, "npi": [1821035940]}, {"billed_charge": 73.0, "npi": [1821035940]}, {"billed_charge": 55.0, "npi": [1821035940]}, {"billed_charge": 429.0, "npi": [1821035940]}, {"billed_charge": 80.0, "npi": [1821035940]}, {"billed_charge": 58.0, "npi": [1821035940]}, {"billed_charge": 45.0, "npi": [1821035940]}, {"billed_charge": 68.7419, "npi": [1821035940]}, {"billed_charge": 44.0, "npi": [1821035940]}, {"billed_charge": 43.0, "npi": [1821035940]}, {"billed_charge": 84.8667, "npi": [1821035940]}, {"billed_charge": 119.0, "npi": [1821035940]}, {"billed_charge": 112.0, "npi": [1821035940]}, {"billed_charge": 109.0, "npi": [1821035940]}, {"billed_charge": 69.0, "npi": [1821035940]}, {"billed_charge": 81.0, "npi": [1821035940]}, {"billed_charge": 104.0, "npi": [1821035940]}, {"billed_charge": 89.0, "npi": [1821035940]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["91"], "providers": [{"billed_charge": 86.0, "npi": [1821035940]}, {"billed_charge": 169.0, "npi": [1821035940]}, {"billed_charge": 32.0, "npi": [1821035940]}, {"billed_charge": 31.0, "npi": [1821035940]}, {"billed_charge": 80.0, "npi": [1821035940]}, {"billed_charge": 26.0, "npi": [1821035940]}, {"billed_charge": 81.0, "npi": [1821035940]}, {"billed_charge": 89.0, "npi": [1821035940]}]}]}]}, {"name": "Laboratory - Hematology", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0305", "description": "Laboratory", "allowed_amounts": [{"tin": {"type": "ein", "value": "344428218"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 62.8, "npi": [1801884655]}, {"billed_charge": 42.9, "npi": [1801884655]}, {"billed_charge": 60.1, "npi": [1801884655]}, {"billed_charge": 105.9, "npi": [1801884655]}, {"billed_charge": 38.0, "npi": [1801884655]}, {"billed_charge": 101.8, "npi": [1801884655]}, {"billed_charge": 101.3, "npi": [1801884655]}, {"billed_charge": 110.1, "npi": [1801884655]}, {"billed_charge": 106.4, "npi": [1801884655]}, {"billed_charge": 44.8, "npi": [1801884655]}, {"billed_charge": 64.7, "npi": [1801884655]}]}]}]}, {"name": "RADEX HIP UNILATERAL WITH PELVIS 2-3 VIEWS", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "73502", "description": "RADEX HIP UNILATERAL WITH PELVIS 2-3 VIEWS", "allowed_amounts": [{"tin": {"type": "ein", "value": "310745303"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 10.1, "billing_code_modifier": ["26LT"], "providers": [{"billed_charge": 223.0, "npi": [1669408159]}, {"billed_charge": 234.0, "npi": [1669408159]}]}, {"allowed_amount": 10.1, "billing_code_modifier": ["26RT"], "providers": [{"billed_charge": 223.0, "npi": [1669408159]}, {"billed_charge": 234.0, "npi": [1669408159]}]}, {"allowed_amount": 10.45, "billing_code_modifier": ["26LT"], "providers": [{"billed_charge": 234.0, "npi": [1669408159]}]}, {"allowed_amount": 10.45, "billing_code_modifier": ["26RT"], "providers": [{"billed_charge": 234.0, "npi": [1669408159]}]}]}]}, {"name": "Pharmacy - Extension of 25X - Drug Requiring Detailed Coding", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0636", "description": "Pharmacy - Extension of 25x", "allowed_amounts": [{"tin": {"type": "ein", "value": "314379509"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.4075, "billing_code_modifier": [""], "providers": [{"billed_charge": 4.81, "npi": [1215936927]}]}, {"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 0.116, "npi": [1215936927]}, {"billed_charge": 42.73, "npi": [1215936927]}, {"billed_charge": 0.2973, "npi": [1215936927]}, {"billed_charge": 14.47, "npi": [1215936927]}, {"billed_charge": 2.53, "npi": [1215936927]}, {"billed_charge": 11.89, "npi": [1215936927]}, {"billed_charge": 1.189, "npi": [1215936927]}, {"billed_charge": 2.32, "npi": [1215936927]}, {"billed_charge": 7.235, "npi": [1215936927]}, {"billed_charge": 45.045, "npi": [1215936927]}, {"billed_charge": 41.75, "npi": [1215936927]}, {"billed_charge": 24.08, "npi": [1215936927]}, {"billed_charge": 0.4303, "npi": [1215936927]}, {"billed_charge": 0.5355, "npi": [1215936927]}, {"billed_charge": 98.61, "npi": [1215936927]}, {"billed_charge": 194.9533, "npi": [1215936927]}, {"billed_charge": 0.5945, "npi": [1215936927]}, {"billed_charge": 2.9725, "npi": [1215936927]}]}, {"allowed_amount": 0.435, "billing_code_modifier": [""], "providers": [{"billed_charge": 5.945, "npi": [1215936927]}]}]}]}, {"name": "Pharmacy - General", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0250", "description": "Pharmacy (also see 063x, an extension of 025x)", "allowed_amounts": [{"tin": {"type": "ein", "value": "340714538"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 24.45, "npi": [1356366991]}, {"billed_charge": 54.25, "npi": [1356366991]}, {"billed_charge": 3.7, "npi": [1356366991]}, {"billed_charge": 6.95, "npi": [1356366991]}, {"billed_charge": 13.55, "npi": [1356366991]}, {"billed_charge": 1.4, "npi": [1356366991]}, {"billed_charge": 4.0, "npi": [1356366991]}, {"billed_charge": 933.15, "npi": [1356366991]}, {"billed_charge": 10.3, "npi": [1356366991]}, {"billed_charge": 0.53, "npi": [1356366991]}, {"billed_charge": 58.65, "npi": [1356366991]}, {"billed_charge": 1.7167, "npi": [1356366991]}, {"billed_charge": 42.7389, "npi": [1356366991]}, {"billed_charge": 6.1, "npi": [1356366991]}, {"billed_charge": 1.25, "npi": [1356366991]}, {"billed_charge": 1.75, "npi": [1356366991]}, {"billed_charge": 1.1, "npi": [1356366991]}, {"billed_charge": 1.6, "npi": [1356366991]}, {"billed_charge": 2.7, "npi": [1356366991]}, {"billed_charge": 1.15, "npi": [1356366991]}, {"billed_charge": 0.62, "npi": [1356366991]}, {"billed_charge": 5.035, "npi": [1356366991]}, {"billed_charge": 2.15, "npi": [1356366991]}, {"billed_charge": 1.05, "npi": [1356366991]}, {"billed_charge": 1.3, "npi": [1356366991]}, {"billed_charge": 1.2, "npi": [1356366991]}, {"billed_charge": 16.3, "npi": [1356366991]}, {"billed_charge": 1.45, "npi": [1356366991]}, {"billed_charge": 18.05, "npi": [1356366991]}, {"billed_charge": 0.57, "npi": [1356366991]}, {"billed_charge": 15.1, "npi": [1356366991]}, {"billed_charge": 44.4, "npi": [1356366991]}, {"billed_charge": 2.25, "npi": [1356366991]}, {"billed_charge": 0.6, "npi": [1356366991]}, {"billed_charge": 1.7, "npi": [1356366991]}]}]}]}, {"name": "Emergency Room - General", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0450", "description": "Emergency Room", "allowed_amounts": [{"tin": {"type": "ein", "value": "340714612"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 2796.0, "npi": [1841299039]}, {"billed_charge": 2688.0, "npi": [1841299039]}, {"billed_charge": 225.0, "npi": [1841299039]}, {"billed_charge": 3917.0, "npi": [1841299039]}, {"billed_charge": 430.0, "npi": [1841299039]}, {"billed_charge": 45.0, "npi": [1841299039]}, {"billed_charge": 2482.0, "npi": [1841299039]}, {"billed_charge": 447.0, "npi": [1841299039]}]}, {"allowed_amount": 359.79, "billing_code_modifier": [""], "providers": [{"billed_charge": 1134.0, "npi": [1841299039]}]}, {"allowed_amount": 767.3, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 2688.0, "npi": [1841299039]}]}, {"allowed_amount": 3313.64, "billing_code_modifier": [""], "providers": [{"billed_charge": 3766.0, "npi": [1841299039]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 2796.0, "npi": [1841299039]}]}, {"allowed_amount": 532.91, "billing_code_modifier": [""], "providers": [{"billed_charge": 1711.0, "npi": [1841299039]}]}, {"allowed_amount": 784.92, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 2796.0, "npi": [1841299039]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["59"], "providers": [{"billed_charge": 225.0, "npi": [1841299039]}]}, {"allowed_amount": 532.91, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 1711.0, "npi": [1841299039]}]}, {"allowed_amount": 1088.71, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 3917.0, "npi": [1841299039]}]}, {"allowed_amount": 767.3, "billing_code_modifier": [""], "providers": [{"billed_charge": 2688.0, "npi": [1841299039]}]}, {"allowed_amount": 346.53, "billing_code_modifier": [""], "providers": [{"billed_charge": 1090.0, "npi": [1841299039]}]}, {"allowed_amount": 549.96, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 1779.0, "npi": [1841299039]}]}, {"allowed_amount": 552.65, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 1779.0, "npi": [1841299039]}]}, {"allowed_amount": 784.92, "billing_code_modifier": [""], "providers": [{"billed_charge": 2796.0, "npi": [1841299039]}]}]}]}, {"name": "Pharmacy - General", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0250", "description": "Pharmacy (also see 063x, an extension of 025x)", "allowed_amounts": [{"tin": {"type": "ein", "value": "344428256"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 3.6667, "npi": [1407854771]}, {"billed_charge": 0.6667, "npi": [1407854771]}, {"billed_charge": 9.0, "npi": [1407854771]}, {"billed_charge": 2.25, "npi": [1407854771]}, {"billed_charge": 1.8889, "npi": [1407854771]}, {"billed_charge": 4.0, "npi": [1407854771]}, {"billed_charge": 1.3333, "npi": [1407854771]}, {"billed_charge": 2.3333, "npi": [1407854771]}, {"billed_charge": 3.0323, "npi": [1407854771]}, {"billed_charge": 1.9286, "npi": [1407854771]}, {"billed_charge": 2.0, "npi": [1407854771]}, {"billed_charge": 3.0714, "npi": [1407854771]}, {"billed_charge": 6.5333, "npi": [1407854771]}, {"billed_charge": 1.2727, "npi": [1407854771]}, {"billed_charge": 1.4, "npi": [1407854771]}, {"billed_charge": 0.5, "npi": [1407854771]}, {"billed_charge": 1.0651, "npi": [1407854771]}, {"billed_charge": 0.1109, "npi": [1407854771]}, {"billed_charge": 1.1739, "npi": [1407854771]}, {"billed_charge": 3.0, "npi": [1407854771]}, {"billed_charge": 1.9851, "npi": [1407854771]}, {"billed_charge": 7.0, "npi": [1407854771]}, {"billed_charge": 1.5, "npi": [1407854771]}, {"billed_charge": 1.75, "npi": [1407854771]}, {"billed_charge": 15.7059, "npi": [1407854771]}, {"billed_charge": 2.2439, "npi": [1407854771]}, {"billed_charge": 4.8, "npi": [1407854771]}, {"billed_charge": 1.8228, "npi": [1407854771]}, {"billed_charge": 10.5453, "npi": [1407854771]}, {"billed_charge": 6.7405, "npi": [1407854771]}, {"billed_charge": 2.6667, "npi": [1407854771]}, {"billed_charge": 3.9375, "npi": [1407854771]}, {"billed_charge": 22.8, "npi": [1407854771]}, {"billed_charge": 11.0, "npi": [1407854771]}, {"billed_charge": 11.3333, "npi": [1407854771]}, {"billed_charge": 4.1866, "npi": [1407854771]}, {"billed_charge": 1.118, "npi": [1407854771]}, {"billed_charge": 8.0, "npi": [1407854771]}, {"billed_charge": 3.4348, "npi": [1407854771]}, {"billed_charge": 2.625, "npi": [1407854771]}, {"billed_charge": 0.8333, "npi": [1407854771]}, {"billed_charge": 2.3401, "npi": [1407854771]}, {"billed_charge": 3.9714, "npi": [1407854771]}, {"billed_charge": 7.0753, "npi": [1407854771]}, {"billed_charge": 1.0, "npi": [1407854771]}, {"billed_charge": 100.5, "npi": [1407854771]}, {"billed_charge": 0.9167, "npi": [1407854771]}, {"billed_charge": 5.0, "npi": [1407854771]}, {"billed_charge": 1.9705, "npi": [1407854771]}, {"billed_charge": 2.9032, "npi": [1407854771]}, {"billed_charge": 0.9091, "npi": [1407854771]}, {"billed_charge": 49.4545, "npi": [1407854771]}, {"billed_charge": 1.2, "npi": [1407854771]}, {"billed_charge": 11.5, "npi": [1407854771]}, {"billed_charge": 5.2, "npi": [1407854771]}]}]}]}, {"name": "Laboratory - General", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0300", "description": "Laboratory", "allowed_amounts": [{"tin": {"type": "ein", "value": "340714585"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 54.5789, "npi": [1679525919]}, {"billed_charge": 226.85, "npi": [1679525919]}, {"billed_charge": 63.0, "npi": [1679525919]}, {"billed_charge": 120.15, "npi": [1679525919]}, {"billed_charge": 524.6641, "npi": [1679525919]}, {"billed_charge": 439.375, "npi": [1679525919]}, {"billed_charge": 44.0, "npi": [1679525919]}, {"billed_charge": 55.0, "npi": [1679525919]}, {"billed_charge": 251.5455, "npi": [1679525919]}, {"billed_charge": 166.2222, "npi": [1679525919]}, {"billed_charge": 16.0, "npi": [1679525919]}, {"billed_charge": 82.5938, "npi": [1679525919]}, {"billed_charge": 52.3333, "npi": [1679525919]}, {"billed_charge": 21.0, "npi": [1679525919]}, {"billed_charge": 50.2222, "npi": [1679525919]}, {"billed_charge": 53.0, "npi": [1679525919]}, {"billed_charge": 56.2609, "npi": [1679525919]}, {"billed_charge": 20.0, "npi": [1679525919]}, {"billed_charge": 116.6942, "npi": [1679525919]}, {"billed_charge": 217.3846, "npi": [1679525919]}, {"billed_charge": 95.2692, "npi": [1679525919]}, {"billed_charge": 425.2174, "npi": [1679525919]}, {"billed_charge": 40.5, "npi": [1679525919]}, {"billed_charge": 173.875, "npi": [1679525919]}, {"billed_charge": 376.6241, "npi": [1679525919]}, {"billed_charge": 67.0, "npi": [1679525919]}, {"billed_charge": 62.25, "npi": [1679525919]}, {"billed_charge": 55.7273, "npi": [1679525919]}, {"billed_charge": 452.9302, "npi": [1679525919]}, {"billed_charge": 58.0, "npi": [1679525919]}, {"billed_charge": 48.1163, "npi": [1679525919]}, {"billed_charge": 52.6154, "npi": [1679525919]}, {"billed_charge": 15.0, "npi": [1679525919]}, {"billed_charge": 64.0, "npi": [1679525919]}]}, {"allowed_amount": 3.15, "billing_code_modifier": [""], "providers": [{"billed_charge": 16.0, "npi": [1679525919]}]}, {"allowed_amount": 12.27, "billing_code_modifier": [""], "providers": [{"billed_charge": 58.0, "npi": [1679525919]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["59"], "providers": [{"billed_charge": 16.0, "npi": [1679525919]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["91"], "providers": [{"billed_charge": 21.0, "npi": [1679525919]}, {"billed_charge": 15.0, "npi": [1679525919]}]}, {"allowed_amount": 13.08, "billing_code_modifier": [""], "providers": [{"billed_charge": 63.0, "npi": [1679525919]}]}, {"allowed_amount": 4.59, "billing_code_modifier": [""], "providers": [{"billed_charge": 23.0, "npi": [1679525919]}]}]}]}, {"name": "Pharmacy - Extension of 25X - Drug Requiring Detailed Coding", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0636", "description": "Pharmacy - Extension of 25x", "allowed_amounts": [{"tin": {"type": "ein", "value": "340714478"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 15.15, "npi": [1821035940]}, {"billed_charge": 14.0, "npi": [1821035940]}, {"billed_charge": 4.3261, "npi": [1821035940]}, {"billed_charge": 3.99, "npi": [1821035940]}, {"billed_charge": 1.3, "npi": [1821035940]}, {"billed_charge": 8.25, "npi": [1821035940]}, {"billed_charge": 0.0308, "npi": [1821035940]}, {"billed_charge": 5.35, "npi": [1821035940]}, {"billed_charge": 1.7842, "npi": [1821035940]}, {"billed_charge": 12.65, "npi": [1821035940]}, {"billed_charge": 0.04, "npi": [1821035940]}, {"billed_charge": 2.9583, "npi": [1821035940]}, {"billed_charge": 16.75, "npi": [1821035940]}, {"billed_charge": 0.0928, "npi": [1821035940]}, {"billed_charge": 24.6833, "npi": [1821035940]}, {"billed_charge": 2.375, "npi": [1821035940]}, {"billed_charge": 4.8925, "npi": [1821035940]}, {"billed_charge": 7.075, "npi": [1821035940]}, {"billed_charge": 2.25, "npi": [1821035940]}, {"billed_charge": 6.185, "npi": [1821035940]}, {"billed_charge": 1.18, "npi": [1821035940]}, {"billed_charge": 5.55, "npi": [1821035940]}, {"billed_charge": 4.225, "npi": [1821035940]}]}, {"allowed_amount": 0.294, "billing_code_modifier": ["JZ"], "providers": [{"billed_charge": 1.542, "npi": [1821035940]}]}, {"allowed_amount": 0.46, "billing_code_modifier": ["JZ"], "providers": [{"billed_charge": 3.65, "npi": [1821035940]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["SE"], "providers": [{"billed_charge": 2.25, "npi": [1821035940]}]}, {"allowed_amount": 0.425, "billing_code_modifier": ["JZ"], "providers": [{"billed_charge": 9.5, "npi": [1821035940]}]}]}]}, {"name": "Laboratory - General", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0300", "description": "Laboratory", "allowed_amounts": [{"tin": {"type": "ein", "value": "340714581"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 57.4, "npi": [1942385794]}, {"billed_charge": 40.0, "npi": [1942385794]}, {"billed_charge": 32.0, "npi": [1942385794]}, {"billed_charge": 12.0, "npi": [1942385794]}, {"billed_charge": 127.0, "npi": [1942385794]}]}]}]}, {"name": "MRI SPINAL CANAL LUMBAR W/O CONTRAST MATERIAL", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "72148", "description": "MRI SPINAL CANAL LUMBAR W/O CONTRAST MATERIAL", "allowed_amounts": [{"tin": {"type": "ein", "value": "310745303"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 95.74, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 1147.0, "npi": [1669408159]}]}, {"allowed_amount": 66.12, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 1147.0, "npi": [1669408159]}, {"billed_charge": 1043.0, "npi": [1669408159]}]}, {"allowed_amount": 67.29, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 1147.0, "npi": [1669408159]}]}]}]}, {"name": "CT ABDOMEN  and  PELVIS W/CONTRAST MATERIAL", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "74177", "description": "CT ABDOMEN  and  PELVIS W/CONTRAST MATERIAL", "allowed_amounts": [{"tin": {"type": "ein", "value": "310983140"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 81.66, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 357.0, "npi": [1093718496]}, {"billed_charge": 340.0, "npi": [1093718496]}]}, {"allowed_amount": 77.57, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 357.0, "npi": [1093718496]}]}, {"allowed_amount": 82.44, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 393.0, "npi": [1093718496]}, {"billed_charge": 357.0, "npi": [1093718496]}, {"billed_charge": 340.0, "npi": [1093718496]}]}]}]}, {"name": "Laboratory - Urology", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0307", "description": "Laboratory", "allowed_amounts": [{"tin": {"type": "ein", "value": "264827222"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 63.5, "npi": [1609189604]}, {"billed_charge": 158.0, "npi": [1609189604]}, {"billed_charge": 99.0, "npi": [1609189604]}, {"billed_charge": 34.0, "npi": [1609189604]}, {"billed_charge": 164.0, "npi": [1609189604]}, {"billed_charge": 89.0, "npi": [1609189604]}, {"billed_charge": 33.0, "npi": [1609189604]}, {"billed_charge": 161.0, "npi": [1609189604]}, {"billed_charge": 93.0, "npi": [1609189604]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["59"], "providers": [{"billed_charge": 34.0, "npi": [1609189604]}]}]}]}, {"name": "Emergency Room - General", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0450", "description": "Emergency Room", "allowed_amounts": [{"tin": {"type": "ein", "value": "340714461"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 653.16, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 2237.0, "npi": [1225128432]}]}, {"allowed_amount": 275.62, "billing_code_modifier": [""], "providers": [{"billed_charge": 909.0, "npi": [1225128432]}]}, {"allowed_amount": 41.16, "billing_code_modifier": [""], "providers": [{"billed_charge": 141.0, "npi": [1225128432]}]}, {"allowed_amount": 183.14, "billing_code_modifier": [""], "providers": [{"billed_charge": 604.0, "npi": [1225128432]}]}, {"allowed_amount": 275.93, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 945.0, "npi": [1225128432]}]}, {"allowed_amount": 653.16, "billing_code_modifier": [""], "providers": [{"billed_charge": 2237.0, "npi": [1225128432]}]}, {"allowed_amount": 66.57, "billing_code_modifier": [""], "providers": [{"billed_charge": 228.0, "npi": [1225128432]}]}, {"allowed_amount": 151.61, "billing_code_modifier": ["LT"], "providers": [{"billed_charge": 500.0, "npi": [1225128432]}]}, {"allowed_amount": 275.93, "billing_code_modifier": [""], "providers": [{"billed_charge": 945.0, "npi": [1225128432]}]}, {"allowed_amount": 275.62, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 909.0, "npi": [1225128432]}]}, {"allowed_amount": 66.41, "billing_code_modifier": [""], "providers": [{"billed_charge": 219.0, "npi": [1225128432]}]}, {"allowed_amount": 41.24, "billing_code_modifier": [""], "providers": [{"billed_charge": 136.0, "npi": [1225128432]}]}, {"allowed_amount": 652.2, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 2151.0, "npi": [1225128432]}]}, {"allowed_amount": 652.2, "billing_code_modifier": [""], "providers": [{"billed_charge": 2151.0, "npi": [1225128432]}]}]}]}, {"name": "IV Therapy -General", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0260", "description": "IV Therapy", "allowed_amounts": [{"tin": {"type": "ein", "value": "340714585"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 61.7267, "billing_code_modifier": [""], "providers": [{"billed_charge": 318.0, "npi": [1679525919]}]}, {"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 491.0, "npi": [1679525919]}, {"billed_charge": 448.9, "npi": [1679525919]}, {"billed_charge": 1324.0, "npi": [1679525919]}, {"billed_charge": 465.6667, "npi": [1679525919]}, {"billed_charge": 318.0, "npi": [1679525919]}, {"billed_charge": 405.0667, "npi": [1679525919]}, {"billed_charge": 809.0, "npi": [1679525919]}, {"billed_charge": 886.0, "npi": [1679525919]}, {"billed_charge": 591.0, "npi": [1679525919]}, {"billed_charge": 488.0, "npi": [1679525919]}, {"billed_charge": 762.0, "npi": [1679525919]}, {"billed_charge": 452.0, "npi": [1679525919]}, {"billed_charge": 774.6667, "npi": [1679525919]}, {"billed_charge": 684.3333, "npi": [1679525919]}, {"billed_charge": 435.0, "npi": [1679525919]}, {"billed_charge": 1454.0, "npi": [1679525919]}, {"billed_charge": 294.0, "npi": [1679525919]}, {"billed_charge": 654.5, "npi": [1679525919]}]}, {"allowed_amount": 263.68, "billing_code_modifier": ["59"], "providers": [{"billed_charge": 1324.0, "npi": [1679525919]}]}, {"allowed_amount": 9349.05, "billing_code_modifier": [""], "providers": [{"billed_charge": 1324.0, "npi": [1679525919]}]}, {"allowed_amount": 2240.56, "billing_code_modifier": [""], "providers": [{"billed_charge": 294.0, "npi": [1679525919]}]}, {"allowed_amount": 57.74, "billing_code_modifier": ["59"], "providers": [{"billed_charge": 294.0, "npi": [1679525919]}]}, {"allowed_amount": 61.725, "billing_code_modifier": [""], "providers": [{"billed_charge": 318.0, "npi": [1679525919]}]}, {"allowed_amount": 57.74, "billing_code_modifier": [""], "providers": [{"billed_charge": 294.0, "npi": [1679525919]}]}, {"allowed_amount": 799.92, "billing_code_modifier": [""], "providers": [{"billed_charge": 294.0, "npi": [1679525919]}]}, {"allowed_amount": 89.07, "billing_code_modifier": [""], "providers": [{"billed_charge": 435.0, "npi": [1679525919]}]}, {"allowed_amount": 280.35, "billing_code_modifier": [""], "providers": [{"billed_charge": 1454.0, "npi": [1679525919]}]}, {"allowed_amount": 280.35, "billing_code_modifier": ["59"], "providers": [{"billed_charge": 1454.0, "npi": [1679525919]}]}, {"allowed_amount": 4607.86, "billing_code_modifier": ["59"], "providers": [{"billed_charge": 1324.0, "npi": [1679525919]}]}, {"allowed_amount": 57.7395, "billing_code_modifier": ["59"], "providers": [{"billed_charge": 294.0, "npi": [1679525919]}]}, {"allowed_amount": 263.68, "billing_code_modifier": [""], "providers": [{"billed_charge": 1324.0, "npi": [1679525919]}]}, {"allowed_amount": 61.73, "billing_code_modifier": [""], "providers": [{"billed_charge": 318.0, "npi": [1679525919]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["59"], "providers": [{"billed_charge": 491.0, "npi": [1679525919]}, {"billed_charge": 1324.0, "npi": [1679525919]}, {"billed_charge": 318.0, "npi": [1679525919]}, {"billed_charge": 488.0, "npi": [1679525919]}, {"billed_charge": 452.0, "npi": [1679525919]}, {"billed_charge": 435.0, "npi": [1679525919]}, {"billed_charge": 1454.0, "npi": [1679525919]}, {"billed_charge": 294.0, "npi": [1679525919]}]}, {"allowed_amount": 279.31, "billing_code_modifier": ["59"], "providers": [{"billed_charge": 1324.0, "npi": [1679525919]}]}, {"allowed_amount": 94.89, "billing_code_modifier": [""], "providers": [{"billed_charge": 491.0, "npi": [1679525919]}]}, {"allowed_amount": 61.725, "billing_code_modifier": ["59"], "providers": [{"billed_charge": 318.0, "npi": [1679525919]}]}, {"allowed_amount": 61.73, "billing_code_modifier": ["59"], "providers": [{"billed_charge": 318.0, "npi": [1679525919]}]}, {"allowed_amount": 5801.905, "billing_code_modifier": ["59"], "providers": [{"billed_charge": 1454.0, "npi": [1679525919]}]}]}]}, {"name": "Emergency Room - General", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0450", "description": "Emergency Room", "allowed_amounts": [{"tin": {"type": "ein", "value": "340714538"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 550.83, "billing_code_modifier": [""], "providers": [{"billed_charge": 2595.0, "npi": [1356366991]}, {"billed_charge": 2093.0, "npi": [1356366991]}]}, {"allowed_amount": 202.37, "billing_code_modifier": [""], "providers": [{"billed_charge": 1355.0, "npi": [1356366991]}]}, {"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 1749.5, "npi": [1356366991]}, {"billed_charge": 2687.0, "npi": [1356366991]}]}, {"allowed_amount": 359.79, "billing_code_modifier": [""], "providers": [{"billed_charge": 1858.0, "npi": [1356366991]}]}, {"allowed_amount": 2119.36, "billing_code_modifier": ["RT"], "providers": [{"billed_charge": 2443.0, "npi": [1356366991]}]}, {"allowed_amount": 910.14, "billing_code_modifier": [""], "providers": [{"billed_charge": 681.0, "npi": [1356366991]}]}, {"allowed_amount": 550.83, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 2595.0, "npi": [1356366991]}, {"billed_charge": 2093.0, "npi": [1356366991]}]}, {"allowed_amount": 358.18, "billing_code_modifier": [""], "providers": [{"billed_charge": 1498.0, "npi": [1356366991]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["RT"], "providers": [{"billed_charge": 650.0, "npi": [1356366991]}]}, {"allowed_amount": 359.79, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 1858.0, "npi": [1356366991]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 3332.0, "npi": [1356366991]}]}, {"allowed_amount": 358.18, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 1498.0, "npi": [1356366991]}]}, {"allowed_amount": 784.92, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 3332.0, "npi": [1356366991]}]}, {"allowed_amount": 933.32, "billing_code_modifier": [""], "providers": [{"billed_charge": 844.0, "npi": [1356366991]}]}, {"allowed_amount": 204.85, "billing_code_modifier": [""], "providers": [{"billed_charge": 1093.0, "npi": [1356366991]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["LT"], "providers": [{"billed_charge": 650.0, "npi": [1356366991]}]}, {"allowed_amount": 3447.28, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 3332.0, "npi": [1356366991]}]}, {"allowed_amount": 793.09, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 3332.0, "npi": [1356366991]}, {"billed_charge": 2687.0, "npi": [1356366991]}]}, {"allowed_amount": 1088.71, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 4998.0, "npi": [1356366991]}]}, {"allowed_amount": 549.96, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 2595.0, "npi": [1356366991]}]}, {"allowed_amount": 549.96, "billing_code_modifier": [""], "providers": [{"billed_charge": 2595.0, "npi": [1356366991]}]}]}]}, {"name": "Laboratory - Hematology", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0305", "description": "Laboratory", "allowed_amounts": [{"tin": {"type": "ein", "value": "340714585"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 37.3881, "npi": [1679525919]}, {"billed_charge": 45.0, "npi": [1679525919]}, {"billed_charge": 42.0, "npi": [1679525919]}, {"billed_charge": 23.5312, "npi": [1679525919]}, {"billed_charge": 32.6618, "npi": [1679525919]}, {"billed_charge": 18.0, "npi": [1679525919]}, {"billed_charge": 49.2222, "npi": [1679525919]}, {"billed_charge": 54.7759, "npi": [1679525919]}, {"billed_charge": 41.0, "npi": [1679525919]}, {"billed_charge": 28.0, "npi": [1679525919]}, {"billed_charge": 51.0, "npi": [1679525919]}, {"billed_charge": 42.8571, "npi": [1679525919]}, {"billed_charge": 32.1667, "npi": [1679525919]}, {"billed_charge": 66.0, "npi": [1679525919]}, {"billed_charge": 32.6574, "npi": [1679525919]}, {"billed_charge": 24.0, "npi": [1679525919]}, {"billed_charge": 19.0, "npi": [1679525919]}, {"billed_charge": 36.8182, "npi": [1679525919]}, {"billed_charge": 33.9615, "npi": [1679525919]}, {"billed_charge": 43.5, "npi": [1679525919]}, {"billed_charge": 38.86, "npi": [1679525919]}, {"billed_charge": 44.125, "npi": [1679525919]}, {"billed_charge": 29.4167, "npi": [1679525919]}, {"billed_charge": 70.0, "npi": [1679525919]}, {"billed_charge": 41.8438, "npi": [1679525919]}, {"billed_charge": 45.9333, "npi": [1679525919]}, {"billed_charge": 32.8769, "npi": [1679525919]}, {"billed_charge": 89.4, "npi": [1679525919]}, {"billed_charge": 40.4, "npi": [1679525919]}, {"billed_charge": 39.0, "npi": [1679525919]}, {"billed_charge": 31.3023, "npi": [1679525919]}, {"billed_charge": 45.5652, "npi": [1679525919]}, {"billed_charge": 44.1429, "npi": [1679525919]}, {"billed_charge": 36.4286, "npi": [1679525919]}, {"billed_charge": 62.1667, "npi": [1679525919]}, {"billed_charge": 54.0, "npi": [1679525919]}, {"billed_charge": 43.8913, "npi": [1679525919]}, {"billed_charge": 43.5385, "npi": [1679525919]}, {"billed_charge": 39.7222, "npi": [1679525919]}, {"billed_charge": 42.3333, "npi": [1679525919]}, {"billed_charge": 30.0, "npi": [1679525919]}, {"billed_charge": 38.1633, "npi": [1679525919]}]}, {"allowed_amount": 10.49, "billing_code_modifier": [""], "providers": [{"billed_charge": 51.0, "npi": [1679525919]}]}, {"allowed_amount": 10.88, "billing_code_modifier": [""], "providers": [{"billed_charge": 54.0, "npi": [1679525919]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["91"], "providers": [{"billed_charge": 42.0, "npi": [1679525919]}, {"billed_charge": 16.0, "npi": [1679525919]}]}, {"allowed_amount": 3.78, "billing_code_modifier": [""], "providers": [{"billed_charge": 19.0, "npi": [1679525919]}]}, {"allowed_amount": 9.06, "billing_code_modifier": [""], "providers": [{"billed_charge": 45.0, "npi": [1679525919]}]}]}]}, {"name": "Laboratory - Urology", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0307", "description": "Laboratory", "allowed_amounts": [{"tin": {"type": "ein", "value": "340714593"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 56.0, "npi": [1235183542]}, {"billed_charge": 59.0, "npi": [1902858152]}, {"billed_charge": 21.0, "npi": [1902858152]}, {"billed_charge": 22.0, "npi": [1235183542]}, {"billed_charge": 22.0, "npi": [1598719346]}, {"billed_charge": 21.0, "npi": [1598719346]}, {"billed_charge": 56.0, "npi": [1598719346]}, {"billed_charge": 38.5, "npi": [1235183542]}, {"billed_charge": 21.0, "npi": [1235183542]}, {"billed_charge": 56.0, "npi": [1902858152]}, {"billed_charge": 59.0, "npi": [1598719346]}, {"billed_charge": 59.0, "npi": [1235183542]}, {"billed_charge": 22.0, "npi": [1902858152]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["59"], "providers": [{"billed_charge": 22.0, "npi": [1235183542]}, {"billed_charge": 22.0, "npi": [1598719346]}, {"billed_charge": 21.0, "npi": [1598719346]}, {"billed_charge": 22.0, "npi": [1902858152]}]}]}]}, {"name": "DIAGNOSTIC MAMMOGRAPHY COMPUTER-AIDED DETCJ BI", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "77066", "description": "DIAGNOSTIC MAMMOGRAPHY COMPUTER-AIDED DETCJ BI", "allowed_amounts": [{"tin": {"type": "ein", "value": "310745303"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 44.29, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 175.0, "npi": [1669408159]}]}, {"allowed_amount": 45.65, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 175.0, "npi": [1669408159]}]}]}]}, {"name": "IV Therapy -General", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0260", "description": "IV Therapy", "allowed_amounts": [{"tin": {"type": "ein", "value": "340714684"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 61.7267, "billing_code_modifier": [""], "providers": [{"billed_charge": 318.0, "npi": [1194763045]}]}, {"allowed_amount": 49.08, "billing_code_modifier": ["59"], "providers": [{"billed_charge": 294.0, "npi": [1194763045]}]}, {"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 1454.0, "npi": [1194763045]}, {"billed_charge": 579.8, "npi": [1194763045]}, {"billed_charge": 762.0, "npi": [1194763045]}, {"billed_charge": 318.0, "npi": [1194763045]}, {"billed_charge": 467.6364, "npi": [1194763045]}, {"billed_charge": 373.8333, "npi": [1194763045]}, {"billed_charge": 491.0, "npi": [1194763045]}, {"billed_charge": 488.0, "npi": [1194763045]}, {"billed_charge": 452.0, "npi": [1194763045]}, {"billed_charge": 435.0, "npi": [1194763045]}]}, {"allowed_amount": 263.68, "billing_code_modifier": ["59"], "providers": [{"billed_charge": 1324.0, "npi": [1194763045]}]}, {"allowed_amount": 57.74, "billing_code_modifier": ["59"], "providers": [{"billed_charge": 294.0, "npi": [1194763045]}]}, {"allowed_amount": 61.725, "billing_code_modifier": [""], "providers": [{"billed_charge": 318.0, "npi": [1194763045]}]}, {"allowed_amount": 57.74, "billing_code_modifier": [""], "providers": [{"billed_charge": 294.0, "npi": [1194763045]}]}, {"allowed_amount": 280.35, "billing_code_modifier": [""], "providers": [{"billed_charge": 1454.0, "npi": [1194763045]}]}, {"allowed_amount": 10934.62, "billing_code_modifier": [""], "providers": [{"billed_charge": 1454.0, "npi": [1194763045]}]}, {"allowed_amount": 280.35, "billing_code_modifier": ["59"], "providers": [{"billed_charge": 1454.0, "npi": [1194763045]}]}, {"allowed_amount": 263.68, "billing_code_modifier": [""], "providers": [{"billed_charge": 1324.0, "npi": [1194763045]}]}, {"allowed_amount": 61.7256, "billing_code_modifier": ["59"], "providers": [{"billed_charge": 318.0, "npi": [1194763045]}]}, {"allowed_amount": 61.73, "billing_code_modifier": [""], "providers": [{"billed_charge": 318.0, "npi": [1194763045]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["59"], "providers": [{"billed_charge": 1454.0, "npi": [1194763045]}, {"billed_charge": 318.0, "npi": [1194763045]}, {"billed_charge": 491.0, "npi": [1194763045]}, {"billed_charge": 452.0, "npi": [1194763045]}, {"billed_charge": 435.0, "npi": [1194763045]}]}, {"allowed_amount": 94.89, "billing_code_modifier": [""], "providers": [{"billed_charge": 491.0, "npi": [1194763045]}]}, {"allowed_amount": 61.725, "billing_code_modifier": ["59"], "providers": [{"billed_charge": 318.0, "npi": [1194763045]}]}, {"allowed_amount": 61.73, "billing_code_modifier": ["59"], "providers": [{"billed_charge": 318.0, "npi": [1194763045]}]}]}]}, {"name": "IV Therapy -General", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0260", "description": "IV Therapy", "allowed_amounts": [{"tin": {"type": "ein", "value": "264827222"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 273.45, "billing_code_modifier": [""], "providers": [{"billed_charge": 394.0, "npi": [1609189604]}]}, {"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 357.0, "npi": [1609189604]}, {"billed_charge": 394.5, "npi": [1609189604]}, {"billed_charge": 365.2, "npi": [1609189604]}, {"billed_charge": 394.0, "npi": [1609189604]}, {"billed_charge": 611.6667, "npi": [1609189604]}, {"billed_charge": 811.0, "npi": [1609189604]}, {"billed_charge": 557.2857, "npi": [1609189604]}, {"billed_charge": 331.0, "npi": [1609189604]}, {"billed_charge": 487.0, "npi": [1609189604]}, {"billed_charge": 467.0, "npi": [1609189604]}]}, {"allowed_amount": 263.68, "billing_code_modifier": ["59"], "providers": [{"billed_charge": 379.0, "npi": [1609189604]}, {"billed_charge": 811.0, "npi": [1609189604]}]}, {"allowed_amount": 61.725, "billing_code_modifier": [""], "providers": [{"billed_charge": 506.0, "npi": [1609189604]}]}, {"allowed_amount": 57.74, "billing_code_modifier": [""], "providers": [{"billed_charge": 487.0, "npi": [1609189604]}, {"billed_charge": 343.0, "npi": [1609189604]}]}, {"allowed_amount": 59.88, "billing_code_modifier": [""], "providers": [{"billed_charge": 506.0, "npi": [1609189604]}]}, {"allowed_amount": 280.35, "billing_code_modifier": [""], "providers": [{"billed_charge": 394.0, "npi": [1609189604]}]}, {"allowed_amount": 280.35, "billing_code_modifier": ["59"], "providers": [{"billed_charge": 394.0, "npi": [1609189604]}, {"billed_charge": 843.0, "npi": [1609189604]}]}, {"allowed_amount": 263.68, "billing_code_modifier": [""], "providers": [{"billed_charge": 379.0, "npi": [1609189604]}, {"billed_charge": 885.0, "npi": [1609189604]}]}, {"allowed_amount": 94.89, "billing_code_modifier": ["59"], "providers": [{"billed_charge": 486.0, "npi": [1609189604]}]}, {"allowed_amount": 61.73, "billing_code_modifier": [""], "providers": [{"billed_charge": 357.0, "npi": [1609189604]}, {"billed_charge": 506.0, "npi": [1609189604]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["59"], "providers": [{"billed_charge": 359.0, "npi": [1609189604]}, {"billed_charge": 225.0, "npi": [1609189604]}]}, {"allowed_amount": 61.73, "billing_code_modifier": ["59"], "providers": [{"billed_charge": 506.0, "npi": [1609189604]}]}]}]}, {"name": "Laboratory - Chemistry", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0301", "description": "Laboratory", "allowed_amounts": [{"tin": {"type": "ein", "value": "341260978"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 5.31, "billing_code_modifier": ["59"], "providers": [{"billed_charge": 58.0, "npi": [1841264868]}]}, {"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 93.0, "npi": [1841264868]}, {"billed_charge": 77.0, "npi": [1841264868]}, {"billed_charge": 206.4, "npi": [1841264868]}, {"billed_charge": 164.0, "npi": [1841264868]}, {"billed_charge": 254.0, "npi": [1841264868]}, {"billed_charge": 172.0, "npi": [1841264868]}, {"billed_charge": 302.0, "npi": [1841264868]}, {"billed_charge": 158.0, "npi": [1841264868]}, {"billed_charge": 135.0, "npi": [1841264868]}, {"billed_charge": 241.0, "npi": [1841264868]}, {"billed_charge": 275.0, "npi": [1841264868]}, {"billed_charge": 146.0, "npi": [1841264868]}, {"billed_charge": 108.0, "npi": [1841264868]}, {"billed_charge": 219.0, "npi": [1841264868]}, {"billed_charge": 264.0, "npi": [1841264868]}, {"billed_charge": 101.0, "npi": [1841264868]}, {"billed_charge": 837.0, "npi": [1841264868]}, {"billed_charge": 329.0, "npi": [1841264868]}, {"billed_charge": 97.0, "npi": [1841264868]}, {"billed_charge": 434.0, "npi": [1841264868]}, {"billed_charge": 152.0, "npi": [1841264868]}, {"billed_charge": 381.0, "npi": [1841264868]}, {"billed_charge": 147.0, "npi": [1841264868]}, {"billed_charge": 179.0, "npi": [1841264868]}]}, {"allowed_amount": 5.5, "billing_code_modifier": [""], "providers": [{"billed_charge": 60.0, "npi": [1841264868]}]}, {"allowed_amount": 5.305, "billing_code_modifier": ["59"], "providers": [{"billed_charge": 58.0, "npi": [1841264868]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["59"], "providers": [{"billed_charge": 57.0, "npi": [1841264868]}, {"billed_charge": 76.0, "npi": [1841264868]}, {"billed_charge": 80.0, "npi": [1841264868]}]}, {"allowed_amount": 5.5, "billing_code_modifier": ["59"], "providers": [{"billed_charge": 60.0, "npi": [1841264868]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["91"], "providers": [{"billed_charge": 172.0, "npi": [1841264868]}, {"billed_charge": 179.0, "npi": [1841264868]}]}, {"allowed_amount": 5.5033, "billing_code_modifier": ["59"], "providers": [{"billed_charge": 60.0, "npi": [1841264868]}]}]}]}, {"name": "IV Therapy -General", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0260", "description": "IV Therapy", "allowed_amounts": [{"tin": {"type": "ein", "value": "340714581"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 57.3167, "billing_code_modifier": ["XU"], "providers": [{"billed_charge": 100.0, "npi": [1942385794]}, {"billed_charge": 110.0, "npi": [1942385794]}]}, {"allowed_amount": 262.8, "billing_code_modifier": ["XU"], "providers": [{"billed_charge": 205.0, "npi": [1942385794]}, {"billed_charge": 110.0, "npi": [1942385794]}]}, {"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 71.0, "npi": [1942385794]}, {"billed_charge": 96.9348, "npi": [1942385794]}, {"billed_charge": 107.4182, "npi": [1942385794]}, {"billed_charge": 119.1077, "npi": [1942385794]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["XU"], "providers": [{"billed_charge": 71.0, "npi": [1942385794]}]}, {"allowed_amount": 262.8, "billing_code_modifier": ["59"], "providers": [{"billed_charge": 110.0, "npi": [1942385794]}]}, {"allowed_amount": 260.33, "billing_code_modifier": ["XU"], "providers": [{"billed_charge": 110.0, "npi": [1942385794]}, {"billed_charge": 205.0, "npi": [1942385794]}]}, {"allowed_amount": 57.315, "billing_code_modifier": ["XU"], "providers": [{"billed_charge": 110.0, "npi": [1942385794]}]}, {"allowed_amount": 88.78, "billing_code_modifier": ["XU"], "providers": [{"billed_charge": 185.0, "npi": [1942385794]}]}, {"allowed_amount": 57.55, "billing_code_modifier": ["XU"], "providers": [{"billed_charge": 100.0, "npi": [1942385794]}, {"billed_charge": 110.0, "npi": [1942385794]}]}, {"allowed_amount": 57.32, "billing_code_modifier": ["XU"], "providers": [{"billed_charge": 100.0, "npi": [1942385794]}, {"billed_charge": 110.0, "npi": [1942385794]}]}, {"allowed_amount": 262.8, "billing_code_modifier": [""], "providers": [{"billed_charge": 110.0, "npi": [1942385794]}]}, {"allowed_amount": 57.55, "billing_code_modifier": [""], "providers": [{"billed_charge": 100.0, "npi": [1942385794]}, {"billed_charge": 110.0, "npi": [1942385794]}]}]}]}, {"name": "Pharmacy - Extension of 25X - Drug Requiring Detailed Coding", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0636", "description": "Pharmacy - Extension of 25x", "allowed_amounts": [{"tin": {"type": "ein", "value": "341623770"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 18.0, "npi": [1639133002]}, {"billed_charge": 13.805, "npi": [1639133002]}, {"billed_charge": 37.75, "npi": [1639133002]}, {"billed_charge": 53.61, "npi": [1639133002]}, {"billed_charge": 13.72, "npi": [1639133002]}, {"billed_charge": 81.25, "npi": [1639133002]}, {"billed_charge": 6.86, "npi": [1639133002]}, {"billed_charge": 76.02, "npi": [1639133002]}, {"billed_charge": 75.29, "npi": [1639133002]}, {"billed_charge": 62.3, "npi": [1639133002]}, {"billed_charge": 64.0, "npi": [1639133002]}, {"billed_charge": 53.29, "npi": [1639133002]}]}, {"allowed_amount": 0.41, "billing_code_modifier": [""], "providers": [{"billed_charge": 30.61, "npi": [1639133002]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["JZ"], "providers": [{"billed_charge": 13.805, "npi": [1639133002]}]}]}]}, {"name": "Laboratory - General", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0300", "description": "Laboratory", "allowed_amounts": [{"tin": {"type": "ein", "value": "311518658"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 64.0, "npi": [1770957185]}, {"billed_charge": 67.0, "npi": [1770957185]}, {"billed_charge": 50.0, "npi": [1770957185]}, {"billed_charge": 139.0, "npi": [1770957185]}, {"billed_charge": 57.0, "npi": [1770957185]}, {"billed_charge": 33.0, "npi": [1770957185]}, {"billed_charge": 40.0, "npi": [1770957185]}, {"billed_charge": 53.0, "npi": [1770957185]}, {"billed_charge": 66.0, "npi": [1770957185]}, {"billed_charge": 136.0, "npi": [1770957185]}, {"billed_charge": 38.0, "npi": [1770957185]}, {"billed_charge": 34.0, "npi": [1770957185]}, {"billed_charge": 54.0, "npi": [1770957185]}, {"billed_charge": 59.0, "npi": [1770957185]}, {"billed_charge": 22.0, "npi": [1770957185]}, {"billed_charge": 92.0, "npi": [1770957185]}, {"billed_charge": 95.0, "npi": [1770957185]}, {"billed_charge": 145.0, "npi": [1770957185]}, {"billed_charge": 141.0, "npi": [1770957185]}, {"billed_charge": 123.0, "npi": [1770957185]}, {"billed_charge": 48.0, "npi": [1770957185]}]}]}]}, {"name": "RADIOLOGIC EXAM CHEST SINGLE VIEW", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "71045", "description": "RADIOLOGIC EXAM CHEST SINGLE VIEW", "allowed_amounts": [{"tin": {"type": "ein", "value": "310874388"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 8.22, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 37.0, "npi": [1346299153]}]}, {"allowed_amount": 8.22, "billing_code_modifier": ["26GC"], "providers": [{"billed_charge": 37.0, "npi": [1346299153]}]}]}]}, {"name": "Emergency Room - General", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0450", "description": "Emergency Room", "allowed_amounts": [{"tin": {"type": "ein", "value": "311724085"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 320.55, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 835.0, "npi": [1669410940]}]}, {"allowed_amount": 270.69, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 679.0, "npi": [1669410940]}]}, {"allowed_amount": 84.45, "billing_code_modifier": [""], "providers": [{"billed_charge": 220.0, "npi": [1669410940]}]}, {"allowed_amount": 83.305, "billing_code_modifier": [""], "providers": [{"billed_charge": 217.0, "npi": [1669410940]}]}, {"allowed_amount": 47.44, "billing_code_modifier": ["59"], "providers": [{"billed_charge": 119.0, "npi": [1669410940]}]}, {"allowed_amount": 332.88, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 835.0, "npi": [1669410940]}]}, {"allowed_amount": 83.3, "billing_code_modifier": [""], "providers": [{"billed_charge": 217.0, "npi": [1669410940]}]}, {"allowed_amount": 137.15, "billing_code_modifier": ["59"], "providers": [{"billed_charge": 344.0, "npi": [1669410940]}]}, {"allowed_amount": 218.05, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 568.0, "npi": [1669410940]}]}, {"allowed_amount": 132.07, "billing_code_modifier": [""], "providers": [{"billed_charge": 344.0, "npi": [1669410940]}]}, {"allowed_amount": 47.445, "billing_code_modifier": ["59"], "providers": [{"billed_charge": 119.0, "npi": [1669410940]}]}, {"allowed_amount": 86.51, "billing_code_modifier": ["59"], "providers": [{"billed_charge": 217.0, "npi": [1669410940]}]}, {"allowed_amount": 45.68, "billing_code_modifier": [""], "providers": [{"billed_charge": 119.0, "npi": [1669410940]}]}, {"allowed_amount": 260.66, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 679.0, "npi": [1669410940]}]}, {"allowed_amount": 67.77, "billing_code_modifier": [""], "providers": [{"billed_charge": 170.0, "npi": [1669410940]}]}, {"allowed_amount": 132.07, "billing_code_modifier": ["59"], "providers": [{"billed_charge": 344.0, "npi": [1669410940]}]}, {"allowed_amount": 45.6825, "billing_code_modifier": [""], "providers": [{"billed_charge": 119.0, "npi": [1669410940]}]}]}]}, {"name": "Laboratory - Hematology", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0305", "description": "Laboratory", "allowed_amounts": [{"tin": {"type": "ein", "value": "340714458"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 45.0, "npi": [1942248737]}, {"billed_charge": 49.5, "npi": [1942248737]}, {"billed_charge": 70.0, "npi": [1942248737]}, {"billed_charge": 56.0, "npi": [1942248737]}, {"billed_charge": 38.4, "npi": [1942248737]}, {"billed_charge": 18.0, "npi": [1942248737]}, {"billed_charge": 16.0, "npi": [1942248737]}, {"billed_charge": 28.0, "npi": [1942248737]}, {"billed_charge": 51.0, "npi": [1942248737]}, {"billed_charge": 66.0, "npi": [1942248737]}, {"billed_charge": 41.0, "npi": [1942248737]}, {"billed_charge": 39.0, "npi": [1942248737]}, {"billed_charge": 38.6, "npi": [1942248737]}, {"billed_charge": 35.4286, "npi": [1942248737]}, {"billed_charge": 41.75, "npi": [1942248737]}, {"billed_charge": 30.0, "npi": [1942248737]}, {"billed_charge": 50.625, "npi": [1942248737]}, {"billed_charge": 42.0, "npi": [1942248737]}, {"billed_charge": 56.3333, "npi": [1942248737]}, {"billed_charge": 41.6667, "npi": [1942248737]}, {"billed_charge": 54.0, "npi": [1942248737]}, {"billed_charge": 44.25, "npi": [1942248737]}, {"billed_charge": 44.6, "npi": [1942248737]}, {"billed_charge": 47.25, "npi": [1942248737]}, {"billed_charge": 40.0, "npi": [1942248737]}, {"billed_charge": 53.0, "npi": [1942248737]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["91"], "providers": [{"billed_charge": 16.0, "npi": [1942248737]}]}]}]}, {"name": "Laboratory - Chemistry", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0301", "description": "Laboratory", "allowed_amounts": [{"tin": {"type": "ein", "value": "314391798"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 5.11, "billing_code_modifier": [""], "providers": [{"billed_charge": 34.0, "npi": [1346247350]}]}, {"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 112.0, "npi": [1346247350]}, {"billed_charge": 74.0, "npi": [1346247350]}, {"billed_charge": 168.0, "npi": [1346247350]}, {"billed_charge": 94.0, "npi": [1346247350]}, {"billed_charge": 144.0, "npi": [1346247350]}, {"billed_charge": 63.0, "npi": [1346247350]}, {"billed_charge": 320.0, "npi": [1346247350]}, {"billed_charge": 85.0, "npi": [1346247350]}, {"billed_charge": 223.0, "npi": [1346247350]}, {"billed_charge": 38.0, "npi": [1346247350]}, {"billed_charge": 348.0, "npi": [1346247350]}, {"billed_charge": 66.0, "npi": [1346247350]}, {"billed_charge": 101.0, "npi": [1346247350]}, {"billed_charge": 34.0, "npi": [1346247350]}, {"billed_charge": 109.85, "npi": [1346247350]}, {"billed_charge": 40.0, "npi": [1346247350]}, {"billed_charge": 253.0, "npi": [1346247350]}, {"billed_charge": 48.0, "npi": [1346247350]}]}, {"allowed_amount": 17.41, "billing_code_modifier": [""], "providers": [{"billed_charge": 51.0, "npi": [1346247350]}]}]}]}, {"name": "Laboratory - Urology", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0307", "description": "Laboratory", "allowed_amounts": [{"tin": {"type": "ein", "value": "341425870"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 93.0, "npi": [1972689172]}, {"billed_charge": 34.0, "npi": [1972689172]}, {"billed_charge": 33.0, "npi": [1972689172]}, {"billed_charge": 164.0, "npi": [1972689172]}, {"billed_charge": 89.0, "npi": [1972689172]}, {"billed_charge": 158.0, "npi": [1972689172]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["59"], "providers": [{"billed_charge": 34.0, "npi": [1972689172]}, {"billed_charge": 164.0, "npi": [1972689172]}, {"billed_charge": 158.0, "npi": [1972689172]}]}]}]}, {"name": "Operating Room Services - General", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0360", "description": "Operating Room Services", "allowed_amounts": [{"tin": {"type": "ein", "value": "340714585"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 3980.8626, "npi": [1679525919]}, {"billed_charge": 41690.0, "npi": [1679525919]}, {"billed_charge": 4389.8889, "npi": [1679525919]}, {"billed_charge": 3670.5333, "npi": [1679525919]}, {"billed_charge": 2620.5122, "npi": [1679525919]}, {"billed_charge": 6245.0769, "npi": [1679525919]}, {"billed_charge": 5316.6429, "npi": [1679525919]}, {"billed_charge": 4734.0, "npi": [1679525919]}, {"billed_charge": 11794.2143, "npi": [1679525919]}, {"billed_charge": 7299.5, "npi": [1679525919]}, {"billed_charge": 5357.0, "npi": [1679525919]}, {"billed_charge": 5913.4, "npi": [1679525919]}, {"billed_charge": 6143.2143, "npi": [1679525919]}, {"billed_charge": 6063.8333, "npi": [1679525919]}, {"billed_charge": 4383.0, "npi": [1679525919]}, {"billed_charge": 11919.3889, "npi": [1679525919]}, {"billed_charge": 6967.0, "npi": [1679525919]}]}, {"allowed_amount": 3979.19, "billing_code_modifier": [""], "providers": [{"billed_charge": 17532.0, "npi": [1679525919]}]}, {"allowed_amount": 11905.25, "billing_code_modifier": ["LT"], "providers": [{"billed_charge": 6574.5, "npi": [1679525919]}]}, {"allowed_amount": 6029.39, "billing_code_modifier": [""], "providers": [{"billed_charge": 6967.0, "npi": [1679525919]}]}, {"allowed_amount": 6697.7, "billing_code_modifier": [""], "providers": [{"billed_charge": 6967.0, "npi": [1679525919]}]}, {"allowed_amount": 1173.37, "billing_code_modifier": [""], "providers": [{"billed_charge": 3732.0, "npi": [1679525919]}]}, {"allowed_amount": 4312.56, "billing_code_modifier": ["T1"], "providers": [{"billed_charge": 6188.5, "npi": [1679525919]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["LT"], "providers": [{"billed_charge": 6574.5, "npi": [1679525919]}]}, {"allowed_amount": 6376.9, "billing_code_modifier": [""], "providers": [{"billed_charge": 6967.0, "npi": [1679525919]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["T1"], "providers": [{"billed_charge": 13149.0, "npi": [1679525919]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["T6"], "providers": [{"billed_charge": 6188.5, "npi": [1679525919]}]}, {"allowed_amount": 7425.78, "billing_code_modifier": ["LT"], "providers": [{"billed_charge": 10957.5, "npi": [1679525919]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["59RT"], "providers": [{"billed_charge": 10957.5, "npi": [1679525919]}]}]}]}, {"name": "Pharmacy - Extension of 25X - Drug Requiring Detailed Coding", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0636", "description": "Pharmacy - Extension of 25x", "allowed_amounts": [{"tin": {"type": "ein", "value": "550357050"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 0.975, "npi": [1164492195]}, {"billed_charge": 23.6667, "npi": [1164492195]}, {"billed_charge": 5.125, "npi": [1164492195]}, {"billed_charge": 388.85, "npi": [1164492195]}, {"billed_charge": 3.71, "npi": [1164492195]}, {"billed_charge": 0.0463, "npi": [1164492195]}, {"billed_charge": 1.6811, "npi": [1164492195]}, {"billed_charge": 0.47, "npi": [1164492195]}, {"billed_charge": 1.41, "npi": [1164492195]}, {"billed_charge": 0.0513, "npi": [1164492195]}, {"billed_charge": 4.325, "npi": [1164492195]}, {"billed_charge": 2.075, "npi": [1164492195]}, {"billed_charge": 326.4, "npi": [1164492195]}, {"billed_charge": 7.52, "npi": [1164492195]}, {"billed_charge": 2.59, "npi": [1164492195]}, {"billed_charge": 44.9875, "npi": [1164492195]}, {"billed_charge": 2.3557, "npi": [1164492195]}, {"billed_charge": 117.55, "npi": [1164492195]}, {"billed_charge": 1.3725, "npi": [1164492195]}, {"billed_charge": 13.2, "npi": [1164492195]}, {"billed_charge": 0.0494, "npi": [1164492195]}, {"billed_charge": 5.65, "npi": [1164492195]}, {"billed_charge": 11.5125, "npi": [1164492195]}, {"billed_charge": 1.5125, "npi": [1164492195]}, {"billed_charge": 0.51, "npi": [1164492195]}, {"billed_charge": 455.05, "npi": [1164492195]}, {"billed_charge": 1.958, "npi": [1164492195]}, {"billed_charge": 30.55, "npi": [1164492195]}, {"billed_charge": 281.95, "npi": [1164492195]}, {"billed_charge": 211.45, "npi": [1164492195]}, {"billed_charge": 1.33, "npi": [1164492195]}, {"billed_charge": 0.0525, "npi": [1164492195]}, {"billed_charge": 0.0563, "npi": [1164492195]}, {"billed_charge": 0.421, "npi": [1164492195]}, {"billed_charge": 2.9212, "npi": [1164492195]}, {"billed_charge": 31.8, "npi": [1164492195]}, {"billed_charge": 0.1318, "npi": [1164492195]}, {"billed_charge": 1.1375, "npi": [1164492195]}, {"billed_charge": 0.0748, "npi": [1164492195]}, {"billed_charge": 0.282, "npi": [1164492195]}, {"billed_charge": 14.575, "npi": [1164492195]}, {"billed_charge": 0.0668, "npi": [1164492195]}, {"billed_charge": 9.15, "npi": [1164492195]}, {"billed_charge": 0.216, "npi": [1164492195]}, {"billed_charge": 0.0493, "npi": [1164492195]}, {"billed_charge": 9.0699, "npi": [1164492195]}]}, {"allowed_amount": 0.42, "billing_code_modifier": [""], "providers": [{"billed_charge": 17.6, "npi": [1164492195]}]}, {"allowed_amount": 0.46, "billing_code_modifier": ["JZ"], "providers": [{"billed_charge": 14.15, "npi": [1164492195]}]}, {"allowed_amount": 0.42, "billing_code_modifier": ["JZ"], "providers": [{"billed_charge": 17.6, "npi": [1164492195]}]}, {"allowed_amount": 0.425, "billing_code_modifier": ["JZ"], "providers": [{"billed_charge": 15.35, "npi": [1164492195]}]}]}]}, {"name": "RADIOLOGIC EXAM CHEST SINGLE VIEW", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "71045", "description": "RADIOLOGIC EXAM CHEST SINGLE VIEW", "allowed_amounts": [{"tin": {"type": "ein", "value": "340714585"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 8.22, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 78.0, "npi": [1235121013]}, {"billed_charge": 79.0, "npi": [1235121013]}]}, {"allowed_amount": 8.22, "billing_code_modifier": ["2676"], "providers": [{"billed_charge": 78.0, "npi": [1235121013]}, {"billed_charge": 79.0, "npi": [1235121013]}]}, {"allowed_amount": 8.22, "billing_code_modifier": ["2677"], "providers": [{"billed_charge": 79.0, "npi": [1235121013]}]}]}]}, {"name": "ECG ROUTINE ECG W/LEAST 12 LDS I and R ONLY", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "93010", "description": "ECG ROUTINE ECG W/LEAST 12 LDS I and R ONLY", "allowed_amounts": [{"tin": {"type": "ein", "value": "264094289"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 21.49, "billing_code_modifier": [""], "providers": [{"billed_charge": 25.0, "npi": [1275773301]}]}, {"allowed_amount": 20.93, "billing_code_modifier": [""], "providers": [{"billed_charge": 25.0, "npi": [1275773301]}]}, {"allowed_amount": 20.93, "billing_code_modifier": ["76"], "providers": [{"billed_charge": 25.0, "npi": [1275773301]}]}]}]}, {"name": "Laboratory - General", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0300", "description": "Laboratory", "allowed_amounts": [{"tin": {"type": "ein", "value": "341425870"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 192.55, "billing_code_modifier": [""], "providers": [{"billed_charge": 384.0, "npi": [1972689172]}]}, {"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 247.6, "npi": [1972689172]}, {"billed_charge": 153.0, "npi": [1972689172]}, {"billed_charge": 399.0, "npi": [1972689172]}, {"billed_charge": 125.0, "npi": [1972689172]}, {"billed_charge": 122.5, "npi": [1972689172]}, {"billed_charge": 131.6429, "npi": [1972689172]}, {"billed_charge": 175.0, "npi": [1972689172]}, {"billed_charge": 563.0, "npi": [1972689172]}, {"billed_charge": 122.25, "npi": [1972689172]}, {"billed_charge": 349.0, "npi": [1972689172]}, {"billed_charge": 147.3333, "npi": [1972689172]}, {"billed_charge": 30.0, "npi": [1972689172]}, {"billed_charge": 585.0, "npi": [1972689172]}, {"billed_charge": 29.0, "npi": [1972689172]}, {"billed_charge": 287.0, "npi": [1972689172]}, {"billed_charge": 79.7143, "npi": [1972689172]}]}]}]}, {"name": "Pharmacy - Extension of 25X - Drug Requiring Detailed Coding", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0636", "description": "Pharmacy - Extension of 25x", "allowed_amounts": [{"tin": {"type": "ein", "value": "310537504"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 29.75, "npi": [1073688354]}, {"billed_charge": 17.0, "npi": [1073688354]}, {"billed_charge": 3.5, "npi": [1073688354]}, {"billed_charge": 6.11, "npi": [1073688354]}, {"billed_charge": 58.26, "npi": [1073688354]}, {"billed_charge": 0.01, "npi": [1073688354]}, {"billed_charge": 0.3535, "npi": [1073688354]}, {"billed_charge": 7.2, "npi": [1073688354]}]}, {"allowed_amount": 0.42, "billing_code_modifier": ["JZSE"], "providers": [{"billed_charge": 7.0, "npi": [1073688354]}]}, {"allowed_amount": 0.47, "billing_code_modifier": ["JZ"], "providers": [{"billed_charge": 3.5, "npi": [1073688354]}]}, {"allowed_amount": 0.46, "billing_code_modifier": ["JZ"], "providers": [{"billed_charge": 7.0, "npi": [1073688354]}]}, {"allowed_amount": 0.42, "billing_code_modifier": ["JZ"], "providers": [{"billed_charge": 7.0, "npi": [1073688354]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["JZ"], "providers": [{"billed_charge": 1.75, "npi": [1073688354]}, {"billed_charge": 11.21, "npi": [1073688354]}, {"billed_charge": 14.725, "npi": [1073688354]}, {"billed_charge": 10.47, "npi": [1073688354]}, {"billed_charge": 2.7125, "npi": [1073688354]}, {"billed_charge": 0.3718, "npi": [1073688354]}, {"billed_charge": 200.4, "npi": [1073688354]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["JW"], "providers": [{"billed_charge": 0.4733, "npi": [1073688354]}, {"billed_charge": 58.26, "npi": [1073688354]}]}]}]}, {"name": "CT Scan - Body Scan", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0352", "description": "CT Scan", "allowed_amounts": [{"tin": {"type": "ein", "value": "340714593"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 231.18, "billing_code_modifier": [""], "providers": [{"billed_charge": 1228.0, "npi": [1902858152]}]}, {"allowed_amount": 566.22, "billing_code_modifier": [""], "providers": [{"billed_charge": 1228.0, "npi": [1235183542]}]}, {"allowed_amount": 222.79, "billing_code_modifier": [""], "providers": [{"billed_charge": 1135.0, "npi": [1902858152]}, {"billed_charge": 1135.0, "npi": [1235183542]}]}, {"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 2375.0, "npi": [1902858152]}, {"billed_charge": 2464.0, "npi": [1235183542]}, {"billed_charge": 1135.0, "npi": [1902858152]}, {"billed_charge": 1228.0, "npi": [1598719346]}, {"billed_charge": 734.0, "npi": [1598719346]}, {"billed_charge": 1228.0, "npi": [1235183542]}, {"billed_charge": 1228.0, "npi": [1902858152]}, {"billed_charge": 1755.0, "npi": [1235183542]}, {"billed_charge": 2464.0, "npi": [1902858152]}, {"billed_charge": 1527.0, "npi": [1902858152]}, {"billed_charge": 1668.0, "npi": [1902858152]}, {"billed_charge": 679.0, "npi": [1598719346]}, {"billed_charge": 1513.0, "npi": [1598719346]}, {"billed_charge": 2375.0, "npi": [1235183542]}, {"billed_charge": 1513.0, "npi": [1235183542]}, {"billed_charge": 679.0, "npi": [1902858152]}, {"billed_charge": 2375.0, "npi": [1598719346]}, {"billed_charge": 1135.0, "npi": [1598719346]}, {"billed_charge": 679.0, "npi": [1235183542]}]}, {"allowed_amount": 544.55, "billing_code_modifier": [""], "providers": [{"billed_charge": 1135.0, "npi": [1902858152]}, {"billed_charge": 1135.0, "npi": [1598719346]}]}, {"allowed_amount": 459.82, "billing_code_modifier": [""], "providers": [{"billed_charge": 2464.0, "npi": [1235183542]}, {"billed_charge": 2464.0, "npi": [1598719346]}, {"billed_charge": 2464.0, "npi": [1902858152]}]}, {"allowed_amount": 137.8, "billing_code_modifier": [""], "providers": [{"billed_charge": 734.0, "npi": [1598719346]}]}, {"allowed_amount": 133.08, "billing_code_modifier": [""], "providers": [{"billed_charge": 679.0, "npi": [1235183542]}]}, {"allowed_amount": 5054.74, "billing_code_modifier": [""], "providers": [{"billed_charge": 2375.0, "npi": [1902858152]}]}, {"allowed_amount": 314.48, "billing_code_modifier": [""], "providers": [{"billed_charge": 1668.0, "npi": [1598719346]}, {"billed_charge": 1668.0, "npi": [1902858152]}]}, {"allowed_amount": 281.03, "billing_code_modifier": [""], "providers": [{"billed_charge": 679.0, "npi": [1902858152]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["RT"], "providers": [{"billed_charge": 734.0, "npi": [1902858152]}]}, {"allowed_amount": 302.51, "billing_code_modifier": [""], "providers": [{"billed_charge": 1513.0, "npi": [1598719346]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["LT"], "providers": [{"billed_charge": 679.0, "npi": [1902858152]}]}, {"allowed_amount": 446.94, "billing_code_modifier": [""], "providers": [{"billed_charge": 2375.0, "npi": [1902858152]}, {"billed_charge": 2375.0, "npi": [1235183542]}, {"billed_charge": 2375.0, "npi": [1598719346]}]}]}]}, {"name": "Laboratory - General", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0300", "description": "Laboratory", "allowed_amounts": [{"tin": {"type": "ein", "value": "264827222"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 103.8, "npi": [1609189604]}, {"billed_charge": 30.0, "npi": [1609189604]}, {"billed_charge": 165.0, "npi": [1609189604]}, {"billed_charge": 563.0, "npi": [1609189604]}, {"billed_charge": 182.0, "npi": [1609189604]}, {"billed_charge": 130.0, "npi": [1609189604]}, {"billed_charge": 29.0, "npi": [1609189604]}, {"billed_charge": 91.5, "npi": [1609189604]}, {"billed_charge": 88.9333, "npi": [1609189604]}, {"billed_charge": 384.0, "npi": [1609189604]}, {"billed_charge": 172.0, "npi": [1609189604]}, {"billed_charge": 122.5, "npi": [1609189604]}, {"billed_charge": 585.0, "npi": [1609189604]}]}, {"allowed_amount": 199.68, "billing_code_modifier": [""], "providers": [{"billed_charge": 399.0, "npi": [1609189604]}]}]}]}, {"name": "Laboratory - Chemistry", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0301", "description": "Laboratory", "allowed_amounts": [{"tin": {"type": "ein", "value": "550357050"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 39.07, "npi": [1164492195]}, {"billed_charge": 35.9, "npi": [1164492195]}, {"billed_charge": 83.4, "npi": [1164492195]}, {"billed_charge": 21.12, "npi": [1164492195]}, {"billed_charge": 192.62, "npi": [1164492195]}, {"billed_charge": 128.0083, "npi": [1164492195]}, {"billed_charge": 92.91, "npi": [1164492195]}, {"billed_charge": 128.81, "npi": [1164492195]}, {"billed_charge": 91.85, "npi": [1164492195]}, {"billed_charge": 59.12, "npi": [1164492195]}, {"billed_charge": 86.57, "npi": [1164492195]}, {"billed_charge": 86.4519, "npi": [1164492195]}, {"billed_charge": 166.81, "npi": [1164492195]}, {"billed_charge": 41.17, "npi": [1164492195]}, {"billed_charge": 330.45, "npi": [1164492195]}, {"billed_charge": 240.71, "npi": [1164492195]}, {"billed_charge": 16.5, "npi": [1164492195]}, {"billed_charge": 40.12, "npi": [1164492195]}, {"billed_charge": 77.49, "npi": [1164492195]}, {"billed_charge": 618.68, "npi": [1164492195]}, {"billed_charge": 58.06, "npi": [1164492195]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["XE"], "providers": [{"billed_charge": 38.01, "npi": [1164492195]}]}, {"allowed_amount": 18.75, "billing_code_modifier": ["QW"], "providers": [{"billed_charge": 117.19, "npi": [1164492195]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["91"], "providers": [{"billed_charge": 86.57, "npi": [1164492195]}]}]}]}, {"name": "IV Therapy -General", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0260", "description": "IV Therapy", "allowed_amounts": [{"tin": {"type": "ein", "value": "314446959"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 500.0, "npi": [1710913462]}, {"billed_charge": 277.0, "npi": [1710913462]}, {"billed_charge": 284.0, "npi": [1710913462]}]}, {"allowed_amount": 61.96, "billing_code_modifier": ["XU"], "providers": [{"billed_charge": 323.0, "npi": [1710913462]}]}, {"allowed_amount": 290.28, "billing_code_modifier": [""], "providers": [{"billed_charge": 351.0, "npi": [1710913462]}, {"billed_charge": 673.0, "npi": [1710913462]}, {"billed_charge": 649.0, "npi": [1710913462]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["XU"], "providers": [{"billed_charge": 241.0, "npi": [1710913462]}]}, {"allowed_amount": 61.96, "billing_code_modifier": [""], "providers": [{"billed_charge": 323.0, "npi": [1710913462]}, {"billed_charge": 195.0, "npi": [1710913462]}]}, {"allowed_amount": 61.958, "billing_code_modifier": ["XU"], "providers": [{"billed_charge": 323.0, "npi": [1710913462]}]}, {"allowed_amount": 290.28, "billing_code_modifier": ["XU"], "providers": [{"billed_charge": 351.0, "npi": [1710913462]}]}, {"allowed_amount": 281.39, "billing_code_modifier": [""], "providers": [{"billed_charge": 351.0, "npi": [1710913462]}, {"billed_charge": 649.0, "npi": [1710913462]}]}, {"allowed_amount": 61.9575, "billing_code_modifier": [""], "providers": [{"billed_charge": 218.0, "npi": [1710913462]}]}, {"allowed_amount": 63.57, "billing_code_modifier": [""], "providers": [{"billed_charge": 323.0, "npi": [1710913462]}, {"billed_charge": 195.0, "npi": [1710913462]}]}, {"allowed_amount": 281.39, "billing_code_modifier": ["59"], "providers": [{"billed_charge": 649.0, "npi": [1710913462]}]}, {"allowed_amount": 61.9567, "billing_code_modifier": ["XU"], "providers": [{"billed_charge": 323.0, "npi": [1710913462]}]}, {"allowed_amount": 281.39, "billing_code_modifier": ["XU"], "providers": [{"billed_charge": 351.0, "npi": [1710913462]}, {"billed_charge": 673.0, "npi": [1710913462]}]}]}]}, {"name": "Occupational Therapy - Evaluation or Reevaluation", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0434", "description": "Occupational Therapy", "allowed_amounts": [{"tin": {"type": "ein", "value": "340714585"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 624.0, "npi": [1679525919]}, {"billed_charge": 674.0, "npi": [1679525919]}]}, {"allowed_amount": 129.92, "billing_code_modifier": ["GO"], "providers": [{"billed_charge": 624.0, "npi": [1679525919]}]}]}]}, {"name": "Emergency Room - General", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0450", "description": "Emergency Room", "allowed_amounts": [{"tin": {"type": "ein", "value": "344428218"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 531.16, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 621.0, "npi": [1801884655]}, {"billed_charge": 807.0, "npi": [1801884655]}]}, {"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 325.0, "npi": [1801884655]}, {"billed_charge": 311.0, "npi": [1801884655]}, {"billed_charge": 867.0, "npi": [1801884655]}, {"billed_charge": 240.0, "npi": [1801884655]}, {"billed_charge": 78.0, "npi": [1801884655]}]}, {"allowed_amount": 330.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 330.0, "npi": [1801884655]}]}, {"allowed_amount": 1010.95, "billing_code_modifier": [""], "providers": [{"billed_charge": 1653.0, "npi": [1801884655]}]}, {"allowed_amount": 260.33, "billing_code_modifier": [""], "providers": [{"billed_charge": 251.0, "npi": [1801884655]}]}, {"allowed_amount": 57.32, "billing_code_modifier": [""], "providers": [{"billed_charge": 251.0, "npi": [1801884655]}]}, {"allowed_amount": 345.38, "billing_code_modifier": [""], "providers": [{"billed_charge": 330.0, "npi": [1801884655]}]}, {"allowed_amount": 262.8, "billing_code_modifier": ["59"], "providers": [{"billed_charge": 240.0, "npi": [1801884655]}]}, {"allowed_amount": 510.68, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 843.0, "npi": [1801884655]}, {"billed_charge": 649.0, "npi": [1801884655]}]}, {"allowed_amount": 57.315, "billing_code_modifier": [""], "providers": [{"billed_charge": 251.0, "npi": [1801884655]}]}, {"allowed_amount": 510.68, "billing_code_modifier": [""], "providers": [{"billed_charge": 649.0, "npi": [1801884655]}]}, {"allowed_amount": 345.38, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 330.0, "npi": [1801884655]}, {"billed_charge": 818.0, "npi": [1801884655]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 330.0, "npi": [1801884655]}]}, {"allowed_amount": 334.09, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 345.0, "npi": [1801884655]}, {"billed_charge": 1049.0, "npi": [1801884655]}]}, {"allowed_amount": 728.86, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 906.0, "npi": [1801884655]}]}, {"allowed_amount": 497.52, "billing_code_modifier": [""], "providers": [{"billed_charge": 676.0, "npi": [1801884655]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["59"], "providers": [{"billed_charge": 240.0, "npi": [1801884655]}]}, {"allowed_amount": 260.33, "billing_code_modifier": ["59"], "providers": [{"billed_charge": 251.0, "npi": [1801884655]}]}, {"allowed_amount": 187.92, "billing_code_modifier": [""], "providers": [{"billed_charge": 206.0, "npi": [1801884655]}]}, {"allowed_amount": 531.16, "billing_code_modifier": [""], "providers": [{"billed_charge": 1295.0, "npi": [1801884655]}, {"billed_charge": 621.0, "npi": [1801884655]}]}, {"allowed_amount": 764.76, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 867.0, "npi": [1801884655]}, {"billed_charge": 1053.0, "npi": [1801884655]}]}, {"allowed_amount": 57.55, "billing_code_modifier": ["59"], "providers": [{"billed_charge": 240.0, "npi": [1801884655]}]}, {"allowed_amount": 262.8, "billing_code_modifier": [""], "providers": [{"billed_charge": 240.0, "npi": [1801884655]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["TA"], "providers": [{"billed_charge": 594.0, "npi": [1801884655]}]}, {"allowed_amount": 57.55, "billing_code_modifier": [""], "providers": [{"billed_charge": 240.0, "npi": [1801884655]}]}, {"allowed_amount": 2021.04, "billing_code_modifier": [""], "providers": [{"billed_charge": 2489.0, "npi": [1801884655]}]}, {"allowed_amount": 334.09, "billing_code_modifier": [""], "providers": [{"billed_charge": 345.0, "npi": [1801884655]}, {"billed_charge": 539.0, "npi": [1801884655]}]}]}]}, {"name": "EKG/ECG (Electrocardiogram) - Telemetry", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0732", "description": "EKG/ECG (Electrocardiogram)", "allowed_amounts": [{"tin": {"type": "ein", "value": "340714458"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 289.0, "npi": [1942248737]}, {"billed_charge": 268.0, "npi": [1942248737]}, {"billed_charge": 282.0, "npi": [1942248737]}]}]}]}, {"name": "Laboratory - General", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0300", "description": "Laboratory", "allowed_amounts": [{"tin": {"type": "ein", "value": "340714458"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 46.3333, "npi": [1942248737]}, {"billed_charge": 64.0, "npi": [1942248737]}, {"billed_charge": 210.0, "npi": [1942248737]}, {"billed_charge": 54.5, "npi": [1942248737]}, {"billed_charge": 66.0, "npi": [1942248737]}, {"billed_charge": 60.7778, "npi": [1942248737]}, {"billed_charge": 56.8, "npi": [1942248737]}, {"billed_charge": 58.0, "npi": [1942248737]}, {"billed_charge": 63.0, "npi": [1942248737]}, {"billed_charge": 1182.0, "npi": [1942248737]}, {"billed_charge": 67.0, "npi": [1942248737]}, {"billed_charge": 161.0, "npi": [1942248737]}, {"billed_charge": 57.8333, "npi": [1942248737]}, {"billed_charge": 68.0, "npi": [1942248737]}, {"billed_charge": 58.5714, "npi": [1942248737]}, {"billed_charge": 21.0, "npi": [1942248737]}, {"billed_charge": 1055.0, "npi": [1942248737]}, {"billed_charge": 67.2857, "npi": [1942248737]}, {"billed_charge": 20.0, "npi": [1942248737]}, {"billed_charge": 93.0, "npi": [1942248737]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["91"], "providers": [{"billed_charge": 32.0, "npi": [1942248737]}, {"billed_charge": 30.0, "npi": [1942248737]}]}]}]}, {"name": "CT HEAD/BRAIN W/O CONTRAST MATERIAL", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "70450", "description": "CT HEAD/BRAIN W/O CONTRAST MATERIAL", "allowed_amounts": [{"tin": {"type": "ein", "value": "310983140"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 37.97, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 179.0, "npi": [1093718496]}, {"billed_charge": 188.0, "npi": [1093718496]}]}, {"allowed_amount": 36.81, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 179.0, "npi": [1093718496]}, {"billed_charge": 207.0, "npi": [1093718496]}]}, {"allowed_amount": 38.75, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 179.0, "npi": [1093718496]}, {"billed_charge": 207.0, "npi": [1093718496]}, {"billed_charge": 188.0, "npi": [1093718496]}]}, {"allowed_amount": 36.07, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 179.0, "npi": [1093718496]}, {"billed_charge": 188.0, "npi": [1093718496]}]}]}]}, {"name": "EKG/ECG (Electrocardiogram) - General", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0730", "description": "EKG/ECG (Electrocardiogram)", "allowed_amounts": [{"tin": {"type": "ein", "value": "344428256"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 625.0, "npi": [1407854771]}, {"billed_charge": 594.0, "npi": [1407854771]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["59"], "providers": [{"billed_charge": 625.0, "npi": [1407854771]}, {"billed_charge": 594.0, "npi": [1407854771]}]}]}]}, {"name": "Pharmacy - Extension of 25X - Drug Requiring Detailed Coding", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0636", "description": "Pharmacy - Extension of 25x", "allowed_amounts": [{"tin": {"type": "ein", "value": "340714538"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.4225, "billing_code_modifier": ["JZ"], "providers": [{"billed_charge": 1.89, "npi": [1356366991]}]}, {"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 14.0514, "npi": [1356366991]}, {"billed_charge": 8.9, "npi": [1356366991]}, {"billed_charge": 0.82, "npi": [1356366991]}, {"billed_charge": 4.0, "npi": [1356366991]}, {"billed_charge": 6.0, "npi": [1356366991]}, {"billed_charge": 2.31, "npi": [1356366991]}, {"billed_charge": 4.46, "npi": [1356366991]}, {"billed_charge": 32.5, "npi": [1356366991]}, {"billed_charge": 0.26, "npi": [1356366991]}, {"billed_charge": 15.4, "npi": [1356366991]}, {"billed_charge": 51.05, "npi": [1356366991]}, {"billed_charge": 1.04, "npi": [1356366991]}, {"billed_charge": 10.45, "npi": [1356366991]}, {"billed_charge": 1.9803, "npi": [1356366991]}, {"billed_charge": 14.6, "npi": [1356366991]}, {"billed_charge": 7.0, "npi": [1356366991]}, {"billed_charge": 0.92, "npi": [1356366991]}, {"billed_charge": 4.15, "npi": [1356366991]}, {"billed_charge": 76.8, "npi": [1356366991]}, {"billed_charge": 83.05, "npi": [1356366991]}, {"billed_charge": 0.84, "npi": [1356366991]}, {"billed_charge": 0.6, "npi": [1356366991]}, {"billed_charge": 64.25, "npi": [1356366991]}, {"billed_charge": 2.5543, "npi": [1356366991]}, {"billed_charge": 24.1206, "npi": [1356366991]}, {"billed_charge": 12.4, "npi": [1356366991]}]}, {"allowed_amount": 0.425, "billing_code_modifier": [""], "providers": [{"billed_charge": 3.17, "npi": [1356366991]}]}, {"allowed_amount": 0.47, "billing_code_modifier": ["JZ"], "providers": [{"billed_charge": 3.17, "npi": [1356366991]}]}, {"allowed_amount": 0.46, "billing_code_modifier": ["JZ"], "providers": [{"billed_charge": 6.25, "npi": [1356366991]}]}, {"allowed_amount": 0.42, "billing_code_modifier": ["JZ"], "providers": [{"billed_charge": 6.25, "npi": [1356366991]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["JZ"], "providers": [{"billed_charge": 15.22, "npi": [1356366991]}, {"billed_charge": 1.015, "npi": [1356366991]}, {"billed_charge": 33.05, "npi": [1356366991]}, {"billed_charge": 24.85, "npi": [1356366991]}, {"billed_charge": 2.1, "npi": [1356366991]}, {"billed_charge": 24.8, "npi": [1356366991]}, {"billed_charge": 0.63, "npi": [1356366991]}, {"billed_charge": 0.82, "npi": [1356366991]}, {"billed_charge": 6.9, "npi": [1356366991]}, {"billed_charge": 58.15, "npi": [1356366991]}, {"billed_charge": 75.25, "npi": [1356366991]}, {"billed_charge": 21.1, "npi": [1356366991]}, {"billed_charge": 22.9, "npi": [1356366991]}, {"billed_charge": 0.1, "npi": [1356366991]}, {"billed_charge": 22.75, "npi": [1356366991]}, {"billed_charge": 19.95, "npi": [1356366991]}, {"billed_charge": 10.7, "npi": [1356366991]}, {"billed_charge": 103.15, "npi": [1356366991]}, {"billed_charge": 5.2, "npi": [1356366991]}, {"billed_charge": 2.5, "npi": [1356366991]}, {"billed_charge": 3.68, "npi": [1356366991]}, {"billed_charge": 5.49, "npi": [1356366991]}, {"billed_charge": 76.9, "npi": [1356366991]}, {"billed_charge": 4.78, "npi": [1356366991]}, {"billed_charge": 1.07, "npi": [1356366991]}]}, {"allowed_amount": 0.47, "billing_code_modifier": [""], "providers": [{"billed_charge": 3.17, "npi": [1356366991]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["TBJZ"], "providers": [{"billed_charge": 2.27, "npi": [1356366991]}]}]}]}, {"name": "Radiology - Diagnostic - General", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0320", "description": "Radiology - Diagnostic", "allowed_amounts": [{"tin": {"type": "ein", "value": "344428218"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 464.0, "npi": [1801884655]}, {"billed_charge": 373.0, "npi": [1801884655]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["RT"], "providers": [{"billed_charge": 431.0, "npi": [1801884655]}, {"billed_charge": 393.0, "npi": [1801884655]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["50"], "providers": [{"billed_charge": 444.0, "npi": [1801884655]}]}, {"allowed_amount": 109.84, "billing_code_modifier": [""], "providers": [{"billed_charge": 312.0, "npi": [1801884655]}, {"billed_charge": 285.0, "npi": [1801884655]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["LT"], "providers": [{"billed_charge": 376.0, "npi": [1801884655]}, {"billed_charge": 393.0, "npi": [1801884655]}, {"billed_charge": 442.0, "npi": [1801884655]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["FA"], "providers": [{"billed_charge": 373.0, "npi": [1801884655]}]}, {"allowed_amount": 106.5, "billing_code_modifier": [""], "providers": [{"billed_charge": 326.0, "npi": [1801884655]}, {"billed_charge": 298.0, "npi": [1801884655]}]}]}]}, {"name": "Radiology - Diagnostic - Chest X-ray", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0324", "description": "Radiology - Diagnostic", "allowed_amounts": [{"tin": {"type": "ein", "value": "341567805"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 391.0, "npi": [1043397292]}, {"billed_charge": 322.0, "npi": [1043397292]}, {"billed_charge": 376.0, "npi": [1043397292]}, {"billed_charge": 335.0, "npi": [1043397292]}]}, {"allowed_amount": 114.28, "billing_code_modifier": [""], "providers": [{"billed_charge": 391.0, "npi": [1043397292]}, {"billed_charge": 335.0, "npi": [1043397292]}]}, {"allowed_amount": 114.69, "billing_code_modifier": [""], "providers": [{"billed_charge": 391.0, "npi": [1043397292]}, {"billed_charge": 335.0, "npi": [1043397292]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["RT"], "providers": [{"billed_charge": 541.0, "npi": [1043397292]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["LT"], "providers": [{"billed_charge": 563.0, "npi": [1043397292]}]}, {"allowed_amount": 110.2, "billing_code_modifier": [""], "providers": [{"billed_charge": 376.0, "npi": [1043397292]}]}]}]}, {"name": "CT Scan - Head Scan", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0351", "description": "CT Scan", "allowed_amounts": [{"tin": {"type": "ein", "value": "340714585"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 734.0, "npi": [1679525919]}, {"billed_charge": 1135.0, "npi": [1679525919]}, {"billed_charge": 679.0, "npi": [1679525919]}, {"billed_charge": 907.0, "npi": [1679525919]}, {"billed_charge": 1228.0, "npi": [1679525919]}, {"billed_charge": 788.8333, "npi": [1679525919]}]}, {"allowed_amount": 544.55, "billing_code_modifier": [""], "providers": [{"billed_charge": 679.0, "npi": [1679525919]}]}, {"allowed_amount": 137.8, "billing_code_modifier": [""], "providers": [{"billed_charge": 734.0, "npi": [1679525919]}]}, {"allowed_amount": 133.08, "billing_code_modifier": [""], "providers": [{"billed_charge": 679.0, "npi": [1679525919]}]}, {"allowed_amount": 281.03, "billing_code_modifier": [""], "providers": [{"billed_charge": 679.0, "npi": [1679525919]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["59"], "providers": [{"billed_charge": 679.0, "npi": [1679525919]}]}]}]}, {"name": "DXA BONE DENSITY STUDY 1 OR GT  SITES AXIAL SKEL", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "77080", "description": "DXA BONE DENSITY STUDY 1 OR GT  SITES AXIAL SKEL", "allowed_amounts": [{"tin": {"type": "ein", "value": "310745303"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 9.2, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 194.0, "npi": [1669408159]}]}, {"allowed_amount": 8.87, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 194.0, "npi": [1669408159]}]}, {"allowed_amount": 8.87, "billing_code_modifier": ["26XU"], "providers": [{"billed_charge": 194.0, "npi": [1669408159]}]}]}]}, {"name": "Laboratory - Chemistry", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0301", "description": "Laboratory", "allowed_amounts": [{"tin": {"type": "ein", "value": "341623770"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 109.0, "npi": [1639133002]}, {"billed_charge": 158.0, "npi": [1639133002]}, {"billed_charge": 284.0, "npi": [1639133002]}, {"billed_charge": 152.0, "npi": [1639133002]}, {"billed_charge": 206.0, "npi": [1639133002]}, {"billed_charge": 191.0, "npi": [1639133002]}, {"billed_charge": 160.0, "npi": [1639133002]}, {"billed_charge": 298.0, "npi": [1639133002]}, {"billed_charge": 169.0, "npi": [1639133002]}, {"billed_charge": 177.0, "npi": [1639133002]}, {"billed_charge": 216.0, "npi": [1639133002]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["XE"], "providers": [{"billed_charge": 56.0, "npi": [1639133002]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["91"], "providers": [{"billed_charge": 169.0, "npi": [1639133002]}, {"billed_charge": 177.0, "npi": [1639133002]}]}]}]}, {"name": "Laboratory Pathological - Histology", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0312", "description": "Laboratory Pathology", "allowed_amounts": [{"tin": {"type": "ein", "value": "340714585"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 729.7778, "npi": [1679525919]}, {"billed_charge": 1182.0, "npi": [1679525919]}, {"billed_charge": 775.0, "npi": [1679525919]}, {"billed_charge": 221.3333, "npi": [1679525919]}, {"billed_charge": 205.2, "npi": [1679525919]}, {"billed_charge": 324.4615, "npi": [1679525919]}, {"billed_charge": 192.0, "npi": [1679525919]}, {"billed_charge": 207.0, "npi": [1679525919]}, {"billed_charge": 785.5, "npi": [1679525919]}, {"billed_charge": 369.0, "npi": [1679525919]}, {"billed_charge": 247.0, "npi": [1679525919]}, {"billed_charge": 584.4, "npi": [1679525919]}, {"billed_charge": 335.0, "npi": [1679525919]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["59"], "providers": [{"billed_charge": 1182.0, "npi": [1679525919]}, {"billed_charge": 247.0, "npi": [1679525919]}]}]}]}, {"name": "LEVEL IV SURG PATHOLOGY GROSS AND MICROSCOPIC EXAM", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "88305", "description": "LEVEL IV SURG PATHOLOGY GROSS AND MICROSCOPIC EXAM", "allowed_amounts": [{"tin": {"type": "ein", "value": "341283689"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 34.34, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 210.0, "npi": [1205025186]}]}, {"allowed_amount": 34.02, "billing_code_modifier": ["26Q6"], "providers": [{"billed_charge": 210.0, "npi": [1205025186]}]}, {"allowed_amount": 34.02, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 210.0, "npi": [1205025186]}]}]}]}, {"name": "Laboratory - Urology", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0307", "description": "Laboratory", "allowed_amounts": [{"tin": {"type": "ein", "value": "340714612"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 99.0, "npi": [1841299039]}, {"billed_charge": 34.0, "npi": [1841299039]}, {"billed_charge": 33.0, "npi": [1841299039]}, {"billed_charge": 164.0, "npi": [1841299039]}, {"billed_charge": 93.0, "npi": [1841299039]}, {"billed_charge": 158.0, "npi": [1841299039]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["59"], "providers": [{"billed_charge": 34.0, "npi": [1841299039]}]}]}]}, {"name": "SCREENING DIGITAL BREAST TOMOSYNTHESIS BI", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "77063", "description": "SCREENING DIGITAL BREAST TOMOSYNTHESIS BI", "allowed_amounts": [{"tin": {"type": "ein", "value": "310874388"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 26.89, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 120.0, "npi": [1346299153]}]}, {"allowed_amount": 27.26, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 120.0, "npi": [1346299153]}]}]}]}, {"name": "Pharmacy - Extension of 25X - Drug Requiring Detailed Coding", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0636", "description": "Pharmacy - Extension of 25x", "allowed_amounts": [{"tin": {"type": "ein", "value": "340714458"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 19.35, "billing_code_modifier": [""], "providers": [{"billed_charge": 73.5, "npi": [1942248737]}]}, {"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 1.84, "npi": [1942248737]}, {"billed_charge": 11.575, "npi": [1942248737]}, {"billed_charge": 2.1682, "npi": [1942248737]}, {"billed_charge": 6.35, "npi": [1942248737]}, {"billed_charge": 2.25, "npi": [1942248737]}, {"billed_charge": 5.25, "npi": [1942248737]}, {"billed_charge": 7.8415, "npi": [1942248737]}, {"billed_charge": 1.13, "npi": [1942248737]}, {"billed_charge": 1.429, "npi": [1942248737]}, {"billed_charge": 1.8661, "npi": [1942248737]}, {"billed_charge": 1.53, "npi": [1942248737]}, {"billed_charge": 3.48, "npi": [1942248737]}, {"billed_charge": 6.9235, "npi": [1942248737]}, {"billed_charge": 0.5, "npi": [1942248737]}, {"billed_charge": 1.44, "npi": [1942248737]}, {"billed_charge": 20.1, "npi": [1942248737]}, {"billed_charge": 1.1167, "npi": [1942248737]}, {"billed_charge": 0.7867, "npi": [1942248737]}, {"billed_charge": 10.05, "npi": [1942248737]}, {"billed_charge": 0.0531, "npi": [1942248737]}, {"billed_charge": 1.9609, "npi": [1942248737]}, {"billed_charge": 1.0, "npi": [1942248737]}, {"billed_charge": 1.7814, "npi": [1942248737]}, {"billed_charge": 0.825, "npi": [1942248737]}, {"billed_charge": 4.05, "npi": [1942248737]}, {"billed_charge": 0.1, "npi": [1942248737]}, {"billed_charge": 4.0991, "npi": [1942248737]}, {"billed_charge": 3.5114, "npi": [1942248737]}, {"billed_charge": 2.0885, "npi": [1942248737]}, {"billed_charge": 1.2667, "npi": [1942248737]}, {"billed_charge": 1.3, "npi": [1942248737]}, {"billed_charge": 1.57, "npi": [1942248737]}, {"billed_charge": 0.56, "npi": [1942248737]}, {"billed_charge": 26.25, "npi": [1942248737]}, {"billed_charge": 0.995, "npi": [1942248737]}, {"billed_charge": 0.8229, "npi": [1942248737]}, {"billed_charge": 1.33, "npi": [1942248737]}, {"billed_charge": 4.625, "npi": [1942248737]}, {"billed_charge": 12.65, "npi": [1942248737]}, {"billed_charge": 2.15, "npi": [1942248737]}, {"billed_charge": 13.45, "npi": [1942248737]}, {"billed_charge": 1.8901, "npi": [1942248737]}, {"billed_charge": 2.0, "npi": [1942248737]}, {"billed_charge": 1.4125, "npi": [1942248737]}, {"billed_charge": 1.9114, "npi": [1942248737]}, {"billed_charge": 13.0375, "npi": [1942248737]}, {"billed_charge": 2.4, "npi": [1942248737]}, {"billed_charge": 35.85, "npi": [1942248737]}, {"billed_charge": 1.66, "npi": [1942248737]}, {"billed_charge": 39.3, "npi": [1942248737]}, {"billed_charge": 1.1733, "npi": [1942248737]}, {"billed_charge": 24.6833, "npi": [1942248737]}, {"billed_charge": 2.29, "npi": [1942248737]}, {"billed_charge": 180.0, "npi": [1942248737]}, {"billed_charge": 6.0033, "npi": [1942248737]}, {"billed_charge": 1.43, "npi": [1942248737]}, {"billed_charge": 0.145, "npi": [1942248737]}, {"billed_charge": 1.45, "npi": [1942248737]}, {"billed_charge": 8.85, "npi": [1942248737]}, {"billed_charge": 3.29, "npi": [1942248737]}, {"billed_charge": 0.85, "npi": [1942248737]}, {"billed_charge": 1.9371, "npi": [1942248737]}, {"billed_charge": 2.8104, "npi": [1942248737]}]}, {"allowed_amount": 0.2838, "billing_code_modifier": ["JZ"], "providers": [{"billed_charge": 3.0375, "npi": [1942248737]}]}, {"allowed_amount": 0.41, "billing_code_modifier": ["JZ"], "providers": [{"billed_charge": 9.5, "npi": [1942248737]}]}, {"allowed_amount": 0.47, "billing_code_modifier": ["JZ"], "providers": [{"billed_charge": 3.65, "npi": [1942248737]}, {"billed_charge": 10.775, "npi": [1942248737]}, {"billed_charge": 9.5, "npi": [1942248737]}, {"billed_charge": 1.775, "npi": [1942248737]}]}, {"allowed_amount": 0.46, "billing_code_modifier": ["JZ"], "providers": [{"billed_charge": 3.65, "npi": [1942248737]}, {"billed_charge": 1.8, "npi": [1942248737]}, {"billed_charge": 9.5, "npi": [1942248737]}, {"billed_charge": 5.65, "npi": [1942248737]}]}, {"allowed_amount": 2.0132, "billing_code_modifier": ["JZ"], "providers": [{"billed_charge": 6.5387, "npi": [1942248737]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["JZ"], "providers": [{"billed_charge": 1.542, "npi": [1942248737]}]}]}]}, {"name": "Pharmacy - General", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0250", "description": "Pharmacy (also see 063x, an extension of 025x)", "allowed_amounts": [{"tin": {"type": "ein", "value": "474442902"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 2.0667, "npi": [1346607017]}, {"billed_charge": 21.2, "npi": [1346607017]}, {"billed_charge": 3.3, "npi": [1346607017]}, {"billed_charge": 2.0, "npi": [1346607017]}, {"billed_charge": 3.8333, "npi": [1346607017]}, {"billed_charge": 2.225, "npi": [1346607017]}, {"billed_charge": 2.2, "npi": [1346607017]}, {"billed_charge": 22.35, "npi": [1346607017]}, {"billed_charge": 7.0, "npi": [1346607017]}, {"billed_charge": 3.0307, "npi": [1346607017]}, {"billed_charge": 9.675, "npi": [1346607017]}, {"billed_charge": 3.8, "npi": [1346607017]}, {"billed_charge": 5.9167, "npi": [1346607017]}, {"billed_charge": 144.3625, "npi": [1346607017]}, {"billed_charge": 12.1667, "npi": [1346607017]}, {"billed_charge": 2.7, "npi": [1346607017]}, {"billed_charge": 7.75, "npi": [1346607017]}, {"billed_charge": 2.25, "npi": [1346607017]}]}]}]}, {"name": "Emergency Room - General", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0450", "description": "Emergency Room", "allowed_amounts": [{"tin": {"type": "ein", "value": "341567805"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 479.62, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 1406.0, "npi": [1043397292]}]}, {"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 438.0, "npi": [1043397292]}, {"billed_charge": 407.0, "npi": [1043397292]}, {"billed_charge": 1465.6667, "npi": [1043397292]}, {"billed_charge": 1957.0, "npi": [1043397292]}, {"billed_charge": 4034.0, "npi": [1043397292]}, {"billed_charge": 2601.0, "npi": [1043397292]}, {"billed_charge": 45.0, "npi": [1043397292]}, {"billed_charge": 394.0, "npi": [1043397292]}, {"billed_charge": 167.0, "npi": [1043397292]}, {"billed_charge": 2705.0, "npi": [1043397292]}, {"billed_charge": 174.0, "npi": [1043397292]}, {"billed_charge": 3879.0, "npi": [1043397292]}, {"billed_charge": 360.0, "npi": [1043397292]}]}, {"allowed_amount": 359.79, "billing_code_modifier": [""], "providers": [{"billed_charge": 1070.0, "npi": [1043397292]}]}, {"allowed_amount": 795.72, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 2705.0, "npi": [1043397292]}]}, {"allowed_amount": 767.3, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 2601.0, "npi": [1043397292]}]}, {"allowed_amount": 111.15, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 342.0, "npi": [1043397292]}]}, {"allowed_amount": 3313.64, "billing_code_modifier": [""], "providers": [{"billed_charge": 2601.0, "npi": [1043397292]}, {"billed_charge": 3879.0, "npi": [1043397292]}]}, {"allowed_amount": 359.79, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 1070.0, "npi": [1043397292]}]}, {"allowed_amount": 532.91, "billing_code_modifier": [""], "providers": [{"billed_charge": 1406.0, "npi": [1043397292]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["59"], "providers": [{"billed_charge": 167.0, "npi": [1043397292]}, {"billed_charge": 174.0, "npi": [1043397292]}]}, {"allowed_amount": 784.92, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 2705.0, "npi": [1043397292]}]}, {"allowed_amount": 3447.28, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 2705.0, "npi": [1043397292]}]}, {"allowed_amount": 532.91, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 1406.0, "npi": [1043397292]}]}, {"allowed_amount": 111.15, "billing_code_modifier": [""], "providers": [{"billed_charge": 342.0, "npi": [1043397292]}]}, {"allowed_amount": 3313.64, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 2601.0, "npi": [1043397292]}]}, {"allowed_amount": 767.3, "billing_code_modifier": [""], "providers": [{"billed_charge": 2601.0, "npi": [1043397292]}]}, {"allowed_amount": 346.53, "billing_code_modifier": [""], "providers": [{"billed_charge": 1029.0, "npi": [1043397292]}]}, {"allowed_amount": 549.96, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 1462.0, "npi": [1043397292]}]}, {"allowed_amount": 784.92, "billing_code_modifier": [""], "providers": [{"billed_charge": 2705.0, "npi": [1043397292]}]}, {"allowed_amount": 205.53, "billing_code_modifier": [""], "providers": [{"billed_charge": 561.0, "npi": [1043397292]}]}, {"allowed_amount": 549.96, "billing_code_modifier": [""], "providers": [{"billed_charge": 1462.0, "npi": [1043397292]}]}, {"allowed_amount": 110.2, "billing_code_modifier": [""], "providers": [{"billed_charge": 329.0, "npi": [1043397292]}]}]}]}, {"name": "Emergency Room - General", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0450", "description": "Emergency Room", "allowed_amounts": [{"tin": {"type": "ein", "value": "340714593"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 202.37, "billing_code_modifier": [""], "providers": [{"billed_charge": 1093.0, "npi": [1235183542]}]}, {"allowed_amount": 264.45, "billing_code_modifier": [""], "providers": [{"billed_charge": 596.0, "npi": [1902858152]}]}, {"allowed_amount": 5544.84, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 3672.0, "npi": [1598719346]}]}, {"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 5814.0, "npi": [1598719346]}, {"billed_charge": 5814.0, "npi": [1235183542]}, {"billed_charge": 3672.0, "npi": [1235183542]}, {"billed_charge": 596.0, "npi": [1902858152]}, {"billed_charge": 273.0, "npi": [1902858152]}, {"billed_charge": 5073.0, "npi": [1598719346]}, {"billed_charge": 3672.0, "npi": [1902858152]}, {"billed_charge": 234.0, "npi": [1902858152]}, {"billed_charge": 413.0, "npi": [1902858152]}, {"billed_charge": 4230.0, "npi": [1598719346]}, {"billed_charge": 596.0, "npi": [1235183542]}, {"billed_charge": 4230.0, "npi": [1902858152]}, {"billed_charge": 2533.0, "npi": [1902858152]}, {"billed_charge": 5814.0, "npi": [1902858152]}, {"billed_charge": 234.0, "npi": [1235183542]}, {"billed_charge": 4230.0, "npi": [1235183542]}, {"billed_charge": 593.0, "npi": [1902858152]}, {"billed_charge": 5073.0, "npi": [1235183542]}, {"billed_charge": 1632.0, "npi": [1598719346]}, {"billed_charge": 273.0, "npi": [1235183542]}, {"billed_charge": 679.0, "npi": [1235183542]}]}, {"allowed_amount": 359.79, "billing_code_modifier": [""], "providers": [{"billed_charge": 1911.0, "npi": [1235183542]}, {"billed_charge": 1911.0, "npi": [1902858152]}, {"billed_charge": 1911.0, "npi": [1598719346]}]}, {"allowed_amount": 6561.93, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 4230.0, "npi": [1235183542]}]}, {"allowed_amount": 6842.46, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 5814.0, "npi": [1235183542]}]}, {"allowed_amount": 133.08, "billing_code_modifier": [""], "providers": [{"billed_charge": 679.0, "npi": [1598719346]}]}, {"allowed_amount": 1054.53, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 5073.0, "npi": [1598719346]}, {"billed_charge": 5073.0, "npi": [1902858152]}]}, {"allowed_amount": 304.38, "billing_code_modifier": [""], "providers": [{"billed_charge": 1018.0, "npi": [1598719346]}]}, {"allowed_amount": 767.3, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 3672.0, "npi": [1235183542]}, {"billed_charge": 3672.0, "npi": [1598719346]}, {"billed_charge": 3672.0, "npi": [1902858152]}]}, {"allowed_amount": 369.43, "billing_code_modifier": ["RT"], "providers": [{"billed_charge": 1829.0, "npi": [1235183542]}]}, {"allowed_amount": 871.14, "billing_code_modifier": ["59"], "providers": [{"billed_charge": 3763.0, "npi": [1902858152]}]}, {"allowed_amount": 346.53, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 1632.0, "npi": [1902858152]}, {"billed_charge": 1632.0, "npi": [1235183542]}, {"billed_charge": 1632.0, "npi": [1598719346]}]}, {"allowed_amount": 198.19, "billing_code_modifier": [""], "providers": [{"billed_charge": 935.0, "npi": [1598719346]}, {"billed_charge": 935.0, "npi": [1235183542]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["RT"], "providers": [{"billed_charge": 7362.0, "npi": [1902858152]}]}, {"allowed_amount": 359.79, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 1911.0, "npi": [1235183542]}, {"billed_charge": 1911.0, "npi": [1902858152]}, {"billed_charge": 1911.0, "npi": [1598719346]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 3672.0, "npi": [1902858152]}, {"billed_charge": 4230.0, "npi": [1902858152]}, {"billed_charge": 4230.0, "npi": [1235183542]}]}, {"allowed_amount": 532.91, "billing_code_modifier": [""], "providers": [{"billed_charge": 2533.0, "npi": [1598719346]}, {"billed_charge": 2533.0, "npi": [1235183542]}]}, {"allowed_amount": 784.92, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 4230.0, "npi": [1598719346]}, {"billed_charge": 4230.0, "npi": [1902858152]}, {"billed_charge": 4230.0, "npi": [1235183542]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["LT"], "providers": [{"billed_charge": 7362.0, "npi": [1902858152]}]}, {"allowed_amount": 325.12, "billing_code_modifier": ["RT"], "providers": [{"billed_charge": 1103.0, "npi": [1902858152]}]}, {"allowed_amount": 300.21, "billing_code_modifier": ["T4"], "providers": [{"billed_charge": 971.0, "npi": [1598719346]}]}, {"allowed_amount": 3447.28, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 5814.0, "npi": [1235183542]}, {"billed_charge": 4230.0, "npi": [1598719346]}, {"billed_charge": 4230.0, "npi": [1902858152]}, {"billed_charge": 4230.0, "npi": [1235183542]}]}, {"allowed_amount": 467.47, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 2938.0, "npi": [1598719346]}]}, {"allowed_amount": 13514.2, "billing_code_modifier": ["LT"], "providers": [{"billed_charge": 7362.0, "npi": [1902858152]}]}, {"allowed_amount": 532.91, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 2533.0, "npi": [1598719346]}, {"billed_charge": 2533.0, "npi": [1235183542]}, {"billed_charge": 2533.0, "npi": [1902858152]}]}, {"allowed_amount": 111.15, "billing_code_modifier": [""], "providers": [{"billed_charge": 608.0, "npi": [1235183542]}, {"billed_charge": 608.0, "npi": [1902858152]}, {"billed_charge": 608.0, "npi": [1598719346]}]}, {"allowed_amount": 3313.64, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 3672.0, "npi": [1235183542]}, {"billed_charge": 3672.0, "npi": [1598719346]}, {"billed_charge": 3672.0, "npi": [1902858152]}]}, {"allowed_amount": 1088.71, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 5814.0, "npi": [1598719346]}, {"billed_charge": 5814.0, "npi": [1902858152]}]}, {"allowed_amount": 767.3, "billing_code_modifier": [""], "providers": [{"billed_charge": 3672.0, "npi": [1235183542]}, {"billed_charge": 3672.0, "npi": [1902858152]}]}, {"allowed_amount": 412.47, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 2938.0, "npi": [1902858152]}]}, {"allowed_amount": 346.53, "billing_code_modifier": [""], "providers": [{"billed_charge": 1632.0, "npi": [1902858152]}, {"billed_charge": 1632.0, "npi": [1235183542]}, {"billed_charge": 1632.0, "npi": [1598719346]}]}, {"allowed_amount": 549.96, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 2938.0, "npi": [1598719346]}, {"billed_charge": 2938.0, "npi": [1235183542]}, {"billed_charge": 2938.0, "npi": [1902858152]}]}, {"allowed_amount": 784.92, "billing_code_modifier": [""], "providers": [{"billed_charge": 4230.0, "npi": [1598719346]}]}, {"allowed_amount": 549.96, "billing_code_modifier": [""], "providers": [{"billed_charge": 2938.0, "npi": [1598719346]}, {"billed_charge": 2938.0, "npi": [1235183542]}]}, {"allowed_amount": 110.2, "billing_code_modifier": [""], "providers": [{"billed_charge": 508.0, "npi": [1235183542]}]}, {"allowed_amount": 4639.1, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 3672.0, "npi": [1235183542]}]}, {"allowed_amount": 7997.38, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 3672.0, "npi": [1902858152]}]}, {"allowed_amount": 6535.37, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 5814.0, "npi": [1235183542]}]}]}]}, {"name": "EKG/ECG (Electrocardiogram) - General", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0730", "description": "EKG/ECG (Electrocardiogram)", "allowed_amounts": [{"tin": {"type": "ein", "value": "340714684"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 342.0, "npi": [1194763045]}, {"billed_charge": 315.0, "npi": [1194763045]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["5976"], "providers": [{"billed_charge": 342.0, "npi": [1194763045]}, {"billed_charge": 315.0, "npi": [1194763045]}]}]}]}, {"name": "Laboratory - Chemistry", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0301", "description": "Laboratory", "allowed_amounts": [{"tin": {"type": "ein", "value": "314446959"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 5.11, "billing_code_modifier": [""], "providers": [{"billed_charge": 8.0, "npi": [1710913462]}]}, {"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 49.0, "npi": [1710913462]}, {"billed_charge": 89.0, "npi": [1710913462]}, {"billed_charge": 35.0, "npi": [1710913462]}, {"billed_charge": 178.0, "npi": [1710913462]}, {"billed_charge": 56.0, "npi": [1710913462]}, {"billed_charge": 65.0, "npi": [1710913462]}, {"billed_charge": 51.0, "npi": [1710913462]}, {"billed_charge": 120.0, "npi": [1710913462]}, {"billed_charge": 41.0, "npi": [1710913462]}, {"billed_charge": 8.0, "npi": [1710913462]}, {"billed_charge": 218.0, "npi": [1710913462]}, {"billed_charge": 71.5, "npi": [1710913462]}, {"billed_charge": 26.0, "npi": [1710913462]}, {"billed_charge": 60.0, "npi": [1710913462]}, {"billed_charge": 19.0, "npi": [1710913462]}, {"billed_charge": 59.0, "npi": [1710913462]}, {"billed_charge": 75.0, "npi": [1710913462]}, {"billed_charge": 58.7059, "npi": [1710913462]}]}, {"allowed_amount": 14.26, "billing_code_modifier": [""], "providers": [{"billed_charge": 41.0, "npi": [1710913462]}]}, {"allowed_amount": 5.31, "billing_code_modifier": [""], "providers": [{"billed_charge": 8.0, "npi": [1710913462]}]}]}]}, {"name": "Laboratory - Hematology", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0305", "description": "Laboratory", "allowed_amounts": [{"tin": {"type": "ein", "value": "341567805"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 131.0, "npi": [1043397292]}, {"billed_charge": 98.1111, "npi": [1043397292]}, {"billed_charge": 73.4583, "npi": [1043397292]}, {"billed_charge": 216.0, "npi": [1043397292]}, {"billed_charge": 140.1429, "npi": [1043397292]}, {"billed_charge": 96.0, "npi": [1043397292]}, {"billed_charge": 49.0, "npi": [1043397292]}, {"billed_charge": 87.1429, "npi": [1043397292]}, {"billed_charge": 85.2222, "npi": [1043397292]}, {"billed_charge": 126.0, "npi": [1043397292]}, {"billed_charge": 124.4167, "npi": [1043397292]}, {"billed_charge": 137.0, "npi": [1043397292]}, {"billed_charge": 102.7368, "npi": [1043397292]}, {"billed_charge": 208.0, "npi": [1043397292]}, {"billed_charge": 97.4545, "npi": [1043397292]}, {"billed_charge": 57.0, "npi": [1043397292]}, {"billed_charge": 123.3077, "npi": [1043397292]}, {"billed_charge": 31.0, "npi": [1043397292]}, {"billed_charge": 85.25, "npi": [1043397292]}, {"billed_charge": 98.8, "npi": [1043397292]}, {"billed_charge": 116.0, "npi": [1043397292]}, {"billed_charge": 166.0, "npi": [1043397292]}, {"billed_charge": 121.0, "npi": [1043397292]}, {"billed_charge": 100.0, "npi": [1043397292]}, {"billed_charge": 145.7778, "npi": [1043397292]}, {"billed_charge": 30.0, "npi": [1043397292]}, {"billed_charge": 173.0, "npi": [1043397292]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["59"], "providers": [{"billed_charge": 42.0, "npi": [1043397292]}, {"billed_charge": 116.0, "npi": [1043397292]}, {"billed_charge": 44.0, "npi": [1043397292]}, {"billed_charge": 30.0, "npi": [1043397292]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["91"], "providers": [{"billed_charge": 30.0, "npi": [1043397292]}]}]}]}, {"name": "Laboratory - Hematology", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0305", "description": "Laboratory", "allowed_amounts": [{"tin": {"type": "ein", "value": "344430849"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 91.0, "npi": [1851338149]}, {"billed_charge": 87.0, "npi": [1851338149]}, {"billed_charge": 118.0, "npi": [1851338149]}, {"billed_charge": 89.0, "npi": [1851338149]}, {"billed_charge": 83.0, "npi": [1851338149]}, {"billed_charge": 94.5, "npi": [1851338149]}, {"billed_charge": 112.0, "npi": [1851338149]}, {"billed_charge": 85.0, "npi": [1851338149]}, {"billed_charge": 96.0, "npi": [1851338149]}, {"billed_charge": 80.0, "npi": [1851338149]}]}]}]}, {"name": "Laboratory - Hematology", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0305", "description": "Laboratory", "allowed_amounts": [{"tin": {"type": "ein", "value": "311070877"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 200.0, "npi": [1215935366]}, {"billed_charge": 38.0, "npi": [1215935366]}, {"billed_charge": 30.0, "npi": [1215935366]}, {"billed_charge": 30.8, "npi": [1215935366]}, {"billed_charge": 34.0, "npi": [1215935366]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["XU"], "providers": [{"billed_charge": 10.0, "npi": [1215935366]}]}]}]}, {"name": "SBSQ HOSPITAL IP/OBS CARE MOD MDM 35 MINUTES", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "99232", "description": "SBSQ HOSPITAL IP/OBS CARE MOD MDM 35 MINUTES", "allowed_amounts": [{"tin": {"type": "ein", "value": "743063166"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 87.11, "billing_code_modifier": [""], "providers": [{"billed_charge": 100.0, "npi": [1861481350]}]}, {"allowed_amount": 89.56, "billing_code_modifier": [""], "providers": [{"billed_charge": 100.0, "npi": [1861481350]}]}]}]}, {"name": "Pharmacy - Extension of 25X - Drug Requiring Detailed Coding", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0636", "description": "Pharmacy - Extension of 25x", "allowed_amounts": [{"tin": {"type": "ein", "value": "341567805"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 0.8075, "npi": [1043397292]}, {"billed_charge": 13.32, "npi": [1043397292]}, {"billed_charge": 0.87, "npi": [1043397292]}, {"billed_charge": 6.47, "npi": [1043397292]}, {"billed_charge": 3.235, "npi": [1043397292]}, {"billed_charge": 0.0484, "npi": [1043397292]}, {"billed_charge": 30.57, "npi": [1043397292]}, {"billed_charge": 0.8677, "npi": [1043397292]}, {"billed_charge": 221.72, "npi": [1043397292]}, {"billed_charge": 21.5, "npi": [1043397292]}, {"billed_charge": 10.28, "npi": [1043397292]}, {"billed_charge": 33.36, "npi": [1043397292]}, {"billed_charge": 8.736, "npi": [1043397292]}, {"billed_charge": 12.33, "npi": [1043397292]}, {"billed_charge": 24.24, "npi": [1043397292]}, {"billed_charge": 14.79, "npi": [1043397292]}, {"billed_charge": 4.5375, "npi": [1043397292]}, {"billed_charge": 1294.6225, "npi": [1043397292]}, {"billed_charge": 9.86, "npi": [1043397292]}, {"billed_charge": 18.89, "npi": [1043397292]}, {"billed_charge": 3.469, "npi": [1043397292]}, {"billed_charge": 0.0775, "npi": [1043397292]}, {"billed_charge": 174.95, "npi": [1043397292]}, {"billed_charge": 22.31, "npi": [1043397292]}, {"billed_charge": 1.282, "npi": [1043397292]}, {"billed_charge": 2.1179, "npi": [1043397292]}, {"billed_charge": 0.0404, "npi": [1043397292]}, {"billed_charge": 1.615, "npi": [1043397292]}, {"billed_charge": 0.0543, "npi": [1043397292]}, {"billed_charge": 9.1867, "npi": [1043397292]}, {"billed_charge": 3.81, "npi": [1043397292]}, {"billed_charge": 13.29, "npi": [1043397292]}, {"billed_charge": 17.26, "npi": [1043397292]}, {"billed_charge": 3.945, "npi": [1043397292]}, {"billed_charge": 0.1972, "npi": [1043397292]}, {"billed_charge": 7.4, "npi": [1043397292]}, {"billed_charge": 3.23, "npi": [1043397292]}, {"billed_charge": 0.3323, "npi": [1043397292]}, {"billed_charge": 3.66, "npi": [1043397292]}, {"billed_charge": 15.14, "npi": [1043397292]}, {"billed_charge": 12.08, "npi": [1043397292]}, {"billed_charge": 1.294, "npi": [1043397292]}, {"billed_charge": 3.98, "npi": [1043397292]}, {"billed_charge": 0.0479, "npi": [1043397292]}, {"billed_charge": 0.3488, "npi": [1043397292]}, {"billed_charge": 0.1179, "npi": [1043397292]}, {"billed_charge": 0.5825, "npi": [1043397292]}, {"billed_charge": 0.4635, "npi": [1043397292]}, {"billed_charge": 9.18, "npi": [1043397292]}, {"billed_charge": 2.022, "npi": [1043397292]}, {"billed_charge": 12.58, "npi": [1043397292]}, {"billed_charge": 29.58, "npi": [1043397292]}, {"billed_charge": 0.2906, "npi": [1043397292]}, {"billed_charge": 0.646, "npi": [1043397292]}, {"billed_charge": 0.4832, "npi": [1043397292]}, {"billed_charge": 19.72, "npi": [1043397292]}, {"billed_charge": 170.21, "npi": [1043397292]}, {"billed_charge": 0.5675, "npi": [1043397292]}, {"billed_charge": 4.93, "npi": [1043397292]}, {"billed_charge": 0.0808, "npi": [1043397292]}, {"billed_charge": 0.3333, "npi": [1043397292]}, {"billed_charge": 12.62, "npi": [1043397292]}, {"billed_charge": 622.23, "npi": [1043397292]}, {"billed_charge": 24.65, "npi": [1043397292]}]}, {"allowed_amount": 0.41, "billing_code_modifier": ["JZSE"], "providers": [{"billed_charge": 3.43, "npi": [1043397292]}]}, {"allowed_amount": 120.778, "billing_code_modifier": ["JZ"], "providers": [{"billed_charge": 423.4535, "npi": [1043397292]}]}, {"allowed_amount": 0.41, "billing_code_modifier": ["JZ"], "providers": [{"billed_charge": 11.41, "npi": [1043397292]}, {"billed_charge": 3.43, "npi": [1043397292]}]}, {"allowed_amount": 0.47, "billing_code_modifier": ["JZ"], "providers": [{"billed_charge": 11.405, "npi": [1043397292]}]}, {"allowed_amount": 0.46, "billing_code_modifier": ["JZ"], "providers": [{"billed_charge": 3.43, "npi": [1043397292]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["JZSE"], "providers": [{"billed_charge": 0.8075, "npi": [1043397292]}, {"billed_charge": 1.116, "npi": [1043397292]}]}, {"allowed_amount": 0.46, "billing_code_modifier": ["JZSE"], "providers": [{"billed_charge": 3.43, "npi": [1043397292]}]}, {"allowed_amount": 0.42, "billing_code_modifier": ["JZ"], "providers": [{"billed_charge": 3.43, "npi": [1043397292]}]}, {"allowed_amount": 0.4667, "billing_code_modifier": ["JZ"], "providers": [{"billed_charge": 3.43, "npi": [1043397292]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["JZ"], "providers": [{"billed_charge": 1.116, "npi": [1043397292]}, {"billed_charge": 2.388, "npi": [1043397292]}, {"billed_charge": 1.4172, "npi": [1043397292]}, {"billed_charge": 0.316, "npi": [1043397292]}, {"billed_charge": 0.837, "npi": [1043397292]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["JW"], "providers": [{"billed_charge": 0.8375, "npi": [1043397292]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["SE"], "providers": [{"billed_charge": 0.87, "npi": [1043397292]}, {"billed_charge": 0.1066, "npi": [1043397292]}, {"billed_charge": 30.57, "npi": [1043397292]}, {"billed_charge": 32.05, "npi": [1043397292]}, {"billed_charge": 14.79, "npi": [1043397292]}, {"billed_charge": 9.86, "npi": [1043397292]}, {"billed_charge": 174.95, "npi": [1043397292]}, {"billed_charge": 22.31, "npi": [1043397292]}, {"billed_charge": 1.615, "npi": [1043397292]}, {"billed_charge": 16.03, "npi": [1043397292]}, {"billed_charge": 3.66, "npi": [1043397292]}, {"billed_charge": 1.294, "npi": [1043397292]}, {"billed_charge": 3.98, "npi": [1043397292]}, {"billed_charge": 0.2906, "npi": [1043397292]}, {"billed_charge": 0.3999, "npi": [1043397292]}]}, {"allowed_amount": 0.47, "billing_code_modifier": ["JZTB"], "providers": [{"billed_charge": 11.405, "npi": [1043397292]}]}, {"allowed_amount": 44.7508, "billing_code_modifier": ["JZ"], "providers": [{"billed_charge": 140.5488, "npi": [1043397292]}]}]}]}, {"name": "Radiology - Diagnostic - Chest X-ray", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0324", "description": "Radiology - Diagnostic", "allowed_amounts": [{"tin": {"type": "ein", "value": "340714618"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 608.0, "npi": [1215989611]}, {"billed_charge": 562.0, "npi": [1215989611]}]}, {"allowed_amount": 114.69, "billing_code_modifier": [""], "providers": [{"billed_charge": 608.0, "npi": [1215989611]}]}, {"allowed_amount": 110.2, "billing_code_modifier": [""], "providers": [{"billed_charge": 562.0, "npi": [1215989611]}]}]}]}, {"name": "IV Therapy -General", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0260", "description": "IV Therapy", "allowed_amounts": [{"tin": {"type": "ein", "value": "341260978"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 61.7267, "billing_code_modifier": [""], "providers": [{"billed_charge": 506.0, "npi": [1841264868]}]}, {"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 462.5, "npi": [1841264868]}, {"billed_charge": 345.0, "npi": [1841264868]}, {"billed_charge": 216.0, "npi": [1841264868]}, {"billed_charge": 343.0, "npi": [1841264868]}, {"billed_charge": 379.0, "npi": [1841264868]}]}, {"allowed_amount": 263.68, "billing_code_modifier": ["59"], "providers": [{"billed_charge": 379.0, "npi": [1841264868]}]}, {"allowed_amount": 61.725, "billing_code_modifier": [""], "providers": [{"billed_charge": 506.0, "npi": [1841264868]}]}, {"allowed_amount": 57.74, "billing_code_modifier": [""], "providers": [{"billed_charge": 343.0, "npi": [1841264868]}, {"billed_charge": 487.0, "npi": [1841264868]}]}, {"allowed_amount": 280.35, "billing_code_modifier": [""], "providers": [{"billed_charge": 394.0, "npi": [1841264868]}, {"billed_charge": 920.0, "npi": [1841264868]}]}, {"allowed_amount": 280.35, "billing_code_modifier": ["59"], "providers": [{"billed_charge": 394.0, "npi": [1841264868]}, {"billed_charge": 920.0, "npi": [1841264868]}]}, {"allowed_amount": 263.68, "billing_code_modifier": [""], "providers": [{"billed_charge": 379.0, "npi": [1841264868]}]}, {"allowed_amount": 61.73, "billing_code_modifier": [""], "providers": [{"billed_charge": 357.0, "npi": [1841264868]}, {"billed_charge": 506.0, "npi": [1841264868]}]}, {"allowed_amount": 61.73, "billing_code_modifier": ["59"], "providers": [{"billed_charge": 357.0, "npi": [1841264868]}]}]}]}, {"name": "Emergency Room - General", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0450", "description": "Emergency Room", "allowed_amounts": [{"tin": {"type": "ein", "value": "340898745"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 627.82, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 2092.0, "npi": [1275533226]}]}, {"allowed_amount": 358.33, "billing_code_modifier": [""], "providers": [{"billed_charge": 1194.0, "npi": [1275533226]}]}, {"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 5325.0, "npi": [1275533226]}]}, {"allowed_amount": 627.82, "billing_code_modifier": [""], "providers": [{"billed_charge": 2092.0, "npi": [1275533226]}]}, {"allowed_amount": 205.47, "billing_code_modifier": [""], "providers": [{"billed_charge": 711.0, "npi": [1275533226]}]}, {"allowed_amount": 764.09, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 2644.0, "npi": [1275533226]}]}, {"allowed_amount": 358.33, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 1194.0, "npi": [1275533226]}]}, {"allowed_amount": 363.55, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 1258.0, "npi": [1275533226]}]}, {"allowed_amount": 363.55, "billing_code_modifier": [""], "providers": [{"billed_charge": 1258.0, "npi": [1275533226]}]}, {"allowed_amount": 1622.1, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 5613.0, "npi": [1275533226]}]}, {"allowed_amount": 202.57, "billing_code_modifier": [""], "providers": [{"billed_charge": 675.0, "npi": [1275533226]}]}, {"allowed_amount": 752.96, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 2509.0, "npi": [1275533226]}]}, {"allowed_amount": 637.22, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 2205.0, "npi": [1275533226]}]}]}]}, {"name": "Laboratory - Chemistry", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0301", "description": "Laboratory", "allowed_amounts": [{"tin": {"type": "ein", "value": "314379509"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 2075.22, "billing_code_modifier": ["QW"], "providers": [{"billed_charge": 211.06, "npi": [1215936927]}]}, {"allowed_amount": 11.73, "billing_code_modifier": [""], "providers": [{"billed_charge": 156.01, "npi": [1215936927]}]}, {"allowed_amount": 25.19, "billing_code_modifier": [""], "providers": [{"billed_charge": 114.65, "npi": [1215936927]}]}, {"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 67.06, "npi": [1215936927]}, {"billed_charge": 218.54, "npi": [1215936927]}, {"billed_charge": 61.25, "npi": [1215936927]}, {"billed_charge": 224.33, "npi": [1215936927]}, {"billed_charge": 43.74, "npi": [1215936927]}, {"billed_charge": 144.7, "npi": [1215936927]}, {"billed_charge": 59.78, "npi": [1215936927]}, {"billed_charge": 150.16, "npi": [1215936927]}, {"billed_charge": 106.42, "npi": [1215936927]}, {"billed_charge": 123.46, "npi": [1215936927]}]}, {"allowed_amount": 35.32, "billing_code_modifier": [""], "providers": [{"billed_charge": 160.66, "npi": [1215936927]}]}, {"allowed_amount": 14.86, "billing_code_modifier": [""], "providers": [{"billed_charge": 66.99, "npi": [1215936927]}]}, {"allowed_amount": 11.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 144.7, "npi": [1215936927]}]}, {"allowed_amount": 24.15, "billing_code_modifier": ["QW"], "providers": [{"billed_charge": 109.88, "npi": [1215936927]}]}, {"allowed_amount": 19.57, "billing_code_modifier": [""], "providers": [{"billed_charge": 231.81, "npi": [1215936927]}]}, {"allowed_amount": 24.08, "billing_code_modifier": ["QW"], "providers": [{"billed_charge": 282.84, "npi": [1215936927]}]}, {"allowed_amount": 8.71, "billing_code_modifier": [""], "providers": [{"billed_charge": 67.06, "npi": [1215936927]}]}, {"allowed_amount": 22.02, "billing_code_modifier": [""], "providers": [{"billed_charge": 100.16, "npi": [1215936927]}]}, {"allowed_amount": 13.96, "billing_code_modifier": [""], "providers": [{"billed_charge": 63.52, "npi": [1215936927]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["QW"], "providers": [{"billed_charge": 167.67, "npi": [1215936927]}, {"billed_charge": 126.85, "npi": [1215936927]}, {"billed_charge": 211.06, "npi": [1215936927]}, {"billed_charge": 237.65, "npi": [1215936927]}, {"billed_charge": 148.73, "npi": [1215936927]}, {"billed_charge": 63.15, "npi": [1215936927]}, {"billed_charge": 65.61, "npi": [1215936927]}]}, {"allowed_amount": 28.25, "billing_code_modifier": [""], "providers": [{"billed_charge": 129.76, "npi": [1215936927]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["QWXU"], "providers": [{"billed_charge": 21.88, "npi": [1215936927]}]}, {"allowed_amount": 21.84, "billing_code_modifier": ["QW"], "providers": [{"billed_charge": 167.67, "npi": [1215936927]}]}, {"allowed_amount": 32.83, "billing_code_modifier": [""], "providers": [{"billed_charge": 149.33, "npi": [1215936927]}]}, {"allowed_amount": 36.32, "billing_code_modifier": [""], "providers": [{"billed_charge": 164.89, "npi": [1215936927]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["91"], "providers": [{"billed_charge": 43.74, "npi": [1215936927]}]}, {"allowed_amount": 17.41, "billing_code_modifier": ["QW"], "providers": [{"billed_charge": 66.38, "npi": [1215936927]}]}, {"allowed_amount": 3474.44, "billing_code_modifier": ["QW"], "providers": [{"billed_charge": 211.06, "npi": [1215936927]}]}, {"allowed_amount": 12.62, "billing_code_modifier": ["QW"], "providers": [{"billed_charge": 148.73, "npi": [1215936927]}]}, {"allowed_amount": 33.55, "billing_code_modifier": [""], "providers": [{"billed_charge": 161.84, "npi": [1215936927]}]}]}]}, {"name": "Laboratory - Chemistry", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0301", "description": "Laboratory", "allowed_amounts": [{"tin": {"type": "ein", "value": "341567805"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 5.31, "billing_code_modifier": ["59"], "providers": [{"billed_charge": 58.0, "npi": [1043397292]}, {"billed_charge": 37.0, "npi": [1043397292]}]}, {"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 90.0, "npi": [1043397292]}, {"billed_charge": 67.0, "npi": [1043397292]}, {"billed_charge": 123.0, "npi": [1043397292]}, {"billed_charge": 70.0, "npi": [1043397292]}, {"billed_charge": 251.0, "npi": [1043397292]}, {"billed_charge": 255.0, "npi": [1043397292]}, {"billed_charge": 114.8519, "npi": [1043397292]}, {"billed_charge": 152.0, "npi": [1043397292]}, {"billed_charge": 264.0, "npi": [1043397292]}, {"billed_charge": 417.0, "npi": [1043397292]}, {"billed_charge": 144.7222, "npi": [1043397292]}, {"billed_charge": 254.0, "npi": [1043397292]}, {"billed_charge": 179.5, "npi": [1043397292]}, {"billed_charge": 146.0, "npi": [1043397292]}, {"billed_charge": 172.0, "npi": [1043397292]}, {"billed_charge": 1271.0, "npi": [1043397292]}, {"billed_charge": 118.0, "npi": [1043397292]}, {"billed_charge": 1222.0, "npi": [1043397292]}, {"billed_charge": 73.0, "npi": [1043397292]}, {"billed_charge": 162.6364, "npi": [1043397292]}, {"billed_charge": 147.5714, "npi": [1043397292]}, {"billed_charge": 72.0, "npi": [1043397292]}, {"billed_charge": 102.0345, "npi": [1043397292]}, {"billed_charge": 77.0, "npi": [1043397292]}, {"billed_charge": 120.0, "npi": [1043397292]}, {"billed_charge": 92.4091, "npi": [1043397292]}, {"billed_charge": 88.0, "npi": [1043397292]}, {"billed_charge": 87.0, "npi": [1043397292]}, {"billed_charge": 104.2035, "npi": [1043397292]}, {"billed_charge": 163.0, "npi": [1043397292]}, {"billed_charge": 241.0, "npi": [1043397292]}, {"billed_charge": 124.0698, "npi": [1043397292]}, {"billed_charge": 157.0, "npi": [1043397292]}, {"billed_charge": 103.1538, "npi": [1043397292]}, {"billed_charge": 381.0, "npi": [1043397292]}, {"billed_charge": 64.0, "npi": [1043397292]}, {"billed_charge": 434.0, "npi": [1043397292]}, {"billed_charge": 74.0, "npi": [1043397292]}, {"billed_charge": 104.0, "npi": [1043397292]}, {"billed_charge": 154.1471, "npi": [1043397292]}, {"billed_charge": 265.0, "npi": [1043397292]}, {"billed_charge": 131.32, "npi": [1043397292]}, {"billed_charge": 155.4091, "npi": [1043397292]}, {"billed_charge": 111.1395, "npi": [1043397292]}, {"billed_charge": 96.6866, "npi": [1043397292]}, {"billed_charge": 81.0, "npi": [1043397292]}, {"billed_charge": 89.0, "npi": [1043397292]}, {"billed_charge": 85.0392, "npi": [1043397292]}, {"billed_charge": 124.0, "npi": [1043397292]}, {"billed_charge": 640.0, "npi": [1043397292]}, {"billed_charge": 84.0, "npi": [1043397292]}, {"billed_charge": 179.0, "npi": [1043397292]}, {"billed_charge": 115.0, "npi": [1043397292]}, {"billed_charge": 100.0, "npi": [1043397292]}, {"billed_charge": 63.0, "npi": [1043397292]}, {"billed_charge": 156.0, "npi": [1043397292]}, {"billed_charge": 275.0, "npi": [1043397292]}, {"billed_charge": 69.0, "npi": [1043397292]}, {"billed_charge": 92.0, "npi": [1043397292]}, {"billed_charge": 55.0, "npi": [1043397292]}]}, {"allowed_amount": 5.5, "billing_code_modifier": [""], "providers": [{"billed_charge": 38.0, "npi": [1043397292]}]}, {"allowed_amount": 5.31, "billing_code_modifier": [""], "providers": [{"billed_charge": 58.0, "npi": [1043397292]}, {"billed_charge": 37.0, "npi": [1043397292]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["59"], "providers": [{"billed_charge": 76.0, "npi": [1043397292]}, {"billed_charge": 49.0, "npi": [1043397292]}, {"billed_charge": 73.0, "npi": [1043397292]}, {"billed_charge": 77.0, "npi": [1043397292]}, {"billed_charge": 80.0, "npi": [1043397292]}, {"billed_charge": 57.0, "npi": [1043397292]}, {"billed_charge": 104.0, "npi": [1043397292]}, {"billed_charge": 38.0, "npi": [1043397292]}, {"billed_charge": 100.0, "npi": [1043397292]}, {"billed_charge": 136.0, "npi": [1043397292]}, {"billed_charge": 55.0, "npi": [1043397292]}]}, {"allowed_amount": 5.5, "billing_code_modifier": ["59"], "providers": [{"billed_charge": 60.0, "npi": [1043397292]}, {"billed_charge": 38.0, "npi": [1043397292]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["91"], "providers": [{"billed_charge": 172.0, "npi": [1043397292]}, {"billed_charge": 88.0, "npi": [1043397292]}, {"billed_charge": 80.0, "npi": [1043397292]}, {"billed_charge": 42.4, "npi": [1043397292]}, {"billed_charge": 179.0, "npi": [1043397292]}, {"billed_charge": 115.0, "npi": [1043397292]}, {"billed_charge": 136.0, "npi": [1043397292]}]}, {"allowed_amount": 4.78, "billing_code_modifier": ["59"], "providers": [{"billed_charge": 58.0, "npi": [1043397292]}]}, {"allowed_amount": 5.5, "billing_code_modifier": ["91"], "providers": [{"billed_charge": 38.0, "npi": [1043397292]}]}]}]}, {"name": "Laboratory - Hematology", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0305", "description": "Laboratory", "allowed_amounts": [{"tin": {"type": "ein", "value": "310537504"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 137.0, "npi": [1073688354]}, {"billed_charge": 97.1538, "npi": [1073688354]}, {"billed_charge": 182.0, "npi": [1073688354]}, {"billed_charge": 68.0, "npi": [1073688354]}, {"billed_charge": 111.0, "npi": [1073688354]}, {"billed_charge": 117.6429, "npi": [1073688354]}, {"billed_charge": 132.0, "npi": [1073688354]}, {"billed_charge": 103.0, "npi": [1073688354]}, {"billed_charge": 44.0, "npi": [1073688354]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["XU"], "providers": [{"billed_charge": 111.0, "npi": [1073688354]}]}]}]}, {"name": "Laboratory - General", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0300", "description": "Laboratory", "allowed_amounts": [{"tin": {"type": "ein", "value": "314446959"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 291.3333, "npi": [1710913462]}, {"billed_charge": 13.0, "npi": [1710913462]}, {"billed_charge": 419.0, "npi": [1710913462]}]}, {"allowed_amount": 12.27, "billing_code_modifier": [""], "providers": [{"billed_charge": 13.0, "npi": [1710913462]}]}]}]}, {"name": "CT Scan - Body Scan", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0352", "description": "CT Scan", "allowed_amounts": [{"tin": {"type": "ein", "value": "340714585"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 231.18, "billing_code_modifier": [""], "providers": [{"billed_charge": 1228.0, "npi": [1679525919]}]}, {"allowed_amount": 222.79, "billing_code_modifier": [""], "providers": [{"billed_charge": 1135.0, "npi": [1679525919]}]}, {"allowed_amount": 291.65, "billing_code_modifier": [""], "providers": [{"billed_charge": 734.0, "npi": [1679525919]}]}, {"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 1809.6, "npi": [1679525919]}, {"billed_charge": 957.0, "npi": [1679525919]}, {"billed_charge": 734.0, "npi": [1679525919]}, {"billed_charge": 1755.0, "npi": [1679525919]}, {"billed_charge": 1135.0, "npi": [1679525919]}, {"billed_charge": 679.0, "npi": [1679525919]}, {"billed_charge": 907.0, "npi": [1679525919]}, {"billed_charge": 1668.0, "npi": [1679525919]}, {"billed_charge": 1228.0, "npi": [1679525919]}, {"billed_charge": 1382.0, "npi": [1679525919]}, {"billed_charge": 2464.0, "npi": [1679525919]}, {"billed_charge": 1841.5, "npi": [1679525919]}, {"billed_charge": 2375.0, "npi": [1679525919]}, {"billed_charge": 1785.3333, "npi": [1679525919]}]}, {"allowed_amount": 544.55, "billing_code_modifier": [""], "providers": [{"billed_charge": 1135.0, "npi": [1679525919]}]}, {"allowed_amount": 459.82, "billing_code_modifier": [""], "providers": [{"billed_charge": 2464.0, "npi": [1679525919]}]}, {"allowed_amount": 137.8, "billing_code_modifier": [""], "providers": [{"billed_charge": 734.0, "npi": [1679525919]}]}, {"allowed_amount": 314.48, "billing_code_modifier": [""], "providers": [{"billed_charge": 1668.0, "npi": [1679525919]}]}, {"allowed_amount": 302.51, "billing_code_modifier": [""], "providers": [{"billed_charge": 1513.0, "npi": [1679525919]}]}, {"allowed_amount": 446.94, "billing_code_modifier": [""], "providers": [{"billed_charge": 2375.0, "npi": [1679525919]}]}]}]}, {"name": "DIGITAL BREAST TOMOSYNTHESIS BILATERAL", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "77062", "description": "DIGITAL BREAST TOMOSYNTHESIS BILATERAL", "allowed_amounts": [{"tin": {"type": "ein", "value": "310745303"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 22.5, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 75.0, "npi": [1669408159]}]}]}]}, {"name": "Laboratory - Bacteriology & Microbiology", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0306", "description": "Laboratory", "allowed_amounts": [{"tin": {"type": "ein", "value": "340714456"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 192.55, "billing_code_modifier": [""], "providers": [{"billed_charge": 384.0, "npi": [1790837235]}]}, {"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 126.0, "npi": [1790837235]}, {"billed_charge": 188.0, "npi": [1790837235]}, {"billed_charge": 71.0, "npi": [1790837235]}, {"billed_charge": 167.625, "npi": [1790837235]}, {"billed_charge": 307.25, "npi": [1790837235]}, {"billed_charge": 144.0, "npi": [1790837235]}, {"billed_charge": 161.0, "npi": [1790837235]}, {"billed_charge": 81.0, "npi": [1790837235]}, {"billed_charge": 178.0, "npi": [1790837235]}, {"billed_charge": 122.0, "npi": [1790837235]}, {"billed_charge": 91.0, "npi": [1790837235]}, {"billed_charge": 483.0, "npi": [1790837235]}, {"billed_charge": 215.4667, "npi": [1790837235]}, {"billed_charge": 253.3333, "npi": [1790837235]}, {"billed_charge": 384.0, "npi": [1790837235]}, {"billed_charge": 154.0, "npi": [1790837235]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["XU"], "providers": [{"billed_charge": 229.0, "npi": [1790837235]}, {"billed_charge": 154.0, "npi": [1790837235]}]}, {"allowed_amount": 185.42, "billing_code_modifier": [""], "providers": [{"billed_charge": 384.0, "npi": [1790837235]}]}]}]}, {"name": "US TRANSVAGINAL", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "76830", "description": "US TRANSVAGINAL", "allowed_amounts": [{"tin": {"type": "ein", "value": "310745303"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 31.81, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 501.0, "npi": [1669408159]}]}, {"allowed_amount": 30.98, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 501.0, "npi": [1669408159]}]}]}]}, {"name": "Laboratory - Bacteriology & Microbiology", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0306", "description": "Laboratory", "allowed_amounts": [{"tin": {"type": "ein", "value": "344428256"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 2842.0, "npi": [1407854771]}, {"billed_charge": 416.0, "npi": [1407854771]}, {"billed_charge": 238.0, "npi": [1407854771]}, {"billed_charge": 415.0, "npi": [1407854771]}, {"billed_charge": 252.0, "npi": [1407854771]}, {"billed_charge": 182.0, "npi": [1407854771]}, {"billed_charge": 240.0, "npi": [1407854771]}, {"billed_charge": 899.0, "npi": [1407854771]}, {"billed_charge": 64.0, "npi": [1407854771]}, {"billed_charge": 140.5, "npi": [1407854771]}, {"billed_charge": 250.0, "npi": [1407854771]}, {"billed_charge": 444.0, "npi": [1407854771]}]}, {"allowed_amount": 199.68, "billing_code_modifier": [""], "providers": [{"billed_charge": 856.0, "npi": [1407854771]}, {"billed_charge": 899.0, "npi": [1407854771]}]}]}]}, {"name": "CT Scan - Body Scan", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0352", "description": "CT Scan", "allowed_amounts": [{"tin": {"type": "ein", "value": "340714618"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 222.79, "billing_code_modifier": [""], "providers": [{"billed_charge": 1135.0, "npi": [1215989611]}]}, {"allowed_amount": 291.65, "billing_code_modifier": [""], "providers": [{"billed_charge": 734.0, "npi": [1215989611]}]}, {"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 734.0, "npi": [1215989611]}, {"billed_charge": 2464.0, "npi": [1215989611]}, {"billed_charge": 1846.0, "npi": [1215989611]}, {"billed_charge": 2375.0, "npi": [1215989611]}, {"billed_charge": 1668.0, "npi": [1215989611]}, {"billed_charge": 1135.0, "npi": [1215989611]}, {"billed_charge": 1228.0, "npi": [1215989611]}]}, {"allowed_amount": 544.55, "billing_code_modifier": [""], "providers": [{"billed_charge": 1135.0, "npi": [1215989611]}]}, {"allowed_amount": 459.82, "billing_code_modifier": [""], "providers": [{"billed_charge": 2464.0, "npi": [1215989611]}]}, {"allowed_amount": 133.08, "billing_code_modifier": ["RT"], "providers": [{"billed_charge": 679.0, "npi": [1215989611]}]}]}]}, {"name": "Pharmacy - General", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0250", "description": "Pharmacy (also see 063x, an extension of 025x)", "allowed_amounts": [{"tin": {"type": "ein", "value": "340827442"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 2.6329, "npi": [1164481677]}, {"billed_charge": 3.9493, "npi": [1164481677]}, {"billed_charge": 2.0933, "npi": [1164481677]}, {"billed_charge": 4.1525, "npi": [1164481677]}, {"billed_charge": 3.23, "npi": [1164481677]}, {"billed_charge": 2.6617, "npi": [1164481677]}, {"billed_charge": 6.47, "npi": [1164481677]}, {"billed_charge": 2.095, "npi": [1164481677]}, {"billed_charge": 33.0219, "npi": [1164481677]}, {"billed_charge": 1.615, "npi": [1164481677]}, {"billed_charge": 5.86, "npi": [1164481677]}, {"billed_charge": 2.678, "npi": [1164481677]}, {"billed_charge": 2.312, "npi": [1164481677]}, {"billed_charge": 1.0767, "npi": [1164481677]}, {"billed_charge": 26.92, "npi": [1164481677]}, {"billed_charge": 2.548, "npi": [1164481677]}]}]}]}, {"name": "Emergency Room - General", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0450", "description": "Emergency Room", "allowed_amounts": [{"tin": {"type": "ein", "value": "340714585"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 202.37, "billing_code_modifier": [""], "providers": [{"billed_charge": 1093.0, "npi": [1679525919]}]}, {"allowed_amount": 264.45, "billing_code_modifier": [""], "providers": [{"billed_charge": 596.0, "npi": [1679525919]}]}, {"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 3672.0, "npi": [1679525919]}, {"billed_charge": 4230.0, "npi": [1679525919]}, {"billed_charge": 596.0, "npi": [1679525919]}, {"billed_charge": 5073.0, "npi": [1679525919]}]}, {"allowed_amount": 359.79, "billing_code_modifier": [""], "providers": [{"billed_charge": 1911.0, "npi": [1679525919]}]}, {"allowed_amount": 710.85, "billing_code_modifier": [""], "providers": [{"billed_charge": 2343.0, "npi": [1679525919]}]}, {"allowed_amount": 300.21, "billing_code_modifier": ["RT"], "providers": [{"billed_charge": 971.0, "npi": [1679525919]}]}, {"allowed_amount": 500.01, "billing_code_modifier": [""], "providers": [{"billed_charge": 821.0, "npi": [1679525919]}]}, {"allowed_amount": 1054.53, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 5073.0, "npi": [1679525919]}]}, {"allowed_amount": 767.3, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 3672.0, "npi": [1679525919]}]}, {"allowed_amount": 325.12, "billing_code_modifier": ["F2"], "providers": [{"billed_charge": 1103.0, "npi": [1679525919]}]}, {"allowed_amount": 346.53, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 1632.0, "npi": [1679525919]}]}, {"allowed_amount": 198.19, "billing_code_modifier": [""], "providers": [{"billed_charge": 935.0, "npi": [1679525919]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["RT"], "providers": [{"billed_charge": 593.0, "npi": [1679525919]}]}, {"allowed_amount": 359.79, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 1911.0, "npi": [1679525919]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 3672.0, "npi": [1679525919]}, {"billed_charge": 4230.0, "npi": [1679525919]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["F7"], "providers": [{"billed_charge": 526.0, "npi": [1679525919]}]}, {"allowed_amount": 535.79, "billing_code_modifier": [""], "providers": [{"billed_charge": 1199.0, "npi": [1679525919]}]}, {"allowed_amount": 325.12, "billing_code_modifier": ["LT"], "providers": [{"billed_charge": 1103.0, "npi": [1679525919]}]}, {"allowed_amount": 532.91, "billing_code_modifier": [""], "providers": [{"billed_charge": 2533.0, "npi": [1679525919]}]}, {"allowed_amount": 784.92, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 4230.0, "npi": [1679525919]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["59"], "providers": [{"billed_charge": 596.0, "npi": [1679525919]}]}, {"allowed_amount": 325.12, "billing_code_modifier": ["RT"], "providers": [{"billed_charge": 1103.0, "npi": [1679525919]}]}, {"allowed_amount": 3447.28, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 4230.0, "npi": [1679525919]}]}, {"allowed_amount": 532.91, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 2533.0, "npi": [1679525919]}]}, {"allowed_amount": 111.15, "billing_code_modifier": [""], "providers": [{"billed_charge": 608.0, "npi": [1679525919]}]}, {"allowed_amount": 248.67, "billing_code_modifier": [""], "providers": [{"billed_charge": 413.0, "npi": [1679525919]}]}, {"allowed_amount": 3313.64, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 3672.0, "npi": [1679525919]}]}, {"allowed_amount": 1088.71, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 5814.0, "npi": [1679525919]}]}, {"allowed_amount": 346.53, "billing_code_modifier": [""], "providers": [{"billed_charge": 1632.0, "npi": [1679525919]}]}, {"allowed_amount": 767.3, "billing_code_modifier": ["2527"], "providers": [{"billed_charge": 3672.0, "npi": [1679525919]}]}, {"allowed_amount": 549.96, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 2938.0, "npi": [1679525919]}]}, {"allowed_amount": 784.92, "billing_code_modifier": [""], "providers": [{"billed_charge": 4230.0, "npi": [1679525919]}]}, {"allowed_amount": 549.96, "billing_code_modifier": [""], "providers": [{"billed_charge": 2938.0, "npi": [1679525919]}]}, {"allowed_amount": 110.2, "billing_code_modifier": [""], "providers": [{"billed_charge": 508.0, "npi": [1679525919]}]}]}]}, {"name": "Pharmacy - Drugs Incident to Radiology", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0255", "description": "Pharmacy (also see 063x, an extension of 025x)", "allowed_amounts": [{"tin": {"type": "ein", "value": "344428256"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 5.9647, "npi": [1407854771]}, {"billed_charge": 3.7, "npi": [1407854771]}, {"billed_charge": 3.72, "npi": [1407854771]}, {"billed_charge": 1065.0, "npi": [1407854771]}, {"billed_charge": 3.2, "npi": [1407854771]}, {"billed_charge": 3.34, "npi": [1407854771]}, {"billed_charge": 26.1333, "npi": [1407854771]}, {"billed_charge": 3.28, "npi": [1407854771]}, {"billed_charge": 6.4625, "npi": [1407854771]}]}]}]}, {"name": "Laboratory - Chemistry", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0301", "description": "Laboratory", "allowed_amounts": [{"tin": {"type": "ein", "value": "311724085"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 40.66, "billing_code_modifier": [""], "providers": [{"billed_charge": 102.0, "npi": [1669410940]}]}, {"allowed_amount": 62.58, "billing_code_modifier": [""], "providers": [{"billed_charge": 163.0, "npi": [1669410940]}]}, {"allowed_amount": 47.05, "billing_code_modifier": ["91"], "providers": [{"billed_charge": 118.0, "npi": [1669410940]}]}, {"allowed_amount": 66.03, "billing_code_modifier": [""], "providers": [{"billed_charge": 172.0, "npi": [1669410940]}]}, {"allowed_amount": 81.77, "billing_code_modifier": [""], "providers": [{"billed_charge": 213.0, "npi": [1669410940]}]}, {"allowed_amount": 63.34, "billing_code_modifier": [""], "providers": [{"billed_charge": 165.0, "npi": [1669410940]}]}, {"allowed_amount": 28.03, "billing_code_modifier": [""], "providers": [{"billed_charge": 73.0, "npi": [1669410940]}]}, {"allowed_amount": 79.85, "billing_code_modifier": [""], "providers": [{"billed_charge": 208.0, "npi": [1669410940]}]}, {"allowed_amount": 46.46, "billing_code_modifier": [""], "providers": [{"billed_charge": 121.0, "npi": [1669410940]}]}, {"allowed_amount": 100.86, "billing_code_modifier": [""], "providers": [{"billed_charge": 253.0, "npi": [1669410940]}]}, {"allowed_amount": 82.93, "billing_code_modifier": [""], "providers": [{"billed_charge": 216.0, "npi": [1669410940]}]}, {"allowed_amount": 50.23, "billing_code_modifier": [""], "providers": [{"billed_charge": 126.0, "npi": [1669410940]}]}, {"allowed_amount": 64.99, "billing_code_modifier": [""], "providers": [{"billed_charge": 163.0, "npi": [1669410940]}]}, {"allowed_amount": 48.75, "billing_code_modifier": [""], "providers": [{"billed_charge": 127.0, "npi": [1669410940]}]}, {"allowed_amount": 54.61, "billing_code_modifier": [""], "providers": [{"billed_charge": 137.0, "npi": [1669410940]}]}, {"allowed_amount": 60.66, "billing_code_modifier": [""], "providers": [{"billed_charge": 158.0, "npi": [1669410940]}]}, {"allowed_amount": 47.05, "billing_code_modifier": [""], "providers": [{"billed_charge": 118.0, "npi": [1669410940]}]}, {"allowed_amount": 64.18, "billing_code_modifier": [""], "providers": [{"billed_charge": 161.0, "npi": [1669410940]}]}, {"allowed_amount": 39.53, "billing_code_modifier": [""], "providers": [{"billed_charge": 103.0, "npi": [1669410940]}]}, {"allowed_amount": 67.77, "billing_code_modifier": [""], "providers": [{"billed_charge": 170.0, "npi": [1669410940]}]}, {"allowed_amount": 25.34, "billing_code_modifier": [""], "providers": [{"billed_charge": 66.0, "npi": [1669410940]}]}, {"allowed_amount": 52.98, "billing_code_modifier": [""], "providers": [{"billed_charge": 138.0, "npi": [1669410940]}]}]}]}, {"name": "Laboratory - Immunology", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0302", "description": "Laboratory", "allowed_amounts": [{"tin": {"type": "ein", "value": "341567805"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 160.1333, "npi": [1043397292]}, {"billed_charge": 71.0, "npi": [1043397292]}, {"billed_charge": 154.0, "npi": [1043397292]}, {"billed_charge": 234.0, "npi": [1043397292]}, {"billed_charge": 232.7083, "npi": [1043397292]}, {"billed_charge": 130.0, "npi": [1043397292]}, {"billed_charge": 136.5556, "npi": [1043397292]}, {"billed_charge": 87.0, "npi": [1043397292]}, {"billed_charge": 160.0, "npi": [1043397292]}, {"billed_charge": 346.6667, "npi": [1043397292]}, {"billed_charge": 74.0, "npi": [1043397292]}, {"billed_charge": 128.0, "npi": [1043397292]}, {"billed_charge": 101.8, "npi": [1043397292]}, {"billed_charge": 116.0, "npi": [1043397292]}, {"billed_charge": 170.0, "npi": [1043397292]}, {"billed_charge": 125.0, "npi": [1043397292]}, {"billed_charge": 84.0, "npi": [1043397292]}]}, {"allowed_amount": 17.87, "billing_code_modifier": [""], "providers": [{"billed_charge": 52.0, "npi": [1043397292]}]}, {"allowed_amount": 18.54, "billing_code_modifier": [""], "providers": [{"billed_charge": 54.0, "npi": [1043397292]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["59"], "providers": [{"billed_charge": 84.0, "npi": [1043397292]}]}]}]}, {"name": "EMERGENCY DEPARTMENT VISIT HIGH MDM", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "99285", "description": "EMERGENCY DEPARTMENT VISIT HIGH MDM", "allowed_amounts": [{"tin": {"type": "ein", "value": "341623418"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 208.79, "billing_code_modifier": [""], "providers": [{"billed_charge": 1699.88, "npi": [1003869652]}, {"billed_charge": 1750.88, "npi": [1003869652]}]}, {"allowed_amount": 208.79, "billing_code_modifier": ["SA"], "providers": [{"billed_charge": 1699.88, "npi": [1003869652]}]}, {"allowed_amount": 493.38, "billing_code_modifier": [""], "providers": [{"billed_charge": 1699.88, "npi": [1003869652]}, {"billed_charge": 1750.88, "npi": [1003869652]}]}, {"allowed_amount": 195.99, "billing_code_modifier": [""], "providers": [{"billed_charge": 1750.88, "npi": [1003869652]}]}, {"allowed_amount": 195.99, "billing_code_modifier": ["GC"], "providers": [{"billed_charge": 1750.88, "npi": [1003869652]}]}, {"allowed_amount": 480.65, "billing_code_modifier": [""], "providers": [{"billed_charge": 1699.88, "npi": [1003869652]}]}]}]}, {"name": "EMERGENCY DEPARTMENT VISIT MODERATE MDM", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "99284", "description": "EMERGENCY DEPARTMENT VISIT MODERATE MDM", "allowed_amounts": [{"tin": {"type": "ein", "value": "472051272"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 143.9, "billing_code_modifier": [""], "providers": [{"billed_charge": 1031.0, "npi": [1184028524]}, {"billed_charge": 1062.0, "npi": [1184028524]}]}, {"allowed_amount": 143.9, "billing_code_modifier": ["UD"], "providers": [{"billed_charge": 1062.0, "npi": [1184028524]}]}, {"allowed_amount": 143.9, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 1062.0, "npi": [1184028524]}]}, {"allowed_amount": 141.13, "billing_code_modifier": [""], "providers": [{"billed_charge": 1062.0, "npi": [1184028524]}]}]}]}, {"name": "Laboratory - Urology", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0307", "description": "Laboratory", "allowed_amounts": [{"tin": {"type": "ein", "value": "474442902"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 59.0, "npi": [1346607017]}, {"billed_charge": 56.0, "npi": [1346607017]}, {"billed_charge": 22.0, "npi": [1346607017]}, {"billed_charge": 21.0, "npi": [1346607017]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["59"], "providers": [{"billed_charge": 22.0, "npi": [1346607017]}]}]}]}, {"name": "Laboratory - Chemistry", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0301", "description": "Laboratory", "allowed_amounts": [{"tin": {"type": "ein", "value": "340714538"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 76.0, "npi": [1356366991]}, {"billed_charge": 73.0, "npi": [1356366991]}, {"billed_charge": 238.0, "npi": [1356366991]}, {"billed_charge": 131.0, "npi": [1356366991]}, {"billed_charge": 52.0, "npi": [1356366991]}, {"billed_charge": 160.0, "npi": [1356366991]}, {"billed_charge": 28.0, "npi": [1356366991]}, {"billed_charge": 50.0, "npi": [1356366991]}, {"billed_charge": 104.0, "npi": [1356366991]}, {"billed_charge": 295.0, "npi": [1356366991]}, {"billed_charge": 126.3333, "npi": [1356366991]}, {"billed_charge": 105.0, "npi": [1356366991]}, {"billed_charge": 114.0, "npi": [1356366991]}, {"billed_charge": 184.0, "npi": [1356366991]}, {"billed_charge": 169.5, "npi": [1356366991]}, {"billed_charge": 35.0, "npi": [1356366991]}, {"billed_charge": 88.0, "npi": [1356366991]}, {"billed_charge": 145.0, "npi": [1356366991]}, {"billed_charge": 140.0, "npi": [1356366991]}, {"billed_charge": 113.0, "npi": [1356366991]}, {"billed_charge": 26.0, "npi": [1356366991]}, {"billed_charge": 59.0, "npi": [1356366991]}]}]}]}, {"name": "Laboratory - Hematology", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0305", "description": "Laboratory", "allowed_amounts": [{"tin": {"type": "ein", "value": "340714593"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 41.0, "npi": [1235183542]}, {"billed_charge": 66.0, "npi": [1598719346]}, {"billed_charge": 37.5789, "npi": [1235183542]}, {"billed_charge": 41.2909, "npi": [1902858152]}, {"billed_charge": 41.0, "npi": [1902858152]}, {"billed_charge": 70.0, "npi": [1902858152]}, {"billed_charge": 39.0, "npi": [1235183542]}, {"billed_charge": 42.0, "npi": [1235183542]}, {"billed_charge": 39.0, "npi": [1902858152]}, {"billed_charge": 51.0, "npi": [1902858152]}, {"billed_charge": 42.0, "npi": [1902858152]}, {"billed_charge": 66.0, "npi": [1902858152]}, {"billed_charge": 42.0, "npi": [1598719346]}, {"billed_charge": 43.0, "npi": [1598719346]}, {"billed_charge": 26.0, "npi": [1598719346]}, {"billed_charge": 49.5, "npi": [1235183542]}, {"billed_charge": 54.0, "npi": [1902858152]}, {"billed_charge": 28.0, "npi": [1598719346]}, {"billed_charge": 51.0, "npi": [1598719346]}, {"billed_charge": 51.0, "npi": [1235183542]}, {"billed_charge": 70.0, "npi": [1235183542]}, {"billed_charge": 16.0, "npi": [1235183542]}, {"billed_charge": 28.0, "npi": [1235183542]}, {"billed_charge": 40.6667, "npi": [1235183542]}, {"billed_charge": 30.0, "npi": [1235183542]}, {"billed_charge": 39.0, "npi": [1598719346]}, {"billed_charge": 44.25, "npi": [1235183542]}, {"billed_charge": 45.9091, "npi": [1902858152]}, {"billed_charge": 66.0, "npi": [1235183542]}, {"billed_charge": 16.0, "npi": [1598719346]}, {"billed_charge": 28.0, "npi": [1902858152]}, {"billed_charge": 45.0, "npi": [1902858152]}, {"billed_charge": 25.0, "npi": [1598719346]}, {"billed_charge": 37.8235, "npi": [1598719346]}, {"billed_charge": 30.0, "npi": [1902858152]}, {"billed_charge": 30.0, "npi": [1598719346]}, {"billed_charge": 35.2, "npi": [1902858152]}, {"billed_charge": 42.5714, "npi": [1598719346]}, {"billed_charge": 54.0, "npi": [1598719346]}, {"billed_charge": 39.2222, "npi": [1235183542]}, {"billed_charge": 18.0, "npi": [1235183542]}, {"billed_charge": 41.0, "npi": [1598719346]}, {"billed_charge": 45.0, "npi": [1598719346]}, {"billed_charge": 54.0, "npi": [1235183542]}, {"billed_charge": 49.5, "npi": [1902858152]}, {"billed_charge": 45.7619, "npi": [1902858152]}, {"billed_charge": 45.0, "npi": [1235183542]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["91"], "providers": [{"billed_charge": 51.0, "npi": [1902858152]}, {"billed_charge": 42.0, "npi": [1598719346]}, {"billed_charge": 54.0, "npi": [1902858152]}, {"billed_charge": 16.0, "npi": [1235183542]}, {"billed_charge": 16.0, "npi": [1598719346]}]}]}]}, {"name": "Emergency Room - General", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0450", "description": "Emergency Room", "allowed_amounts": [{"tin": {"type": "ein", "value": "341105619"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 363.99, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 1859.0, "npi": [1811939887]}]}, {"allowed_amount": 576.32, "billing_code_modifier": [""], "providers": [{"billed_charge": 2205.0, "npi": [1811939887]}, {"billed_charge": 1965.0, "npi": [1811939887]}]}, {"allowed_amount": 503.8, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 2100.0, "npi": [1811939887]}]}, {"allowed_amount": 805.97, "billing_code_modifier": [""], "providers": [{"billed_charge": 2520.0, "npi": [1811939887]}]}, {"allowed_amount": 559.78, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 2205.0, "npi": [1811939887]}, {"billed_charge": 2100.0, "npi": [1811939887]}]}, {"allowed_amount": 3612.57, "billing_code_modifier": [""], "providers": [{"billed_charge": 1952.0, "npi": [1811939887]}, {"billed_charge": 2646.0, "npi": [1811939887]}]}, {"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 2520.0, "npi": [1811939887]}, {"billed_charge": 2646.0, "npi": [1811939887]}, {"billed_charge": 1776.5, "npi": [1811939887]}, {"billed_charge": 504.0, "npi": [1811939887]}, {"billed_charge": 1964.0, "npi": [1811939887]}]}, {"allowed_amount": 208.18, "billing_code_modifier": [""], "providers": [{"billed_charge": 1050.0, "npi": [1811939887]}]}, {"allowed_amount": 822.56, "billing_code_modifier": [""], "providers": [{"billed_charge": 2646.0, "npi": [1811939887]}]}, {"allowed_amount": 475.81, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 2205.0, "npi": [1811939887]}]}, {"allowed_amount": 576.32, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 2205.0, "npi": [1811939887]}]}, {"allowed_amount": 805.97, "billing_code_modifier": ["2527"], "providers": [{"billed_charge": 2520.0, "npi": [1811939887]}]}, {"allowed_amount": 419.84, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 2100.0, "npi": [1811939887]}]}, {"allowed_amount": 3480.64, "billing_code_modifier": [""], "providers": [{"billed_charge": 2520.0, "npi": [1811939887]}]}, {"allowed_amount": 525.21, "billing_code_modifier": [""], "providers": [{"billed_charge": 1250.0, "npi": [1811939887]}]}, {"allowed_amount": 363.99, "billing_code_modifier": [""], "providers": [{"billed_charge": 1952.0, "npi": [1811939887]}, {"billed_charge": 1859.0, "npi": [1811939887]}, {"billed_charge": 1033.0, "npi": [1811939887]}]}, {"allowed_amount": 561.48, "billing_code_modifier": [""], "providers": [{"billed_charge": 1152.0, "npi": [1811939887]}]}, {"allowed_amount": 377.03, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 1952.0, "npi": [1811939887]}]}, {"allowed_amount": 3480.64, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 2520.0, "npi": [1811939887]}]}, {"allowed_amount": 3612.57, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 2646.0, "npi": [1811939887]}]}, {"allowed_amount": 805.97, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 2520.0, "npi": [1811939887]}, {"billed_charge": 2646.0, "npi": [1811939887]}]}, {"allowed_amount": 377.03, "billing_code_modifier": [""], "providers": [{"billed_charge": 1085.0, "npi": [1811939887]}, {"billed_charge": 1952.0, "npi": [1811939887]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["RT"], "providers": [{"billed_charge": 700.0, "npi": [1811939887]}]}, {"allowed_amount": 212.07, "billing_code_modifier": [""], "providers": [{"billed_charge": 1103.0, "npi": [1811939887]}]}, {"allowed_amount": 559.78, "billing_code_modifier": [""], "providers": [{"billed_charge": 2100.0, "npi": [1811939887]}]}, {"allowed_amount": 822.56, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 2646.0, "npi": [1811939887]}]}]}]}, {"name": "Respiratory Services - General", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0410", "description": "Respiratory Services", "allowed_amounts": [{"tin": {"type": "ein", "value": "340714593"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 936.0, "npi": [1235183542]}, {"billed_charge": 1272.0, "npi": [1235183542]}, {"billed_charge": 11604.0, "npi": [1235183542]}, {"billed_charge": 8703.0, "npi": [1235183542]}, {"billed_charge": 450.0, "npi": [1235183542]}, {"billed_charge": 593.0, "npi": [1235183542]}, {"billed_charge": 359.0, "npi": [1235183542]}, {"billed_charge": 2520.0, "npi": [1235183542]}, {"billed_charge": 6264.0, "npi": [1235183542]}, {"billed_charge": 822.2857, "npi": [1235183542]}, {"billed_charge": 483.0, "npi": [1235183542]}, {"billed_charge": 2901.0, "npi": [1235183542]}]}]}]}, {"name": "Pharmacy - General", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0250", "description": "Pharmacy (also see 063x, an extension of 025x)", "allowed_amounts": [{"tin": {"type": "ein", "value": "341425870"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 5.0178, "npi": [1972689172]}, {"billed_charge": 3.2322, "npi": [1972689172]}, {"billed_charge": 6.96, "npi": [1972689172]}, {"billed_charge": 2.1533, "npi": [1972689172]}, {"billed_charge": 7.65, "npi": [1972689172]}, {"billed_charge": 2.5959, "npi": [1972689172]}, {"billed_charge": 3.6753, "npi": [1972689172]}, {"billed_charge": 1.0767, "npi": [1972689172]}, {"billed_charge": 2.934, "npi": [1972689172]}, {"billed_charge": 0.8075, "npi": [1972689172]}, {"billed_charge": 6.47, "npi": [1972689172]}, {"billed_charge": 40.43, "npi": [1972689172]}, {"billed_charge": 1.1078, "npi": [1972689172]}, {"billed_charge": 3.2285, "npi": [1972689172]}, {"billed_charge": 3.77, "npi": [1972689172]}, {"billed_charge": 31.545, "npi": [1972689172]}, {"billed_charge": 1.615, "npi": [1972689172]}, {"billed_charge": 3.64, "npi": [1972689172]}, {"billed_charge": 3.4667, "npi": [1972689172]}, {"billed_charge": 1.2823, "npi": [1972689172]}, {"billed_charge": 2.0775, "npi": [1972689172]}, {"billed_charge": 20.455, "npi": [1972689172]}, {"billed_charge": 33.97, "npi": [1972689172]}, {"billed_charge": 1.735, "npi": [1972689172]}, {"billed_charge": 3.9511, "npi": [1972689172]}, {"billed_charge": 3.4083, "npi": [1972689172]}, {"billed_charge": 17.9095, "npi": [1972689172]}, {"billed_charge": 3.7222, "npi": [1972689172]}, {"billed_charge": 42.16, "npi": [1972689172]}, {"billed_charge": 4.4733, "npi": [1972689172]}, {"billed_charge": 7.0134, "npi": [1972689172]}, {"billed_charge": 2.2625, "npi": [1972689172]}, {"billed_charge": 7.946, "npi": [1972689172]}, {"billed_charge": 15.905, "npi": [1972689172]}, {"billed_charge": 22.2079, "npi": [1972689172]}, {"billed_charge": 0.2087, "npi": [1972689172]}, {"billed_charge": 3.23, "npi": [1972689172]}, {"billed_charge": 4.31, "npi": [1972689172]}, {"billed_charge": 3.2657, "npi": [1972689172]}, {"billed_charge": 59.86, "npi": [1972689172]}, {"billed_charge": 3.7717, "npi": [1972689172]}, {"billed_charge": 40.23, "npi": [1972689172]}]}]}]}, {"name": "Pharmacy - Extension of 25X - Drug Requiring Detailed Coding", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0636", "description": "Pharmacy - Extension of 25x", "allowed_amounts": [{"tin": {"type": "ein", "value": "340714461"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.99, "billing_code_modifier": ["JZ"], "providers": [{"billed_charge": 3.23, "npi": [1225128432]}]}, {"allowed_amount": 0.0775, "billing_code_modifier": [""], "providers": [{"billed_charge": 0.2656, "npi": [1225128432]}]}, {"allowed_amount": 3.86, "billing_code_modifier": [""], "providers": [{"billed_charge": 12.75, "npi": [1225128432]}]}, {"allowed_amount": 0.95, "billing_code_modifier": ["JZSE"], "providers": [{"billed_charge": 3.23, "npi": [1225128432]}]}, {"allowed_amount": 4.16, "billing_code_modifier": [""], "providers": [{"billed_charge": 13.72, "npi": [1225128432]}]}, {"allowed_amount": 0.2475, "billing_code_modifier": [""], "providers": [{"billed_charge": 0.8075, "npi": [1225128432]}]}, {"allowed_amount": 0.3568, "billing_code_modifier": ["JZ"], "providers": [{"billed_charge": 1.2216, "npi": [1225128432]}]}, {"allowed_amount": 2.58, "billing_code_modifier": [""], "providers": [{"billed_charge": 8.5, "npi": [1225128432]}]}, {"allowed_amount": 0.495, "billing_code_modifier": ["JZ"], "providers": [{"billed_charge": 1.615, "npi": [1225128432]}]}, {"allowed_amount": 0.475, "billing_code_modifier": ["JZ"], "providers": [{"billed_charge": 1.615, "npi": [1225128432]}]}, {"allowed_amount": 1.96, "billing_code_modifier": [""], "providers": [{"billed_charge": 6.47, "npi": [1225128432]}]}, {"allowed_amount": 0.99, "billing_code_modifier": ["JZSE"], "providers": [{"billed_charge": 3.23, "npi": [1225128432]}]}, {"allowed_amount": 4.17, "billing_code_modifier": ["SE"], "providers": [{"billed_charge": 13.72, "npi": [1225128432]}]}, {"allowed_amount": 3.86, "billing_code_modifier": ["SE"], "providers": [{"billed_charge": 12.75, "npi": [1225128432]}]}, {"allowed_amount": 0.95, "billing_code_modifier": ["JZ"], "providers": [{"billed_charge": 3.23, "npi": [1225128432]}]}, {"allowed_amount": 0.0779, "billing_code_modifier": ["SE"], "providers": [{"billed_charge": 0.2658, "npi": [1225128432]}]}, {"allowed_amount": 4.95, "billing_code_modifier": [""], "providers": [{"billed_charge": 17.0, "npi": [1225128432]}]}, {"allowed_amount": 8.3967, "billing_code_modifier": [""], "providers": [{"billed_charge": 28.76, "npi": [1225128432]}]}]}]}, {"name": "Emergency Room - General", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0450", "description": "Emergency Room", "allowed_amounts": [{"tin": {"type": "ein", "value": "314379491"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 531.16, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 679.0, "npi": [1942256888]}]}, {"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 176.0, "npi": [1942256888]}, {"billed_charge": 170.0, "npi": [1942256888]}]}, {"allowed_amount": 260.33, "billing_code_modifier": [""], "providers": [{"billed_charge": 344.0, "npi": [1942256888]}]}, {"allowed_amount": 345.38, "billing_code_modifier": [""], "providers": [{"billed_charge": 568.0, "npi": [1942256888]}]}, {"allowed_amount": 57.315, "billing_code_modifier": [""], "providers": [{"billed_charge": 119.0, "npi": [1942256888]}]}, {"allowed_amount": 510.68, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 679.0, "npi": [1942256888]}]}, {"allowed_amount": 57.32, "billing_code_modifier": ["59"], "providers": [{"billed_charge": 119.0, "npi": [1942256888]}, {"billed_charge": 217.0, "npi": [1942256888]}]}, {"allowed_amount": 510.68, "billing_code_modifier": [""], "providers": [{"billed_charge": 679.0, "npi": [1942256888]}]}, {"allowed_amount": 728.86, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 835.0, "npi": [1942256888]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["59"], "providers": [{"billed_charge": 176.0, "npi": [1942256888]}, {"billed_charge": 119.0, "npi": [1942256888]}]}, {"allowed_amount": 260.33, "billing_code_modifier": ["59"], "providers": [{"billed_charge": 344.0, "npi": [1942256888]}]}, {"allowed_amount": 57.315, "billing_code_modifier": ["59"], "providers": [{"billed_charge": 119.0, "npi": [1942256888]}]}, {"allowed_amount": 57.3167, "billing_code_modifier": ["59"], "providers": [{"billed_charge": 217.0, "npi": [1942256888]}]}, {"allowed_amount": 764.76, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 835.0, "npi": [1942256888]}]}, {"allowed_amount": 262.8, "billing_code_modifier": [""], "providers": [{"billed_charge": 220.0, "npi": [1942256888]}]}, {"allowed_amount": 57.3167, "billing_code_modifier": [""], "providers": [{"billed_charge": 217.0, "npi": [1942256888]}]}, {"allowed_amount": 57.55, "billing_code_modifier": [""], "providers": [{"billed_charge": 119.0, "npi": [1942256888]}, {"billed_charge": 217.0, "npi": [1942256888]}]}, {"allowed_amount": 334.09, "billing_code_modifier": [""], "providers": [{"billed_charge": 568.0, "npi": [1942256888]}]}]}]}, {"name": "Emergency Room - General", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0450", "description": "Emergency Room", "allowed_amounts": [{"tin": {"type": "ein", "value": "311518658"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 531.16, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 704.0, "npi": [1770957185]}]}, {"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 147.0, "npi": [1770957185]}]}, {"allowed_amount": 260.33, "billing_code_modifier": [""], "providers": [{"billed_charge": 284.0, "npi": [1770957185]}]}, {"allowed_amount": 57.32, "billing_code_modifier": [""], "providers": [{"billed_charge": 266.0, "npi": [1770957185]}]}, {"allowed_amount": 301.9, "billing_code_modifier": ["LT"], "providers": [{"billed_charge": 389.0, "npi": [1770957185]}]}, {"allowed_amount": 196.82, "billing_code_modifier": ["LT"], "providers": [{"billed_charge": 289.0, "npi": [1770957185]}]}, {"allowed_amount": 262.8, "billing_code_modifier": ["59"], "providers": [{"billed_charge": 276.0, "npi": [1770957185]}]}, {"allowed_amount": 510.68, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 743.0, "npi": [1770957185]}]}, {"allowed_amount": 345.38, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 584.0, "npi": [1770957185]}]}, {"allowed_amount": 3302.71, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 1063.0, "npi": [1770957185]}]}, {"allowed_amount": 334.09, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 616.0, "npi": [1770957185]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["LT"], "providers": [{"billed_charge": 262.0, "npi": [1770957185]}]}, {"allowed_amount": 98.42, "billing_code_modifier": ["LT59"], "providers": [{"billed_charge": 245.0, "npi": [1770957185]}]}, {"allowed_amount": 764.76, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 1063.0, "npi": [1770957185]}]}, {"allowed_amount": 262.8, "billing_code_modifier": [""], "providers": [{"billed_charge": 219.0, "npi": [1770957185]}]}, {"allowed_amount": 57.55, "billing_code_modifier": [""], "providers": [{"billed_charge": 258.0, "npi": [1770957185]}, {"billed_charge": 61.0, "npi": [1770957185]}]}, {"allowed_amount": 334.09, "billing_code_modifier": [""], "providers": [{"billed_charge": 616.0, "npi": [1770957185]}]}]}]}, {"name": "EMERGENCY DEPARTMENT VISIT MODERATE MDM", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "99284", "description": "EMERGENCY DEPARTMENT VISIT MODERATE MDM", "allowed_amounts": [{"tin": {"type": "ein", "value": "264094289"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 129.37, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 370.0, "npi": [1275773301]}]}, {"allowed_amount": 370.0, "billing_code_modifier": ["FS"], "providers": [{"billed_charge": 370.0, "npi": [1275773301]}]}, {"allowed_amount": 370.0, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 370.0, "npi": [1275773301]}]}, {"allowed_amount": 370.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 370.0, "npi": [1275773301]}]}]}]}, {"name": "Laboratory - Hematology", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0305", "description": "Laboratory", "allowed_amounts": [{"tin": {"type": "ein", "value": "341425870"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 96.0, "npi": [1972689172]}, {"billed_charge": 89.3846, "npi": [1972689172]}, {"billed_charge": 124.5, "npi": [1972689172]}, {"billed_charge": 49.0, "npi": [1972689172]}, {"billed_charge": 121.0, "npi": [1972689172]}, {"billed_charge": 97.8182, "npi": [1972689172]}, {"billed_charge": 104.6522, "npi": [1972689172]}, {"billed_charge": 134.0, "npi": [1972689172]}, {"billed_charge": 134.5, "npi": [1972689172]}, {"billed_charge": 288.0, "npi": [1972689172]}, {"billed_charge": 277.0, "npi": [1972689172]}, {"billed_charge": 93.2, "npi": [1972689172]}, {"billed_charge": 104.0, "npi": [1972689172]}, {"billed_charge": 173.0, "npi": [1972689172]}, {"billed_charge": 127.0, "npi": [1972689172]}, {"billed_charge": 139.0, "npi": [1972689172]}, {"billed_charge": 99.6667, "npi": [1972689172]}]}]}]}, {"name": "Laboratory - Chemistry", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0301", "description": "Laboratory", "allowed_amounts": [{"tin": {"type": "ein", "value": "340714612"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 5.31, "billing_code_modifier": ["59"], "providers": [{"billed_charge": 58.0, "npi": [1841299039]}]}, {"allowed_amount": 18.75, "billing_code_modifier": [""], "providers": [{"billed_charge": 191.0, "npi": [1841299039]}]}, {"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 74.0, "npi": [1841299039]}, {"billed_charge": 264.0, "npi": [1841299039]}, {"billed_charge": 837.0, "npi": [1841299039]}, {"billed_charge": 290.0, "npi": [1841299039]}, {"billed_charge": 78.0, "npi": [1841299039]}, {"billed_charge": 302.0, "npi": [1841299039]}, {"billed_charge": 153.0, "npi": [1841299039]}, {"billed_charge": 101.0, "npi": [1841299039]}, {"billed_charge": 97.0, "npi": [1841299039]}, {"billed_charge": 182.8, "npi": [1841299039]}, {"billed_charge": 47.0, "npi": [1841299039]}, {"billed_charge": 75.0, "npi": [1841299039]}, {"billed_charge": 219.0, "npi": [1841299039]}, {"billed_charge": 215.3548, "npi": [1841299039]}, {"billed_charge": 329.0, "npi": [1841299039]}, {"billed_charge": 110.0, "npi": [1841299039]}, {"billed_charge": 130.0, "npi": [1841299039]}, {"billed_charge": 152.0, "npi": [1841299039]}, {"billed_charge": 146.0, "npi": [1841299039]}, {"billed_charge": 172.0, "npi": [1841299039]}, {"billed_charge": 254.0, "npi": [1841299039]}, {"billed_charge": 81.0, "npi": [1841299039]}, {"billed_charge": 108.4331, "npi": [1841299039]}, {"billed_charge": 434.0, "npi": [1841299039]}, {"billed_charge": 135.5333, "npi": [1841299039]}, {"billed_charge": 372.7143, "npi": [1841299039]}, {"billed_charge": 164.0, "npi": [1841299039]}, {"billed_charge": 241.0, "npi": [1841299039]}, {"billed_charge": 108.0, "npi": [1841299039]}, {"billed_charge": 145.75, "npi": [1841299039]}, {"billed_charge": 179.0, "npi": [1841299039]}, {"billed_charge": 193.0, "npi": [1841299039]}, {"billed_charge": 80.0, "npi": [1841299039]}, {"billed_charge": 71.0, "npi": [1841299039]}, {"billed_charge": 93.0, "npi": [1841299039]}, {"billed_charge": 116.475, "npi": [1841299039]}, {"billed_charge": 417.0, "npi": [1841299039]}, {"billed_charge": 109.7692, "npi": [1841299039]}, {"billed_charge": 275.0, "npi": [1841299039]}, {"billed_charge": 135.0, "npi": [1841299039]}, {"billed_charge": 104.0, "npi": [1841299039]}]}, {"allowed_amount": 5.5, "billing_code_modifier": [""], "providers": [{"billed_charge": 60.0, "npi": [1841299039]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["59"], "providers": [{"billed_charge": 55.0, "npi": [1841299039]}, {"billed_charge": 77.0, "npi": [1841299039]}, {"billed_charge": 73.0, "npi": [1841299039]}, {"billed_charge": 76.0, "npi": [1841299039]}, {"billed_charge": 57.0, "npi": [1841299039]}, {"billed_charge": 80.0, "npi": [1841299039]}, {"billed_charge": 104.0, "npi": [1841299039]}]}, {"allowed_amount": 5.5, "billing_code_modifier": ["59"], "providers": [{"billed_charge": 60.0, "npi": [1841299039]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["91"], "providers": [{"billed_charge": 172.0, "npi": [1841299039]}, {"billed_charge": 108.0, "npi": [1841299039]}, {"billed_charge": 179.0, "npi": [1841299039]}]}]}]}, {"name": "Pharmacy - Extension of 25X - Drug Requiring Detailed Coding", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0636", "description": "Pharmacy - Extension of 25x", "allowed_amounts": [{"tin": {"type": "ein", "value": "340714612"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 170.21, "npi": [1841299039]}, {"billed_charge": 40.86, "npi": [1841299039]}, {"billed_charge": 4.9967, "npi": [1841299039]}, {"billed_charge": 592.74, "npi": [1841299039]}, {"billed_charge": 7.4, "npi": [1841299039]}, {"billed_charge": 0.8075, "npi": [1841299039]}, {"billed_charge": 2.6725, "npi": [1841299039]}, {"billed_charge": 20.61, "npi": [1841299039]}, {"billed_charge": 0.646, "npi": [1841299039]}, {"billed_charge": 0.7438, "npi": [1841299039]}, {"billed_charge": 6.47, "npi": [1841299039]}, {"billed_charge": 10.28, "npi": [1841299039]}, {"billed_charge": 0.0808, "npi": [1841299039]}, {"billed_charge": 24.65, "npi": [1841299039]}, {"billed_charge": 8.23, "npi": [1841299039]}, {"billed_charge": 4.9957, "npi": [1841299039]}, {"billed_charge": 9.86, "npi": [1841299039]}, {"billed_charge": 3.98, "npi": [1841299039]}, {"billed_charge": 0.672, "npi": [1841299039]}, {"billed_charge": 12.62, "npi": [1841299039]}, {"billed_charge": 3.23, "npi": [1841299039]}, {"billed_charge": 27.52, "npi": [1841299039]}, {"billed_charge": 0.6717, "npi": [1841299039]}, {"billed_charge": 0.4635, "npi": [1841299039]}, {"billed_charge": 1.0767, "npi": [1841299039]}, {"billed_charge": 3.49, "npi": [1841299039]}, {"billed_charge": 0.0646, "npi": [1841299039]}, {"billed_charge": 9.95, "npi": [1841299039]}, {"billed_charge": 5.44, "npi": [1841299039]}, {"billed_charge": 4.005, "npi": [1841299039]}, {"billed_charge": 20.88, "npi": [1841299039]}, {"billed_charge": 8.05, "npi": [1841299039]}, {"billed_charge": 14.79, "npi": [1841299039]}, {"billed_charge": 0.0404, "npi": [1841299039]}, {"billed_charge": 3.52, "npi": [1841299039]}, {"billed_charge": 4.0, "npi": [1841299039]}, {"billed_charge": 1.282, "npi": [1841299039]}, {"billed_charge": 0.0538, "npi": [1841299039]}, {"billed_charge": 3.945, "npi": [1841299039]}, {"billed_charge": 6.98, "npi": [1841299039]}, {"billed_charge": 0.0776, "npi": [1841299039]}, {"billed_charge": 11.16, "npi": [1841299039]}, {"billed_charge": 18.89, "npi": [1841299039]}, {"billed_charge": 12.08, "npi": [1841299039]}, {"billed_charge": 3.235, "npi": [1841299039]}, {"billed_charge": 23.385, "npi": [1841299039]}, {"billed_charge": 1.4172, "npi": [1841299039]}, {"billed_charge": 12.33, "npi": [1841299039]}]}, {"allowed_amount": 0.41, "billing_code_modifier": ["JZ"], "providers": [{"billed_charge": 1.615, "npi": [1841299039]}]}, {"allowed_amount": 0.46, "billing_code_modifier": [""], "providers": [{"billed_charge": 3.23, "npi": [1841299039]}]}, {"allowed_amount": 0.41, "billing_code_modifier": ["JW"], "providers": [{"billed_charge": 1.58, "npi": [1841299039]}]}, {"allowed_amount": 0.41, "billing_code_modifier": [""], "providers": [{"billed_charge": 3.23, "npi": [1841299039]}]}, {"allowed_amount": 0.47, "billing_code_modifier": ["JZ"], "providers": [{"billed_charge": 1.615, "npi": [1841299039]}]}, {"allowed_amount": 0.46, "billing_code_modifier": ["JW"], "providers": [{"billed_charge": 1.58, "npi": [1841299039]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["JZ"], "providers": [{"billed_charge": 2.194, "npi": [1841299039]}, {"billed_charge": 2.388, "npi": [1841299039]}, {"billed_charge": 2.534, "npi": [1841299039]}, {"billed_charge": 1.4172, "npi": [1841299039]}]}]}]}, {"name": "Emergency Room - General", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0450", "description": "Emergency Room", "allowed_amounts": [{"tin": {"type": "ein", "value": "341260978"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 225.0, "npi": [1841264868]}, {"billed_charge": 2796.0, "npi": [1841264868]}]}, {"allowed_amount": 359.79, "billing_code_modifier": [""], "providers": [{"billed_charge": 1134.0, "npi": [1841264868]}]}, {"allowed_amount": 767.3, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 2688.0, "npi": [1841264868]}]}, {"allowed_amount": 784.92, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 2796.0, "npi": [1841264868]}]}, {"allowed_amount": 532.91, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 1711.0, "npi": [1841264868]}]}, {"allowed_amount": 3313.64, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 2688.0, "npi": [1841264868]}]}, {"allowed_amount": 346.53, "billing_code_modifier": [""], "providers": [{"billed_charge": 1090.0, "npi": [1841264868]}]}, {"allowed_amount": 549.96, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 1779.0, "npi": [1841264868]}]}, {"allowed_amount": 549.96, "billing_code_modifier": [""], "providers": [{"billed_charge": 1779.0, "npi": [1841264868]}]}]}]}, {"name": "Medical/Surgical Supplies and Devices - Sterile Supply", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0272", "description": "Med/Surg Supplies &Devices (also see 062x, extension of 027x", "allowed_amounts": [{"tin": {"type": "ein", "value": "340714593"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 198.2075, "npi": [1902858152]}, {"billed_charge": 564.328, "npi": [1902858152]}, {"billed_charge": 143.08, "npi": [1902858152]}, {"billed_charge": 485.3436, "npi": [1902858152]}, {"billed_charge": 265.04, "npi": [1902858152]}, {"billed_charge": 294.98, "npi": [1902858152]}, {"billed_charge": 90.0, "npi": [1902858152]}, {"billed_charge": 303.08, "npi": [1902858152]}, {"billed_charge": 84.0867, "npi": [1902858152]}, {"billed_charge": 306.41, "npi": [1902858152]}, {"billed_charge": 69.65, "npi": [1902858152]}, {"billed_charge": 373.43, "npi": [1902858152]}, {"billed_charge": 1245.0, "npi": [1902858152]}, {"billed_charge": 220.3167, "npi": [1902858152]}, {"billed_charge": 301.735, "npi": [1902858152]}, {"billed_charge": 316.08, "npi": [1902858152]}]}, {"allowed_amount": 5993.925, "billing_code_modifier": [""], "providers": [{"billed_charge": 1245.0, "npi": [1902858152]}]}]}]}, {"name": "Emergency Room - General", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0450", "description": "Emergency Room", "allowed_amounts": [{"tin": {"type": "ein", "value": "340714478"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 550.83, "billing_code_modifier": [""], "providers": [{"billed_charge": 2533.0, "npi": [1821035940]}]}, {"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 4230.0, "npi": [1821035940]}]}, {"allowed_amount": 359.79, "billing_code_modifier": [""], "providers": [{"billed_charge": 1911.0, "npi": [1821035940]}]}, {"allowed_amount": 550.83, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 2533.0, "npi": [1821035940]}]}, {"allowed_amount": 358.18, "billing_code_modifier": [""], "providers": [{"billed_charge": 1632.0, "npi": [1821035940]}]}, {"allowed_amount": 16561.17, "billing_code_modifier": ["RT"], "providers": [{"billed_charge": 7252.0, "npi": [1821035940]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 5073.0, "npi": [1821035940]}]}, {"allowed_amount": 784.92, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 4230.0, "npi": [1821035940]}]}, {"allowed_amount": 793.09, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 3672.0, "npi": [1821035940]}]}, {"allowed_amount": 111.15, "billing_code_modifier": [""], "providers": [{"billed_charge": 608.0, "npi": [1821035940]}]}, {"allowed_amount": 549.96, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 2938.0, "npi": [1821035940]}]}, {"allowed_amount": 17909.99, "billing_code_modifier": ["RT"], "providers": [{"billed_charge": 7252.0, "npi": [1821035940]}]}]}]}, {"name": "Laboratory - Chemistry", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0301", "description": "Laboratory", "allowed_amounts": [{"tin": {"type": "ein", "value": "474442902"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 48.0, "npi": [1346607017]}, {"billed_charge": 112.0, "npi": [1346607017]}, {"billed_charge": 58.0, "npi": [1346607017]}, {"billed_charge": 69.0, "npi": [1346607017]}, {"billed_charge": 403.0, "npi": [1346607017]}, {"billed_charge": 46.0, "npi": [1346607017]}, {"billed_charge": 271.0, "npi": [1346607017]}, {"billed_charge": 44.0, "npi": [1346607017]}, {"billed_charge": 86.0, "npi": [1346607017]}, {"billed_charge": 80.0, "npi": [1346607017]}, {"billed_charge": 81.0, "npi": [1346607017]}, {"billed_charge": 23.0, "npi": [1346607017]}, {"billed_charge": 104.0, "npi": [1346607017]}, {"billed_charge": 61.9444, "npi": [1346607017]}, {"billed_charge": 429.0, "npi": [1346607017]}, {"billed_charge": 181.2143, "npi": [1346607017]}, {"billed_charge": 119.0, "npi": [1346607017]}, {"billed_charge": 73.0, "npi": [1346607017]}, {"billed_charge": 255.0, "npi": [1346607017]}, {"billed_charge": 45.0, "npi": [1346607017]}, {"billed_charge": 104.4074, "npi": [1346607017]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["91"], "providers": [{"billed_charge": 86.0, "npi": [1346607017]}, {"billed_charge": 81.0, "npi": [1346607017]}]}]}]}, {"name": "EKG/ECG (Electrocardiogram) - General", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0730", "description": "EKG/ECG (Electrocardiogram)", "allowed_amounts": [{"tin": {"type": "ein", "value": "344428218"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 170.0, "npi": [1801884655]}, {"billed_charge": 178.0, "npi": [1801884655]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["59"], "providers": [{"billed_charge": 170.0, "npi": [1801884655]}]}]}]}, {"name": "AMBULANCE SERVICE BLS EMERGENCY TRANSPORT", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "A0429", "description": "AMBULANCE SERVICE BLS EMERGENCY TRANSPORT", "allowed_amounts": [{"tin": {"type": "ein", "value": "346000646"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 426.93, "billing_code_modifier": ["PH"], "providers": [{"billed_charge": 748.8, "npi": [1699867077]}]}, {"allowed_amount": 426.93, "billing_code_modifier": ["HH"], "providers": [{"billed_charge": 748.8, "npi": [1699867077]}]}, {"allowed_amount": 436.12, "billing_code_modifier": ["NH"], "providers": [{"billed_charge": 748.8, "npi": [1699867077]}]}, {"allowed_amount": 436.12, "billing_code_modifier": ["RH"], "providers": [{"billed_charge": 748.8, "npi": [1699867077]}]}, {"allowed_amount": 436.12, "billing_code_modifier": ["EH"], "providers": [{"billed_charge": 748.8, "npi": [1699867077]}]}, {"allowed_amount": 436.12, "billing_code_modifier": ["SH"], "providers": [{"billed_charge": 748.8, "npi": [1699867077]}]}, {"allowed_amount": 426.93, "billing_code_modifier": ["RH"], "providers": [{"billed_charge": 748.8, "npi": [1699867077]}]}, {"allowed_amount": 426.93, "billing_code_modifier": ["EH"], "providers": [{"billed_charge": 748.8, "npi": [1699867077]}]}, {"allowed_amount": 426.93, "billing_code_modifier": ["NH"], "providers": [{"billed_charge": 748.8, "npi": [1699867077]}]}, {"allowed_amount": 426.93, "billing_code_modifier": ["SH"], "providers": [{"billed_charge": 748.8, "npi": [1699867077]}]}]}]}, {"name": "EKG/ECG (Electrocardiogram) - Telemetry", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0732", "description": "EKG/ECG (Electrocardiogram)", "allowed_amounts": [{"tin": {"type": "ein", "value": "340714585"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 280.9231, "npi": [1679525919]}, {"billed_charge": 275.0, "npi": [1679525919]}, {"billed_charge": 268.0, "npi": [1679525919]}, {"billed_charge": 281.3636, "npi": [1679525919]}, {"billed_charge": 289.0, "npi": [1679525919]}]}, {"allowed_amount": 195.8, "billing_code_modifier": [""], "providers": [{"billed_charge": 268.0, "npi": [1679525919]}]}]}]}, {"name": "Laboratory - Chemistry", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0301", "description": "Laboratory", "allowed_amounts": [{"tin": {"type": "ein", "value": "341105619"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 18.75, "billing_code_modifier": [""], "providers": [{"billed_charge": 159.0, "npi": [1811939887]}, {"billed_charge": 207.0, "npi": [1811939887]}]}, {"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 668.0, "npi": [1811939887]}, {"billed_charge": 131.0, "npi": [1811939887]}, {"billed_charge": 125.0, "npi": [1811939887]}, {"billed_charge": 212.0, "npi": [1811939887]}, {"billed_charge": 226.0, "npi": [1811939887]}, {"billed_charge": 67.0, "npi": [1811939887]}, {"billed_charge": 255.125, "npi": [1811939887]}, {"billed_charge": 228.0, "npi": [1811939887]}, {"billed_charge": 44.0, "npi": [1811939887]}, {"billed_charge": 512.5, "npi": [1811939887]}, {"billed_charge": 61.0, "npi": [1811939887]}, {"billed_charge": 183.0, "npi": [1811939887]}, {"billed_charge": 97.0, "npi": [1811939887]}, {"billed_charge": 229.0, "npi": [1811939887]}, {"billed_charge": 221.1, "npi": [1811939887]}, {"billed_charge": 38.0, "npi": [1811939887]}, {"billed_charge": 226.6667, "npi": [1811939887]}, {"billed_charge": 259.2308, "npi": [1811939887]}, {"billed_charge": 141.7024, "npi": [1811939887]}, {"billed_charge": 98.0, "npi": [1811939887]}, {"billed_charge": 207.0, "npi": [1811939887]}, {"billed_charge": 411.0, "npi": [1811939887]}, {"billed_charge": 46.0, "npi": [1811939887]}, {"billed_charge": 293.0, "npi": [1811939887]}, {"billed_charge": 323.0, "npi": [1811939887]}, {"billed_charge": 89.0, "npi": [1811939887]}, {"billed_charge": 332.3, "npi": [1811939887]}, {"billed_charge": 207.3333, "npi": [1811939887]}, {"billed_charge": 102.0, "npi": [1811939887]}, {"billed_charge": 79.3827, "npi": [1811939887]}, {"billed_charge": 98.1881, "npi": [1811939887]}, {"billed_charge": 129.7297, "npi": [1811939887]}, {"billed_charge": 244.0, "npi": [1811939887]}, {"billed_charge": 136.6296, "npi": [1811939887]}, {"billed_charge": 391.0, "npi": [1811939887]}, {"billed_charge": 174.9697, "npi": [1811939887]}, {"billed_charge": 104.1607, "npi": [1811939887]}, {"billed_charge": 99.0, "npi": [1811939887]}, {"billed_charge": 371.0, "npi": [1811939887]}, {"billed_charge": 88.9538, "npi": [1811939887]}, {"billed_charge": 179.0, "npi": [1811939887]}, {"billed_charge": 58.0, "npi": [1811939887]}, {"billed_charge": 113.2899, "npi": [1811939887]}, {"billed_charge": 110.0, "npi": [1811939887]}, {"billed_charge": 113.0, "npi": [1811939887]}, {"billed_charge": 232.0, "npi": [1811939887]}, {"billed_charge": 104.0, "npi": [1811939887]}, {"billed_charge": 432.0, "npi": [1811939887]}, {"billed_charge": 70.0, "npi": [1811939887]}, {"billed_charge": 178.0, "npi": [1811939887]}, {"billed_charge": 402.3333, "npi": [1811939887]}, {"billed_charge": 93.3333, "npi": [1811939887]}, {"billed_charge": 296.0, "npi": [1811939887]}, {"billed_charge": 418.0, "npi": [1811939887]}, {"billed_charge": 877.0, "npi": [1811939887]}, {"billed_charge": 84.0, "npi": [1811939887]}, {"billed_charge": 279.0, "npi": [1811939887]}, {"billed_charge": 217.0, "npi": [1811939887]}, {"billed_charge": 99.5254, "npi": [1811939887]}, {"billed_charge": 299.0, "npi": [1811939887]}, {"billed_charge": 701.0, "npi": [1811939887]}, {"billed_charge": 35.0, "npi": [1811939887]}, {"billed_charge": 27.0, "npi": [1811939887]}, {"billed_charge": 1162.0, "npi": [1811939887]}, {"billed_charge": 223.0, "npi": [1811939887]}, {"billed_charge": 278.0, "npi": [1811939887]}, {"billed_charge": 170.0, "npi": [1811939887]}, {"billed_charge": 108.0, "npi": [1811939887]}, {"billed_charge": 134.5938, "npi": [1811939887]}, {"billed_charge": 40.0, "npi": [1811939887]}, {"billed_charge": 835.0, "npi": [1811939887]}, {"billed_charge": 154.0, "npi": [1811939887]}, {"billed_charge": 85.0, "npi": [1811939887]}, {"billed_charge": 116.0, "npi": [1811939887]}, {"billed_charge": 163.0, "npi": [1811939887]}, {"billed_charge": 308.0, "npi": [1811939887]}, {"billed_charge": 261.0, "npi": [1811939887]}, {"billed_charge": 164.0, "npi": [1811939887]}, {"billed_charge": 201.12, "npi": [1811939887]}, {"billed_charge": 254.8182, "npi": [1811939887]}, {"billed_charge": 192.0, "npi": [1811939887]}, {"billed_charge": 241.6087, "npi": [1811939887]}, {"billed_charge": 37.0, "npi": [1811939887]}, {"billed_charge": 93.0, "npi": [1811939887]}, {"billed_charge": 615.0, "npi": [1811939887]}, {"billed_charge": 324.4545, "npi": [1811939887]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["XU"], "providers": [{"billed_charge": 131.0, "npi": [1811939887]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["91"], "providers": [{"billed_charge": 97.0, "npi": [1811939887]}, {"billed_charge": 46.0, "npi": [1811939887]}, {"billed_charge": 102.0, "npi": [1811939887]}, {"billed_charge": 244.0, "npi": [1811939887]}, {"billed_charge": 113.0, "npi": [1811939887]}, {"billed_charge": 232.0, "npi": [1811939887]}, {"billed_charge": 27.0, "npi": [1811939887]}, {"billed_charge": 37.0, "npi": [1811939887]}]}]}]}, {"name": "EMERGENCY DEPARTMENT VISIT MODERATE MDM", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "99284", "description": "EMERGENCY DEPARTMENT VISIT MODERATE MDM", "allowed_amounts": [{"tin": {"type": "ein", "value": "471776582"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 138.14, "billing_code_modifier": ["UD"], "providers": [{"billed_charge": 1151.76, "npi": [1801287511]}, {"billed_charge": 1186.31, "npi": [1801287511]}]}, {"allowed_amount": 138.14, "billing_code_modifier": ["57"], "providers": [{"billed_charge": 1151.76, "npi": [1801287511]}]}, {"allowed_amount": 147.01, "billing_code_modifier": [""], "providers": [{"billed_charge": 1186.31, "npi": [1801287511]}]}, {"allowed_amount": 339.46, "billing_code_modifier": [""], "providers": [{"billed_charge": 1151.76, "npi": [1801287511]}, {"billed_charge": 985.0, "npi": [1801287511]}]}, {"allowed_amount": 138.14, "billing_code_modifier": [""], "providers": [{"billed_charge": 1151.76, "npi": [1801287511]}, {"billed_charge": 1186.31, "npi": [1801287511]}, {"billed_charge": 985.0, "npi": [1801287511]}]}, {"allowed_amount": 138.14, "billing_code_modifier": ["GC"], "providers": [{"billed_charge": 1186.31, "npi": [1801287511]}]}, {"allowed_amount": 339.46, "billing_code_modifier": ["UD"], "providers": [{"billed_charge": 1151.76, "npi": [1801287511]}]}, {"allowed_amount": 330.7, "billing_code_modifier": ["UD"], "providers": [{"billed_charge": 1151.76, "npi": [1801287511]}]}, {"allowed_amount": 147.01, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 1186.31, "npi": [1801287511]}]}]}]}, {"name": "Laboratory - General", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0300", "description": "Laboratory", "allowed_amounts": [{"tin": {"type": "ein", "value": "340714755"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 1393.2, "npi": [1396765681]}, {"billed_charge": 56.5, "npi": [1396765681]}, {"billed_charge": 729.6667, "npi": [1396765681]}, {"billed_charge": 53.75, "npi": [1396765681]}]}]}]}, {"name": "Pharmacy - Extension of 25X - Drug Requiring Detailed Coding", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0636", "description": "Pharmacy - Extension of 25x", "allowed_amounts": [{"tin": {"type": "ein", "value": "310537486"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 4.44, "npi": [1508835828]}, {"billed_charge": 1.037, "npi": [1508835828]}, {"billed_charge": 1.6337, "npi": [1508835828]}, {"billed_charge": 43.2, "npi": [1508835828]}, {"billed_charge": 10.0, "npi": [1508835828]}, {"billed_charge": 23.64, "npi": [1508835828]}]}, {"allowed_amount": 0.47, "billing_code_modifier": ["JZ"], "providers": [{"billed_charge": 11.98, "npi": [1508835828]}]}, {"allowed_amount": 10.0058, "billing_code_modifier": ["JZ"], "providers": [{"billed_charge": 25.374, "npi": [1508835828]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["JZ"], "providers": [{"billed_charge": 1.95, "npi": [1508835828]}, {"billed_charge": 25.374, "npi": [1508835828]}, {"billed_charge": 1.54, "npi": [1508835828]}, {"billed_charge": 3.96, "npi": [1508835828]}, {"billed_charge": 0.55, "npi": [1508835828]}, {"billed_charge": 0.6875, "npi": [1508835828]}, {"billed_charge": 1.992, "npi": [1508835828]}, {"billed_charge": 2.072, "npi": [1508835828]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["JW"], "providers": [{"billed_charge": 1.037, "npi": [1508835828]}]}]}]}, {"name": "IV Therapy -General", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0260", "description": "IV Therapy", "allowed_amounts": [{"tin": {"type": "ein", "value": "311070877"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 283.0, "npi": [1215935366]}, {"billed_charge": 590.0, "npi": [1215935366]}, {"billed_charge": 314.0, "npi": [1215935366]}, {"billed_charge": 252.0, "npi": [1215935366]}, {"billed_charge": 192.0, "npi": [1215935366]}, {"billed_charge": 212.0, "npi": [1215935366]}, {"billed_charge": 302.8, "npi": [1215935366]}, {"billed_charge": 172.0, "npi": [1215935366]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["XU"], "providers": [{"billed_charge": 283.0, "npi": [1215935366]}, {"billed_charge": 590.0, "npi": [1215935366]}, {"billed_charge": 252.0, "npi": [1215935366]}]}, {"allowed_amount": 59.36, "billing_code_modifier": [""], "providers": [{"billed_charge": 172.0, "npi": [1215935366]}]}, {"allowed_amount": 262.74, "billing_code_modifier": [""], "providers": [{"billed_charge": 568.0, "npi": [1215935366]}]}, {"allowed_amount": 57.85, "billing_code_modifier": [""], "providers": [{"billed_charge": 172.0, "npi": [1215935366]}]}, {"allowed_amount": 271.04, "billing_code_modifier": [""], "providers": [{"billed_charge": 590.0, "npi": [1215935366]}]}]}]}, {"name": "EMERGENCY DEPARTMENT VISIT HIGH MDM", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "99285", "description": "EMERGENCY DEPARTMENT VISIT HIGH MDM", "allowed_amounts": [{"tin": {"type": "ein", "value": "311597469"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 187.47, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 1516.0, "npi": [1841232196]}]}, {"allowed_amount": 187.47, "billing_code_modifier": [""], "providers": [{"billed_charge": 1516.0, "npi": [1841232196]}]}, {"allowed_amount": 193.86, "billing_code_modifier": [""], "providers": [{"billed_charge": 1516.0, "npi": [1841232196]}]}, {"allowed_amount": 193.86, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 1516.0, "npi": [1841232196]}]}]}]}, {"name": "Radiology - Diagnostic - General", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0320", "description": "Radiology - Diagnostic", "allowed_amounts": [{"tin": {"type": "ein", "value": "344428256"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 436.0, "npi": [1407854771]}, {"billed_charge": 416.0, "npi": [1407854771]}, {"billed_charge": 865.0, "npi": [1407854771]}, {"billed_charge": 695.2222, "npi": [1407854771]}, {"billed_charge": 841.8, "npi": [1407854771]}, {"billed_charge": 678.0, "npi": [1407854771]}, {"billed_charge": 525.3182, "npi": [1407854771]}, {"billed_charge": 766.0, "npi": [1407854771]}, {"billed_charge": 459.0, "npi": [1407854771]}]}, {"allowed_amount": 116.45, "billing_code_modifier": [""], "providers": [{"billed_charge": 436.0, "npi": [1407854771]}, {"billed_charge": 644.0, "npi": [1407854771]}]}, {"allowed_amount": 117.77, "billing_code_modifier": [""], "providers": [{"billed_charge": 459.0, "npi": [1407854771]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["RT"], "providers": [{"billed_charge": 821.0, "npi": [1407854771]}, {"billed_charge": 584.0, "npi": [1407854771]}, {"billed_charge": 766.0, "npi": [1407854771]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["LT"], "providers": [{"billed_charge": 335.0, "npi": [1407854771]}, {"billed_charge": 584.0, "npi": [1407854771]}]}]}]}, {"name": "Pharmacy - General", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0250", "description": "Pharmacy (also see 063x, an extension of 025x)", "allowed_amounts": [{"tin": {"type": "ein", "value": "311070877"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 5.2, "npi": [1215935366]}, {"billed_charge": 6.4, "npi": [1215935366]}, {"billed_charge": 5.65, "npi": [1215935366]}, {"billed_charge": 9.8, "npi": [1215935366]}, {"billed_charge": 3.1, "npi": [1215935366]}, {"billed_charge": 0.65, "npi": [1215935366]}, {"billed_charge": 0.15, "npi": [1215935366]}, {"billed_charge": 24.15, "npi": [1215935366]}, {"billed_charge": 67.15, "npi": [1215935366]}, {"billed_charge": 5.3, "npi": [1215935366]}, {"billed_charge": 10.25, "npi": [1215935366]}, {"billed_charge": 11.85, "npi": [1215935366]}, {"billed_charge": 0.1, "npi": [1215935366]}, {"billed_charge": 3.05, "npi": [1215935366]}, {"billed_charge": 64.15, "npi": [1215935366]}, {"billed_charge": 5.05, "npi": [1215935366]}, {"billed_charge": 15.65, "npi": [1215935366]}, {"billed_charge": 5.8, "npi": [1215935366]}, {"billed_charge": 0.05, "npi": [1215935366]}, {"billed_charge": 4.05, "npi": [1215935366]}, {"billed_charge": 2.9, "npi": [1215935366]}, {"billed_charge": 16.3, "npi": [1215935366]}, {"billed_charge": 5.0, "npi": [1215935366]}, {"billed_charge": 5.35, "npi": [1215935366]}, {"billed_charge": 8.3105, "npi": [1215935366]}, {"billed_charge": 6.35, "npi": [1215935366]}, {"billed_charge": 65.5, "npi": [1215935366]}, {"billed_charge": 9.65, "npi": [1215935366]}, {"billed_charge": 10.525, "npi": [1215935366]}, {"billed_charge": 5.6, "npi": [1215935366]}, {"billed_charge": 8.4, "npi": [1215935366]}, {"billed_charge": 2.825, "npi": [1215935366]}, {"billed_charge": 5.25, "npi": [1215935366]}, {"billed_charge": 3.325, "npi": [1215935366]}]}]}]}, {"name": "Pharmacy - Extension of 25X - Drug Requiring Detailed Coding", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0636", "description": "Pharmacy - Extension of 25x", "allowed_amounts": [{"tin": {"type": "ein", "value": "344428218"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 1.023, "npi": [1801884655]}]}, {"allowed_amount": 0.41, "billing_code_modifier": ["JZ"], "providers": [{"billed_charge": 6.56, "npi": [1801884655]}]}, {"allowed_amount": 0.43, "billing_code_modifier": ["JZ"], "providers": [{"billed_charge": 6.56, "npi": [1801884655]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["JZ"], "providers": [{"billed_charge": 0.175, "npi": [1801884655]}, {"billed_charge": 15.06, "npi": [1801884655]}, {"billed_charge": 104.88, "npi": [1801884655]}, {"billed_charge": 1.327, "npi": [1801884655]}, {"billed_charge": 38.18, "npi": [1801884655]}, {"billed_charge": 2.186, "npi": [1801884655]}, {"billed_charge": 1.995, "npi": [1801884655]}, {"billed_charge": 4.72, "npi": [1801884655]}, {"billed_charge": 16.8225, "npi": [1801884655]}, {"billed_charge": 243.85, "npi": [1801884655]}, {"billed_charge": 251.14, "npi": [1801884655]}, {"billed_charge": 0.875, "npi": [1801884655]}, {"billed_charge": 4.354, "npi": [1801884655]}, {"billed_charge": 27.43, "npi": [1801884655]}, {"billed_charge": 1.025, "npi": [1801884655]}, {"billed_charge": 26.22, "npi": [1801884655]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["JW"], "providers": [{"billed_charge": 1.025, "npi": [1801884655]}]}, {"allowed_amount": 0.4325, "billing_code_modifier": ["JZ"], "providers": [{"billed_charge": 4.1575, "npi": [1801884655]}, {"billed_charge": 4.59, "npi": [1801884655]}]}]}]}, {"name": "SCREENING MAMMOGRAPHY BI 2-VIEW BREAST INC CAD", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "77067", "description": "SCREENING MAMMOGRAPHY BI 2-VIEW BREAST INC CAD", "allowed_amounts": [{"tin": {"type": "ein", "value": "310874388"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 34.47, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 148.0, "npi": [1346299153]}]}, {"allowed_amount": 34.17, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 148.0, "npi": [1346299153]}]}]}]}, {"name": "Laboratory - Bacteriology & Microbiology", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0306", "description": "Laboratory", "allowed_amounts": [{"tin": {"type": "ein", "value": "340714593"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 192.55, "billing_code_modifier": [""], "providers": [{"billed_charge": 925.0, "npi": [1902858152]}, {"billed_charge": 925.0, "npi": [1598719346]}, {"billed_charge": 925.0, "npi": [1235183542]}]}, {"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 56.0, "npi": [1235183542]}, {"billed_charge": 460.3333, "npi": [1235183542]}, {"billed_charge": 242.0, "npi": [1598719346]}, {"billed_charge": 984.0, "npi": [1902858152]}, {"billed_charge": 242.0, "npi": [1902858152]}, {"billed_charge": 228.0, "npi": [1235183542]}, {"billed_charge": 484.0, "npi": [1235183542]}, {"billed_charge": 925.0, "npi": [1902858152]}, {"billed_charge": 71.0, "npi": [1598719346]}, {"billed_charge": 469.6667, "npi": [1235183542]}, {"billed_charge": 53.0, "npi": [1598719346]}, {"billed_charge": 51.0, "npi": [1902858152]}, {"billed_charge": 984.0, "npi": [1235183542]}, {"billed_charge": 181.0, "npi": [1598719346]}, {"billed_charge": 93.0, "npi": [1235183542]}, {"billed_charge": 62.0, "npi": [1235183542]}, {"billed_charge": 484.0, "npi": [1902858152]}, {"billed_charge": 242.0, "npi": [1235183542]}, {"billed_charge": 54.4286, "npi": [1902858152]}, {"billed_charge": 278.0, "npi": [1598719346]}, {"billed_charge": 28.0, "npi": [1235183542]}, {"billed_charge": 60.0, "npi": [1598719346]}, {"billed_charge": 984.0, "npi": [1598719346]}, {"billed_charge": 270.0, "npi": [1235183542]}, {"billed_charge": 228.0, "npi": [1598719346]}, {"billed_charge": 67.0, "npi": [1598719346]}, {"billed_charge": 71.0, "npi": [1902858152]}, {"billed_charge": 56.0, "npi": [1598719346]}, {"billed_charge": 228.0, "npi": [1902858152]}, {"billed_charge": 53.0, "npi": [1235183542]}, {"billed_charge": 31.0, "npi": [1235183542]}, {"billed_charge": 469.6667, "npi": [1598719346]}, {"billed_charge": 925.0, "npi": [1598719346]}, {"billed_charge": 67.0, "npi": [1235183542]}, {"billed_charge": 169.6667, "npi": [1902858152]}, {"billed_charge": 1414.0, "npi": [1235183542]}, {"billed_charge": 56.0, "npi": [1902858152]}, {"billed_charge": 1071.25, "npi": [1902858152]}, {"billed_charge": 484.0, "npi": [1598719346]}, {"billed_charge": 60.0, "npi": [1235183542]}, {"billed_charge": 67.0, "npi": [1902858152]}, {"billed_charge": 925.0, "npi": [1235183542]}]}, {"allowed_amount": 149.76, "billing_code_modifier": [""], "providers": [{"billed_charge": 925.0, "npi": [1902858152]}]}, {"allowed_amount": 199.68, "billing_code_modifier": [""], "providers": [{"billed_charge": 925.0, "npi": [1902858152]}, {"billed_charge": 925.0, "npi": [1598719346]}, {"billed_charge": 925.0, "npi": [1235183542]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["59"], "providers": [{"billed_charge": 242.0, "npi": [1598719346]}, {"billed_charge": 242.0, "npi": [1902858152]}, {"billed_charge": 242.0, "npi": [1235183542]}, {"billed_charge": 228.0, "npi": [1598719346]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["91"], "providers": [{"billed_charge": 71.0, "npi": [1598719346]}, {"billed_charge": 67.0, "npi": [1598719346]}, {"billed_charge": 71.0, "npi": [1902858152]}, {"billed_charge": 67.0, "npi": [1235183542]}, {"billed_charge": 67.0, "npi": [1902858152]}]}]}]}, {"name": "Emergency Room - General", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0450", "description": "Emergency Room", "allowed_amounts": [{"tin": {"type": "ein", "value": "311070877"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 57.85, "billing_code_modifier": ["59"], "providers": [{"billed_charge": 283.0, "npi": [1215935366]}]}, {"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 283.0, "npi": [1215935366]}, {"billed_charge": 1536.0, "npi": [1215935366]}, {"billed_charge": 252.0, "npi": [1215935366]}, {"billed_charge": 212.0, "npi": [1215935366]}]}, {"allowed_amount": 3230.71, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 1536.0, "npi": [1215935366]}]}, {"allowed_amount": 203.72, "billing_code_modifier": [""], "providers": [{"billed_charge": 443.0, "npi": [1215935366]}]}, {"allowed_amount": 356.2, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 701.0, "npi": [1215935366]}]}, {"allowed_amount": 261.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 310.0, "npi": [1215935366]}]}, {"allowed_amount": 547.78, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 1109.0, "npi": [1215935366]}]}, {"allowed_amount": 59.36, "billing_code_modifier": [""], "providers": [{"billed_charge": 283.0, "npi": [1215935366]}]}, {"allowed_amount": 189.66, "billing_code_modifier": [""], "providers": [{"billed_charge": 443.0, "npi": [1215935366]}]}, {"allowed_amount": 356.2, "billing_code_modifier": [""], "providers": [{"billed_charge": 701.0, "npi": [1215935366]}]}, {"allowed_amount": 271.04, "billing_code_modifier": ["XU"], "providers": [{"billed_charge": 310.0, "npi": [1215935366]}]}, {"allowed_amount": 202.99, "billing_code_modifier": ["RT"], "providers": [{"billed_charge": 1076.0, "npi": [1215935366]}]}, {"allowed_amount": 527.49, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 1109.0, "npi": [1215935366]}]}, {"allowed_amount": 337.18, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 701.0, "npi": [1215935366]}]}, {"allowed_amount": 262.74, "billing_code_modifier": [""], "providers": [{"billed_charge": 310.0, "npi": [1215935366]}]}, {"allowed_amount": 262.74, "billing_code_modifier": ["59"], "providers": [{"billed_charge": 310.0, "npi": [1215935366]}]}, {"allowed_amount": 735.61, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 1536.0, "npi": [1215935366]}]}, {"allowed_amount": 788.7, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 1536.0, "npi": [1215935366]}]}, {"allowed_amount": 3406.08, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 1109.0, "npi": [1215935366]}]}, {"allowed_amount": 515.41, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 1109.0, "npi": [1215935366]}]}, {"allowed_amount": 57.85, "billing_code_modifier": [""], "providers": [{"billed_charge": 283.0, "npi": [1215935366]}]}, {"allowed_amount": 271.04, "billing_code_modifier": [""], "providers": [{"billed_charge": 310.0, "npi": [1215935366]}]}, {"allowed_amount": 337.18, "billing_code_modifier": [""], "providers": [{"billed_charge": 701.0, "npi": [1215935366]}]}]}]}, {"name": "Radiology - Diagnostic - Chest X-ray", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0324", "description": "Radiology - Diagnostic", "allowed_amounts": [{"tin": {"type": "ein", "value": "340714684"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 562.0, "npi": [1194763045]}, {"billed_charge": 608.0, "npi": [1194763045]}]}, {"allowed_amount": 114.69, "billing_code_modifier": [""], "providers": [{"billed_charge": 608.0, "npi": [1194763045]}]}, {"allowed_amount": 110.2, "billing_code_modifier": [""], "providers": [{"billed_charge": 562.0, "npi": [1194763045]}]}]}]}, {"name": "Pharmacy - Extension of 25X - Drug Requiring Detailed Coding", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0636", "description": "Pharmacy - Extension of 25x", "allowed_amounts": [{"tin": {"type": "ein", "value": "341924226"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 0.0808, "npi": [1669562864]}, {"billed_charge": 8.23, "npi": [1669562864]}, {"billed_charge": 14.79, "npi": [1669562864]}, {"billed_charge": 9.86, "npi": [1669562864]}, {"billed_charge": 1.775, "npi": [1669562864]}, {"billed_charge": 10.28, "npi": [1669562864]}, {"billed_charge": 0.4643, "npi": [1669562864]}, {"billed_charge": 0.3334, "npi": [1669562864]}, {"billed_charge": 1.282, "npi": [1669562864]}, {"billed_charge": 0.072, "npi": [1669562864]}, {"billed_charge": 24.65, "npi": [1669562864]}, {"billed_charge": 0.8075, "npi": [1669562864]}, {"billed_charge": 3.4525, "npi": [1669562864]}, {"billed_charge": 4.16, "npi": [1669562864]}, {"billed_charge": 19.72, "npi": [1669562864]}, {"billed_charge": 0.646, "npi": [1669562864]}, {"billed_charge": 3.945, "npi": [1669562864]}, {"billed_charge": 3.2763, "npi": [1669562864]}, {"billed_charge": 7.8, "npi": [1669562864]}]}, {"allowed_amount": 0.41, "billing_code_modifier": ["JZ"], "providers": [{"billed_charge": 3.99, "npi": [1669562864]}]}, {"allowed_amount": 0.46, "billing_code_modifier": ["JZ"], "providers": [{"billed_charge": 3.23, "npi": [1669562864]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["JZ"], "providers": [{"billed_charge": 6.47, "npi": [1669562864]}]}]}]}, {"name": "IV Therapy -General", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0260", "description": "IV Therapy", "allowed_amounts": [{"tin": {"type": "ein", "value": "340714456"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 189.0, "npi": [1790837235]}, {"billed_charge": 318.6667, "npi": [1790837235]}, {"billed_charge": 473.0, "npi": [1790837235]}, {"billed_charge": 137.0, "npi": [1790837235]}, {"billed_charge": 170.0, "npi": [1790837235]}, {"billed_charge": 155.0, "npi": [1790837235]}, {"billed_charge": 255.0, "npi": [1790837235]}, {"billed_charge": 202.0, "npi": [1790837235]}, {"billed_charge": 231.0, "npi": [1790837235]}, {"billed_charge": 305.0, "npi": [1790837235]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["XU"], "providers": [{"billed_charge": 473.0, "npi": [1790837235]}, {"billed_charge": 137.0, "npi": [1790837235]}, {"billed_charge": 170.0, "npi": [1790837235]}, {"billed_charge": 202.0, "npi": [1790837235]}]}, {"allowed_amount": 59.36, "billing_code_modifier": [""], "providers": [{"billed_charge": 137.0, "npi": [1790837235]}, {"billed_charge": 227.0, "npi": [1790837235]}]}, {"allowed_amount": 59.36, "billing_code_modifier": ["59"], "providers": [{"billed_charge": 137.0, "npi": [1790837235]}]}, {"allowed_amount": 262.74, "billing_code_modifier": [""], "providers": [{"billed_charge": 473.0, "npi": [1790837235]}, {"billed_charge": 247.0, "npi": [1790837235]}, {"billed_charge": 456.0, "npi": [1790837235]}]}, {"allowed_amount": 262.74, "billing_code_modifier": ["XU"], "providers": [{"billed_charge": 456.0, "npi": [1790837235]}]}, {"allowed_amount": 262.74, "billing_code_modifier": ["59"], "providers": [{"billed_charge": 473.0, "npi": [1790837235]}]}, {"allowed_amount": 57.85, "billing_code_modifier": [""], "providers": [{"billed_charge": 137.0, "npi": [1790837235]}, {"billed_charge": 155.0, "npi": [1790837235]}, {"billed_charge": 227.0, "npi": [1790837235]}]}, {"allowed_amount": 271.04, "billing_code_modifier": [""], "providers": [{"billed_charge": 247.0, "npi": [1790837235]}, {"billed_charge": 456.0, "npi": [1790837235]}]}, {"allowed_amount": 271.04, "billing_code_modifier": ["59"], "providers": [{"billed_charge": 473.0, "npi": [1790837235]}]}]}]}, {"name": "Laboratory - Bacteriology & Microbiology", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0306", "description": "Laboratory", "allowed_amounts": [{"tin": {"type": "ein", "value": "550357050"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 122.47, "npi": [1164492195]}, {"billed_charge": 181.58, "npi": [1164492195]}, {"billed_charge": 166.6953, "npi": [1164492195]}, {"billed_charge": 86.57, "npi": [1164492195]}, {"billed_charge": 100.29, "npi": [1164492195]}, {"billed_charge": 475.1, "npi": [1164492195]}, {"billed_charge": 73.98, "npi": [1164492195]}, {"billed_charge": 286.11, "npi": [1164492195]}, {"billed_charge": 858.33, "npi": [1164492195]}, {"billed_charge": 156.25, "npi": [1164492195]}, {"billed_charge": 246.41, "npi": [1164492195]}, {"billed_charge": 69.69, "npi": [1164492195]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["XU"], "providers": [{"billed_charge": 73.98, "npi": [1164492195]}, {"billed_charge": 26.4, "npi": [1164492195]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["91"], "providers": [{"billed_charge": 181.58, "npi": [1164492195]}]}, {"allowed_amount": 57.93, "billing_code_modifier": [""], "providers": [{"billed_charge": 85.52, "npi": [1164492195]}]}]}]}, {"name": "Emergency Room - General", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0450", "description": "Emergency Room", "allowed_amounts": [{"tin": {"type": "ein", "value": "340714755"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 550.83, "billing_code_modifier": [""], "providers": [{"billed_charge": 2864.25, "npi": [1396765681]}]}, {"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 946.0, "npi": [1396765681]}, {"billed_charge": 561.5, "npi": [1396765681]}, {"billed_charge": 7177.25, "npi": [1396765681]}]}, {"allowed_amount": 1089.97, "billing_code_modifier": [""], "providers": [{"billed_charge": 8124.75, "npi": [1396765681]}]}, {"allowed_amount": 359.79, "billing_code_modifier": [""], "providers": [{"billed_charge": 1667.25, "npi": [1396765681]}]}, {"allowed_amount": 550.83, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 2864.25, "npi": [1396765681]}]}, {"allowed_amount": 358.18, "billing_code_modifier": [""], "providers": [{"billed_charge": 1667.25, "npi": [1396765681]}]}, {"allowed_amount": 793.09, "billing_code_modifier": [""], "providers": [{"billed_charge": 4350.5, "npi": [1396765681]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 4350.5, "npi": [1396765681]}]}, {"allowed_amount": 784.92, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 4350.5, "npi": [1396765681]}]}, {"allowed_amount": 3447.28, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 4350.5, "npi": [1396765681]}]}, {"allowed_amount": 793.09, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 4350.5, "npi": [1396765681]}]}, {"allowed_amount": 549.96, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 2864.25, "npi": [1396765681]}]}, {"allowed_amount": 113.9, "billing_code_modifier": [""], "providers": [{"billed_charge": 634.75, "npi": [1396765681]}]}, {"allowed_amount": 549.96, "billing_code_modifier": [""], "providers": [{"billed_charge": 2864.25, "npi": [1396765681]}]}]}]}, {"name": "RADIOLOGIC EXAM CHEST 2 VIEWS", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "71046", "description": "RADIOLOGIC EXAM CHEST 2 VIEWS", "allowed_amounts": [{"tin": {"type": "ein", "value": "310983140"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 10.79, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 47.0, "npi": [1093718496]}]}, {"allowed_amount": 9.84, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 49.0, "npi": [1093718496]}, {"billed_charge": 54.0, "npi": [1093718496]}, {"billed_charge": 47.0, "npi": [1093718496]}]}, {"allowed_amount": 9.81, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 49.0, "npi": [1093718496]}, {"billed_charge": 47.0, "npi": [1093718496]}]}]}]}, {"name": "Pharmacy - General", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0250", "description": "Pharmacy (also see 063x, an extension of 025x)", "allowed_amounts": [{"tin": {"type": "ein", "value": "314394942"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 2.925, "npi": [1467484972]}, {"billed_charge": 6.2311, "npi": [1255377149]}, {"billed_charge": 59.5, "npi": [1467484972]}, {"billed_charge": 0.4, "npi": [1255377149]}, {"billed_charge": 16.4, "npi": [1467484972]}, {"billed_charge": 5.6, "npi": [1255377149]}, {"billed_charge": 8.75, "npi": [1255377149]}, {"billed_charge": 0.15, "npi": [1467484972]}, {"billed_charge": 7.1531, "npi": [1255377149]}, {"billed_charge": 61.9, "npi": [1467484972]}, {"billed_charge": 16.05, "npi": [1467484972]}, {"billed_charge": 5.2, "npi": [1255377149]}, {"billed_charge": 2.6, "npi": [1467484972]}, {"billed_charge": 5.15, "npi": [1467484972]}, {"billed_charge": 0.1, "npi": [1255377149]}, {"billed_charge": 83.9, "npi": [1255377149]}, {"billed_charge": 6.5, "npi": [1255377149]}, {"billed_charge": 47.7, "npi": [1467484972]}, {"billed_charge": 4.8, "npi": [1467484972]}, {"billed_charge": 8.7, "npi": [1467484972]}, {"billed_charge": 30.0, "npi": [1255377149]}, {"billed_charge": 5.8, "npi": [1467484972]}, {"billed_charge": 1.15, "npi": [1467484972]}, {"billed_charge": 5.6827, "npi": [1255377149]}, {"billed_charge": 48.75, "npi": [1467484972]}, {"billed_charge": 11.2, "npi": [1467484972]}, {"billed_charge": 8.35, "npi": [1467484972]}, {"billed_charge": 0.05, "npi": [1467484972]}, {"billed_charge": 0.7, "npi": [1255377149]}, {"billed_charge": 41.4, "npi": [1255377149]}, {"billed_charge": 10.6961, "npi": [1255377149]}, {"billed_charge": 4.85, "npi": [1255377149]}, {"billed_charge": 9.418, "npi": [1255377149]}, {"billed_charge": 3.1, "npi": [1467484972]}, {"billed_charge": 8.55, "npi": [1255377149]}, {"billed_charge": 48.7833, "npi": [1467484972]}, {"billed_charge": 7.2742, "npi": [1467484972]}, {"billed_charge": 70.95, "npi": [1255377149]}, {"billed_charge": 9.7266, "npi": [1467484972]}, {"billed_charge": 7.55, "npi": [1255377149]}, {"billed_charge": 8.2473, "npi": [1255377149]}, {"billed_charge": 8.2, "npi": [1255377149]}, {"billed_charge": 22.7, "npi": [1467484972]}, {"billed_charge": 7.1204, "npi": [1467484972]}, {"billed_charge": 5.25, "npi": [1255377149]}, {"billed_charge": 2.7, "npi": [1255377149]}, {"billed_charge": 38.5, "npi": [1255377149]}, {"billed_charge": 2.4, "npi": [1467484972]}, {"billed_charge": 0.15, "npi": [1255377149]}, {"billed_charge": 7.7, "npi": [1255377149]}, {"billed_charge": 2.725, "npi": [1255377149]}, {"billed_charge": 3.075, "npi": [1467484972]}, {"billed_charge": 46.35, "npi": [1467484972]}, {"billed_charge": 0.05, "npi": [1255377149]}, {"billed_charge": 10.1788, "npi": [1467484972]}, {"billed_charge": 30.0, "npi": [1467484972]}, {"billed_charge": 6.0, "npi": [1467484972]}, {"billed_charge": 2.1, "npi": [1467484972]}, {"billed_charge": 67.15, "npi": [1255377149]}, {"billed_charge": 9.55, "npi": [1255377149]}, {"billed_charge": 8.0984, "npi": [1467484972]}, {"billed_charge": 4.9, "npi": [1255377149]}, {"billed_charge": 13.5, "npi": [1467484972]}, {"billed_charge": 22.7, "npi": [1255377149]}, {"billed_charge": 4.35, "npi": [1255377149]}, {"billed_charge": 1.8167, "npi": [1467484972]}, {"billed_charge": 5.2, "npi": [1467484972]}, {"billed_charge": 5.5, "npi": [1255377149]}, {"billed_charge": 38.5609, "npi": [1255377149]}, {"billed_charge": 5.0, "npi": [1255377149]}, {"billed_charge": 16.8, "npi": [1467484972]}, {"billed_charge": 6.05, "npi": [1255377149]}, {"billed_charge": 4.3167, "npi": [1467484972]}, {"billed_charge": 516.95, "npi": [1467484972]}, {"billed_charge": 7.1, "npi": [1467484972]}]}]}]}, {"name": "Pharmacy - General", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0250", "description": "Pharmacy (also see 063x, an extension of 025x)", "allowed_amounts": [{"tin": {"type": "ein", "value": "314446959"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 36.75, "npi": [1710913462]}, {"billed_charge": 3.25, "npi": [1710913462]}, {"billed_charge": 5.55, "npi": [1710913462]}, {"billed_charge": 2.7, "npi": [1710913462]}, {"billed_charge": 66.3, "npi": [1710913462]}, {"billed_charge": 2.1, "npi": [1710913462]}, {"billed_charge": 5.5, "npi": [1710913462]}, {"billed_charge": 0.1, "npi": [1710913462]}, {"billed_charge": 8.45, "npi": [1710913462]}, {"billed_charge": 4.05, "npi": [1710913462]}, {"billed_charge": 46.8, "npi": [1710913462]}, {"billed_charge": 13.4885, "npi": [1710913462]}, {"billed_charge": 0.0167, "npi": [1710913462]}, {"billed_charge": 5.6, "npi": [1710913462]}, {"billed_charge": 5.2, "npi": [1710913462]}, {"billed_charge": 5.1, "npi": [1710913462]}, {"billed_charge": 10.9942, "npi": [1710913462]}, {"billed_charge": 17.1583, "npi": [1710913462]}, {"billed_charge": 1.15, "npi": [1710913462]}, {"billed_charge": 0.4, "npi": [1710913462]}, {"billed_charge": 6.1, "npi": [1710913462]}, {"billed_charge": 10.8, "npi": [1710913462]}, {"billed_charge": 5.9, "npi": [1710913462]}, {"billed_charge": 2.55, "npi": [1710913462]}, {"billed_charge": 22.7, "npi": [1710913462]}]}]}]}, {"name": "Laboratory - Chemistry", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0301", "description": "Laboratory", "allowed_amounts": [{"tin": {"type": "ein", "value": "341924226"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 5.3067, "billing_code_modifier": ["59"], "providers": [{"billed_charge": 58.0, "npi": [1669562864]}]}, {"allowed_amount": 5.502, "billing_code_modifier": ["91"], "providers": [{"billed_charge": 60.0, "npi": [1669562864]}]}, {"allowed_amount": 5.31, "billing_code_modifier": ["59"], "providers": [{"billed_charge": 58.0, "npi": [1669562864]}]}, {"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 61.0, "npi": [1669562864]}, {"billed_charge": 108.0, "npi": [1669562864]}, {"billed_charge": 97.0, "npi": [1669562864]}, {"billed_charge": 146.0, "npi": [1669562864]}, {"billed_charge": 101.0, "npi": [1669562864]}, {"billed_charge": 164.0, "npi": [1669562864]}, {"billed_charge": 434.0, "npi": [1669562864]}, {"billed_charge": 77.0, "npi": [1669562864]}, {"billed_charge": 264.0, "npi": [1669562864]}, {"billed_charge": 194.0, "npi": [1669562864]}, {"billed_charge": 254.0, "npi": [1669562864]}, {"billed_charge": 99.0, "npi": [1669562864]}, {"billed_charge": 80.0, "npi": [1669562864]}, {"billed_charge": 81.0, "npi": [1669562864]}, {"billed_charge": 366.0, "npi": [1669562864]}, {"billed_charge": 172.0, "npi": [1669562864]}, {"billed_charge": 179.0, "npi": [1669562864]}, {"billed_charge": 89.0, "npi": [1669562864]}, {"billed_charge": 74.0, "npi": [1669562864]}, {"billed_charge": 93.0, "npi": [1669562864]}, {"billed_charge": 219.0, "npi": [1669562864]}, {"billed_charge": 837.0, "npi": [1669562864]}, {"billed_charge": 104.0, "npi": [1669562864]}, {"billed_charge": 59.0, "npi": [1669562864]}, {"billed_charge": 329.0, "npi": [1669562864]}, {"billed_charge": 290.0, "npi": [1669562864]}, {"billed_charge": 153.0, "npi": [1669562864]}, {"billed_charge": 158.0, "npi": [1669562864]}, {"billed_charge": 88.0, "npi": [1669562864]}, {"billed_charge": 152.0, "npi": [1669562864]}]}, {"allowed_amount": 5.3067, "billing_code_modifier": ["5991"], "providers": [{"billed_charge": 58.0, "npi": [1669562864]}]}, {"allowed_amount": 5.305, "billing_code_modifier": ["5991"], "providers": [{"billed_charge": 58.0, "npi": [1669562864]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["91"], "providers": [{"billed_charge": 108.0, "npi": [1669562864]}, {"billed_charge": 172.0, "npi": [1669562864]}]}, {"allowed_amount": 5.5, "billing_code_modifier": ["91"], "providers": [{"billed_charge": 60.0, "npi": [1669562864]}]}, {"allowed_amount": 5.31, "billing_code_modifier": ["5991"], "providers": [{"billed_charge": 58.0, "npi": [1669562864]}]}]}]}, {"name": "Laboratory - General", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0300", "description": "Laboratory", "allowed_amounts": [{"tin": {"type": "ein", "value": "474442902"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 63.0, "npi": [1346607017]}, {"billed_charge": 58.0, "npi": [1346607017]}]}]}]}, {"name": "RADIOLOGIC EXAM CHEST 2 VIEWS", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "71046", "description": "RADIOLOGIC EXAM CHEST 2 VIEWS", "allowed_amounts": [{"tin": {"type": "ein", "value": "310745303"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 9.81, "billing_code_modifier": ["2677"], "providers": [{"billed_charge": 196.0, "npi": [1669408159]}]}, {"allowed_amount": 9.84, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 216.0, "npi": [1669408159]}]}, {"allowed_amount": 9.81, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 196.0, "npi": [1669408159]}, {"billed_charge": 216.0, "npi": [1669408159]}]}, {"allowed_amount": 9.81, "billing_code_modifier": ["26XP"], "providers": [{"billed_charge": 196.0, "npi": [1669408159]}]}]}]}, {"name": "Emergency Room - General", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0450", "description": "Emergency Room", "allowed_amounts": [{"tin": {"type": "ein", "value": "340714456"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 57.85, "billing_code_modifier": ["59"], "providers": [{"billed_charge": 227.0, "npi": [1790837235]}]}, {"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 855.0, "npi": [1790837235]}, {"billed_charge": 1590.0, "npi": [1790837235]}, {"billed_charge": 415.0, "npi": [1790837235]}, {"billed_charge": 1006.5, "npi": [1790837235]}, {"billed_charge": 535.3333, "npi": [1790837235]}, {"billed_charge": 746.6667, "npi": [1790837235]}, {"billed_charge": 372.8333, "npi": [1790837235]}, {"billed_charge": 1863.0, "npi": [1790837235]}, {"billed_charge": 996.5, "npi": [1790837235]}, {"billed_charge": 170.0, "npi": [1790837235]}, {"billed_charge": 481.0, "npi": [1790837235]}, {"billed_charge": 1766.0, "npi": [1790837235]}, {"billed_charge": 460.0, "npi": [1790837235]}, {"billed_charge": 227.0, "npi": [1790837235]}, {"billed_charge": 552.0, "npi": [1790837235]}, {"billed_charge": 445.75, "npi": [1790837235]}, {"billed_charge": 586.6667, "npi": [1790837235]}, {"billed_charge": 740.0, "npi": [1790837235]}, {"billed_charge": 202.0, "npi": [1790837235]}]}, {"allowed_amount": 3230.71, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 1863.0, "npi": [1790837235]}, {"billed_charge": 1202.0, "npi": [1790837235]}]}, {"allowed_amount": 203.72, "billing_code_modifier": [""], "providers": [{"billed_charge": 458.0, "npi": [1790837235]}]}, {"allowed_amount": 356.2, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 720.0, "npi": [1790837235]}]}, {"allowed_amount": 547.78, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 1139.0, "npi": [1790837235]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["XU"], "providers": [{"billed_charge": 247.0, "npi": [1790837235]}, {"billed_charge": 227.0, "npi": [1790837235]}, {"billed_charge": 202.0, "npi": [1790837235]}]}, {"allowed_amount": 59.36, "billing_code_modifier": [""], "providers": [{"billed_charge": 227.0, "npi": [1790837235]}]}, {"allowed_amount": 189.66, "billing_code_modifier": [""], "providers": [{"billed_charge": 483.0, "npi": [1790837235]}]}, {"allowed_amount": 356.2, "billing_code_modifier": [""], "providers": [{"billed_charge": 720.0, "npi": [1790837235]}]}, {"allowed_amount": 788.7, "billing_code_modifier": [""], "providers": [{"billed_charge": 1766.0, "npi": [1790837235]}]}, {"allowed_amount": 17383.07, "billing_code_modifier": ["CALT"], "providers": [{"billed_charge": 6371.0, "npi": [1790837235]}]}, {"allowed_amount": 59.36, "billing_code_modifier": ["59"], "providers": [{"billed_charge": 227.0, "npi": [1790837235]}]}, {"allowed_amount": 527.49, "billing_code_modifier": [""], "providers": [{"billed_charge": 1202.0, "npi": [1790837235]}]}, {"allowed_amount": 337.18, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 760.0, "npi": [1790837235]}]}, {"allowed_amount": 262.74, "billing_code_modifier": [""], "providers": [{"billed_charge": 247.0, "npi": [1790837235]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["RT"], "providers": [{"billed_charge": 434.0, "npi": [1790837235]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 1766.0, "npi": [1790837235]}]}, {"allowed_amount": 515.41, "billing_code_modifier": [""], "providers": [{"billed_charge": 1202.0, "npi": [1790837235]}]}, {"allowed_amount": 262.74, "billing_code_modifier": ["XU"], "providers": [{"billed_charge": 247.0, "npi": [1790837235]}]}, {"allowed_amount": 735.61, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 1863.0, "npi": [1790837235]}]}, {"allowed_amount": 788.7, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 1766.0, "npi": [1790837235]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["LT"], "providers": [{"billed_charge": 2955.0, "npi": [1790837235]}]}, {"allowed_amount": 249.73, "billing_code_modifier": ["ER"], "providers": [{"billed_charge": 611.0, "npi": [1790837235]}]}, {"allowed_amount": 515.41, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 1202.0, "npi": [1790837235]}]}, {"allowed_amount": 547.78, "billing_code_modifier": [""], "providers": [{"billed_charge": 1139.0, "npi": [1790837235]}]}, {"allowed_amount": 189.66, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 483.0, "npi": [1790837235]}]}, {"allowed_amount": 271.04, "billing_code_modifier": [""], "providers": [{"billed_charge": 247.0, "npi": [1790837235]}]}, {"allowed_amount": 513.96, "billing_code_modifier": [""], "providers": [{"billed_charge": 509.0, "npi": [1790837235]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["XURT"], "providers": [{"billed_charge": 1727.0, "npi": [1790837235]}]}, {"allowed_amount": 337.18, "billing_code_modifier": [""], "providers": [{"billed_charge": 760.0, "npi": [1790837235]}]}, {"allowed_amount": 271.04, "billing_code_modifier": ["59"], "providers": [{"billed_charge": 247.0, "npi": [1790837235]}]}]}]}, {"name": "IV Therapy -General", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0260", "description": "IV Therapy", "allowed_amounts": [{"tin": {"type": "ein", "value": "341425870"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 253.92, "billing_code_modifier": [""], "providers": [{"billed_charge": 920.0, "npi": [1972689172]}, {"billed_charge": 394.0, "npi": [1972689172]}]}, {"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 506.0, "npi": [1972689172]}, {"billed_charge": 551.4, "npi": [1972689172]}, {"billed_charge": 463.5882, "npi": [1972689172]}, {"billed_charge": 379.0, "npi": [1972689172]}, {"billed_charge": 345.0, "npi": [1972689172]}, {"billed_charge": 507.5, "npi": [1972689172]}, {"billed_charge": 486.0, "npi": [1972689172]}, {"billed_charge": 359.0, "npi": [1972689172]}, {"billed_charge": 506.375, "npi": [1972689172]}, {"billed_charge": 468.6667, "npi": [1972689172]}, {"billed_charge": 447.1176, "npi": [1972689172]}, {"billed_charge": 394.0, "npi": [1972689172]}]}, {"allowed_amount": 263.68, "billing_code_modifier": ["59"], "providers": [{"billed_charge": 811.0, "npi": [1972689172]}, {"billed_charge": 379.0, "npi": [1972689172]}]}, {"allowed_amount": 260.33, "billing_code_modifier": [""], "providers": [{"billed_charge": 920.0, "npi": [1972689172]}, {"billed_charge": 394.0, "npi": [1972689172]}]}, {"allowed_amount": 57.32, "billing_code_modifier": [""], "providers": [{"billed_charge": 506.0, "npi": [1972689172]}, {"billed_charge": 357.0, "npi": [1972689172]}]}, {"allowed_amount": 57.3171, "billing_code_modifier": [""], "providers": [{"billed_charge": 506.0, "npi": [1972689172]}]}, {"allowed_amount": 57.74, "billing_code_modifier": ["59"], "providers": [{"billed_charge": 343.0, "npi": [1972689172]}]}, {"allowed_amount": 57.74, "billing_code_modifier": [""], "providers": [{"billed_charge": 331.0, "npi": [1972689172]}, {"billed_charge": 343.0, "npi": [1972689172]}, {"billed_charge": 487.0, "npi": [1972689172]}]}, {"allowed_amount": 89.07, "billing_code_modifier": [""], "providers": [{"billed_charge": 467.0, "npi": [1972689172]}]}, {"allowed_amount": 57.315, "billing_code_modifier": [""], "providers": [{"billed_charge": 506.0, "npi": [1972689172]}, {"billed_charge": 357.0, "npi": [1972689172]}]}, {"allowed_amount": 57.32, "billing_code_modifier": ["59"], "providers": [{"billed_charge": 357.0, "npi": [1972689172]}]}, {"allowed_amount": 263.68, "billing_code_modifier": [""], "providers": [{"billed_charge": 811.0, "npi": [1972689172]}, {"billed_charge": 379.0, "npi": [1972689172]}, {"billed_charge": 885.0, "npi": [1972689172]}]}, {"allowed_amount": 55.6, "billing_code_modifier": [""], "providers": [{"billed_charge": 506.0, "npi": [1972689172]}, {"billed_charge": 357.0, "npi": [1972689172]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["59"], "providers": [{"billed_charge": 506.0, "npi": [1972689172]}, {"billed_charge": 379.0, "npi": [1972689172]}, {"billed_charge": 357.0, "npi": [1972689172]}, {"billed_charge": 394.0, "npi": [1972689172]}]}, {"allowed_amount": 260.33, "billing_code_modifier": ["59"], "providers": [{"billed_charge": 843.0, "npi": [1972689172]}, {"billed_charge": 394.0, "npi": [1972689172]}]}, {"allowed_amount": 57.3167, "billing_code_modifier": ["59"], "providers": [{"billed_charge": 357.0, "npi": [1972689172]}]}, {"allowed_amount": 57.3167, "billing_code_modifier": [""], "providers": [{"billed_charge": 506.0, "npi": [1972689172]}, {"billed_charge": 357.0, "npi": [1972689172]}]}, {"allowed_amount": 253.92, "billing_code_modifier": ["59"], "providers": [{"billed_charge": 394.0, "npi": [1972689172]}]}]}]}, {"name": "Emergency Room - General", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0450", "description": "Emergency Room", "allowed_amounts": [{"tin": {"type": "ein", "value": "310537504"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 576.32, "billing_code_modifier": [""], "providers": [{"billed_charge": 3716.0, "npi": [1073688354]}]}, {"allowed_amount": 3603.4, "billing_code_modifier": [""], "providers": [{"billed_charge": 5844.0, "npi": [1073688354]}]}, {"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 1035.0, "npi": [1073688354]}, {"billed_charge": 258.0, "npi": [1073688354]}, {"billed_charge": 5844.0, "npi": [1073688354]}, {"billed_charge": 6078.0, "npi": [1073688354]}, {"billed_charge": 3573.0, "npi": [1073688354]}, {"billed_charge": 268.0, "npi": [1073688354]}]}, {"allowed_amount": 834.39, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 5844.0, "npi": [1073688354]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["XU"], "providers": [{"billed_charge": 430.0, "npi": [1073688354]}, {"billed_charge": 229.0, "npi": [1073688354]}]}, {"allowed_amount": 62.79, "billing_code_modifier": [""], "providers": [{"billed_charge": 229.0, "npi": [1073688354]}]}, {"allowed_amount": 834.39, "billing_code_modifier": [""], "providers": [{"billed_charge": 5844.0, "npi": [1073688354]}]}, {"allowed_amount": 377.03, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 1812.0, "npi": [1073688354]}]}, {"allowed_amount": 293.79, "billing_code_modifier": [""], "providers": [{"billed_charge": 447.0, "npi": [1073688354]}]}, {"allowed_amount": 377.03, "billing_code_modifier": [""], "providers": [{"billed_charge": 1812.0, "npi": [1073688354]}]}, {"allowed_amount": 286.73, "billing_code_modifier": [""], "providers": [{"billed_charge": 430.0, "npi": [1073688354]}]}, {"allowed_amount": 579.52, "billing_code_modifier": [""], "providers": [{"billed_charge": 3573.0, "npi": [1073688354]}]}, {"allowed_amount": 277.13, "billing_code_modifier": [""], "providers": [{"billed_charge": 1035.0, "npi": [1073688354]}]}, {"allowed_amount": 822.56, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 6078.0, "npi": [1073688354]}]}]}]}, {"name": "Laboratory - General", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0300", "description": "Laboratory", "allowed_amounts": [{"tin": {"type": "ein", "value": "341260978"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 29.0, "npi": [1841264868]}, {"billed_charge": 58.0, "npi": [1841264868]}, {"billed_charge": 130.0, "npi": [1841264868]}, {"billed_charge": 182.0, "npi": [1841264868]}, {"billed_charge": 563.0, "npi": [1841264868]}, {"billed_charge": 30.0, "npi": [1841264868]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["59"], "providers": [{"billed_charge": 29.0, "npi": [1841264868]}]}]}]}, {"name": "Pharmacy - Extension of 25X - Drug Requiring Detailed Coding", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0636", "description": "Pharmacy - Extension of 25x", "allowed_amounts": [{"tin": {"type": "ein", "value": "344428256"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 0.0167, "npi": [1407854771]}, {"billed_charge": 21.0, "npi": [1407854771]}, {"billed_charge": 7.5, "npi": [1407854771]}, {"billed_charge": 6.25, "npi": [1407854771]}, {"billed_charge": 884.0, "npi": [1407854771]}, {"billed_charge": 0.075, "npi": [1407854771]}, {"billed_charge": 9.0, "npi": [1407854771]}, {"billed_charge": 2.25, "npi": [1407854771]}, {"billed_charge": 3.6, "npi": [1407854771]}, {"billed_charge": 19.0, "npi": [1407854771]}, {"billed_charge": 35.0, "npi": [1407854771]}, {"billed_charge": 2.0, "npi": [1407854771]}, {"billed_charge": 0.3, "npi": [1407854771]}, {"billed_charge": 1.7143, "npi": [1407854771]}, {"billed_charge": 5.6667, "npi": [1407854771]}, {"billed_charge": 1.4, "npi": [1407854771]}, {"billed_charge": 0.5, "npi": [1407854771]}, {"billed_charge": 14.0, "npi": [1407854771]}, {"billed_charge": 34.0, "npi": [1407854771]}, {"billed_charge": 7.5714, "npi": [1407854771]}, {"billed_charge": 3.0, "npi": [1407854771]}, {"billed_charge": 7.0, "npi": [1407854771]}, {"billed_charge": 10.0, "npi": [1407854771]}, {"billed_charge": 1.75, "npi": [1407854771]}, {"billed_charge": 61.0, "npi": [1407854771]}, {"billed_charge": 0.06, "npi": [1407854771]}, {"billed_charge": 2.75, "npi": [1407854771]}, {"billed_charge": 22.0, "npi": [1407854771]}, {"billed_charge": 0.25, "npi": [1407854771]}, {"billed_charge": 66.0, "npi": [1407854771]}, {"billed_charge": 64.0, "npi": [1407854771]}, {"billed_charge": 0.025, "npi": [1407854771]}, {"billed_charge": 6.0, "npi": [1407854771]}, {"billed_charge": 8.0, "npi": [1407854771]}, {"billed_charge": 0.75, "npi": [1407854771]}, {"billed_charge": 1.7067, "npi": [1407854771]}, {"billed_charge": 1.1, "npi": [1407854771]}, {"billed_charge": 1.9, "npi": [1407854771]}, {"billed_charge": 0.26, "npi": [1407854771]}, {"billed_charge": 1.0, "npi": [1407854771]}, {"billed_charge": 13.0, "npi": [1407854771]}, {"billed_charge": 6.5, "npi": [1407854771]}, {"billed_charge": 24.0, "npi": [1407854771]}, {"billed_charge": 9.25, "npi": [1407854771]}, {"billed_charge": 6.8, "npi": [1407854771]}, {"billed_charge": 7.25, "npi": [1407854771]}, {"billed_charge": 23.5, "npi": [1407854771]}, {"billed_charge": 5.2, "npi": [1407854771]}]}, {"allowed_amount": 0.47, "billing_code_modifier": ["JZSEU6"], "providers": [{"billed_charge": 3.0, "npi": [1407854771]}]}, {"allowed_amount": 0.425, "billing_code_modifier": [""], "providers": [{"billed_charge": 3.0, "npi": [1407854771]}]}, {"allowed_amount": 0.42, "billing_code_modifier": [""], "providers": [{"billed_charge": 3.0, "npi": [1407854771]}]}, {"allowed_amount": 0.545, "billing_code_modifier": ["JZ"], "providers": [{"billed_charge": 2.5, "npi": [1407854771]}]}, {"allowed_amount": 0.425, "billing_code_modifier": ["JW"], "providers": [{"billed_charge": 9.0, "npi": [1407854771]}]}, {"allowed_amount": 0.47, "billing_code_modifier": ["JZ"], "providers": [{"billed_charge": 2.0, "npi": [1407854771]}, {"billed_charge": 2.5, "npi": [1407854771]}]}, {"allowed_amount": 0.46, "billing_code_modifier": ["JZ"], "providers": [{"billed_charge": 6.0, "npi": [1407854771]}]}, {"allowed_amount": 0.42, "billing_code_modifier": ["JZ"], "providers": [{"billed_charge": 6.0, "npi": [1407854771]}]}, {"allowed_amount": 0.42, "billing_code_modifier": ["JZTB"], "providers": [{"billed_charge": 6.0, "npi": [1407854771]}]}, {"allowed_amount": 0.42, "billing_code_modifier": ["JW"], "providers": [{"billed_charge": 9.0, "npi": [1407854771]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["JZ"], "providers": [{"billed_charge": 5.375, "npi": [1407854771]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["SE"], "providers": [{"billed_charge": 2.25, "npi": [1407854771]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["TB"], "providers": [{"billed_charge": 0.51, "npi": [1407854771]}]}, {"allowed_amount": 0.425, "billing_code_modifier": ["JZ"], "providers": [{"billed_charge": 2.5, "npi": [1407854771]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["SEU6"], "providers": [{"billed_charge": 1.0, "npi": [1407854771]}]}]}]}, {"name": "Pharmacy - General", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0250", "description": "Pharmacy (also see 063x, an extension of 025x)", "allowed_amounts": [{"tin": {"type": "ein", "value": "341260978"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 11.228, "npi": [1841264868]}, {"billed_charge": 1.2838, "npi": [1841264868]}, {"billed_charge": 1.0767, "npi": [1841264868]}, {"billed_charge": 1.292, "npi": [1841264868]}, {"billed_charge": 20.455, "npi": [1841264868]}, {"billed_charge": 2.1542, "npi": [1841264868]}, {"billed_charge": 1.7845, "npi": [1841264868]}, {"billed_charge": 8.82, "npi": [1841264868]}, {"billed_charge": 1.615, "npi": [1841264868]}, {"billed_charge": 4.525, "npi": [1841264868]}, {"billed_charge": 3.23, "npi": [1841264868]}, {"billed_charge": 8.222, "npi": [1841264868]}, {"billed_charge": 2.3167, "npi": [1841264868]}]}]}]}, {"name": "CT ABDOMEN  and  PELVIS W/O CONTRAST MATERIAL", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "74176", "description": "CT ABDOMEN  and  PELVIS W/O CONTRAST MATERIAL", "allowed_amounts": [{"tin": {"type": "ein", "value": "310745303"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 78.5, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 1860.0, "npi": [1669408159]}]}, {"allowed_amount": 77.52, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 1617.0, "npi": [1669408159]}, {"billed_charge": 1860.0, "npi": [1669408159]}]}, {"allowed_amount": 73.64, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 1617.0, "npi": [1669408159]}]}]}]}, {"name": "Emergency Room - General", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0450", "description": "Emergency Room", "allowed_amounts": [{"tin": {"type": "ein", "value": "314391798"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 568.86, "billing_code_modifier": [""], "providers": [{"billed_charge": 1115.0, "npi": [1346247350]}]}, {"allowed_amount": 357.8, "billing_code_modifier": [""], "providers": [{"billed_charge": 719.0, "npi": [1346247350]}]}, {"allowed_amount": 780.61, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 1856.0, "npi": [1346247350]}]}, {"allowed_amount": 3428.32, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 1856.0, "npi": [1346247350]}]}, {"allowed_amount": 327.48, "billing_code_modifier": [""], "providers": [{"billed_charge": 863.0, "npi": [1346247350]}]}, {"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 1856.0, "npi": [1346247350]}]}, {"allowed_amount": 356.21, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 719.0, "npi": [1346247350]}]}, {"allowed_amount": 211.56, "billing_code_modifier": [""], "providers": [{"billed_charge": 465.0, "npi": [1346247350]}]}, {"allowed_amount": 201.25, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 465.0, "npi": [1346247350]}]}, {"allowed_amount": 819.06, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 1856.0, "npi": [1346247350]}]}, {"allowed_amount": 201.25, "billing_code_modifier": [""], "providers": [{"billed_charge": 465.0, "npi": [1346247350]}]}, {"allowed_amount": 357.8, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 719.0, "npi": [1346247350]}]}, {"allowed_amount": 304.13, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 719.0, "npi": [1346247350]}]}, {"allowed_amount": 568.86, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 1115.0, "npi": [1346247350]}]}, {"allowed_amount": 369.91, "billing_code_modifier": [""], "providers": [{"billed_charge": 719.0, "npi": [1346247350]}]}, {"allowed_amount": 546.94, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 1115.0, "npi": [1346247350]}]}, {"allowed_amount": 788.72, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 1856.0, "npi": [1346247350]}]}]}]}, {"name": "RADEX SPINE LUMBOSACRAL 2/3 VIEWS", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "72100", "description": "RADEX SPINE LUMBOSACRAL 2/3 VIEWS", "allowed_amounts": [{"tin": {"type": "ein", "value": "310745303"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 10.45, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 201.0, "npi": [1669408159]}]}, {"allowed_amount": 10.1, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 201.0, "npi": [1669408159]}, {"billed_charge": 191.0, "npi": [1669408159]}]}]}]}, {"name": "LEVEL IV SURG PATHOLOGY GROSS AND MICROSCOPIC EXAM", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "88305", "description": "LEVEL IV SURG PATHOLOGY GROSS AND MICROSCOPIC EXAM", "allowed_amounts": [{"tin": {"type": "ein", "value": "341046013"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 34.34, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 164.0, "npi": [1326096181]}]}, {"allowed_amount": 34.02, "billing_code_modifier": ["26XU"], "providers": [{"billed_charge": 164.0, "npi": [1326096181]}]}, {"allowed_amount": 34.02, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 164.0, "npi": [1326096181]}]}]}]}, {"name": "Emergency Room - General", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0450", "description": "Emergency Room", "allowed_amounts": [{"tin": {"type": "ein", "value": "550357050"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 364.8, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 577.5, "npi": [1164492195]}]}, {"allowed_amount": 62.58, "billing_code_modifier": [""], "providers": [{"billed_charge": 239.65, "npi": [1164492195]}]}, {"allowed_amount": 284.26, "billing_code_modifier": ["XU"], "providers": [{"billed_charge": 528.94, "npi": [1164492195]}, {"billed_charge": 451.86, "npi": [1164492195]}]}, {"allowed_amount": 59.135, "billing_code_modifier": [""], "providers": [{"billed_charge": 239.655, "npi": [1164492195]}]}, {"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 281.88, "npi": [1164492195]}, {"billed_charge": 175.26, "npi": [1164492195]}, {"billed_charge": 665.13, "npi": [1164492195]}, {"billed_charge": 451.335, "npi": [1164492195]}, {"billed_charge": 1297.53, "npi": [1164492195]}, {"billed_charge": 239.65, "npi": [1164492195]}]}, {"allowed_amount": 543.26, "billing_code_modifier": [""], "providers": [{"billed_charge": 4404.62, "npi": [1164492195]}]}, {"allowed_amount": 557.62, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 843.55, "npi": [1164492195]}]}, {"allowed_amount": 270.02, "billing_code_modifier": ["XU"], "providers": [{"billed_charge": 528.94, "npi": [1164492195]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["XU"], "providers": [{"billed_charge": 528.94, "npi": [1164492195]}, {"billed_charge": 451.86, "npi": [1164492195]}, {"billed_charge": 239.655, "npi": [1164492195]}]}, {"allowed_amount": 270.02, "billing_code_modifier": [""], "providers": [{"billed_charge": 528.94, "npi": [1164492195]}]}, {"allowed_amount": 795.86, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 1297.53, "npi": [1164492195]}]}, {"allowed_amount": 354.86, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 577.5, "npi": [1164492195]}]}, {"allowed_amount": 205.2, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 229.1, "npi": [1164492195]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 1297.53, "npi": [1164492195]}]}, {"allowed_amount": 202.94, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 229.1, "npi": [1164492195]}]}, {"allowed_amount": 59.14, "billing_code_modifier": ["XU"], "providers": [{"billed_charge": 239.65, "npi": [1164492195]}]}, {"allowed_amount": 785.72, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 1297.53, "npi": [1164492195]}]}, {"allowed_amount": 284.26, "billing_code_modifier": [""], "providers": [{"billed_charge": 528.94, "npi": [1164492195]}]}, {"allowed_amount": 3495.3, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 1297.53, "npi": [1164492195]}]}, {"allowed_amount": 3393.22, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 1297.53, "npi": [1164492195]}]}, {"allowed_amount": 545.72, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 843.55, "npi": [1164492195]}]}]}]}, {"name": "Emergency Room - General", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0450", "description": "Emergency Room", "allowed_amounts": [{"tin": {"type": "ein", "value": "314394942"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 4036.83, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 2891.0, "npi": [1255377149]}]}, {"allowed_amount": 422.16, "billing_code_modifier": [""], "providers": [{"billed_charge": 1748.0, "npi": [1255377149]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["ER"], "providers": [{"billed_charge": 485.0, "npi": [1255377149]}]}, {"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 349.0, "npi": [1255377149]}, {"billed_charge": 319.0, "npi": [1255377149]}, {"billed_charge": 281.0, "npi": [1255377149]}, {"billed_charge": 1868.3333, "npi": [1255377149]}, {"billed_charge": 1620.0, "npi": [1255377149]}, {"billed_charge": 4144.0, "npi": [1255377149]}]}, {"allowed_amount": 206.25, "billing_code_modifier": [""], "providers": [{"billed_charge": 1104.0, "npi": [1255377149]}]}, {"allowed_amount": 649.22, "billing_code_modifier": [""], "providers": [{"billed_charge": 2891.0, "npi": [1255377149]}]}, {"allowed_amount": 241.44, "billing_code_modifier": [""], "providers": [{"billed_charge": 1104.0, "npi": [1255377149]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["XU"], "providers": [{"billed_charge": 319.0, "npi": [1255377149]}]}, {"allowed_amount": 366.69, "billing_code_modifier": [""], "providers": [{"billed_charge": 1748.0, "npi": [1255377149]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 2891.0, "npi": [1255377149]}]}, {"allowed_amount": 369.39, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 1748.0, "npi": [1255377149]}]}, {"allowed_amount": 366.69, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 1748.0, "npi": [1255377149]}]}, {"allowed_amount": 799.97, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 4144.0, "npi": [1255377149]}]}, {"allowed_amount": 321.23, "billing_code_modifier": [""], "providers": [{"billed_charge": 349.0, "npi": [1255377149]}]}, {"allowed_amount": 649.22, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 2891.0, "npi": [1255377149]}]}, {"allowed_amount": 560.5, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 2891.0, "npi": [1255377149]}]}, {"allowed_amount": 422.16, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 1748.0, "npi": [1255377149]}]}, {"allowed_amount": 3513.4, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 2891.0, "npi": [1255377149]}]}, {"allowed_amount": 568.06, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 2891.0, "npi": [1255377149]}]}]}]}, {"name": "Pharmacy - Extension of 25X - Drug Requiring Detailed Coding", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0636", "description": "Pharmacy - Extension of 25x", "allowed_amounts": [{"tin": {"type": "ein", "value": "311724085"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 12.97, "billing_code_modifier": [""], "providers": [{"billed_charge": 32.55, "npi": [1669410940]}]}, {"allowed_amount": 1.1517, "billing_code_modifier": [""], "providers": [{"billed_charge": 3.0, "npi": [1669410940]}]}, {"allowed_amount": 0.1518, "billing_code_modifier": [""], "providers": [{"billed_charge": 0.3955, "npi": [1669410940]}]}, {"allowed_amount": 29.01, "billing_code_modifier": ["JZ"], "providers": [{"billed_charge": 72.75, "npi": [1669410940]}]}, {"allowed_amount": 12.29, "billing_code_modifier": [""], "providers": [{"billed_charge": 30.8, "npi": [1669410940]}]}, {"allowed_amount": 8.92, "billing_code_modifier": ["JZ"], "providers": [{"billed_charge": 23.25, "npi": [1669410940]}]}, {"allowed_amount": 0.2763, "billing_code_modifier": ["JZ"], "providers": [{"billed_charge": 0.7198, "npi": [1669410940]}]}, {"allowed_amount": 16.25, "billing_code_modifier": [""], "providers": [{"billed_charge": 42.35, "npi": [1669410940]}]}, {"allowed_amount": 2.65, "billing_code_modifier": ["JZ"], "providers": [{"billed_charge": 6.9, "npi": [1669410940]}]}, {"allowed_amount": 12.49, "billing_code_modifier": [""], "providers": [{"billed_charge": 32.55, "npi": [1669410940]}]}, {"allowed_amount": 0.7616, "billing_code_modifier": ["JZ"], "providers": [{"billed_charge": 1.91, "npi": [1669410940]}]}, {"allowed_amount": 6.57, "billing_code_modifier": [""], "providers": [{"billed_charge": 17.125, "npi": [1669410940]}]}, {"allowed_amount": 0.502, "billing_code_modifier": [""], "providers": [{"billed_charge": 1.26, "npi": [1669410940]}]}, {"allowed_amount": 5.16, "billing_code_modifier": ["JZ"], "providers": [{"billed_charge": 13.45, "npi": [1669410940]}]}, {"allowed_amount": 6.86, "billing_code_modifier": ["JZ"], "providers": [{"billed_charge": 17.87, "npi": [1669410940]}]}, {"allowed_amount": 1.196, "billing_code_modifier": [""], "providers": [{"billed_charge": 3.0, "npi": [1669410940]}]}, {"allowed_amount": 1.03, "billing_code_modifier": ["JZ"], "providers": [{"billed_charge": 2.5813, "npi": [1669410940]}]}, {"allowed_amount": 1.7125, "billing_code_modifier": ["JZ"], "providers": [{"billed_charge": 4.4625, "npi": [1669410940]}]}, {"allowed_amount": 5.0725, "billing_code_modifier": ["JZ"], "providers": [{"billed_charge": 13.2125, "npi": [1669410940]}]}, {"allowed_amount": 2.86, "billing_code_modifier": ["JZ"], "providers": [{"billed_charge": 7.45, "npi": [1669410940]}]}]}]}, {"name": "Pharmacy - IV Solutions", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0258", "description": "Pharmacy (also see 063x, an extension of 025x)", "allowed_amounts": [{"tin": {"type": "ein", "value": "344428218"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 64.08, "npi": [1801884655]}, {"billed_charge": 61.01, "npi": [1801884655]}, {"billed_charge": 59.46, "npi": [1801884655]}, {"billed_charge": 59.62, "npi": [1801884655]}, {"billed_charge": 62.34, "npi": [1801884655]}, {"billed_charge": 62.05, "npi": [1801884655]}]}]}]}, {"name": "Laboratory - Bacteriology & Microbiology", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0306", "description": "Laboratory", "allowed_amounts": [{"tin": {"type": "ein", "value": "340714585"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 12.11, "billing_code_modifier": [""], "providers": [{"billed_charge": 60.0, "npi": [1679525919]}]}, {"allowed_amount": 192.55, "billing_code_modifier": [""], "providers": [{"billed_charge": 925.0, "npi": [1679525919]}]}, {"allowed_amount": 11.33, "billing_code_modifier": [""], "providers": [{"billed_charge": 56.0, "npi": [1679525919]}]}, {"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 29.0, "npi": [1679525919]}, {"billed_charge": 203.1944, "npi": [1679525919]}, {"billed_charge": 28.0, "npi": [1679525919]}, {"billed_charge": 307.5, "npi": [1679525919]}, {"billed_charge": 304.5625, "npi": [1679525919]}, {"billed_charge": 490.5, "npi": [1679525919]}, {"billed_charge": 44.0, "npi": [1679525919]}, {"billed_charge": 55.0, "npi": [1679525919]}, {"billed_charge": 925.0, "npi": [1679525919]}, {"billed_charge": 98.0, "npi": [1679525919]}, {"billed_charge": 110.6667, "npi": [1679525919]}, {"billed_charge": 56.0, "npi": [1679525919]}, {"billed_charge": 70.0, "npi": [1679525919]}, {"billed_charge": 228.0, "npi": [1679525919]}, {"billed_charge": 53.0, "npi": [1679525919]}, {"billed_charge": 279.7647, "npi": [1679525919]}, {"billed_charge": 144.0, "npi": [1679525919]}, {"billed_charge": 601.5, "npi": [1679525919]}, {"billed_charge": 56.0294, "npi": [1679525919]}, {"billed_charge": 39.0, "npi": [1679525919]}, {"billed_charge": 242.0, "npi": [1679525919]}, {"billed_charge": 35.0, "npi": [1679525919]}, {"billed_charge": 59.0, "npi": [1679525919]}, {"billed_charge": 67.0, "npi": [1679525919]}, {"billed_charge": 53.25, "npi": [1679525919]}, {"billed_charge": 62.0, "npi": [1679525919]}, {"billed_charge": 57.0, "npi": [1679525919]}, {"billed_charge": 162.7273, "npi": [1679525919]}, {"billed_charge": 563.0833, "npi": [1679525919]}, {"billed_charge": 102.0426, "npi": [1679525919]}, {"billed_charge": 88.7059, "npi": [1679525919]}, {"billed_charge": 65.0, "npi": [1679525919]}, {"billed_charge": 60.0, "npi": [1679525919]}, {"billed_charge": 154.5, "npi": [1679525919]}, {"billed_charge": 484.0, "npi": [1679525919]}, {"billed_charge": 46.0, "npi": [1679525919]}, {"billed_charge": 108.0, "npi": [1679525919]}, {"billed_charge": 114.0, "npi": [1679525919]}, {"billed_charge": 78.0, "npi": [1679525919]}, {"billed_charge": 70.3636, "npi": [1679525919]}, {"billed_charge": 984.0, "npi": [1679525919]}, {"billed_charge": 71.0, "npi": [1679525919]}, {"billed_charge": 101.3958, "npi": [1679525919]}]}, {"allowed_amount": 98.25, "billing_code_modifier": [""], "providers": [{"billed_charge": 484.0, "npi": [1679525919]}]}, {"allowed_amount": 11.68, "billing_code_modifier": [""], "providers": [{"billed_charge": 57.0, "npi": [1679525919]}]}, {"allowed_amount": 199.68, "billing_code_modifier": [""], "providers": [{"billed_charge": 925.0, "npi": [1679525919]}, {"billed_charge": 984.0, "npi": [1679525919]}]}, {"allowed_amount": 10.89, "billing_code_modifier": [""], "providers": [{"billed_charge": 53.0, "npi": [1679525919]}]}, {"allowed_amount": 10.91, "billing_code_modifier": [""], "providers": [{"billed_charge": 53.0, "npi": [1679525919]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["59"], "providers": [{"billed_charge": 228.0, "npi": [1679525919]}]}, {"allowed_amount": 49.13, "billing_code_modifier": [""], "providers": [{"billed_charge": 242.0, "npi": [1679525919]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["91"], "providers": [{"billed_charge": 925.0, "npi": [1679525919]}, {"billed_charge": 71.0, "npi": [1679525919]}]}, {"allowed_amount": 11.3, "billing_code_modifier": [""], "providers": [{"billed_charge": 56.0, "npi": [1679525919]}]}]}]}, {"name": "Pharmacy - Extension of 25X - Drug Requiring Detailed Coding", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0636", "description": "Pharmacy - Extension of 25x", "allowed_amounts": [{"tin": {"type": "ein", "value": "311070877"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 115.35, "npi": [1215935366]}, {"billed_charge": 17.575, "npi": [1215935366]}, {"billed_charge": 6.965, "npi": [1215935366]}, {"billed_charge": 59.2, "npi": [1215935366]}, {"billed_charge": 4.195, "npi": [1215935366]}, {"billed_charge": 43.85, "npi": [1215935366]}, {"billed_charge": 7.135, "npi": [1215935366]}, {"billed_charge": 18.05, "npi": [1215935366]}, {"billed_charge": 50.3429, "npi": [1215935366]}, {"billed_charge": 8.6875, "npi": [1215935366]}, {"billed_charge": 11.6625, "npi": [1215935366]}, {"billed_charge": 51.3, "npi": [1215935366]}, {"billed_charge": 67.15, "npi": [1215935366]}, {"billed_charge": 41.4, "npi": [1215935366]}, {"billed_charge": 41.3, "npi": [1215935366]}, {"billed_charge": 38.2, "npi": [1215935366]}, {"billed_charge": 14.31, "npi": [1215935366]}, {"billed_charge": 44.4, "npi": [1215935366]}, {"billed_charge": 29.52, "npi": [1215935366]}, {"billed_charge": 65.9, "npi": [1215935366]}, {"billed_charge": 120.35, "npi": [1215935366]}, {"billed_charge": 65.05, "npi": [1215935366]}, {"billed_charge": 0.699, "npi": [1215935366]}, {"billed_charge": 47.95, "npi": [1215935366]}, {"billed_charge": 34.15, "npi": [1215935366]}, {"billed_charge": 0.47, "npi": [1215935366]}, {"billed_charge": 1.5842, "npi": [1215935366]}, {"billed_charge": 34.8, "npi": [1215935366]}, {"billed_charge": 36.65, "npi": [1215935366]}, {"billed_charge": 9.27, "npi": [1215935366]}, {"billed_charge": 3.87, "npi": [1215935366]}, {"billed_charge": 4.0525, "npi": [1215935366]}, {"billed_charge": 0.4792, "npi": [1215935366]}, {"billed_charge": 8.7, "npi": [1215935366]}, {"billed_charge": 7.5, "npi": [1215935366]}, {"billed_charge": 5.2063, "npi": [1215935366]}, {"billed_charge": 19.62, "npi": [1215935366]}]}, {"allowed_amount": 0.2836, "billing_code_modifier": [""], "providers": [{"billed_charge": 2.822, "npi": [1215935366]}]}, {"allowed_amount": 0.41, "billing_code_modifier": [""], "providers": [{"billed_charge": 36.0, "npi": [1215935366]}]}, {"allowed_amount": 0.43, "billing_code_modifier": [""], "providers": [{"billed_charge": 36.0, "npi": [1215935366]}]}]}]}, {"name": "Pharmacy - Drugs Incident to Radiology", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0255", "description": "Pharmacy (also see 063x, an extension of 025x)", "allowed_amounts": [{"tin": {"type": "ein", "value": "341425870"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 0.8086, "npi": [1972689172]}, {"billed_charge": 0.6755, "npi": [1972689172]}, {"billed_charge": 0.8087, "npi": [1972689172]}, {"billed_charge": 0.8085, "npi": [1972689172]}, {"billed_charge": 0.6756, "npi": [1972689172]}]}]}]}, {"name": "Room & Board - Semiprivate - 2 Beds - General", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0120", "description": "Room & Board - Semi-private (Two Beds)", "allowed_amounts": [{"tin": {"type": "ein", "value": "340714585"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 13512.78, "billing_code_modifier": [""], "providers": [{"billed_charge": 3403.0, "npi": [1679525919]}]}, {"allowed_amount": 2793.1814, "billing_code_modifier": [""], "providers": [{"billed_charge": 3403.0, "npi": [1679525919]}]}, {"allowed_amount": 898.9488, "billing_code_modifier": [""], "providers": [{"billed_charge": 3675.0, "npi": [1679525919]}]}, {"allowed_amount": 4681.3233, "billing_code_modifier": [""], "providers": [{"billed_charge": 3403.0, "npi": [1679525919]}]}, {"allowed_amount": 1745.2031, "billing_code_modifier": [""], "providers": [{"billed_charge": 3675.0, "npi": [1679525919]}]}, {"allowed_amount": 1659.82, "billing_code_modifier": [""], "providers": [{"billed_charge": 3675.0, "npi": [1679525919]}]}, {"allowed_amount": 13124.4192, "billing_code_modifier": [""], "providers": [{"billed_charge": 3403.0, "npi": [1679525919]}]}, {"allowed_amount": 14219.0167, "billing_code_modifier": [""], "providers": [{"billed_charge": 3675.0, "npi": [1679525919]}]}, {"allowed_amount": 8984.35, "billing_code_modifier": [""], "providers": [{"billed_charge": 3403.0, "npi": [1679525919]}]}, {"allowed_amount": 3187.092, "billing_code_modifier": [""], "providers": [{"billed_charge": 3675.0, "npi": [1679525919]}]}, {"allowed_amount": 4487.77, "billing_code_modifier": [""], "providers": [{"billed_charge": 3403.0, "npi": [1679525919]}]}, {"allowed_amount": 4986.975, "billing_code_modifier": [""], "providers": [{"billed_charge": 3675.0, "npi": [1679525919]}]}, {"allowed_amount": 1966.9816, "billing_code_modifier": [""], "providers": [{"billed_charge": 3675.0, "npi": [1679525919]}]}, {"allowed_amount": 5297.754, "billing_code_modifier": [""], "providers": [{"billed_charge": 3403.0, "npi": [1679525919]}]}, {"allowed_amount": 79672.91, "billing_code_modifier": [""], "providers": [{"billed_charge": 3403.0, "npi": [1679525919]}]}, {"allowed_amount": 2501.7967, "billing_code_modifier": [""], "providers": [{"billed_charge": 3403.0, "npi": [1679525919]}]}, {"allowed_amount": 6896.51, "billing_code_modifier": [""], "providers": [{"billed_charge": 3675.0, "npi": [1679525919]}]}, {"allowed_amount": 6274.675, "billing_code_modifier": [""], "providers": [{"billed_charge": 3403.0, "npi": [1679525919]}]}, {"allowed_amount": 2929.1275, "billing_code_modifier": [""], "providers": [{"billed_charge": 3675.0, "npi": [1679525919]}]}, {"allowed_amount": 1905.1825, "billing_code_modifier": [""], "providers": [{"billed_charge": 3675.0, "npi": [1679525919]}]}, {"allowed_amount": 3250.172, "billing_code_modifier": [""], "providers": [{"billed_charge": 3403.0, "npi": [1679525919]}]}, {"allowed_amount": 4128.0477, "billing_code_modifier": [""], "providers": [{"billed_charge": 3403.0, "npi": [1679525919]}]}, {"allowed_amount": 6409.8933, "billing_code_modifier": [""], "providers": [{"billed_charge": 3403.0, "npi": [1679525919]}]}, {"allowed_amount": 5314.4267, "billing_code_modifier": [""], "providers": [{"billed_charge": 3675.0, "npi": [1679525919]}]}, {"allowed_amount": 2078.4641, "billing_code_modifier": [""], "providers": [{"billed_charge": 3675.0, "npi": [1679525919]}]}, {"allowed_amount": 8823.04, "billing_code_modifier": [""], "providers": [{"billed_charge": 3403.0, "npi": [1679525919]}]}, {"allowed_amount": 3253.6288, "billing_code_modifier": [""], "providers": [{"billed_charge": 3675.0, "npi": [1679525919]}]}]}]}, {"name": "Emergency Room - General", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0450", "description": "Emergency Room", "allowed_amounts": [{"tin": {"type": "ein", "value": "340827442"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 216.0, "npi": [1164481677]}, {"billed_charge": 2796.0, "npi": [1164481677]}, {"billed_charge": 3917.0, "npi": [1164481677]}, {"billed_charge": 225.0, "npi": [1164481677]}, {"billed_charge": 255.0, "npi": [1164481677]}, {"billed_charge": 265.0, "npi": [1164481677]}]}, {"allowed_amount": 359.79, "billing_code_modifier": [""], "providers": [{"billed_charge": 1134.0, "npi": [1164481677]}]}, {"allowed_amount": 767.3, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 2688.0, "npi": [1164481677]}]}, {"allowed_amount": 359.79, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 1134.0, "npi": [1164481677]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 2796.0, "npi": [1164481677]}]}, {"allowed_amount": 532.91, "billing_code_modifier": [""], "providers": [{"billed_charge": 1711.0, "npi": [1164481677]}]}, {"allowed_amount": 784.92, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 2796.0, "npi": [1164481677]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["LT"], "providers": [{"billed_charge": 394.0, "npi": [1164481677]}]}, {"allowed_amount": 532.91, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 1711.0, "npi": [1164481677]}]}, {"allowed_amount": 111.15, "billing_code_modifier": [""], "providers": [{"billed_charge": 416.0, "npi": [1164481677]}]}, {"allowed_amount": 346.53, "billing_code_modifier": [""], "providers": [{"billed_charge": 1090.0, "npi": [1164481677]}]}, {"allowed_amount": 549.96, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 1779.0, "npi": [1164481677]}]}, {"allowed_amount": 549.96, "billing_code_modifier": [""], "providers": [{"billed_charge": 1779.0, "npi": [1164481677]}]}, {"allowed_amount": 4639.1, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 2688.0, "npi": [1164481677]}]}]}]}, {"name": "Laboratory - General", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0300", "description": "Laboratory", "allowed_amounts": [{"tin": {"type": "ein", "value": "341924226"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 182.0, "npi": [1669562864]}, {"billed_charge": 563.0, "npi": [1669562864]}, {"billed_charge": 585.0, "npi": [1669562864]}, {"billed_charge": 130.0, "npi": [1669562864]}, {"billed_charge": 29.0, "npi": [1669562864]}, {"billed_charge": 172.0, "npi": [1669562864]}, {"billed_charge": 125.0, "npi": [1669562864]}, {"billed_charge": 30.0, "npi": [1669562864]}, {"billed_charge": 175.0, "npi": [1669562864]}]}, {"allowed_amount": 199.68, "billing_code_modifier": [""], "providers": [{"billed_charge": 399.0, "npi": [1669562864]}]}]}]}, {"name": "CT HEAD/BRAIN W/O CONTRAST MATERIAL", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "70450", "description": "CT HEAD/BRAIN W/O CONTRAST MATERIAL", "allowed_amounts": [{"tin": {"type": "ein", "value": "310745303"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 37.97, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 637.0, "npi": [1669408159]}, {"billed_charge": 733.0, "npi": [1669408159]}]}, {"allowed_amount": 37.97, "billing_code_modifier": ["26XP"], "providers": [{"billed_charge": 637.0, "npi": [1669408159]}]}, {"allowed_amount": 36.81, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 733.0, "npi": [1669408159]}]}, {"allowed_amount": 36.07, "billing_code_modifier": ["26XU"], "providers": [{"billed_charge": 637.0, "npi": [1669408159]}]}, {"allowed_amount": 36.07, "billing_code_modifier": ["26XP"], "providers": [{"billed_charge": 637.0, "npi": [1669408159]}]}, {"allowed_amount": 38.75, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 733.0, "npi": [1669408159]}]}, {"allowed_amount": 36.07, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 637.0, "npi": [1669408159]}, {"billed_charge": 733.0, "npi": [1669408159]}]}, {"allowed_amount": 36.07, "billing_code_modifier": ["2677"], "providers": [{"billed_charge": 637.0, "npi": [1669408159]}, {"billed_charge": 733.0, "npi": [1669408159]}]}]}]}, {"name": "Emergency Room - General", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0450", "description": "Emergency Room", "allowed_amounts": [{"tin": {"type": "ein", "value": "314379509"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 262.8, "billing_code_modifier": ["XU"], "providers": [{"billed_charge": 783.8, "npi": [1215936927]}]}, {"allowed_amount": 531.16, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 1890.92, "npi": [1215936927]}]}, {"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 147.6, "npi": [1215936927]}, {"billed_charge": 185.63, "npi": [1215936927]}, {"billed_charge": 946.6, "npi": [1215936927]}, {"billed_charge": 783.8, "npi": [1215936927]}, {"billed_charge": 242.09, "npi": [1215936927]}]}, {"allowed_amount": 260.33, "billing_code_modifier": [""], "providers": [{"billed_charge": 488.58, "npi": [1215936927]}]}, {"allowed_amount": 57.32, "billing_code_modifier": [""], "providers": [{"billed_charge": 147.6, "npi": [1215936927]}, {"billed_charge": 185.63, "npi": [1215936927]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["XU"], "providers": [{"billed_charge": 185.63, "npi": [1215936927]}, {"billed_charge": 488.58, "npi": [1215936927]}, {"billed_charge": 242.09, "npi": [1215936927]}]}, {"allowed_amount": 345.38, "billing_code_modifier": [""], "providers": [{"billed_charge": 1182.81, "npi": [1215936927]}]}, {"allowed_amount": 197.53, "billing_code_modifier": [""], "providers": [{"billed_charge": 747.44, "npi": [1215936927]}]}, {"allowed_amount": 510.68, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 1890.92, "npi": [1215936927]}]}, {"allowed_amount": 260.33, "billing_code_modifier": ["XU"], "providers": [{"billed_charge": 783.8, "npi": [1215936927]}, {"billed_charge": 488.58, "npi": [1215936927]}]}, {"allowed_amount": 2512.0, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 1890.92, "npi": [1215936927]}]}, {"allowed_amount": 345.38, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 1182.81, "npi": [1215936927]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["RT"], "providers": [{"billed_charge": 518.75, "npi": [1215936927]}]}, {"allowed_amount": 334.09, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 1182.81, "npi": [1215936927]}]}, {"allowed_amount": 3201.04, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 2795.76, "npi": [1215936927]}]}, {"allowed_amount": 2819.79, "billing_code_modifier": ["XU"], "providers": [{"billed_charge": 242.09, "npi": [1215936927]}]}, {"allowed_amount": 728.86, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 2795.76, "npi": [1215936927]}]}, {"allowed_amount": 497.52, "billing_code_modifier": [""], "providers": [{"billed_charge": 2074.26, "npi": [1215936927]}]}, {"allowed_amount": 88.78, "billing_code_modifier": ["XU"], "providers": [{"billed_charge": 242.09, "npi": [1215936927]}]}, {"allowed_amount": 57.55, "billing_code_modifier": ["XU"], "providers": [{"billed_charge": 147.6, "npi": [1215936927]}, {"billed_charge": 185.63, "npi": [1215936927]}]}, {"allowed_amount": 187.92, "billing_code_modifier": [""], "providers": [{"billed_charge": 747.44, "npi": [1215936927]}]}, {"allowed_amount": 711.105, "billing_code_modifier": [""], "providers": [{"billed_charge": 242.09, "npi": [1215936927]}]}, {"allowed_amount": 764.76, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 2795.76, "npi": [1215936927]}]}, {"allowed_amount": 262.8, "billing_code_modifier": [""], "providers": [{"billed_charge": 783.8, "npi": [1215936927]}, {"billed_charge": 488.58, "npi": [1215936927]}]}, {"allowed_amount": 57.32, "billing_code_modifier": ["XU"], "providers": [{"billed_charge": 147.6, "npi": [1215936927]}, {"billed_charge": 185.63, "npi": [1215936927]}]}, {"allowed_amount": 57.55, "billing_code_modifier": [""], "providers": [{"billed_charge": 147.6, "npi": [1215936927]}, {"billed_charge": 185.63, "npi": [1215936927]}]}, {"allowed_amount": 334.09, "billing_code_modifier": [""], "providers": [{"billed_charge": 1182.81, "npi": [1215936927]}]}]}]}, {"name": "Pharmacy - Extension of 25X - Drug Requiring Detailed Coding", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0636", "description": "Pharmacy - Extension of 25x", "allowed_amounts": [{"tin": {"type": "ein", "value": "340714585"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.1701, "billing_code_modifier": [""], "providers": [{"billed_charge": 0.9006, "npi": [1679525919]}]}, {"allowed_amount": 26.9865, "billing_code_modifier": ["JZ"], "providers": [{"billed_charge": 340.7608, "npi": [1679525919]}]}, {"allowed_amount": 14.8673, "billing_code_modifier": ["JZ"], "providers": [{"billed_charge": 9.7364, "npi": [1679525919]}]}, {"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 26.2, "npi": [1679525919]}, {"billed_charge": 0.065, "npi": [1679525919]}, {"billed_charge": 1.02, "npi": [1679525919]}, {"billed_charge": 0.2175, "npi": [1679525919]}, {"billed_charge": 2.2167, "npi": [1679525919]}, {"billed_charge": 1.51, "npi": [1679525919]}, {"billed_charge": 2.01, "npi": [1679525919]}, {"billed_charge": 1.4462, "npi": [1679525919]}, {"billed_charge": 1.375, "npi": [1679525919]}, {"billed_charge": 0.048, "npi": [1679525919]}, {"billed_charge": 15.35, "npi": [1679525919]}, {"billed_charge": 18.8, "npi": [1679525919]}, {"billed_charge": 63.1, "npi": [1679525919]}, {"billed_charge": 0.1088, "npi": [1679525919]}, {"billed_charge": 1.8041, "npi": [1679525919]}, {"billed_charge": 3.29, "npi": [1679525919]}, {"billed_charge": 28.8, "npi": [1679525919]}, {"billed_charge": 1.2885, "npi": [1679525919]}, {"billed_charge": 0.1, "npi": [1679525919]}, {"billed_charge": 10.05, "npi": [1679525919]}, {"billed_charge": 12.3333, "npi": [1679525919]}, {"billed_charge": 13.75, "npi": [1679525919]}, {"billed_charge": 39.6407, "npi": [1679525919]}, {"billed_charge": 13.475, "npi": [1679525919]}, {"billed_charge": 12.65, "npi": [1679525919]}, {"billed_charge": 1.4057, "npi": [1679525919]}, {"billed_charge": 2.35, "npi": [1679525919]}, {"billed_charge": 176.8, "npi": [1679525919]}, {"billed_charge": 2.25, "npi": [1679525919]}, {"billed_charge": 0.303, "npi": [1679525919]}, {"billed_charge": 0.5, "npi": [1679525919]}, {"billed_charge": 1.57, "npi": [1679525919]}, {"billed_charge": 1.4393, "npi": [1679525919]}, {"billed_charge": 3.5625, "npi": [1679525919]}, {"billed_charge": 0.076, "npi": [1679525919]}, {"billed_charge": 0.0355, "npi": [1679525919]}, {"billed_charge": 1.3848, "npi": [1679525919]}, {"billed_charge": 2.5226, "npi": [1679525919]}, {"billed_charge": 1.8064, "npi": [1679525919]}, {"billed_charge": 19.0, "npi": [1679525919]}, {"billed_charge": 2.7043, "npi": [1679525919]}, {"billed_charge": 4.0, "npi": [1679525919]}, {"billed_charge": 16.0, "npi": [1679525919]}, {"billed_charge": 39.3, "npi": [1679525919]}, {"billed_charge": 7.075, "npi": [1679525919]}, {"billed_charge": 0.4413, "npi": [1679525919]}, {"billed_charge": 2.4063, "npi": [1679525919]}, {"billed_charge": 16.75, "npi": [1679525919]}, {"billed_charge": 1.1112, "npi": [1679525919]}, {"billed_charge": 0.1987, "npi": [1679525919]}, {"billed_charge": 7.7, "npi": [1679525919]}, {"billed_charge": 6.35, "npi": [1679525919]}, {"billed_charge": 0.1475, "npi": [1679525919]}, {"billed_charge": 4.625, "npi": [1679525919]}, {"billed_charge": 5.25, "npi": [1679525919]}, {"billed_charge": 2.2125, "npi": [1679525919]}, {"billed_charge": 0.5963, "npi": [1679525919]}, {"billed_charge": 0.675, "npi": [1679525919]}, {"billed_charge": 1.66, "npi": [1679525919]}, {"billed_charge": 3.675, "npi": [1679525919]}, {"billed_charge": 8.425, "npi": [1679525919]}, {"billed_charge": 1.6692, "npi": [1679525919]}, {"billed_charge": 10.0, "npi": [1679525919]}, {"billed_charge": 24.6833, "npi": [1679525919]}, {"billed_charge": 198.2, "npi": [1679525919]}, {"billed_charge": 1.5307, "npi": [1679525919]}, {"billed_charge": 0.26, "npi": [1679525919]}, {"billed_charge": 0.0221, "npi": [1679525919]}, {"billed_charge": 11.575, "npi": [1679525919]}, {"billed_charge": 17.4, "npi": [1679525919]}, {"billed_charge": 1.2667, "npi": [1679525919]}, {"billed_charge": 1.13, "npi": [1679525919]}, {"billed_charge": 1.145, "npi": [1679525919]}, {"billed_charge": 8.05, "npi": [1679525919]}, {"billed_charge": 0.0765, "npi": [1679525919]}, {"billed_charge": 0.062, "npi": [1679525919]}, {"billed_charge": 0.0531, "npi": [1679525919]}, {"billed_charge": 0.4125, "npi": [1679525919]}, {"billed_charge": 0.3026, "npi": [1679525919]}, {"billed_charge": 2.9625, "npi": [1679525919]}, {"billed_charge": 4.46, "npi": [1679525919]}, {"billed_charge": 12.05, "npi": [1679525919]}, {"billed_charge": 57.2, "npi": [1679525919]}, {"billed_charge": 1.5151, "npi": [1679525919]}, {"billed_charge": 29.953, "npi": [1679525919]}, {"billed_charge": 2.8485, "npi": [1679525919]}, {"billed_charge": 0.8229, "npi": [1679525919]}, {"billed_charge": 5.5, "npi": [1679525919]}, {"billed_charge": 1.44, "npi": [1679525919]}, {"billed_charge": 2.8, "npi": [1679525919]}, {"billed_charge": 1.2081, "npi": [1679525919]}, {"billed_charge": 13.1, "npi": [1679525919]}, {"billed_charge": 74.5, "npi": [1679525919]}, {"billed_charge": 5.6195, "npi": [1679525919]}, {"billed_charge": 18.425, "npi": [1679525919]}, {"billed_charge": 1.8851, "npi": [1679525919]}, {"billed_charge": 1.5352, "npi": [1679525919]}, {"billed_charge": 2.1815, "npi": [1679525919]}, {"billed_charge": 1.55, "npi": [1679525919]}, {"billed_charge": 170.05, "npi": [1679525919]}, {"billed_charge": 1.0173, "npi": [1679525919]}, {"billed_charge": 0.13, "npi": [1679525919]}, {"billed_charge": 0.106, "npi": [1679525919]}, {"billed_charge": 0.4756, "npi": [1679525919]}, {"billed_charge": 3.48, "npi": [1679525919]}, {"billed_charge": 5.3955, "npi": [1679525919]}, {"billed_charge": 1.9318, "npi": [1679525919]}, {"billed_charge": 1.1752, "npi": [1679525919]}, {"billed_charge": 0.0383, "npi": [1679525919]}, {"billed_charge": 25.7, "npi": [1679525919]}, {"billed_charge": 0.9938, "npi": [1679525919]}, {"billed_charge": 17.9625, "npi": [1679525919]}, {"billed_charge": 3.0939, "npi": [1679525919]}, {"billed_charge": 20.1, "npi": [1679525919]}, {"billed_charge": 3.4875, "npi": [1679525919]}, {"billed_charge": 0.86, "npi": [1679525919]}, {"billed_charge": 14.0, "npi": [1679525919]}, {"billed_charge": 1.8996, "npi": [1679525919]}, {"billed_charge": 3.4739, "npi": [1679525919]}, {"billed_charge": 2.2536, "npi": [1679525919]}, {"billed_charge": 0.615, "npi": [1679525919]}, {"billed_charge": 0.982, "npi": [1679525919]}, {"billed_charge": 1.3, "npi": [1679525919]}, {"billed_charge": 0.272, "npi": [1679525919]}, {"billed_charge": 14.3, "npi": [1679525919]}, {"billed_charge": 10.15, "npi": [1679525919]}, {"billed_charge": 39.6476, "npi": [1679525919]}, {"billed_charge": 0.0435, "npi": [1679525919]}, {"billed_charge": 1.4125, "npi": [1679525919]}, {"billed_charge": 19.3, "npi": [1679525919]}, {"billed_charge": 6.8, "npi": [1679525919]}, {"billed_charge": 1.1733, "npi": [1679525919]}, {"billed_charge": 0.4063, "npi": [1679525919]}, {"billed_charge": 0.69, "npi": [1679525919]}, {"billed_charge": 0.6985, "npi": [1679525919]}, {"billed_charge": 9.3167, "npi": [1679525919]}, {"billed_charge": 2.0797, "npi": [1679525919]}, {"billed_charge": 157.9125, "npi": [1679525919]}]}, {"allowed_amount": 14.8676, "billing_code_modifier": ["JZ"], "providers": [{"billed_charge": 39.6454, "npi": [1679525919]}, {"billed_charge": 39.6476, "npi": [1679525919]}]}, {"allowed_amount": 0.41, "billing_code_modifier": ["JZ"], "providers": [{"billed_charge": 12.3, "npi": [1679525919]}, {"billed_charge": 9.5, "npi": [1679525919]}, {"billed_charge": 3.65, "npi": [1679525919]}, {"billed_charge": 10.775, "npi": [1679525919]}, {"billed_charge": 10.15, "npi": [1679525919]}]}, {"allowed_amount": 33.908, "billing_code_modifier": ["JZ"], "providers": [{"billed_charge": 340.7608, "npi": [1679525919]}]}, {"allowed_amount": 15.4672, "billing_code_modifier": ["JW"], "providers": [{"billed_charge": 9.9307, "npi": [1679525919]}]}, {"allowed_amount": 0.47, "billing_code_modifier": ["JZ"], "providers": [{"billed_charge": 1.775, "npi": [1679525919]}, {"billed_charge": 3.65, "npi": [1679525919]}]}, {"allowed_amount": 14.8673, "billing_code_modifier": [""], "providers": [{"billed_charge": 9.7364, "npi": [1679525919]}]}, {"allowed_amount": 0.46, "billing_code_modifier": ["JZ"], "providers": [{"billed_charge": 1.8, "npi": [1679525919]}, {"billed_charge": 9.5, "npi": [1679525919]}, {"billed_charge": 3.65, "npi": [1679525919]}]}, {"allowed_amount": 14.8675, "billing_code_modifier": ["JW"], "providers": [{"billed_charge": 9.9307, "npi": [1679525919]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["JZ"], "providers": [{"billed_charge": 275.81, "npi": [1679525919]}, {"billed_charge": 340.7608, "npi": [1679525919]}, {"billed_charge": 1.542, "npi": [1679525919]}, {"billed_charge": 67.61, "npi": [1679525919]}, {"billed_charge": 275.86, "npi": [1679525919]}, {"billed_charge": 275.785, "npi": [1679525919]}, {"billed_charge": 39.6389, "npi": [1679525919]}, {"billed_charge": 20.95, "npi": [1679525919]}, {"billed_charge": 67.65, "npi": [1679525919]}]}, {"allowed_amount": 0.4075, "billing_code_modifier": ["JZ"], "providers": [{"billed_charge": 9.5, "npi": [1679525919]}]}, {"allowed_amount": 15.4673, "billing_code_modifier": [""], "providers": [{"billed_charge": 9.7364, "npi": [1679525919]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["JW"], "providers": [{"billed_charge": 39.8579, "npi": [1679525919]}, {"billed_charge": 39.8553, "npi": [1679525919]}]}, {"allowed_amount": 15.4672, "billing_code_modifier": ["JZ"], "providers": [{"billed_charge": 39.6476, "npi": [1679525919]}]}]}]}, {"name": "Laboratory - Immunology", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0302", "description": "Laboratory", "allowed_amounts": [{"tin": {"type": "ein", "value": "340714684"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 5.94, "billing_code_modifier": [""], "providers": [{"billed_charge": 29.0, "npi": [1194763045]}]}, {"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 36.0, "npi": [1194763045]}, {"billed_charge": 83.0, "npi": [1194763045]}, {"billed_charge": 95.0, "npi": [1194763045]}, {"billed_charge": 68.5, "npi": [1194763045]}, {"billed_charge": 69.5714, "npi": [1194763045]}, {"billed_charge": 89.0, "npi": [1194763045]}]}, {"allowed_amount": 5.76, "billing_code_modifier": [""], "providers": [{"billed_charge": 28.0, "npi": [1194763045]}]}, {"allowed_amount": 17.87, "billing_code_modifier": [""], "providers": [{"billed_charge": 86.0, "npi": [1194763045]}]}, {"allowed_amount": 18.54, "billing_code_modifier": [""], "providers": [{"billed_charge": 91.0, "npi": [1194763045]}]}, {"allowed_amount": 17.875, "billing_code_modifier": [""], "providers": [{"billed_charge": 86.0, "npi": [1194763045]}]}]}]}, {"name": "SBSQ HOSPITAL IP/OBS CARE HIGH MDM 50 MINUTES", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "99233", "description": "SBSQ HOSPITAL IP/OBS CARE HIGH MDM 50 MINUTES", "allowed_amounts": [{"tin": {"type": "ein", "value": "412119889"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 125.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 125.0, "npi": [1790769149]}]}]}]}, {"name": "Laboratory - Chemistry", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0301", "description": "Laboratory", "allowed_amounts": [{"tin": {"type": "ein", "value": "340898745"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 31.74, "billing_code_modifier": [""], "providers": [{"billed_charge": 109.0, "npi": [1275533226]}]}, {"allowed_amount": 35.835, "billing_code_modifier": [""], "providers": [{"billed_charge": 124.0, "npi": [1275533226]}]}, {"allowed_amount": 50.86, "billing_code_modifier": [""], "providers": [{"billed_charge": 176.0, "npi": [1275533226]}]}, {"allowed_amount": 31.5, "billing_code_modifier": [""], "providers": [{"billed_charge": 109.0, "npi": [1275533226]}]}, {"allowed_amount": 26.87, "billing_code_modifier": [""], "providers": [{"billed_charge": 93.0, "npi": [1275533226]}]}, {"allowed_amount": 51.915, "billing_code_modifier": [""], "providers": [{"billed_charge": 173.0, "npi": [1275533226]}]}, {"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 115.75, "npi": [1275533226]}]}, {"allowed_amount": 50.67, "billing_code_modifier": [""], "providers": [{"billed_charge": 174.0, "npi": [1275533226]}]}, {"allowed_amount": 35.41, "billing_code_modifier": [""], "providers": [{"billed_charge": 118.0, "npi": [1275533226]}]}, {"allowed_amount": 156.65, "billing_code_modifier": [""], "providers": [{"billed_charge": 522.0, "npi": [1275533226]}]}, {"allowed_amount": 35.42, "billing_code_modifier": [""], "providers": [{"billed_charge": 118.0, "npi": [1275533226]}]}, {"allowed_amount": 50.28, "billing_code_modifier": [""], "providers": [{"billed_charge": 174.0, "npi": [1275533226]}]}, {"allowed_amount": 26.72, "billing_code_modifier": [""], "providers": [{"billed_charge": 89.0, "npi": [1275533226]}]}, {"allowed_amount": 49.82, "billing_code_modifier": [""], "providers": [{"billed_charge": 166.0, "npi": [1275533226]}]}, {"allowed_amount": 27.08, "billing_code_modifier": [""], "providers": [{"billed_charge": 93.0, "npi": [1275533226]}]}, {"allowed_amount": 51.25, "billing_code_modifier": [""], "providers": [{"billed_charge": 176.0, "npi": [1275533226]}]}, {"allowed_amount": 36.11, "billing_code_modifier": [""], "providers": [{"billed_charge": 124.0, "npi": [1275533226]}]}, {"allowed_amount": 34.51, "billing_code_modifier": [""], "providers": [{"billed_charge": 115.0, "npi": [1275533226]}]}, {"allowed_amount": 31.21, "billing_code_modifier": [""], "providers": [{"billed_charge": 104.0, "npi": [1275533226]}]}, {"allowed_amount": 19.805, "billing_code_modifier": ["91"], "providers": [{"billed_charge": 66.0, "npi": [1275533226]}]}, {"allowed_amount": 12.61, "billing_code_modifier": ["59"], "providers": [{"billed_charge": 42.0, "npi": [1275533226]}]}]}]}, {"name": "Pharmacy - General", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0250", "description": "Pharmacy (also see 063x, an extension of 025x)", "allowed_amounts": [{"tin": {"type": "ein", "value": "264827222"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 25.81, "npi": [1609189604]}, {"billed_charge": 2.3, "npi": [1609189604]}, {"billed_charge": 7.4402, "npi": [1609189604]}, {"billed_charge": 1.0767, "npi": [1609189604]}, {"billed_charge": 12.67, "npi": [1609189604]}, {"billed_charge": 3.23, "npi": [1609189604]}, {"billed_charge": 7.7398, "npi": [1609189604]}, {"billed_charge": 3.0433, "npi": [1609189604]}, {"billed_charge": 7.6217, "npi": [1609189604]}, {"billed_charge": 6.47, "npi": [1609189604]}, {"billed_charge": 3.67, "npi": [1609189604]}, {"billed_charge": 16.075, "npi": [1609189604]}, {"billed_charge": 4.28, "npi": [1609189604]}, {"billed_charge": 2.0775, "npi": [1609189604]}, {"billed_charge": 3.3257, "npi": [1609189604]}, {"billed_charge": 4.01, "npi": [1609189604]}, {"billed_charge": 3.698, "npi": [1609189604]}, {"billed_charge": 10.1075, "npi": [1609189604]}, {"billed_charge": 19.61, "npi": [1609189604]}, {"billed_charge": 3.78, "npi": [1609189604]}, {"billed_charge": 6.9327, "npi": [1609189604]}, {"billed_charge": 3.505, "npi": [1609189604]}, {"billed_charge": 2.0933, "npi": [1609189604]}, {"billed_charge": 2.834, "npi": [1609189604]}, {"billed_charge": 2.6933, "npi": [1609189604]}, {"billed_charge": 1.292, "npi": [1609189604]}, {"billed_charge": 1.615, "npi": [1609189604]}, {"billed_charge": 3.888, "npi": [1609189604]}, {"billed_charge": 1.7956, "npi": [1609189604]}]}]}]}, {"name": "Laboratory - Chemistry", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0301", "description": "Laboratory", "allowed_amounts": [{"tin": {"type": "ein", "value": "310653685"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 18.06, "billing_code_modifier": [""], "providers": [{"billed_charge": 42.0, "npi": [1225053119]}]}, {"allowed_amount": 43.04, "billing_code_modifier": [""], "providers": [{"billed_charge": 106.0, "npi": [1225053119]}]}, {"allowed_amount": 66.99, "billing_code_modifier": ["QW"], "providers": [{"billed_charge": 165.0, "npi": [1225053119]}]}, {"allowed_amount": 6.09, "billing_code_modifier": [""], "providers": [{"billed_charge": 15.0, "npi": [1225053119]}]}, {"allowed_amount": 32.89, "billing_code_modifier": [""], "providers": [{"billed_charge": 81.0, "npi": [1225053119]}]}, {"allowed_amount": 17.05, "billing_code_modifier": [""], "providers": [{"billed_charge": 42.0, "npi": [1225053119]}]}, {"allowed_amount": 52.46, "billing_code_modifier": [""], "providers": [{"billed_charge": 122.0, "npi": [1225053119]}]}, {"allowed_amount": 94.19, "billing_code_modifier": ["QW"], "providers": [{"billed_charge": 232.0, "npi": [1225053119]}]}, {"allowed_amount": 55.89, "billing_code_modifier": [""], "providers": [{"billed_charge": 130.0, "npi": [1225053119]}]}, {"allowed_amount": 36.13, "billing_code_modifier": ["QW"], "providers": [{"billed_charge": 89.0, "npi": [1225053119]}]}, {"allowed_amount": 15.83, "billing_code_modifier": ["QW"], "providers": [{"billed_charge": 39.0, "npi": [1225053119]}]}, {"allowed_amount": 18.68, "billing_code_modifier": ["QW"], "providers": [{"billed_charge": 46.0, "npi": [1225053119]}]}, {"allowed_amount": 49.53, "billing_code_modifier": [""], "providers": [{"billed_charge": 122.0, "npi": [1225053119]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["91QW"], "providers": [{"billed_charge": 46.0, "npi": [1225053119]}]}, {"allowed_amount": 99.75, "billing_code_modifier": ["QW"], "providers": [{"billed_charge": 232.0, "npi": [1225053119]}]}, {"allowed_amount": 70.94, "billing_code_modifier": ["QW"], "providers": [{"billed_charge": 165.0, "npi": [1225053119]}]}, {"allowed_amount": 31.67, "billing_code_modifier": [""], "providers": [{"billed_charge": 78.0, "npi": [1225053119]}]}, {"allowed_amount": 19.49, "billing_code_modifier": [""], "providers": [{"billed_charge": 48.0, "npi": [1225053119]}]}]}]}, {"name": "Laboratory - Hematology", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0305", "description": "Laboratory", "allowed_amounts": [{"tin": {"type": "ein", "value": "314394942"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 31.0, "npi": [1255377149]}, {"billed_charge": 28.0, "npi": [1255377149]}, {"billed_charge": 36.0, "npi": [1255377149]}, {"billed_charge": 51.1538, "npi": [1255377149]}, {"billed_charge": 23.5, "npi": [1255377149]}, {"billed_charge": 44.3333, "npi": [1255377149]}, {"billed_charge": 27.3636, "npi": [1255377149]}, {"billed_charge": 10.0, "npi": [1255377149]}, {"billed_charge": 70.3333, "npi": [1255377149]}, {"billed_charge": 38.4, "npi": [1255377149]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["XU"], "providers": [{"billed_charge": 10.0, "npi": [1255377149]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["59"], "providers": [{"billed_charge": 10.0, "npi": [1255377149]}]}]}]}, {"name": "EKG/ECG (Electrocardiogram) - General", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0730", "description": "EKG/ECG (Electrocardiogram)", "allowed_amounts": [{"tin": {"type": "ein", "value": "341425870"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 375.0, "npi": [1972689172]}, {"billed_charge": 390.0, "npi": [1972689172]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["XU"], "providers": [{"billed_charge": 390.0, "npi": [1972689172]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["76"], "providers": [{"billed_charge": 390.0, "npi": [1972689172]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["59"], "providers": [{"billed_charge": 375.0, "npi": [1972689172]}, {"billed_charge": 390.0, "npi": [1972689172]}]}]}]}, {"name": "RADIOLOGIC EXAM CHEST SINGLE VIEW", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "71045", "description": "RADIOLOGIC EXAM CHEST SINGLE VIEW", "allowed_amounts": [{"tin": {"type": "ein", "value": "310983140"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 8.22, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 41.0, "npi": [1093718496]}, {"billed_charge": 45.0, "npi": [1093718496]}, {"billed_charge": 39.0, "npi": [1093718496]}]}, {"allowed_amount": 8.22, "billing_code_modifier": ["2676"], "providers": [{"billed_charge": 41.0, "npi": [1093718496]}]}, {"allowed_amount": 8.22, "billing_code_modifier": ["2677"], "providers": [{"billed_charge": 41.0, "npi": [1093718496]}]}]}]}, {"name": "IADNA SARSCOV2  and  INF A and B  and  RSV MULT AMP PROBE", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "87637", "description": "IADNA SARSCOV2  and  INF A and B  and  RSV MULT AMP PROBE", "allowed_amounts": [{"tin": {"type": "ein", "value": "340714593"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 192.55, "billing_code_modifier": [""], "providers": [{"billed_charge": 925.0, "npi": [1598719346]}]}, {"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 925.0, "npi": [1598719346]}]}, {"allowed_amount": 199.68, "billing_code_modifier": [""], "providers": [{"billed_charge": 925.0, "npi": [1598719346]}]}]}]}, {"name": "Pharmacy - General", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0250", "description": "Pharmacy (also see 063x, an extension of 025x)", "allowed_amounts": [{"tin": {"type": "ein", "value": "341567805"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 1.7117, "npi": [1043397292]}, {"billed_charge": 3.67, "npi": [1043397292]}, {"billed_charge": 1.3675, "npi": [1043397292]}, {"billed_charge": 4.4286, "npi": [1043397292]}, {"billed_charge": 3.235, "npi": [1043397292]}, {"billed_charge": 2.3467, "npi": [1043397292]}, {"billed_charge": 3.8496, "npi": [1043397292]}, {"billed_charge": 7.92, "npi": [1043397292]}, {"billed_charge": 1.735, "npi": [1043397292]}, {"billed_charge": 1.88, "npi": [1043397292]}, {"billed_charge": 4.4275, "npi": [1043397292]}, {"billed_charge": 3.134, "npi": [1043397292]}, {"billed_charge": 4.6148, "npi": [1043397292]}, {"billed_charge": 6.2129, "npi": [1043397292]}, {"billed_charge": 16.055, "npi": [1043397292]}, {"billed_charge": 2.2988, "npi": [1043397292]}, {"billed_charge": 6.1987, "npi": [1043397292]}, {"billed_charge": 1.938, "npi": [1043397292]}, {"billed_charge": 3.86, "npi": [1043397292]}, {"billed_charge": 4.9445, "npi": [1043397292]}, {"billed_charge": 9.86, "npi": [1043397292]}, {"billed_charge": 29.03, "npi": [1043397292]}, {"billed_charge": 17.7017, "npi": [1043397292]}, {"billed_charge": 53.045, "npi": [1043397292]}, {"billed_charge": 4.31, "npi": [1043397292]}, {"billed_charge": 8.29, "npi": [1043397292]}, {"billed_charge": 1.818, "npi": [1043397292]}, {"billed_charge": 5.1636, "npi": [1043397292]}, {"billed_charge": 1.7646, "npi": [1043397292]}, {"billed_charge": 1.615, "npi": [1043397292]}, {"billed_charge": 5.9033, "npi": [1043397292]}, {"billed_charge": 1.0767, "npi": [1043397292]}, {"billed_charge": 1.9406, "npi": [1043397292]}, {"billed_charge": 35.2308, "npi": [1043397292]}, {"billed_charge": 3.3133, "npi": [1043397292]}, {"billed_charge": 23.6567, "npi": [1043397292]}, {"billed_charge": 3.2325, "npi": [1043397292]}, {"billed_charge": 2.5325, "npi": [1043397292]}, {"billed_charge": 3.81, "npi": [1043397292]}, {"billed_charge": 18.7467, "npi": [1043397292]}, {"billed_charge": 3.7119, "npi": [1043397292]}, {"billed_charge": 31.68, "npi": [1043397292]}, {"billed_charge": 23.52, "npi": [1043397292]}, {"billed_charge": 5.86, "npi": [1043397292]}, {"billed_charge": 3.4233, "npi": [1043397292]}, {"billed_charge": 4.13, "npi": [1043397292]}, {"billed_charge": 2.054, "npi": [1043397292]}, {"billed_charge": 2.1533, "npi": [1043397292]}, {"billed_charge": 2.4225, "npi": [1043397292]}, {"billed_charge": 3.23, "npi": [1043397292]}, {"billed_charge": 4.414, "npi": [1043397292]}, {"billed_charge": 1.8131, "npi": [1043397292]}, {"billed_charge": 2.026, "npi": [1043397292]}, {"billed_charge": 1.292, "npi": [1043397292]}, {"billed_charge": 2.8108, "npi": [1043397292]}, {"billed_charge": 23.5423, "npi": [1043397292]}, {"billed_charge": 5.14, "npi": [1043397292]}, {"billed_charge": 68.1, "npi": [1043397292]}, {"billed_charge": 2.2157, "npi": [1043397292]}, {"billed_charge": 4.85, "npi": [1043397292]}, {"billed_charge": 3.47, "npi": [1043397292]}, {"billed_charge": 1.0851, "npi": [1043397292]}, {"billed_charge": 7.975, "npi": [1043397292]}, {"billed_charge": 3.45, "npi": [1043397292]}, {"billed_charge": 1.8457, "npi": [1043397292]}, {"billed_charge": 9.405, "npi": [1043397292]}, {"billed_charge": 0.67, "npi": [1043397292]}, {"billed_charge": 2.3015, "npi": [1043397292]}, {"billed_charge": 15.592, "npi": [1043397292]}, {"billed_charge": 123.7095, "npi": [1043397292]}, {"billed_charge": 29.07, "npi": [1043397292]}, {"billed_charge": 11.085, "npi": [1043397292]}, {"billed_charge": 3.75, "npi": [1043397292]}, {"billed_charge": 1.34, "npi": [1043397292]}, {"billed_charge": 7.3823, "npi": [1043397292]}, {"billed_charge": 1.76, "npi": [1043397292]}, {"billed_charge": 10.0335, "npi": [1043397292]}, {"billed_charge": 4.9212, "npi": [1043397292]}, {"billed_charge": 15.905, "npi": [1043397292]}, {"billed_charge": 8.1088, "npi": [1043397292]}, {"billed_charge": 11.226, "npi": [1043397292]}]}]}]}, {"name": "Laboratory - Urology", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0307", "description": "Laboratory", "allowed_amounts": [{"tin": {"type": "ein", "value": "341567805"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 119.0, "npi": [1043397292]}, {"billed_charge": 82.0, "npi": [1043397292]}, {"billed_charge": 31.0, "npi": [1043397292]}, {"billed_charge": 79.0, "npi": [1043397292]}, {"billed_charge": 124.0, "npi": [1043397292]}, {"billed_charge": 30.0, "npi": [1043397292]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["59"], "providers": [{"billed_charge": 119.0, "npi": [1043397292]}, {"billed_charge": 31.0, "npi": [1043397292]}, {"billed_charge": 124.0, "npi": [1043397292]}]}]}]}, {"name": "IV Therapy -General", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0260", "description": "IV Therapy", "allowed_amounts": [{"tin": {"type": "ein", "value": "340714618"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 318.0, "npi": [1215989611]}, {"billed_charge": 467.9091, "npi": [1215989611]}, {"billed_charge": 452.0, "npi": [1215989611]}, {"billed_charge": 1454.0, "npi": [1215989611]}, {"billed_charge": 1324.0, "npi": [1215989611]}, {"billed_charge": 540.2857, "npi": [1215989611]}, {"billed_charge": 294.0, "npi": [1215989611]}, {"billed_charge": 488.0, "npi": [1215989611]}, {"billed_charge": 528.2, "npi": [1215989611]}, {"billed_charge": 602.0, "npi": [1215989611]}, {"billed_charge": 536.1667, "npi": [1215989611]}, {"billed_charge": 696.6667, "npi": [1215989611]}, {"billed_charge": 435.0, "npi": [1215989611]}, {"billed_charge": 809.0, "npi": [1215989611]}, {"billed_charge": 491.0, "npi": [1215989611]}]}, {"allowed_amount": 263.68, "billing_code_modifier": ["59"], "providers": [{"billed_charge": 1324.0, "npi": [1215989611]}]}, {"allowed_amount": 57.74, "billing_code_modifier": [""], "providers": [{"billed_charge": 294.0, "npi": [1215989611]}]}, {"allowed_amount": 280.35, "billing_code_modifier": [""], "providers": [{"billed_charge": 1454.0, "npi": [1215989611]}]}, {"allowed_amount": 286.36, "billing_code_modifier": [""], "providers": [{"billed_charge": 1454.0, "npi": [1215989611]}]}, {"allowed_amount": 1203.5, "billing_code_modifier": [""], "providers": [{"billed_charge": 318.0, "npi": [1215989611]}]}, {"allowed_amount": 280.35, "billing_code_modifier": ["59"], "providers": [{"billed_charge": 1454.0, "npi": [1215989611]}]}, {"allowed_amount": 0.3, "billing_code_modifier": ["59"], "providers": [{"billed_charge": 318.0, "npi": [1215989611]}]}, {"allowed_amount": 0.26, "billing_code_modifier": ["59"], "providers": [{"billed_charge": 1454.0, "npi": [1215989611]}]}, {"allowed_amount": 263.68, "billing_code_modifier": [""], "providers": [{"billed_charge": 1324.0, "npi": [1215989611]}]}, {"allowed_amount": 61.73, "billing_code_modifier": [""], "providers": [{"billed_charge": 318.0, "npi": [1215989611]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["59"], "providers": [{"billed_charge": 318.0, "npi": [1215989611]}, {"billed_charge": 452.0, "npi": [1215989611]}, {"billed_charge": 1454.0, "npi": [1215989611]}, {"billed_charge": 1324.0, "npi": [1215989611]}, {"billed_charge": 294.0, "npi": [1215989611]}, {"billed_charge": 488.0, "npi": [1215989611]}, {"billed_charge": 435.0, "npi": [1215989611]}, {"billed_charge": 491.0, "npi": [1215989611]}]}, {"allowed_amount": 63.0489, "billing_code_modifier": [""], "providers": [{"billed_charge": 318.0, "npi": [1215989611]}]}, {"allowed_amount": 61.73, "billing_code_modifier": ["59"], "providers": [{"billed_charge": 318.0, "npi": [1215989611]}]}]}]}, {"name": "Radiology - Diagnostic - General", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0320", "description": "Radiology - Diagnostic", "allowed_amounts": [{"tin": {"type": "ein", "value": "341567805"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 294.0, "npi": [1043397292]}, {"billed_charge": 467.0, "npi": [1043397292]}, {"billed_charge": 363.3333, "npi": [1043397292]}, {"billed_charge": 385.0, "npi": [1043397292]}, {"billed_charge": 351.1667, "npi": [1043397292]}, {"billed_charge": 444.0, "npi": [1043397292]}, {"billed_charge": 549.0, "npi": [1043397292]}, {"billed_charge": 473.75, "npi": [1043397292]}, {"billed_charge": 283.0, "npi": [1043397292]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["RT"], "providers": [{"billed_charge": 517.0, "npi": [1043397292]}, {"billed_charge": 411.0, "npi": [1043397292]}, {"billed_charge": 551.0, "npi": [1043397292]}, {"billed_charge": 506.0, "npi": [1043397292]}, {"billed_charge": 526.0, "npi": [1043397292]}, {"billed_charge": 580.0, "npi": [1043397292]}, {"billed_charge": 491.0, "npi": [1043397292]}, {"billed_charge": 530.0, "npi": [1043397292]}, {"billed_charge": 553.0, "npi": [1043397292]}, {"billed_charge": 524.0, "npi": [1043397292]}, {"billed_charge": 428.0, "npi": [1043397292]}, {"billed_charge": 445.0, "npi": [1043397292]}, {"billed_charge": 474.0, "npi": [1043397292]}, {"billed_charge": 603.0, "npi": [1043397292]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["50"], "providers": [{"billed_charge": 1206.0, "npi": [1043397292]}, {"billed_charge": 1048.0, "npi": [1043397292]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["LT"], "providers": [{"billed_charge": 551.0, "npi": [1043397292]}, {"billed_charge": 526.0, "npi": [1043397292]}, {"billed_charge": 580.0, "npi": [1043397292]}, {"billed_charge": 553.0, "npi": [1043397292]}, {"billed_charge": 524.0, "npi": [1043397292]}, {"billed_charge": 428.0, "npi": [1043397292]}, {"billed_charge": 445.0, "npi": [1043397292]}, {"billed_charge": 603.0, "npi": [1043397292]}]}]}]}, {"name": "Pharmacy - Extension of 25X - Drug Requiring Detailed Coding", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0636", "description": "Pharmacy - Extension of 25x", "allowed_amounts": [{"tin": {"type": "ein", "value": "340714618"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 44.2, "npi": [1215989611]}, {"billed_charge": 3.2306, "npi": [1215989611]}, {"billed_charge": 1.4, "npi": [1215989611]}, {"billed_charge": 3.48, "npi": [1215989611]}, {"billed_charge": 57.2, "npi": [1215989611]}, {"billed_charge": 2.72, "npi": [1215989611]}, {"billed_charge": 1.2833, "npi": [1215989611]}, {"billed_charge": 1.13, "npi": [1215989611]}, {"billed_charge": 13.0375, "npi": [1215989611]}, {"billed_charge": 12.65, "npi": [1215989611]}, {"billed_charge": 1.57, "npi": [1215989611]}, {"billed_charge": 5.5, "npi": [1215989611]}, {"billed_charge": 2.85, "npi": [1215989611]}, {"billed_charge": 2.25, "npi": [1215989611]}, {"billed_charge": 11.575, "npi": [1215989611]}, {"billed_charge": 1.4125, "npi": [1215989611]}, {"billed_charge": 19.3, "npi": [1215989611]}, {"billed_charge": 5.2931, "npi": [1215989611]}, {"billed_charge": 0.145, "npi": [1215989611]}, {"billed_charge": 0.164, "npi": [1215989611]}, {"billed_charge": 13.6625, "npi": [1215989611]}, {"billed_charge": 0.0531, "npi": [1215989611]}, {"billed_charge": 0.15, "npi": [1215989611]}, {"billed_charge": 10.65, "npi": [1215989611]}, {"billed_charge": 1.02, "npi": [1215989611]}, {"billed_charge": 12.05, "npi": [1215989611]}, {"billed_charge": 6.8159, "npi": [1215989611]}, {"billed_charge": 40.575, "npi": [1215989611]}, {"billed_charge": 1.542, "npi": [1215989611]}, {"billed_charge": 1.66, "npi": [1215989611]}, {"billed_charge": 0.436, "npi": [1215989611]}, {"billed_charge": 1.1733, "npi": [1215989611]}, {"billed_charge": 1.3, "npi": [1215989611]}, {"billed_charge": 1.315, "npi": [1215989611]}, {"billed_charge": 24.6833, "npi": [1215989611]}, {"billed_charge": 0.106, "npi": [1215989611]}, {"billed_charge": 643.375, "npi": [1215989611]}, {"billed_charge": 0.0383, "npi": [1215989611]}, {"billed_charge": 0.048, "npi": [1215989611]}, {"billed_charge": 10.05, "npi": [1215989611]}, {"billed_charge": 9.087, "npi": [1215989611]}, {"billed_charge": 0.125, "npi": [1215989611]}, {"billed_charge": 2.4183, "npi": [1215989611]}, {"billed_charge": 5.25, "npi": [1215989611]}, {"billed_charge": 1.8113, "npi": [1215989611]}, {"billed_charge": 0.109, "npi": [1215989611]}, {"billed_charge": 0.1355, "npi": [1215989611]}, {"billed_charge": 19.522, "npi": [1215989611]}, {"billed_charge": 13.05, "npi": [1215989611]}, {"billed_charge": 2.7492, "npi": [1215989611]}, {"billed_charge": 12.7, "npi": [1215989611]}, {"billed_charge": 1.5126, "npi": [1215989611]}, {"billed_charge": 1.9008, "npi": [1215989611]}, {"billed_charge": 19.0, "npi": [1215989611]}, {"billed_charge": 3.9245, "npi": [1215989611]}, {"billed_charge": 4.05, "npi": [1215989611]}, {"billed_charge": 0.4553, "npi": [1215989611]}, {"billed_charge": 2.14, "npi": [1215989611]}, {"billed_charge": 14.0, "npi": [1215989611]}, {"billed_charge": 0.1, "npi": [1215989611]}, {"billed_charge": 4.625, "npi": [1215989611]}]}, {"allowed_amount": 0.41, "billing_code_modifier": ["JZ"], "providers": [{"billed_charge": 14.5, "npi": [1215989611]}, {"billed_charge": 9.5, "npi": [1215989611]}]}, {"allowed_amount": 0.47, "billing_code_modifier": ["JZ"], "providers": [{"billed_charge": 14.5, "npi": [1215989611]}, {"billed_charge": 3.65, "npi": [1215989611]}, {"billed_charge": 9.5, "npi": [1215989611]}]}, {"allowed_amount": 0.46, "billing_code_modifier": ["JZ"], "providers": [{"billed_charge": 14.5, "npi": [1215989611]}, {"billed_charge": 3.65, "npi": [1215989611]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["JZ"], "providers": [{"billed_charge": 23.9, "npi": [1215989611]}]}, {"allowed_amount": 0.4075, "billing_code_modifier": ["JZ"], "providers": [{"billed_charge": 9.5, "npi": [1215989611]}]}, {"allowed_amount": 9.3237, "billing_code_modifier": ["JZ"], "providers": [{"billed_charge": 66.9167, "npi": [1215989611]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["JW"], "providers": [{"billed_charge": 1.542, "npi": [1215989611]}]}, {"allowed_amount": 3.9501, "billing_code_modifier": ["JZ"], "providers": [{"billed_charge": 27.874, "npi": [1215989611]}]}]}]}, {"name": "RADIOLOGIC EXAM CHEST 2 VIEWS", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "71046", "description": "RADIOLOGIC EXAM CHEST 2 VIEWS", "allowed_amounts": [{"tin": {"type": "ein", "value": "310983140"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 10.79, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 47.0, "npi": [1093718496]}]}, {"allowed_amount": 9.84, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 49.0, "npi": [1093718496]}, {"billed_charge": 54.0, "npi": [1093718496]}, {"billed_charge": 47.0, "npi": [1093718496]}]}, {"allowed_amount": 9.81, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 49.0, "npi": [1093718496]}, {"billed_charge": 47.0, "npi": [1093718496]}]}]}]}, {"name": "Physical Therapy - Evaluation or Reevaluation", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0424", "description": "Physical Therapy", "allowed_amounts": [{"tin": {"type": "ein", "value": "340714585"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 97.89, "billing_code_modifier": ["GP"], "providers": [{"billed_charge": 560.0, "npi": [1679525919]}]}, {"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 560.0, "npi": [1679525919]}, {"billed_charge": 605.0, "npi": [1679525919]}]}, {"allowed_amount": 131.4, "billing_code_modifier": ["GP"], "providers": [{"billed_charge": 605.0, "npi": [1679525919]}]}]}]}, {"name": "Laboratory - Chemistry", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0301", "description": "Laboratory", "allowed_amounts": [{"tin": {"type": "ein", "value": "340714461"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 29.2, "billing_code_modifier": [""], "providers": [{"billed_charge": 100.0, "npi": [1225128432]}]}, {"allowed_amount": 39.72, "billing_code_modifier": [""], "providers": [{"billed_charge": 131.0, "npi": [1225128432]}]}, {"allowed_amount": 29.11, "billing_code_modifier": [""], "providers": [{"billed_charge": 96.0, "npi": [1225128432]}]}, {"allowed_amount": 54.89, "billing_code_modifier": [""], "providers": [{"billed_charge": 188.0, "npi": [1225128432]}]}, {"allowed_amount": 57.6, "billing_code_modifier": [""], "providers": [{"billed_charge": 190.0, "npi": [1225128432]}]}, {"allowed_amount": 248.63, "billing_code_modifier": [""], "providers": [{"billed_charge": 820.0, "npi": [1225128432]}]}, {"allowed_amount": 56.7, "billing_code_modifier": [""], "providers": [{"billed_charge": 187.0, "npi": [1225128432]}]}, {"allowed_amount": 66.57, "billing_code_modifier": [""], "providers": [{"billed_charge": 228.0, "npi": [1225128432]}]}, {"allowed_amount": 48.82, "billing_code_modifier": [""], "providers": [{"billed_charge": 161.0, "npi": [1225128432]}]}, {"allowed_amount": 24.25, "billing_code_modifier": [""], "providers": [{"billed_charge": 80.0, "npi": [1225128432]}]}, {"allowed_amount": 66.57, "billing_code_modifier": ["91"], "providers": [{"billed_charge": 228.0, "npi": [1225128432]}]}, {"allowed_amount": 48.76, "billing_code_modifier": [""], "providers": [{"billed_charge": 167.0, "npi": [1225128432]}]}]}]}, {"name": "Laboratory - Bacteriology & Microbiology", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0306", "description": "Laboratory", "allowed_amounts": [{"tin": {"type": "ein", "value": "341105619"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 233.0, "npi": [1811939887]}, {"billed_charge": 327.1429, "npi": [1811939887]}, {"billed_charge": 304.0, "npi": [1811939887]}, {"billed_charge": 386.0, "npi": [1811939887]}, {"billed_charge": 118.0, "npi": [1811939887]}, {"billed_charge": 190.0, "npi": [1811939887]}, {"billed_charge": 244.6667, "npi": [1811939887]}, {"billed_charge": 144.0, "npi": [1811939887]}, {"billed_charge": 319.0, "npi": [1811939887]}, {"billed_charge": 166.0, "npi": [1811939887]}, {"billed_charge": 108.0, "npi": [1811939887]}, {"billed_charge": 164.0, "npi": [1811939887]}, {"billed_charge": 124.0, "npi": [1811939887]}, {"billed_charge": 186.0, "npi": [1811939887]}]}, {"allowed_amount": 199.68, "billing_code_modifier": [""], "providers": [{"billed_charge": 304.0, "npi": [1811939887]}]}]}]}, {"name": "Other Imaging Services - Ultrasound", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0402", "description": "Other Imaging Services", "allowed_amounts": [{"tin": {"type": "ein", "value": "340714585"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 557.4444, "npi": [1679525919]}, {"billed_charge": 734.0, "npi": [1679525919]}, {"billed_charge": 679.0, "npi": [1679525919]}, {"billed_charge": 246.0, "npi": [1679525919]}, {"billed_charge": 2149.0, "npi": [1679525919]}]}, {"allowed_amount": 137.8, "billing_code_modifier": [""], "providers": [{"billed_charge": 734.0, "npi": [1679525919]}]}, {"allowed_amount": 133.08, "billing_code_modifier": [""], "providers": [{"billed_charge": 679.0, "npi": [1679525919]}]}, {"allowed_amount": 314.48, "billing_code_modifier": [""], "providers": [{"billed_charge": 1668.0, "npi": [1679525919]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["RT"], "providers": [{"billed_charge": 734.0, "npi": [1679525919]}]}]}]}, {"name": "Other Diagnostic Services - Peripheral Vascular Lab", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0921", "description": "Other Diagnostic Services", "allowed_amounts": [{"tin": {"type": "ein", "value": "340714585"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 1029.3333, "npi": [1679525919]}, {"billed_charge": 658.0, "npi": [1679525919]}, {"billed_charge": 1000.5, "npi": [1679525919]}, {"billed_charge": 804.0, "npi": [1679525919]}, {"billed_charge": 1261.0, "npi": [1679525919]}, {"billed_charge": 566.0, "npi": [1679525919]}, {"billed_charge": 1087.3333, "npi": [1679525919]}, {"billed_charge": 611.0, "npi": [1679525919]}, {"billed_charge": 1033.0, "npi": [1679525919]}, {"billed_charge": 1325.5, "npi": [1679525919]}, {"billed_charge": 1099.2857, "npi": [1679525919]}, {"billed_charge": 1390.0, "npi": [1679525919]}]}, {"allowed_amount": 302.51, "billing_code_modifier": [""], "providers": [{"billed_charge": 1261.0, "npi": [1679525919]}]}, {"allowed_amount": 137.8, "billing_code_modifier": ["LT"], "providers": [{"billed_charge": 611.0, "npi": [1679525919]}]}]}]}, {"name": "Laboratory - Urology", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0307", "description": "Laboratory", "allowed_amounts": [{"tin": {"type": "ein", "value": "344428218"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 23.895, "npi": [1801884655]}, {"billed_charge": 25.9, "npi": [1801884655]}, {"billed_charge": 38.1, "npi": [1801884655]}, {"billed_charge": 11.8, "npi": [1801884655]}, {"billed_charge": 27.1, "npi": [1801884655]}, {"billed_charge": 36.5, "npi": [1801884655]}, {"billed_charge": 11.29, "npi": [1801884655]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["59"], "providers": [{"billed_charge": 38.1, "npi": [1801884655]}]}]}]}, {"name": "Laboratory - Bacteriology & Microbiology", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0306", "description": "Laboratory", "allowed_amounts": [{"tin": {"type": "ein", "value": "264827222"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 193.0, "npi": [1609189604]}, {"billed_charge": 201.0, "npi": [1609189604]}, {"billed_charge": 113.0, "npi": [1609189604]}, {"billed_charge": 231.0, "npi": [1609189604]}, {"billed_charge": 118.0, "npi": [1609189604]}, {"billed_charge": 105.0, "npi": [1609189604]}, {"billed_charge": 148.0, "npi": [1609189604]}, {"billed_charge": 225.0, "npi": [1609189604]}, {"billed_charge": 162.0, "npi": [1609189604]}, {"billed_charge": 222.0, "npi": [1609189604]}, {"billed_charge": 186.5, "npi": [1609189604]}, {"billed_charge": 168.0, "npi": [1609189604]}, {"billed_charge": 189.0, "npi": [1609189604]}, {"billed_charge": 216.0, "npi": [1609189604]}, {"billed_charge": 46.0, "npi": [1609189604]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["59"], "providers": [{"billed_charge": 193.0, "npi": [1609189604]}, {"billed_charge": 201.0, "npi": [1609189604]}, {"billed_charge": 163.0, "npi": [1609189604]}]}]}]}, {"name": "IV Therapy -General", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0260", "description": "IV Therapy", "allowed_amounts": [{"tin": {"type": "ein", "value": "340714755"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 92.06, "billing_code_modifier": [""], "providers": [{"billed_charge": 1180.75, "npi": [1396765681]}]}, {"allowed_amount": 59.6833, "billing_code_modifier": [""], "providers": [{"billed_charge": 780.25, "npi": [1396765681]}]}, {"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 704.5, "npi": [1396765681]}, {"billed_charge": 910.5, "npi": [1396765681]}, {"billed_charge": 398.75, "npi": [1396765681]}, {"billed_charge": 376.75, "npi": [1396765681]}, {"billed_charge": 735.75, "npi": [1396765681]}, {"billed_charge": 780.25, "npi": [1396765681]}]}, {"allowed_amount": 61.725, "billing_code_modifier": [""], "providers": [{"billed_charge": 910.5, "npi": [1396765681]}, {"billed_charge": 780.25, "npi": [1396765681]}]}, {"allowed_amount": 272.54, "billing_code_modifier": ["59"], "providers": [{"billed_charge": 1471.25, "npi": [1396765681]}, {"billed_charge": 704.5, "npi": [1396765681]}, {"billed_charge": 1318.0, "npi": [1396765681]}]}, {"allowed_amount": 280.35, "billing_code_modifier": [""], "providers": [{"billed_charge": 704.5, "npi": [1396765681]}, {"billed_charge": 1318.0, "npi": [1396765681]}]}, {"allowed_amount": 59.68, "billing_code_modifier": [""], "providers": [{"billed_charge": 910.5, "npi": [1396765681]}, {"billed_charge": 780.25, "npi": [1396765681]}]}, {"allowed_amount": 61.73, "billing_code_modifier": [""], "providers": [{"billed_charge": 910.5, "npi": [1396765681]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["59"], "providers": [{"billed_charge": 1471.25, "npi": [1396765681]}, {"billed_charge": 704.5, "npi": [1396765681]}, {"billed_charge": 910.5, "npi": [1396765681]}, {"billed_charge": 398.75, "npi": [1396765681]}, {"billed_charge": 376.75, "npi": [1396765681]}, {"billed_charge": 735.75, "npi": [1396765681]}]}, {"allowed_amount": 59.68, "billing_code_modifier": ["59"], "providers": [{"billed_charge": 910.5, "npi": [1396765681]}]}, {"allowed_amount": 272.54, "billing_code_modifier": [""], "providers": [{"billed_charge": 704.5, "npi": [1396765681]}]}]}]}, {"name": "Laboratory - Hematology", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0305", "description": "Laboratory", "allowed_amounts": [{"tin": {"type": "ein", "value": "314379491"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 128.0, "npi": [1942256888]}, {"billed_charge": 87.0, "npi": [1942256888]}, {"billed_charge": 85.0, "npi": [1942256888]}, {"billed_charge": 88.0, "npi": [1942256888]}, {"billed_charge": 67.0, "npi": [1942256888]}]}]}]}, {"name": "Pharmacy - General", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0250", "description": "Pharmacy (also see 063x, an extension of 025x)", "allowed_amounts": [{"tin": {"type": "ein", "value": "340714618"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 12.9341, "npi": [1215989611]}, {"billed_charge": 2.95, "npi": [1215989611]}, {"billed_charge": 2.7793, "npi": [1215989611]}, {"billed_charge": 6.5, "npi": [1215989611]}, {"billed_charge": 3.125, "npi": [1215989611]}, {"billed_charge": 7.169, "npi": [1215989611]}, {"billed_charge": 3.075, "npi": [1215989611]}, {"billed_charge": 7.6976, "npi": [1215989611]}, {"billed_charge": 6.2833, "npi": [1215989611]}, {"billed_charge": 2.8267, "npi": [1215989611]}, {"billed_charge": 5.5, "npi": [1215989611]}, {"billed_charge": 4.55, "npi": [1215989611]}, {"billed_charge": 7.75, "npi": [1215989611]}, {"billed_charge": 3.275, "npi": [1215989611]}, {"billed_charge": 3.7333, "npi": [1215989611]}, {"billed_charge": 2.93, "npi": [1215989611]}, {"billed_charge": 5.17, "npi": [1215989611]}, {"billed_charge": 18.6476, "npi": [1215989611]}, {"billed_charge": 10.8175, "npi": [1215989611]}, {"billed_charge": 7.9619, "npi": [1215989611]}, {"billed_charge": 159.825, "npi": [1215989611]}, {"billed_charge": 2.375, "npi": [1215989611]}, {"billed_charge": 6.135, "npi": [1215989611]}, {"billed_charge": 4.2536, "npi": [1215989611]}, {"billed_charge": 44.6, "npi": [1215989611]}, {"billed_charge": 6.7833, "npi": [1215989611]}, {"billed_charge": 3.2136, "npi": [1215989611]}, {"billed_charge": 68.8452, "npi": [1215989611]}, {"billed_charge": 4.7731, "npi": [1215989611]}, {"billed_charge": 5.7333, "npi": [1215989611]}, {"billed_charge": 16.0, "npi": [1215989611]}, {"billed_charge": 2.0, "npi": [1215989611]}, {"billed_charge": 26.5333, "npi": [1215989611]}, {"billed_charge": 2.0063, "npi": [1215989611]}, {"billed_charge": 10.104, "npi": [1215989611]}, {"billed_charge": 46.25, "npi": [1215989611]}, {"billed_charge": 2.9438, "npi": [1215989611]}, {"billed_charge": 5.9206, "npi": [1215989611]}, {"billed_charge": 2.2, "npi": [1215989611]}, {"billed_charge": 5.9167, "npi": [1215989611]}, {"billed_charge": 2.1333, "npi": [1215989611]}, {"billed_charge": 11.9167, "npi": [1215989611]}, {"billed_charge": 2.35, "npi": [1215989611]}, {"billed_charge": 3.3667, "npi": [1215989611]}, {"billed_charge": 2.15, "npi": [1215989611]}, {"billed_charge": 3.5875, "npi": [1215989611]}, {"billed_charge": 5.7466, "npi": [1215989611]}, {"billed_charge": 28.8637, "npi": [1215989611]}, {"billed_charge": 3.4563, "npi": [1215989611]}, {"billed_charge": 7.0, "npi": [1215989611]}, {"billed_charge": 9.6, "npi": [1215989611]}, {"billed_charge": 22.0, "npi": [1215989611]}, {"billed_charge": 5.687, "npi": [1215989611]}]}, {"allowed_amount": 437.5221, "billing_code_modifier": [""], "providers": [{"billed_charge": 2.375, "npi": [1215989611]}]}]}]}, {"name": "CT Scan - Body Scan", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0352", "description": "CT Scan", "allowed_amounts": [{"tin": {"type": "ein", "value": "340714684"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 566.22, "billing_code_modifier": [""], "providers": [{"billed_charge": 1228.0, "npi": [1194763045]}]}, {"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 679.0, "npi": [1194763045]}, {"billed_charge": 2464.0, "npi": [1194763045]}, {"billed_charge": 1228.0, "npi": [1194763045]}, {"billed_charge": 1135.0, "npi": [1194763045]}, {"billed_charge": 2375.0, "npi": [1194763045]}, {"billed_charge": 734.0, "npi": [1194763045]}, {"billed_charge": 1668.0, "npi": [1194763045]}]}, {"allowed_amount": 459.82, "billing_code_modifier": [""], "providers": [{"billed_charge": 2464.0, "npi": [1194763045]}]}, {"allowed_amount": 302.51, "billing_code_modifier": [""], "providers": [{"billed_charge": 1513.0, "npi": [1194763045]}]}, {"allowed_amount": 446.94, "billing_code_modifier": [""], "providers": [{"billed_charge": 2375.0, "npi": [1194763045]}]}]}]}, {"name": "GROUND MILEAGE PER STATUTE MILE", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "A0425", "description": "GROUND MILEAGE PER STATUTE MILE", "allowed_amounts": [{"tin": {"type": "ein", "value": "346401447"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 9.3286, "billing_code_modifier": ["SH"], "providers": [{"billed_charge": 16.0, "npi": [1164598769]}]}, {"allowed_amount": 9.1529, "billing_code_modifier": ["RH"], "providers": [{"billed_charge": 16.0, "npi": [1164598769]}]}, {"allowed_amount": 9.3303, "billing_code_modifier": ["RH"], "providers": [{"billed_charge": 16.0, "npi": [1164598769]}]}, {"allowed_amount": 9.15, "billing_code_modifier": ["RH"], "providers": [{"billed_charge": 16.0, "npi": [1164598769]}]}, {"allowed_amount": 9.1571, "billing_code_modifier": ["HH"], "providers": [{"billed_charge": 16.0, "npi": [1164598769]}]}, {"allowed_amount": 9.15, "billing_code_modifier": ["EH"], "providers": [{"billed_charge": 16.0, "npi": [1164598769]}]}, {"allowed_amount": 9.33, "billing_code_modifier": ["SH"], "providers": [{"billed_charge": 16.0, "npi": [1164598769]}]}, {"allowed_amount": 9.3294, "billing_code_modifier": ["RH"], "providers": [{"billed_charge": 16.0, "npi": [1164598769]}]}, {"allowed_amount": 9.3286, "billing_code_modifier": ["RH"], "providers": [{"billed_charge": 16.0, "npi": [1164598769]}]}, {"allowed_amount": 9.3273, "billing_code_modifier": ["RH"], "providers": [{"billed_charge": 16.0, "npi": [1164598769]}]}, {"allowed_amount": 9.3299, "billing_code_modifier": ["RH"], "providers": [{"billed_charge": 16.0, "npi": [1164598769]}]}, {"allowed_amount": 9.152, "billing_code_modifier": ["EH"], "providers": [{"billed_charge": 16.0, "npi": [1164598769]}]}, {"allowed_amount": 9.1515, "billing_code_modifier": ["SH"], "providers": [{"billed_charge": 16.0, "npi": [1164598769]}]}, {"allowed_amount": 9.3294, "billing_code_modifier": ["SH"], "providers": [{"billed_charge": 16.0, "npi": [1164598769]}]}, {"allowed_amount": 9.15, "billing_code_modifier": ["SH"], "providers": [{"billed_charge": 16.0, "npi": [1164598769]}]}]}]}, {"name": "Radiology - Diagnostic - Chest X-ray", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0324", "description": "Radiology - Diagnostic", "allowed_amounts": [{"tin": {"type": "ein", "value": "340714458"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 608.0, "npi": [1942248737]}, {"billed_charge": 562.0, "npi": [1942248737]}]}, {"allowed_amount": 114.69, "billing_code_modifier": [""], "providers": [{"billed_charge": 608.0, "npi": [1942248737]}]}, {"allowed_amount": 110.2, "billing_code_modifier": [""], "providers": [{"billed_charge": 562.0, "npi": [1942248737]}]}]}]}, {"name": "Laboratory - Hematology", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0305", "description": "Laboratory", "allowed_amounts": [{"tin": {"type": "ein", "value": "341105619"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 274.0, "npi": [1811939887]}, {"billed_charge": 105.0, "npi": [1811939887]}, {"billed_charge": 78.3571, "npi": [1811939887]}, {"billed_charge": 92.0, "npi": [1811939887]}, {"billed_charge": 114.0, "npi": [1811939887]}, {"billed_charge": 45.0, "npi": [1811939887]}, {"billed_charge": 89.375, "npi": [1811939887]}, {"billed_charge": 94.6667, "npi": [1811939887]}, {"billed_charge": 91.5, "npi": [1811939887]}, {"billed_charge": 247.0, "npi": [1811939887]}, {"billed_charge": 162.0, "npi": [1811939887]}, {"billed_charge": 119.6333, "npi": [1811939887]}, {"billed_charge": 89.0, "npi": [1811939887]}, {"billed_charge": 90.3333, "npi": [1811939887]}, {"billed_charge": 111.2353, "npi": [1811939887]}, {"billed_charge": 260.0, "npi": [1811939887]}, {"billed_charge": 85.9355, "npi": [1811939887]}, {"billed_charge": 90.0, "npi": [1811939887]}, {"billed_charge": 120.0, "npi": [1811939887]}, {"billed_charge": 89.5, "npi": [1811939887]}, {"billed_charge": 76.6667, "npi": [1811939887]}, {"billed_charge": 95.0, "npi": [1811939887]}, {"billed_charge": 78.0, "npi": [1811939887]}, {"billed_charge": 97.1538, "npi": [1811939887]}, {"billed_charge": 59.0, "npi": [1811939887]}, {"billed_charge": 176.0, "npi": [1811939887]}, {"billed_charge": 171.3333, "npi": [1811939887]}, {"billed_charge": 288.0, "npi": [1811939887]}, {"billed_charge": 136.8, "npi": [1811939887]}, {"billed_charge": 100.9355, "npi": [1811939887]}, {"billed_charge": 235.0, "npi": [1811939887]}, {"billed_charge": 113.8, "npi": [1811939887]}, {"billed_charge": 85.0, "npi": [1811939887]}, {"billed_charge": 191.4545, "npi": [1811939887]}, {"billed_charge": 88.0833, "npi": [1811939887]}, {"billed_charge": 186.0, "npi": [1811939887]}, {"billed_charge": 122.5714, "npi": [1811939887]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["91"], "providers": [{"billed_charge": 260.0, "npi": [1811939887]}]}]}]}, {"name": "Emergency Room - General", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0450", "description": "Emergency Room", "allowed_amounts": [{"tin": {"type": "ein", "value": "310833936"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 3434.26, "billing_code_modifier": ["25PO"], "providers": [{"billed_charge": 3978.0, "npi": [1548212988]}]}, {"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 1989.0, "npi": [1548212988]}, {"billed_charge": 1873.0, "npi": [1548212988]}, {"billed_charge": 831.6667, "npi": [1548212988]}, {"billed_charge": 737.1429, "npi": [1548212988]}]}, {"allowed_amount": 205.41, "billing_code_modifier": [""], "providers": [{"billed_charge": 598.0, "npi": [1548212988]}]}, {"allowed_amount": 912.6, "billing_code_modifier": ["RT"], "providers": [{"billed_charge": 330.0, "npi": [1548212988]}]}, {"allowed_amount": 566.5, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 2395.0, "npi": [1548212988]}]}, {"allowed_amount": 2542.5, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 1032.0, "npi": [1548212988]}]}, {"allowed_amount": 359.14, "billing_code_modifier": [""], "providers": [{"billed_charge": 1420.0, "npi": [1548212988]}, {"billed_charge": 986.0, "npi": [1548212988]}]}, {"allowed_amount": 63.57, "billing_code_modifier": [""], "providers": [{"billed_charge": 170.0, "npi": [1548212988]}]}, {"allowed_amount": 205.41, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 1032.0, "npi": [1548212988]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["PO"], "providers": [{"billed_charge": 381.0, "npi": [1548212988]}]}, {"allowed_amount": 288.78, "billing_code_modifier": [""], "providers": [{"billed_charge": 502.0, "npi": [1548212988]}, {"billed_charge": 381.0, "npi": [1548212988]}]}, {"allowed_amount": 370.61, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 1420.0, "npi": [1548212988]}, {"billed_charge": 986.0, "npi": [1548212988]}]}]}]}, {"name": "Emergency Room - General", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0450", "description": "Emergency Room", "allowed_amounts": [{"tin": {"type": "ein", "value": "341425870"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 728.86, "billing_code_modifier": [""], "providers": [{"billed_charge": 2796.0, "npi": [1972689172]}]}, {"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 2688.0, "npi": [1972689172]}, {"billed_charge": 1930.5, "npi": [1972689172]}, {"billed_charge": 470.0, "npi": [1972689172]}, {"billed_charge": 486.0, "npi": [1972689172]}, {"billed_charge": 423.0, "npi": [1972689172]}, {"billed_charge": 1732.75, "npi": [1972689172]}, {"billed_charge": 3917.0, "npi": [1972689172]}, {"billed_charge": 2174.0, "npi": [1972689172]}, {"billed_charge": 45.0, "npi": [1972689172]}, {"billed_charge": 2796.0, "npi": [1972689172]}, {"billed_charge": 414.0, "npi": [1972689172]}, {"billed_charge": 225.0, "npi": [1972689172]}, {"billed_charge": 438.0, "npi": [1972689172]}]}, {"allowed_amount": 372.94, "billing_code_modifier": [""], "providers": [{"billed_charge": 621.0, "npi": [1972689172]}]}, {"allowed_amount": 103.21, "billing_code_modifier": [""], "providers": [{"billed_charge": 416.0, "npi": [1972689172]}]}, {"allowed_amount": 738.88, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 2796.0, "npi": [1972689172]}]}, {"allowed_amount": 767.3, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 2688.0, "npi": [1972689172]}]}, {"allowed_amount": 510.68, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 1779.0, "npi": [1972689172]}]}, {"allowed_amount": 513.18, "billing_code_modifier": [""], "providers": [{"billed_charge": 1779.0, "npi": [1972689172]}]}, {"allowed_amount": 510.68, "billing_code_modifier": [""], "providers": [{"billed_charge": 1779.0, "npi": [1972689172]}]}, {"allowed_amount": 346.53, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 1090.0, "npi": [1972689172]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 884.0, "npi": [1972689172]}]}, {"allowed_amount": 198.89, "billing_code_modifier": ["RT"], "providers": [{"billed_charge": 629.0, "npi": [1972689172]}]}, {"allowed_amount": 334.09, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 1134.0, "npi": [1972689172]}]}, {"allowed_amount": 3201.04, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 3917.0, "npi": [1972689172]}, {"billed_charge": 2796.0, "npi": [1972689172]}]}, {"allowed_amount": 728.86, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 2796.0, "npi": [1972689172]}]}, {"allowed_amount": 532.91, "billing_code_modifier": [""], "providers": [{"billed_charge": 1711.0, "npi": [1972689172]}]}, {"allowed_amount": 497.52, "billing_code_modifier": [""], "providers": [{"billed_charge": 686.0, "npi": [1972689172]}, {"billed_charge": 2623.0, "npi": [1972689172]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["59"], "providers": [{"billed_charge": 225.0, "npi": [1972689172]}]}, {"allowed_amount": 110.2, "billing_code_modifier": ["27"], "providers": [{"billed_charge": 400.0, "npi": [1972689172]}]}, {"allowed_amount": 187.92, "billing_code_modifier": [""], "providers": [{"billed_charge": 680.0, "npi": [1972689172]}]}, {"allowed_amount": 532.91, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 1711.0, "npi": [1972689172]}]}, {"allowed_amount": 767.3, "billing_code_modifier": [""], "providers": [{"billed_charge": 2688.0, "npi": [1972689172]}]}, {"allowed_amount": 346.53, "billing_code_modifier": [""], "providers": [{"billed_charge": 1090.0, "npi": [1972689172]}]}, {"allowed_amount": 1010.95, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 3917.0, "npi": [1972689172]}]}, {"allowed_amount": 513.18, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 1779.0, "npi": [1972689172]}]}, {"allowed_amount": 333.7, "billing_code_modifier": [""], "providers": [{"billed_charge": 1134.0, "npi": [1972689172]}]}, {"allowed_amount": 110.2, "billing_code_modifier": [""], "providers": [{"billed_charge": 400.0, "npi": [1972689172]}]}, {"allowed_amount": 334.09, "billing_code_modifier": [""], "providers": [{"billed_charge": 1134.0, "npi": [1972689172]}]}]}]}, {"name": "DIAGNOSTIC COMPUTED TOMOGRAPHY THORAX W/O CNTRST", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "71250", "description": "DIAGNOSTIC COMPUTED TOMOGRAPHY THORAX W/O CNTRST", "allowed_amounts": [{"tin": {"type": "ein", "value": "310745303"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 48.62, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 768.0, "npi": [1669408159]}]}, {"allowed_amount": 24.31, "billing_code_modifier": ["2652"], "providers": [{"billed_charge": 768.0, "npi": [1669408159]}]}, {"allowed_amount": 46.19, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 768.0, "npi": [1669408159]}]}, {"allowed_amount": 48.1, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 768.0, "npi": [1669408159]}, {"billed_charge": 731.0, "npi": [1669408159]}]}]}]}, {"name": "CT Scan - Body Scan", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0352", "description": "CT Scan", "allowed_amounts": [{"tin": {"type": "ein", "value": "314391798"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 322.92, "billing_code_modifier": [""], "providers": [{"billed_charge": 2538.0, "npi": [1346247350]}]}, {"allowed_amount": 288.87, "billing_code_modifier": [""], "providers": [{"billed_charge": 2524.0, "npi": [1346247350]}]}, {"allowed_amount": 142.06, "billing_code_modifier": [""], "providers": [{"billed_charge": 2564.0, "npi": [1346247350]}]}, {"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 2538.0, "npi": [1346247350]}, {"billed_charge": 2644.0, "npi": [1346247350]}, {"billed_charge": 3352.0, "npi": [1346247350]}, {"billed_charge": 3891.0, "npi": [1346247350]}, {"billed_charge": 2564.0, "npi": [1346247350]}, {"billed_charge": 3370.0, "npi": [1346247350]}, {"billed_charge": 2058.0, "npi": [1346247350]}]}, {"allowed_amount": 142.06, "billing_code_modifier": ["RT"], "providers": [{"billed_charge": 2139.0, "npi": [1346247350]}]}, {"allowed_amount": 290.04, "billing_code_modifier": [""], "providers": [{"billed_charge": 2524.0, "npi": [1346247350]}]}, {"allowed_amount": 237.83, "billing_code_modifier": [""], "providers": [{"billed_charge": 3891.0, "npi": [1346247350]}]}, {"allowed_amount": 477.1, "billing_code_modifier": [""], "providers": [{"billed_charge": 3370.0, "npi": [1346247350]}]}, {"allowed_amount": 457.29, "billing_code_modifier": [""], "providers": [{"billed_charge": 3370.0, "npi": [1346247350]}]}, {"allowed_amount": 229.91, "billing_code_modifier": [""], "providers": [{"billed_charge": 3891.0, "npi": [1346247350]}]}]}]}, {"name": "Laboratory - Chemistry", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0301", "description": "Laboratory", "allowed_amounts": [{"tin": {"type": "ein", "value": "310537504"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 137.0, "npi": [1073688354]}, {"billed_charge": 347.0, "npi": [1073688354]}, {"billed_charge": 105.0, "npi": [1073688354]}, {"billed_charge": 130.8837, "npi": [1073688354]}, {"billed_charge": 241.0, "npi": [1073688354]}, {"billed_charge": 108.1667, "npi": [1073688354]}, {"billed_charge": 92.0, "npi": [1073688354]}, {"billed_charge": 106.0, "npi": [1073688354]}, {"billed_charge": 251.0, "npi": [1073688354]}, {"billed_charge": 228.0, "npi": [1073688354]}, {"billed_charge": 261.0, "npi": [1073688354]}, {"billed_charge": 361.0, "npi": [1073688354]}, {"billed_charge": 63.0, "npi": [1073688354]}, {"billed_charge": 271.0, "npi": [1073688354]}, {"billed_charge": 132.0, "npi": [1073688354]}, {"billed_charge": 102.0, "npi": [1073688354]}, {"billed_charge": 145.0, "npi": [1073688354]}, {"billed_charge": 152.0, "npi": [1073688354]}, {"billed_charge": 120.0, "npi": [1073688354]}, {"billed_charge": 57.0, "npi": [1073688354]}, {"billed_charge": 77.0, "npi": [1073688354]}, {"billed_charge": 55.0, "npi": [1073688354]}, {"billed_charge": 146.0, "npi": [1073688354]}, {"billed_charge": 96.0, "npi": [1073688354]}, {"billed_charge": 205.0, "npi": [1073688354]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["91"], "providers": [{"billed_charge": 137.0, "npi": [1073688354]}]}]}]}, {"name": "Pharmacy - General", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0250", "description": "Pharmacy (also see 063x, an extension of 025x)", "allowed_amounts": [{"tin": {"type": "ein", "value": "550357050"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 20.5813, "npi": [1164492195]}, {"billed_charge": 0.9857, "npi": [1164492195]}, {"billed_charge": 3.6, "npi": [1164492195]}, {"billed_charge": 111.4, "npi": [1164492195]}, {"billed_charge": 6.4056, "npi": [1164492195]}, {"billed_charge": 26.175, "npi": [1164492195]}, {"billed_charge": 12.2055, "npi": [1164492195]}, {"billed_charge": 1.1, "npi": [1164492195]}, {"billed_charge": 29.95, "npi": [1164492195]}, {"billed_charge": 87.3, "npi": [1164492195]}, {"billed_charge": 2.3107, "npi": [1164492195]}, {"billed_charge": 56.7917, "npi": [1164492195]}, {"billed_charge": 1.38, "npi": [1164492195]}, {"billed_charge": 2.2231, "npi": [1164492195]}, {"billed_charge": 22.75, "npi": [1164492195]}, {"billed_charge": 10.4929, "npi": [1164492195]}, {"billed_charge": 6.2745, "npi": [1164492195]}, {"billed_charge": 1.45, "npi": [1164492195]}, {"billed_charge": 23.925, "npi": [1164492195]}, {"billed_charge": 10.65, "npi": [1164492195]}, {"billed_charge": 3.4, "npi": [1164492195]}, {"billed_charge": 3.9, "npi": [1164492195]}, {"billed_charge": 13.8667, "npi": [1164492195]}, {"billed_charge": 2.8875, "npi": [1164492195]}, {"billed_charge": 0.5, "npi": [1164492195]}]}]}]}, {"name": "Laboratory - Urology", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0307", "description": "Laboratory", "allowed_amounts": [{"tin": {"type": "ein", "value": "550357050"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 28.5, "npi": [1164492195]}, {"billed_charge": 21.12, "npi": [1164492195]}, {"billed_charge": 78.12, "npi": [1164492195]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["XU"], "providers": [{"billed_charge": 21.12, "npi": [1164492195]}]}]}]}, {"name": "Pharmacy - Drugs Incident to Radiology", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0255", "description": "Pharmacy (also see 063x, an extension of 025x)", "allowed_amounts": [{"tin": {"type": "ein", "value": "340714612"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 0.7877, "npi": [1841299039]}, {"billed_charge": 0.8085, "npi": [1841299039]}, {"billed_charge": 0.9972, "npi": [1841299039]}, {"billed_charge": 0.917, "npi": [1841299039]}, {"billed_charge": 0.656, "npi": [1841299039]}, {"billed_charge": 0.8086, "npi": [1841299039]}, {"billed_charge": 0.8234, "npi": [1841299039]}, {"billed_charge": 46.84, "npi": [1841299039]}, {"billed_charge": 0.55, "npi": [1841299039]}, {"billed_charge": 0.6755, "npi": [1841299039]}, {"billed_charge": 1.0994, "npi": [1841299039]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["JZ"], "providers": [{"billed_charge": 0.9171, "npi": [1841299039]}]}]}]}, {"name": "Laboratory - General", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0300", "description": "Laboratory", "allowed_amounts": [{"tin": {"type": "ein", "value": "340714478"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 53.3333, "npi": [1821035940]}, {"billed_charge": 20.0, "npi": [1821035940]}, {"billed_charge": 80.0, "npi": [1821035940]}, {"billed_charge": 58.0, "npi": [1821035940]}, {"billed_charge": 1055.0, "npi": [1821035940]}, {"billed_charge": 56.8, "npi": [1821035940]}, {"billed_charge": 64.0, "npi": [1821035940]}, {"billed_charge": 63.0, "npi": [1821035940]}]}]}]}, {"name": "Laboratory - Immunology", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0302", "description": "Laboratory", "allowed_amounts": [{"tin": {"type": "ein", "value": "344428256"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 209.0, "npi": [1407854771]}, {"billed_charge": 240.5714, "npi": [1407854771]}, {"billed_charge": 132.0, "npi": [1407854771]}, {"billed_charge": 142.3333, "npi": [1407854771]}, {"billed_charge": 158.25, "npi": [1407854771]}, {"billed_charge": 423.0, "npi": [1407854771]}, {"billed_charge": 135.6667, "npi": [1407854771]}, {"billed_charge": 87.0, "npi": [1407854771]}, {"billed_charge": 79.0, "npi": [1407854771]}, {"billed_charge": 229.0, "npi": [1407854771]}, {"billed_charge": 171.0, "npi": [1407854771]}, {"billed_charge": 15.0, "npi": [1407854771]}, {"billed_charge": 127.0, "npi": [1407854771]}, {"billed_charge": 201.6667, "npi": [1407854771]}, {"billed_charge": 91.0, "npi": [1407854771]}, {"billed_charge": 121.0, "npi": [1407854771]}, {"billed_charge": 72.0, "npi": [1407854771]}, {"billed_charge": 457.0, "npi": [1407854771]}, {"billed_charge": 199.0, "npi": [1407854771]}, {"billed_charge": 210.0, "npi": [1407854771]}, {"billed_charge": 114.0, "npi": [1407854771]}, {"billed_charge": 137.5, "npi": [1407854771]}, {"billed_charge": 444.0, "npi": [1407854771]}, {"billed_charge": 247.0, "npi": [1407854771]}, {"billed_charge": 162.0, "npi": [1407854771]}]}]}]}, {"name": "Pharmacy - General", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0250", "description": "Pharmacy (also see 063x, an extension of 025x)", "allowed_amounts": [{"tin": {"type": "ein", "value": "310537122"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 4.62, "npi": [1396714663]}, {"billed_charge": 7.6462, "npi": [1396714663]}, {"billed_charge": 2.49, "npi": [1396714663]}, {"billed_charge": 0.3, "npi": [1396714663]}, {"billed_charge": 3.43, "npi": [1396714663]}, {"billed_charge": 21.2, "npi": [1396714663]}, {"billed_charge": 5.23, "npi": [1396714663]}, {"billed_charge": 23.25, "npi": [1396714663]}, {"billed_charge": 33.8, "npi": [1396714663]}, {"billed_charge": 1.81, "npi": [1396714663]}, {"billed_charge": 3.9, "npi": [1396714663]}, {"billed_charge": 7.6, "npi": [1396714663]}, {"billed_charge": 2.34, "npi": [1396714663]}, {"billed_charge": 69.34, "npi": [1396714663]}, {"billed_charge": 3.13, "npi": [1396714663]}, {"billed_charge": 3.1555, "npi": [1396714663]}, {"billed_charge": 3.93, "npi": [1396714663]}, {"billed_charge": 2.0, "npi": [1396714663]}, {"billed_charge": 13.42, "npi": [1396714663]}]}]}]}, {"name": "Treatment or Observation Room - Treatment Room", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0761", "description": "Specialty Services", "allowed_amounts": [{"tin": {"type": "ein", "value": "340714585"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 413.23, "billing_code_modifier": ["RT"], "providers": [{"billed_charge": 1358.0, "npi": [1679525919]}]}, {"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 4313.0, "npi": [1679525919]}, {"billed_charge": 3555.0, "npi": [1679525919]}, {"billed_charge": 4043.55, "npi": [1679525919]}, {"billed_charge": 626.25, "npi": [1679525919]}, {"billed_charge": 1009.0, "npi": [1679525919]}, {"billed_charge": 8253.5, "npi": [1679525919]}, {"billed_charge": 4810.0, "npi": [1679525919]}, {"billed_charge": 8241.0, "npi": [1679525919]}, {"billed_charge": 6432.7778, "npi": [1679525919]}, {"billed_charge": 9175.75, "npi": [1679525919]}, {"billed_charge": 222.0, "npi": [1679525919]}, {"billed_charge": 8932.0, "npi": [1679525919]}, {"billed_charge": 8201.6667, "npi": [1679525919]}, {"billed_charge": 273.0, "npi": [1679525919]}, {"billed_charge": 256.0, "npi": [1679525919]}]}, {"allowed_amount": 413.23, "billing_code_modifier": ["LT"], "providers": [{"billed_charge": 1358.0, "npi": [1679525919]}]}, {"allowed_amount": 391.32, "billing_code_modifier": ["RT"], "providers": [{"billed_charge": 1220.0, "npi": [1679525919]}]}]}]}, {"name": "Pharmacy - General", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0250", "description": "Pharmacy (also see 063x, an extension of 025x)", "allowed_amounts": [{"tin": {"type": "ein", "value": "314379509"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 9.09, "npi": [1215936927]}, {"billed_charge": 42.73, "npi": [1215936927]}, {"billed_charge": 2.835, "npi": [1215936927]}, {"billed_charge": 6.13, "npi": [1215936927]}, {"billed_charge": 21.41, "npi": [1215936927]}, {"billed_charge": 11.89, "npi": [1215936927]}, {"billed_charge": 2.32, "npi": [1215936927]}, {"billed_charge": 16.75, "npi": [1215936927]}, {"billed_charge": 3.645, "npi": [1215936927]}, {"billed_charge": 5.0, "npi": [1215936927]}, {"billed_charge": 6.84, "npi": [1215936927]}, {"billed_charge": 7.55, "npi": [1215936927]}, {"billed_charge": 7.22, "npi": [1215936927]}, {"billed_charge": 5.4, "npi": [1215936927]}, {"billed_charge": 2.97, "npi": [1215936927]}, {"billed_charge": 10.585, "npi": [1215936927]}]}, {"allowed_amount": 5415.17, "billing_code_modifier": [""], "providers": [{"billed_charge": 11.89, "npi": [1215936927]}]}, {"allowed_amount": 4376.87, "billing_code_modifier": [""], "providers": [{"billed_charge": 2.32, "npi": [1215936927]}]}]}]}, {"name": "Laboratory - Urology", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0307", "description": "Laboratory", "allowed_amounts": [{"tin": {"type": "ein", "value": "340714755"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 33.0, "npi": [1396765681]}, {"billed_charge": 135.75, "npi": [1396765681]}, {"billed_charge": 86.0, "npi": [1396765681]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["59"], "providers": [{"billed_charge": 33.0, "npi": [1396765681]}]}]}]}, {"name": "Laboratory - Urology", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0307", "description": "Laboratory", "allowed_amounts": [{"tin": {"type": "ein", "value": "340714684"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 59.0, "npi": [1194763045]}, {"billed_charge": 21.0, "npi": [1194763045]}, {"billed_charge": 56.0, "npi": [1194763045]}, {"billed_charge": 22.0, "npi": [1194763045]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["59"], "providers": [{"billed_charge": 21.0, "npi": [1194763045]}, {"billed_charge": 22.0, "npi": [1194763045]}]}]}]}, {"name": "Anesthesia - General", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0370", "description": "Anesthesia", "allowed_amounts": [{"tin": {"type": "ein", "value": "340714593"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 382.0, "npi": [1902858152]}, {"billed_charge": 413.0, "npi": [1902858152]}, {"billed_charge": 442.6364, "npi": [1902858152]}, {"billed_charge": 314.0, "npi": [1902858152]}, {"billed_charge": 456.0, "npi": [1902858152]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["59"], "providers": [{"billed_charge": 584.0, "npi": [1902858152]}, {"billed_charge": 276.0, "npi": [1902858152]}]}]}]}, {"name": "RADIOLOGIC EXAM CHEST SINGLE VIEW", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "71045", "description": "RADIOLOGIC EXAM CHEST SINGLE VIEW", "allowed_amounts": [{"tin": {"type": "ein", "value": "310745303"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 8.22, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 176.0, "npi": [1669408159]}, {"billed_charge": 202.0, "npi": [1669408159]}]}, {"allowed_amount": 8.22, "billing_code_modifier": ["2676"], "providers": [{"billed_charge": 202.0, "npi": [1669408159]}]}, {"allowed_amount": 8.22, "billing_code_modifier": ["2677"], "providers": [{"billed_charge": 176.0, "npi": [1669408159]}, {"billed_charge": 202.0, "npi": [1669408159]}]}]}]}, {"name": "Laboratory - Chemistry", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0301", "description": "Laboratory", "allowed_amounts": [{"tin": {"type": "ein", "value": "344430849"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 223.0, "npi": [1851338149]}, {"billed_charge": 46.0, "npi": [1851338149]}, {"billed_charge": 234.0, "npi": [1851338149]}, {"billed_charge": 98.0, "npi": [1851338149]}, {"billed_charge": 109.9375, "npi": [1851338149]}, {"billed_charge": 44.0, "npi": [1851338149]}, {"billed_charge": 118.0, "npi": [1851338149]}, {"billed_charge": 156.0, "npi": [1851338149]}, {"billed_charge": 98.6, "npi": [1851338149]}, {"billed_charge": 63.0, "npi": [1851338149]}, {"billed_charge": 124.0, "npi": [1851338149]}, {"billed_charge": 167.0, "npi": [1851338149]}, {"billed_charge": 283.0, "npi": [1851338149]}, {"billed_charge": 222.0, "npi": [1851338149]}, {"billed_charge": 112.0, "npi": [1851338149]}, {"billed_charge": 69.0, "npi": [1851338149]}, {"billed_charge": 85.0, "npi": [1851338149]}, {"billed_charge": 103.0, "npi": [1851338149]}, {"billed_charge": 66.0, "npi": [1851338149]}, {"billed_charge": 159.0, "npi": [1851338149]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["59"], "providers": [{"billed_charge": 30.0, "npi": [1851338149]}]}]}]}, {"name": "Laboratory - Chemistry", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0301", "description": "Laboratory", "allowed_amounts": [{"tin": {"type": "ein", "value": "314394942"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 6.29, "billing_code_modifier": ["XU"], "providers": [{"billed_charge": 9.0, "npi": [1255377149]}]}, {"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 115.0, "npi": [1255377149]}, {"billed_charge": 102.0, "npi": [1467484972]}, {"billed_charge": 55.0, "npi": [1467484972]}, {"billed_charge": 56.0, "npi": [1467484972]}, {"billed_charge": 62.5484, "npi": [1255377149]}, {"billed_charge": 123.0, "npi": [1255377149]}, {"billed_charge": 74.0, "npi": [1467484972]}, {"billed_charge": 92.0, "npi": [1255377149]}, {"billed_charge": 9.0, "npi": [1467484972]}, {"billed_charge": 67.0, "npi": [1255377149]}, {"billed_charge": 92.0, "npi": [1467484972]}, {"billed_charge": 32.0, "npi": [1255377149]}, {"billed_charge": 71.2308, "npi": [1255377149]}, {"billed_charge": 70.0, "npi": [1255377149]}, {"billed_charge": 28.0, "npi": [1255377149]}, {"billed_charge": 225.0, "npi": [1255377149]}, {"billed_charge": 37.0, "npi": [1255377149]}, {"billed_charge": 46.0, "npi": [1255377149]}, {"billed_charge": 84.1667, "npi": [1255377149]}, {"billed_charge": 62.0, "npi": [1255377149]}, {"billed_charge": 83.0, "npi": [1255377149]}, {"billed_charge": 71.0, "npi": [1467484972]}, {"billed_charge": 56.0, "npi": [1255377149]}, {"billed_charge": 79.0, "npi": [1255377149]}, {"billed_charge": 51.0, "npi": [1255377149]}, {"billed_charge": 67.6129, "npi": [1467484972]}, {"billed_charge": 123.0, "npi": [1467484972]}, {"billed_charge": 69.0, "npi": [1255377149]}, {"billed_charge": 55.6, "npi": [1467484972]}, {"billed_charge": 63.0, "npi": [1255377149]}, {"billed_charge": 74.0, "npi": [1255377149]}, {"billed_charge": 49.8125, "npi": [1255377149]}, {"billed_charge": 46.0, "npi": [1467484972]}, {"billed_charge": 269.0, "npi": [1467484972]}, {"billed_charge": 43.6, "npi": [1255377149]}, {"billed_charge": 10.0, "npi": [1255377149]}, {"billed_charge": 65.0909, "npi": [1467484972]}, {"billed_charge": 70.0, "npi": [1467484972]}, {"billed_charge": 121.4, "npi": [1467484972]}, {"billed_charge": 46.75, "npi": [1255377149]}, {"billed_charge": 225.0, "npi": [1467484972]}, {"billed_charge": 71.0, "npi": [1255377149]}, {"billed_charge": 111.0, "npi": [1255377149]}, {"billed_charge": 75.3913, "npi": [1467484972]}, {"billed_charge": 9.0, "npi": [1255377149]}, {"billed_charge": 61.6154, "npi": [1255377149]}, {"billed_charge": 65.0, "npi": [1255377149]}, {"billed_charge": 59.0, "npi": [1255377149]}, {"billed_charge": 89.1154, "npi": [1467484972]}, {"billed_charge": 47.0, "npi": [1255377149]}, {"billed_charge": 32.0, "npi": [1467484972]}, {"billed_charge": 55.0, "npi": [1255377149]}]}, {"allowed_amount": 6.29, "billing_code_modifier": [""], "providers": [{"billed_charge": 9.0, "npi": [1255377149]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["XU"], "providers": [{"billed_charge": 9.0, "npi": [1255377149]}]}, {"allowed_amount": 5.5, "billing_code_modifier": [""], "providers": [{"billed_charge": 9.0, "npi": [1467484972]}, {"billed_charge": 9.0, "npi": [1255377149]}]}, {"allowed_amount": 5.5, "billing_code_modifier": ["XU"], "providers": [{"billed_charge": 9.0, "npi": [1255377149]}]}, {"allowed_amount": 21.42, "billing_code_modifier": [""], "providers": [{"billed_charge": 61.0, "npi": [1467484972]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["59"], "providers": [{"billed_charge": 9.0, "npi": [1255377149]}]}, {"allowed_amount": 5.5, "billing_code_modifier": ["59"], "providers": [{"billed_charge": 9.0, "npi": [1255377149]}]}]}]}, {"name": "IV Therapy -General", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0260", "description": "IV Therapy", "allowed_amounts": [{"tin": {"type": "ein", "value": "341105619"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 60.6478, "billing_code_modifier": [""], "providers": [{"billed_charge": 284.0, "npi": [1811939887]}]}, {"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 206.75, "npi": [1811939887]}, {"billed_charge": 296.6216, "npi": [1811939887]}, {"billed_charge": 296.4545, "npi": [1811939887]}, {"billed_charge": 388.5, "npi": [1811939887]}, {"billed_charge": 167.0, "npi": [1811939887]}, {"billed_charge": 175.0, "npi": [1811939887]}, {"billed_charge": 298.0, "npi": [1811939887]}, {"billed_charge": 227.0, "npi": [1811939887]}, {"billed_charge": 201.0, "npi": [1811939887]}, {"billed_charge": 216.0, "npi": [1811939887]}, {"billed_charge": 133.0, "npi": [1811939887]}, {"billed_charge": 244.0, "npi": [1811939887]}, {"billed_charge": 284.0, "npi": [1811939887]}, {"billed_charge": 753.0, "npi": [1811939887]}, {"billed_charge": 232.0, "npi": [1811939887]}, {"billed_charge": 226.85, "npi": [1811939887]}, {"billed_charge": 179.25, "npi": [1811939887]}, {"billed_charge": 250.0, "npi": [1811939887]}, {"billed_charge": 277.75, "npi": [1811939887]}, {"billed_charge": 238.0, "npi": [1811939887]}, {"billed_charge": 309.6, "npi": [1811939887]}, {"billed_charge": 140.0, "npi": [1811939887]}, {"billed_charge": 641.0, "npi": [1811939887]}]}, {"allowed_amount": 64.68, "billing_code_modifier": ["XU"], "providers": [{"billed_charge": 175.0, "npi": [1811939887]}]}, {"allowed_amount": 60.65, "billing_code_modifier": [""], "providers": [{"billed_charge": 167.0, "npi": [1811939887]}, {"billed_charge": 175.0, "npi": [1811939887]}, {"billed_charge": 244.0, "npi": [1811939887]}, {"billed_charge": 232.0, "npi": [1811939887]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["XU"], "providers": [{"billed_charge": 167.0, "npi": [1811939887]}, {"billed_charge": 175.0, "npi": [1811939887]}, {"billed_charge": 227.0, "npi": [1811939887]}, {"billed_charge": 610.0, "npi": [1811939887]}, {"billed_charge": 216.0, "npi": [1811939887]}, {"billed_charge": 133.0, "npi": [1811939887]}, {"billed_charge": 238.0, "npi": [1811939887]}, {"billed_charge": 792.0, "npi": [1811939887]}, {"billed_charge": 140.0, "npi": [1811939887]}, {"billed_charge": 641.0, "npi": [1811939887]}]}, {"allowed_amount": 276.96, "billing_code_modifier": [""], "providers": [{"billed_charge": 610.0, "npi": [1811939887]}, {"billed_charge": 227.0, "npi": [1811939887]}, {"billed_charge": 216.0, "npi": [1811939887]}, {"billed_charge": 792.0, "npi": [1811939887]}]}, {"allowed_amount": 207.72, "billing_code_modifier": [""], "providers": [{"billed_charge": 216.0, "npi": [1811939887]}]}, {"allowed_amount": 64.68, "billing_code_modifier": [""], "providers": [{"billed_charge": 175.0, "npi": [1811939887]}, {"billed_charge": 298.0, "npi": [1811939887]}, {"billed_charge": 244.0, "npi": [1811939887]}]}, {"allowed_amount": 293.79, "billing_code_modifier": [""], "providers": [{"billed_charge": 227.0, "npi": [1811939887]}, {"billed_charge": 641.0, "npi": [1811939887]}]}, {"allowed_amount": 293.79, "billing_code_modifier": ["XU"], "providers": [{"billed_charge": 227.0, "npi": [1811939887]}, {"billed_charge": 641.0, "npi": [1811939887]}]}, {"allowed_amount": 46.78, "billing_code_modifier": [""], "providers": [{"billed_charge": 133.0, "npi": [1811939887]}]}, {"allowed_amount": 276.96, "billing_code_modifier": ["XU"], "providers": [{"billed_charge": 216.0, "npi": [1811939887]}]}, {"allowed_amount": 60.65, "billing_code_modifier": ["XU"], "providers": [{"billed_charge": 167.0, "npi": [1811939887]}]}]}]}, {"name": "Emergency Room - General", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0450", "description": "Emergency Room", "allowed_amounts": [{"tin": {"type": "ein", "value": "344440884"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 550.83, "billing_code_modifier": [""], "providers": [{"billed_charge": 1096.5, "npi": [1790751253]}]}, {"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 432.0, "npi": [1790751253]}, {"billed_charge": 126.5, "npi": [1790751253]}]}, {"allowed_amount": 359.79, "billing_code_modifier": [""], "providers": [{"billed_charge": 601.75, "npi": [1790751253]}]}, {"allowed_amount": 358.18, "billing_code_modifier": [""], "providers": [{"billed_charge": 601.75, "npi": [1790751253]}]}, {"allowed_amount": 59.68, "billing_code_modifier": [""], "providers": [{"billed_charge": 81.5, "npi": [1790751253]}, {"billed_charge": 162.25, "npi": [1790751253]}]}, {"allowed_amount": 280.35, "billing_code_modifier": [""], "providers": [{"billed_charge": 418.25, "npi": [1790751253]}]}, {"allowed_amount": 359.79, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 601.75, "npi": [1790751253]}]}, {"allowed_amount": 61.73, "billing_code_modifier": [""], "providers": [{"billed_charge": 81.5, "npi": [1790751253]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["59"], "providers": [{"billed_charge": 126.5, "npi": [1790751253]}]}, {"allowed_amount": 784.92, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 1657.5, "npi": [1790751253]}]}, {"allowed_amount": 793.09, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 1657.5, "npi": [1790751253]}]}, {"allowed_amount": 549.96, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 1096.5, "npi": [1790751253]}]}, {"allowed_amount": 549.96, "billing_code_modifier": [""], "providers": [{"billed_charge": 1096.5, "npi": [1790751253]}]}, {"allowed_amount": 272.54, "billing_code_modifier": [""], "providers": [{"billed_charge": 418.25, "npi": [1790751253]}]}]}]}, {"name": "CT ANGIOGRAPHY CHEST W/CONTRAST/NONCONTRAST", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "71275", "description": "CT ANGIOGRAPHY CHEST W/CONTRAST/NONCONTRAST", "allowed_amounts": [{"tin": {"type": "ein", "value": "310983140"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 81.37, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 377.0, "npi": [1093718496]}, {"billed_charge": 396.0, "npi": [1093718496]}]}, {"allowed_amount": 77.3, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 396.0, "npi": [1093718496]}]}, {"allowed_amount": 82.14, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 377.0, "npi": [1093718496]}, {"billed_charge": 396.0, "npi": [1093718496]}, {"billed_charge": 436.0, "npi": [1093718496]}]}]}]}, {"name": "Cardiology - Echocardiology", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0483", "description": "Cardiology", "allowed_amounts": [{"tin": {"type": "ein", "value": "340714585"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 934.6667, "npi": [1679525919]}, {"billed_charge": 1856.0, "npi": [1679525919]}, {"billed_charge": 1413.0, "npi": [1679525919]}, {"billed_charge": 1410.75, "npi": [1679525919]}, {"billed_charge": 1498.1667, "npi": [1679525919]}, {"billed_charge": 556.0, "npi": [1679525919]}, {"billed_charge": 1261.0, "npi": [1679525919]}, {"billed_charge": 2839.0, "npi": [1679525919]}, {"billed_charge": 1018.6667, "npi": [1679525919]}, {"billed_charge": 987.0, "npi": [1679525919]}, {"billed_charge": 2603.0, "npi": [1679525919]}, {"billed_charge": 1993.0, "npi": [1679525919]}, {"billed_charge": 1552.25, "npi": [1679525919]}]}, {"allowed_amount": 302.51, "billing_code_modifier": [""], "providers": [{"billed_charge": 1261.0, "npi": [1679525919]}]}]}]}, {"name": "Laboratory - Chemistry", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0301", "description": "Laboratory", "allowed_amounts": [{"tin": {"type": "ein", "value": "311070877"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 65.0, "npi": [1215935366]}, {"billed_charge": 48.0, "npi": [1215935366]}, {"billed_charge": 94.0, "npi": [1215935366]}, {"billed_charge": 86.0, "npi": [1215935366]}, {"billed_charge": 335.0, "npi": [1215935366]}, {"billed_charge": 114.0, "npi": [1215935366]}, {"billed_charge": 76.0, "npi": [1215935366]}, {"billed_charge": 200.0, "npi": [1215935366]}, {"billed_charge": 38.0, "npi": [1215935366]}, {"billed_charge": 30.0, "npi": [1215935366]}, {"billed_charge": 63.0, "npi": [1215935366]}, {"billed_charge": 70.0, "npi": [1215935366]}, {"billed_charge": 75.9444, "npi": [1215935366]}, {"billed_charge": 97.0, "npi": [1215935366]}, {"billed_charge": 108.0, "npi": [1215935366]}, {"billed_charge": 243.0, "npi": [1215935366]}, {"billed_charge": 56.0, "npi": [1215935366]}, {"billed_charge": 71.0, "npi": [1215935366]}]}]}]}, {"name": "CT Scan - Body Scan", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0352", "description": "CT Scan", "allowed_amounts": [{"tin": {"type": "ein", "value": "340714456"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 430.92, "billing_code_modifier": [""], "providers": [{"billed_charge": 4347.0, "npi": [1790837235]}, {"billed_charge": 5249.0, "npi": [1790837235]}]}, {"allowed_amount": 216.66, "billing_code_modifier": [""], "providers": [{"billed_charge": 3332.0, "npi": [1790837235]}]}, {"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 3256.0, "npi": [1790837235]}, {"billed_charge": 4347.0, "npi": [1790837235]}, {"billed_charge": 5249.0, "npi": [1790837235]}, {"billed_charge": 2470.0, "npi": [1790837235]}, {"billed_charge": 2518.0, "npi": [1790837235]}, {"billed_charge": 1823.0, "npi": [1790837235]}, {"billed_charge": 3300.5, "npi": [1790837235]}, {"billed_charge": 3644.5, "npi": [1790837235]}, {"billed_charge": 3399.0, "npi": [1790837235]}, {"billed_charge": 2899.75, "npi": [1790837235]}, {"billed_charge": 3332.0, "npi": [1790837235]}, {"billed_charge": 2982.0, "npi": [1790837235]}]}, {"allowed_amount": 459.42, "billing_code_modifier": [""], "providers": [{"billed_charge": 3890.0, "npi": [1790837235]}]}, {"allowed_amount": 273.33, "billing_code_modifier": [""], "providers": [{"billed_charge": 2470.0, "npi": [1790837235]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["RT"], "providers": [{"billed_charge": 1823.0, "npi": [1790837235]}]}]}]}, {"name": "SCREENING DIGITAL BREAST TOMOSYNTHESIS BI", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "77063", "description": "SCREENING DIGITAL BREAST TOMOSYNTHESIS BI", "allowed_amounts": [{"tin": {"type": "ein", "value": "310745303"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 13.45, "billing_code_modifier": ["2652"], "providers": [{"billed_charge": 75.0, "npi": [1669408159]}]}, {"allowed_amount": 26.89, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 75.0, "npi": [1669408159]}]}, {"allowed_amount": 27.26, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 75.0, "npi": [1669408159]}]}]}]}, {"name": "Pharmacy - Extension of 25X - Drug Requiring Detailed Coding", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0636", "description": "Pharmacy - Extension of 25x", "allowed_amounts": [{"tin": {"type": "ein", "value": "340714593"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 5.5, "npi": [1598719346]}, {"billed_charge": 0.86, "npi": [1598719346]}, {"billed_charge": 0.0531, "npi": [1235183542]}, {"billed_charge": 1.66, "npi": [1598719346]}, {"billed_charge": 24.6833, "npi": [1902858152]}, {"billed_charge": 5.35, "npi": [1598719346]}, {"billed_charge": 1.06, "npi": [1598719346]}, {"billed_charge": 0.2, "npi": [1235183542]}, {"billed_charge": 0.371, "npi": [1235183542]}, {"billed_charge": 5.5, "npi": [1902858152]}, {"billed_charge": 1.73, "npi": [1902858152]}, {"billed_charge": 2.15, "npi": [1598719346]}, {"billed_charge": 15.15, "npi": [1902858152]}, {"billed_charge": 19.3, "npi": [1598719346]}, {"billed_charge": 39.3, "npi": [1235183542]}, {"billed_charge": 0.1, "npi": [1902858152]}, {"billed_charge": 2.1223, "npi": [1598719346]}, {"billed_charge": 0.0531, "npi": [1902858152]}, {"billed_charge": 1.2192, "npi": [1902858152]}, {"billed_charge": 1.425, "npi": [1598719346]}, {"billed_charge": 19.0, "npi": [1902858152]}, {"billed_charge": 3.48, "npi": [1598719346]}, {"billed_charge": 15.15, "npi": [1235183542]}, {"billed_charge": 13.65, "npi": [1235183542]}, {"billed_charge": 0.125, "npi": [1598719346]}, {"billed_charge": 5.25, "npi": [1598719346]}, {"billed_charge": 0.1907, "npi": [1902858152]}, {"billed_charge": 13.0375, "npi": [1598719346]}, {"billed_charge": 63.1, "npi": [1598719346]}, {"billed_charge": 1.57, "npi": [1235183542]}, {"billed_charge": 176.8, "npi": [1902858152]}, {"billed_charge": 170.05, "npi": [1235183542]}, {"billed_charge": 105.05, "npi": [1902858152]}, {"billed_charge": 1.3923, "npi": [1235183542]}, {"billed_charge": 7.9103, "npi": [1235183542]}, {"billed_charge": 0.7867, "npi": [1235183542]}, {"billed_charge": 1.14, "npi": [1902858152]}, {"billed_charge": 0.4825, "npi": [1902858152]}, {"billed_charge": 37.0, "npi": [1902858152]}, {"billed_charge": 2.2, "npi": [1235183542]}, {"billed_charge": 40.5, "npi": [1598719346]}, {"billed_charge": 11.575, "npi": [1598719346]}, {"billed_charge": 1.02, "npi": [1235183542]}, {"billed_charge": 14.0, "npi": [1235183542]}, {"billed_charge": 6.35, "npi": [1598719346]}, {"billed_charge": 6.7149, "npi": [1902858152]}, {"billed_charge": 1.8903, "npi": [1902858152]}, {"billed_charge": 1.73, "npi": [1235183542]}, {"billed_charge": 0.982, "npi": [1598719346]}, {"billed_charge": 1.3, "npi": [1598719346]}, {"billed_charge": 40.575, "npi": [1598719346]}, {"billed_charge": 8.575, "npi": [1902858152]}, {"billed_charge": 5.9281, "npi": [1598719346]}, {"billed_charge": 3.0041, "npi": [1598719346]}, {"billed_charge": 17.55, "npi": [1902858152]}, {"billed_charge": 25.7, "npi": [1902858152]}, {"billed_charge": 0.062, "npi": [1235183542]}, {"billed_charge": 11.575, "npi": [1902858152]}, {"billed_charge": 1.44, "npi": [1598719346]}, {"billed_charge": 176.8, "npi": [1235183542]}, {"billed_charge": 11.9833, "npi": [1235183542]}, {"billed_charge": 62.35, "npi": [1598719346]}, {"billed_charge": 3.5635, "npi": [1902858152]}, {"billed_charge": 3.29, "npi": [1902858152]}, {"billed_charge": 0.982, "npi": [1235183542]}, {"billed_charge": 2.8, "npi": [1902858152]}, {"billed_charge": 1.57, "npi": [1598719346]}, {"billed_charge": 62.35, "npi": [1235183542]}, {"billed_charge": 13.475, "npi": [1235183542]}, {"billed_charge": 3.225, "npi": [1235183542]}, {"billed_charge": 1.3355, "npi": [1235183542]}, {"billed_charge": 3.0839, "npi": [1235183542]}, {"billed_charge": 1.27, "npi": [1235183542]}, {"billed_charge": 2.0, "npi": [1598719346]}, {"billed_charge": 19.3, "npi": [1235183542]}, {"billed_charge": 11.575, "npi": [1235183542]}, {"billed_charge": 0.7867, "npi": [1598719346]}, {"billed_charge": 1.252, "npi": [1902858152]}, {"billed_charge": 4.05, "npi": [1902858152]}, {"billed_charge": 170.05, "npi": [1598719346]}, {"billed_charge": 0.1, "npi": [1235183542]}, {"billed_charge": 39.3, "npi": [1598719346]}, {"billed_charge": 22.0, "npi": [1598719346]}, {"billed_charge": 1.0625, "npi": [1235183542]}, {"billed_charge": 0.1, "npi": [1598719346]}, {"billed_charge": 13.4667, "npi": [1598719346]}, {"billed_charge": 0.0531, "npi": [1598719346]}, {"billed_charge": 0.95, "npi": [1598719346]}, {"billed_charge": 3.48, "npi": [1902858152]}, {"billed_charge": 4.0, "npi": [1902858152]}, {"billed_charge": 3.02, "npi": [1235183542]}, {"billed_charge": 5.25, "npi": [1902858152]}, {"billed_charge": 0.86, "npi": [1235183542]}, {"billed_charge": 0.9938, "npi": [1902858152]}, {"billed_charge": 0.5965, "npi": [1902858152]}, {"billed_charge": 13.4667, "npi": [1235183542]}, {"billed_charge": 0.4, "npi": [1902858152]}, {"billed_charge": 12.05, "npi": [1235183542]}, {"billed_charge": 5.5, "npi": [1235183542]}, {"billed_charge": 1.1733, "npi": [1598719346]}, {"billed_charge": 35.85, "npi": [1902858152]}, {"billed_charge": 0.066, "npi": [1235183542]}, {"billed_charge": 16.0, "npi": [1598719346]}, {"billed_charge": 1.7516, "npi": [1902858152]}, {"billed_charge": 2.2, "npi": [1902858152]}, {"billed_charge": 10.65, "npi": [1235183542]}, {"billed_charge": 0.1355, "npi": [1235183542]}, {"billed_charge": 12.65, "npi": [1598719346]}, {"billed_charge": 0.29, "npi": [1598719346]}, {"billed_charge": 12.65, "npi": [1902858152]}, {"billed_charge": 4.3683, "npi": [1902858152]}, {"billed_charge": 7.4319, "npi": [1598719346]}, {"billed_charge": 24.6833, "npi": [1598719346]}, {"billed_charge": 1.3, "npi": [1902858152]}, {"billed_charge": 0.5953, "npi": [1598719346]}, {"billed_charge": 1.2896, "npi": [1902858152]}, {"billed_charge": 35.85, "npi": [1235183542]}, {"billed_charge": 1.13, "npi": [1902858152]}, {"billed_charge": 28.9, "npi": [1902858152]}, {"billed_charge": 0.85, "npi": [1235183542]}, {"billed_charge": 0.1925, "npi": [1902858152]}, {"billed_charge": 0.5, "npi": [1235183542]}, {"billed_charge": 8.575, "npi": [1235183542]}, {"billed_charge": 0.04, "npi": [1235183542]}, {"billed_charge": 13.65, "npi": [1598719346]}, {"billed_charge": 157.9125, "npi": [1235183542]}, {"billed_charge": 1.44, "npi": [1902858152]}, {"billed_charge": 2.06, "npi": [1598719346]}, {"billed_charge": 1.66, "npi": [1235183542]}, {"billed_charge": 17.4, "npi": [1598719346]}, {"billed_charge": 14.0, "npi": [1598719346]}, {"billed_charge": 1.45, "npi": [1598719346]}, {"billed_charge": 1.5194, "npi": [1235183542]}, {"billed_charge": 62.35, "npi": [1902858152]}, {"billed_charge": 2.25, "npi": [1235183542]}, {"billed_charge": 1.0, "npi": [1902858152]}, {"billed_charge": 24.6833, "npi": [1235183542]}, {"billed_charge": 2.8578, "npi": [1235183542]}, {"billed_charge": 1.625, "npi": [1235183542]}, {"billed_charge": 19.3, "npi": [1902858152]}, {"billed_charge": 0.925, "npi": [1598719346]}, {"billed_charge": 1.4125, "npi": [1902858152]}, {"billed_charge": 3.48, "npi": [1235183542]}, {"billed_charge": 12.05, "npi": [1902858152]}, {"billed_charge": 1.7257, "npi": [1235183542]}, {"billed_charge": 1.57, "npi": [1902858152]}, {"billed_charge": 1.4125, "npi": [1598719346]}, {"billed_charge": 0.615, "npi": [1235183542]}, {"billed_charge": 4.625, "npi": [1902858152]}, {"billed_charge": 2.25, "npi": [1902858152]}, {"billed_charge": 1.0172, "npi": [1902858152]}, {"billed_charge": 1.5833, "npi": [1598719346]}, {"billed_charge": 1.3, "npi": [1235183542]}, {"billed_charge": 1.7115, "npi": [1598719346]}, {"billed_charge": 20.1, "npi": [1235183542]}, {"billed_charge": 57.2, "npi": [1235183542]}, {"billed_charge": 2.25, "npi": [1598719346]}, {"billed_charge": 74.5, "npi": [1902858152]}, {"billed_charge": 0.5115, "npi": [1902858152]}, {"billed_charge": 5.25, "npi": [1235183542]}, {"billed_charge": 1.66, "npi": [1902858152]}, {"billed_charge": 0.9667, "npi": [1598719346]}, {"billed_charge": 10.65, "npi": [1598719346]}, {"billed_charge": 6.5, "npi": [1902858152]}, {"billed_charge": 40.575, "npi": [1902858152]}, {"billed_charge": 0.1075, "npi": [1902858152]}, {"billed_charge": 0.79, "npi": [1902858152]}, {"billed_charge": 23.64, "npi": [1235183542]}, {"billed_charge": 0.145, "npi": [1902858152]}, {"billed_charge": 0.2892, "npi": [1598719346]}, {"billed_charge": 10.65, "npi": [1902858152]}, {"billed_charge": 19.0, "npi": [1598719346]}]}, {"allowed_amount": 0.41, "billing_code_modifier": ["JZ"], "providers": [{"billed_charge": 9.5, "npi": [1902858152]}, {"billed_charge": 9.5, "npi": [1598719346]}, {"billed_charge": 14.5, "npi": [1598719346]}, {"billed_charge": 9.5, "npi": [1235183542]}, {"billed_charge": 1.8, "npi": [1902858152]}, {"billed_charge": 14.5, "npi": [1902858152]}]}, {"allowed_amount": 0.2836, "billing_code_modifier": ["JZ"], "providers": [{"billed_charge": 1.542, "npi": [1902858152]}, {"billed_charge": 1.542, "npi": [1598719346]}]}, {"allowed_amount": 0.2833, "billing_code_modifier": ["JZ"], "providers": [{"billed_charge": 1.5417, "npi": [1902858152]}]}, {"allowed_amount": 0.47, "billing_code_modifier": ["JZ"], "providers": [{"billed_charge": 3.65, "npi": [1598719346]}, {"billed_charge": 9.5, "npi": [1902858152]}, {"billed_charge": 9.5, "npi": [1598719346]}, {"billed_charge": 14.5, "npi": [1598719346]}, {"billed_charge": 1.775, "npi": [1902858152]}, {"billed_charge": 9.5, "npi": [1235183542]}, {"billed_charge": 3.65, "npi": [1902858152]}]}, {"allowed_amount": 0.46, "billing_code_modifier": ["JZ"], "providers": [{"billed_charge": 9.5, "npi": [1902858152]}, {"billed_charge": 14.5, "npi": [1598719346]}, {"billed_charge": 9.5, "npi": [1235183542]}, {"billed_charge": 3.65, "npi": [1235183542]}, {"billed_charge": 10.8, "npi": [1902858152]}, {"billed_charge": 1.8, "npi": [1902858152]}, {"billed_charge": 14.5, "npi": [1902858152]}]}, {"allowed_amount": 0.35, "billing_code_modifier": ["JZ"], "providers": [{"billed_charge": 14.5, "npi": [1902858152]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["JZ"], "providers": [{"billed_charge": 1.542, "npi": [1235183542]}, {"billed_charge": 1.542, "npi": [1902858152]}, {"billed_charge": 2.1256, "npi": [1235183542]}, {"billed_charge": 137.5667, "npi": [1235183542]}, {"billed_charge": 14.5, "npi": [1598719346]}, {"billed_charge": 1.5417, "npi": [1598719346]}, {"billed_charge": 333.825, "npi": [1235183542]}, {"billed_charge": 1.542, "npi": [1598719346]}, {"billed_charge": 3.0375, "npi": [1235183542]}, {"billed_charge": 798.95, "npi": [1902858152]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["SE"], "providers": [{"billed_charge": 1.87, "npi": [1598719346]}, {"billed_charge": 39.3, "npi": [1598719346]}, {"billed_charge": 12.65, "npi": [1598719346]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["JZEC"], "providers": [{"billed_charge": 27.8808, "npi": [1235183542]}]}]}]}, {"name": "Laboratory - Hematology", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0305", "description": "Laboratory", "allowed_amounts": [{"tin": {"type": "ein", "value": "340714618"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 43.6667, "npi": [1215989611]}, {"billed_charge": 34.1429, "npi": [1215989611]}, {"billed_charge": 37.0952, "npi": [1215989611]}, {"billed_charge": 38.1364, "npi": [1215989611]}, {"billed_charge": 45.8571, "npi": [1215989611]}, {"billed_charge": 37.0769, "npi": [1215989611]}, {"billed_charge": 39.9815, "npi": [1215989611]}, {"billed_charge": 28.0, "npi": [1215989611]}, {"billed_charge": 54.0, "npi": [1215989611]}, {"billed_charge": 51.0, "npi": [1215989611]}, {"billed_charge": 48.0, "npi": [1215989611]}, {"billed_charge": 45.0, "npi": [1215989611]}, {"billed_charge": 70.0, "npi": [1215989611]}, {"billed_charge": 39.7857, "npi": [1215989611]}, {"billed_charge": 37.75, "npi": [1215989611]}, {"billed_charge": 66.0, "npi": [1215989611]}, {"billed_charge": 42.0, "npi": [1215989611]}, {"billed_charge": 19.0, "npi": [1215989611]}, {"billed_charge": 35.875, "npi": [1215989611]}, {"billed_charge": 30.0, "npi": [1215989611]}, {"billed_charge": 38.9259, "npi": [1215989611]}, {"billed_charge": 41.0, "npi": [1215989611]}, {"billed_charge": 45.8, "npi": [1215989611]}, {"billed_charge": 36.8571, "npi": [1215989611]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["91"], "providers": [{"billed_charge": 16.0, "npi": [1215989611]}]}]}]}, {"name": "IV Therapy -General", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0260", "description": "IV Therapy", "allowed_amounts": [{"tin": {"type": "ein", "value": "474442902"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 61.7267, "billing_code_modifier": [""], "providers": [{"billed_charge": 318.0, "npi": [1346607017]}]}, {"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 602.0, "npi": [1346607017]}, {"billed_charge": 637.3333, "npi": [1346607017]}, {"billed_charge": 491.0, "npi": [1346607017]}, {"billed_charge": 435.0, "npi": [1346607017]}, {"billed_charge": 318.0, "npi": [1346607017]}]}, {"allowed_amount": 263.68, "billing_code_modifier": ["59"], "providers": [{"billed_charge": 1324.0, "npi": [1346607017]}]}, {"allowed_amount": 57.74, "billing_code_modifier": ["59"], "providers": [{"billed_charge": 294.0, "npi": [1346607017]}]}, {"allowed_amount": 57.74, "billing_code_modifier": [""], "providers": [{"billed_charge": 294.0, "npi": [1346607017]}]}, {"allowed_amount": 280.35, "billing_code_modifier": [""], "providers": [{"billed_charge": 1454.0, "npi": [1346607017]}]}, {"allowed_amount": 280.35, "billing_code_modifier": ["59"], "providers": [{"billed_charge": 1454.0, "npi": [1346607017]}]}, {"allowed_amount": 263.68, "billing_code_modifier": [""], "providers": [{"billed_charge": 1324.0, "npi": [1346607017]}]}, {"allowed_amount": 61.73, "billing_code_modifier": [""], "providers": [{"billed_charge": 318.0, "npi": [1346607017]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["59"], "providers": [{"billed_charge": 491.0, "npi": [1346607017]}, {"billed_charge": 488.0, "npi": [1346607017]}, {"billed_charge": 1454.0, "npi": [1346607017]}]}, {"allowed_amount": 61.725, "billing_code_modifier": ["59"], "providers": [{"billed_charge": 318.0, "npi": [1346607017]}]}]}]}, {"name": "CT Scan - Body Scan", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0352", "description": "CT Scan", "allowed_amounts": [{"tin": {"type": "ein", "value": "344428256"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 235.44, "billing_code_modifier": [""], "providers": [{"billed_charge": 1925.0, "npi": [1407854771]}]}, {"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 1925.0, "npi": [1407854771]}, {"billed_charge": 2140.6667, "npi": [1407854771]}, {"billed_charge": 1690.75, "npi": [1407854771]}, {"billed_charge": 1541.0, "npi": [1407854771]}, {"billed_charge": 2708.0, "npi": [1407854771]}, {"billed_charge": 879.0, "npi": [1407854771]}, {"billed_charge": 2488.0, "npi": [1407854771]}, {"billed_charge": 2363.0, "npi": [1407854771]}, {"billed_charge": 2299.5, "npi": [1407854771]}, {"billed_charge": 835.0, "npi": [1407854771]}, {"billed_charge": 1683.5, "npi": [1407854771]}, {"billed_charge": 1922.0, "npi": [1407854771]}]}, {"allowed_amount": 472.32, "billing_code_modifier": [""], "providers": [{"billed_charge": 2363.0, "npi": [1407854771]}]}, {"allowed_amount": 299.47, "billing_code_modifier": [""], "providers": [{"billed_charge": 879.0, "npi": [1407854771]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["RT"], "providers": [{"billed_charge": 879.0, "npi": [1407854771]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["LT"], "providers": [{"billed_charge": 879.0, "npi": [1407854771]}]}, {"allowed_amount": 472.15, "billing_code_modifier": [""], "providers": [{"billed_charge": 2488.0, "npi": [1407854771]}]}, {"allowed_amount": 319.69, "billing_code_modifier": [""], "providers": [{"billed_charge": 1922.0, "npi": [1407854771]}]}]}]}, {"name": "Radiology - Diagnostic - Chest X-ray", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0324", "description": "Radiology - Diagnostic", "allowed_amounts": [{"tin": {"type": "ein", "value": "340714538"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 231.0, "npi": [1356366991]}, {"billed_charge": 286.0, "npi": [1356366991]}]}, {"allowed_amount": 114.69, "billing_code_modifier": [""], "providers": [{"billed_charge": 486.0, "npi": [1356366991]}, {"billed_charge": 286.0, "npi": [1356366991]}]}, {"allowed_amount": 113.9, "billing_code_modifier": [""], "providers": [{"billed_charge": 231.0, "npi": [1356366991]}, {"billed_charge": 392.0, "npi": [1356366991]}, {"billed_charge": 286.0, "npi": [1356366991]}]}]}]}, {"name": "Laboratory - Chemistry", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0301", "description": "Laboratory", "allowed_amounts": [{"tin": {"type": "ein", "value": "340733166"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 63.0, "npi": [1083696710]}, {"billed_charge": 69.0, "npi": [1083696710]}, {"billed_charge": 111.6, "npi": [1083696710]}, {"billed_charge": 81.0, "npi": [1083696710]}, {"billed_charge": 403.0, "npi": [1083696710]}, {"billed_charge": 44.0, "npi": [1083696710]}, {"billed_charge": 22.0, "npi": [1083696710]}, {"billed_charge": 55.0, "npi": [1083696710]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["91"], "providers": [{"billed_charge": 81.0, "npi": [1083696710]}, {"billed_charge": 22.0, "npi": [1083696710]}]}]}]}, {"name": "Physical Therapy - General", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0420", "description": "Physical Therapy", "allowed_amounts": [{"tin": {"type": "ein", "value": "340714585"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 32.4, "billing_code_modifier": ["GP"], "providers": [{"billed_charge": 274.0, "npi": [1679525919]}]}, {"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 211.0, "npi": [1679525919]}, {"billed_charge": 245.5294, "npi": [1679525919]}, {"billed_charge": 240.375, "npi": [1679525919]}, {"billed_charge": 262.3333, "npi": [1679525919]}, {"billed_charge": 245.6667, "npi": [1679525919]}, {"billed_charge": 274.0, "npi": [1679525919]}, {"billed_charge": 228.2, "npi": [1679525919]}, {"billed_charge": 256.093, "npi": [1679525919]}, {"billed_charge": 254.0, "npi": [1679525919]}, {"billed_charge": 249.0, "npi": [1679525919]}, {"billed_charge": 259.2667, "npi": [1679525919]}, {"billed_charge": 254.2143, "npi": [1679525919]}]}, {"allowed_amount": 28.66, "billing_code_modifier": ["GP"], "providers": [{"billed_charge": 211.0, "npi": [1679525919]}]}, {"allowed_amount": 30.27, "billing_code_modifier": ["GP"], "providers": [{"billed_charge": 258.0, "npi": [1679525919]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["GP"], "providers": [{"billed_charge": 211.0, "npi": [1679525919]}, {"billed_charge": 254.0, "npi": [1679525919]}]}, {"allowed_amount": 36.605, "billing_code_modifier": ["GP"], "providers": [{"billed_charge": 242.0, "npi": [1679525919]}]}, {"allowed_amount": 46.66, "billing_code_modifier": ["GP"], "providers": [{"billed_charge": 274.0, "npi": [1679525919]}]}, {"allowed_amount": 32.935, "billing_code_modifier": ["GP"], "providers": [{"billed_charge": 239.0, "npi": [1679525919]}]}]}]}, {"name": "Laboratory - General", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0300", "description": "Laboratory", "allowed_amounts": [{"tin": {"type": "ein", "value": "340827442"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 287.0, "npi": [1164481677]}, {"billed_charge": 103.8, "npi": [1164481677]}, {"billed_charge": 30.0, "npi": [1164481677]}, {"billed_charge": 228.0, "npi": [1164481677]}, {"billed_charge": 29.0, "npi": [1164481677]}]}, {"allowed_amount": 199.68, "billing_code_modifier": [""], "providers": [{"billed_charge": 399.0, "npi": [1164481677]}]}]}]}, {"name": "Laboratory - Chemistry", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0301", "description": "Laboratory", "allowed_amounts": [{"tin": {"type": "ein", "value": "384105653"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 201.0, "npi": [1326020447]}, {"billed_charge": 41.0, "npi": [1326020447]}, {"billed_charge": 59.0, "npi": [1326020447]}, {"billed_charge": 55.0, "npi": [1326020447]}, {"billed_charge": 70.0, "npi": [1326020447]}, {"billed_charge": 102.0, "npi": [1326020447]}, {"billed_charge": 16.0, "npi": [1326020447]}, {"billed_charge": 38.0, "npi": [1326020447]}, {"billed_charge": 35.0, "npi": [1326020447]}, {"billed_charge": 52.0, "npi": [1326020447]}, {"billed_charge": 43.0, "npi": [1326020447]}, {"billed_charge": 23.0, "npi": [1326020447]}, {"billed_charge": 74.0, "npi": [1326020447]}, {"billed_charge": 36.0, "npi": [1326020447]}, {"billed_charge": 144.0, "npi": [1326020447]}, {"billed_charge": 170.0, "npi": [1326020447]}, {"billed_charge": 46.0, "npi": [1326020447]}, {"billed_charge": 192.0, "npi": [1326020447]}]}]}]}, {"name": "Laboratory - Chemistry", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0301", "description": "Laboratory", "allowed_amounts": [{"tin": {"type": "ein", "value": "340714684"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 31.0, "npi": [1194763045]}, {"billed_charge": 33.0, "npi": [1194763045]}, {"billed_charge": 403.0, "npi": [1194763045]}, {"billed_charge": 101.0, "npi": [1194763045]}, {"billed_charge": 80.0, "npi": [1194763045]}, {"billed_charge": 511.0, "npi": [1194763045]}, {"billed_charge": 94.0, "npi": [1194763045]}, {"billed_charge": 85.0, "npi": [1194763045]}, {"billed_charge": 119.0, "npi": [1194763045]}, {"billed_charge": 62.0, "npi": [1194763045]}, {"billed_charge": 271.0, "npi": [1194763045]}, {"billed_charge": 86.0, "npi": [1194763045]}, {"billed_charge": 43.0, "npi": [1194763045]}, {"billed_charge": 57.0, "npi": [1194763045]}, {"billed_charge": 58.0, "npi": [1194763045]}, {"billed_charge": 55.0, "npi": [1194763045]}, {"billed_charge": 129.0, "npi": [1194763045]}, {"billed_charge": 45.0, "npi": [1194763045]}, {"billed_charge": 81.0, "npi": [1194763045]}, {"billed_charge": 67.0, "npi": [1194763045]}, {"billed_charge": 121.0, "npi": [1194763045]}, {"billed_charge": 52.2308, "npi": [1194763045]}, {"billed_charge": 544.0, "npi": [1194763045]}, {"billed_charge": 104.0, "npi": [1194763045]}, {"billed_charge": 429.0, "npi": [1194763045]}, {"billed_charge": 65.8, "npi": [1194763045]}, {"billed_charge": 75.0, "npi": [1194763045]}, {"billed_charge": 71.25, "npi": [1194763045]}, {"billed_charge": 255.0, "npi": [1194763045]}, {"billed_charge": 73.0, "npi": [1194763045]}, {"billed_charge": 116.0, "npi": [1194763045]}, {"billed_charge": 46.0, "npi": [1194763045]}, {"billed_charge": 53.0, "npi": [1194763045]}, {"billed_charge": 88.0, "npi": [1194763045]}, {"billed_charge": 54.0, "npi": [1194763045]}, {"billed_charge": 23.0, "npi": [1194763045]}, {"billed_charge": 81.6037, "npi": [1194763045]}, {"billed_charge": 48.0, "npi": [1194763045]}, {"billed_charge": 22.0, "npi": [1194763045]}, {"billed_charge": 44.0, "npi": [1194763045]}, {"billed_charge": 188.0, "npi": [1194763045]}, {"billed_charge": 69.0, "npi": [1194763045]}, {"billed_charge": 112.0, "npi": [1194763045]}, {"billed_charge": 108.6667, "npi": [1194763045]}, {"billed_charge": 89.0, "npi": [1194763045]}]}, {"allowed_amount": 5.91, "billing_code_modifier": [""], "providers": [{"billed_charge": 29.0, "npi": [1194763045]}]}, {"allowed_amount": 5.31, "billing_code_modifier": ["91"], "providers": [{"billed_charge": 26.0, "npi": [1194763045]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["91"], "providers": [{"billed_charge": 31.0, "npi": [1194763045]}, {"billed_charge": 33.0, "npi": [1194763045]}, {"billed_charge": 80.0, "npi": [1194763045]}, {"billed_charge": 86.0, "npi": [1194763045]}, {"billed_charge": 81.0, "npi": [1194763045]}, {"billed_charge": 45.0, "npi": [1194763045]}, {"billed_charge": 75.0, "npi": [1194763045]}, {"billed_charge": 73.0, "npi": [1194763045]}, {"billed_charge": 23.0, "npi": [1194763045]}, {"billed_charge": 22.0, "npi": [1194763045]}, {"billed_charge": 32.0, "npi": [1194763045]}]}, {"allowed_amount": 5.5, "billing_code_modifier": ["91"], "providers": [{"billed_charge": 27.0, "npi": [1194763045]}]}]}]}, {"name": "GROUND MILEAGE PER STATUTE MILE", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "A0425", "description": "GROUND MILEAGE PER STATUTE MILE", "allowed_amounts": [{"tin": {"type": "ein", "value": "346002162"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 9.33, "billing_code_modifier": ["RH"], "providers": [{"billed_charge": 15.0, "npi": [1841367539]}]}, {"allowed_amount": 9.33, "billing_code_modifier": ["NH"], "providers": [{"billed_charge": 15.0, "npi": [1841367539]}]}, {"allowed_amount": 9.15, "billing_code_modifier": ["RH"], "providers": [{"billed_charge": 15.0, "npi": [1841367539]}]}, {"allowed_amount": 9.33, "billing_code_modifier": ["SH"], "providers": [{"billed_charge": 15.0, "npi": [1841367539]}]}, {"allowed_amount": 9.15, "billing_code_modifier": ["SH"], "providers": [{"billed_charge": 15.0, "npi": [1841367539]}]}]}]}, {"name": "EKG/ECG (Electrocardiogram) - General", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0730", "description": "EKG/ECG (Electrocardiogram)", "allowed_amounts": [{"tin": {"type": "ein", "value": "340714458"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 315.0, "npi": [1942248737]}, {"billed_charge": 342.0, "npi": [1942248737]}]}]}]}, {"name": "Laboratory - General", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0300", "description": "Laboratory", "allowed_amounts": [{"tin": {"type": "ein", "value": "550357050"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 13.73, "npi": [1164492195]}, {"billed_charge": 20.595, "npi": [1164492195]}]}]}]}, {"name": "CT ABDOMEN  and  PELVIS W/CONTRAST MATERIAL", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "74177", "description": "CT ABDOMEN  and  PELVIS W/CONTRAST MATERIAL", "allowed_amounts": [{"tin": {"type": "ein", "value": "310745303"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 81.66, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 1692.0, "npi": [1669408159]}, {"billed_charge": 1946.0, "npi": [1669408159]}]}, {"allowed_amount": 77.57, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 1692.0, "npi": [1669408159]}]}, {"allowed_amount": 78.32, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 1946.0, "npi": [1669408159]}]}, {"allowed_amount": 77.3, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 1692.0, "npi": [1669408159]}]}, {"allowed_amount": 82.44, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 1946.0, "npi": [1669408159]}]}, {"allowed_amount": 77.58, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 1946.0, "npi": [1669408159]}]}]}]}, {"name": "EKG/ECG (Electrocardiogram) - General", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0730", "description": "EKG/ECG (Electrocardiogram)", "allowed_amounts": [{"tin": {"type": "ein", "value": "340714593"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 315.0, "npi": [1235183542]}, {"billed_charge": 342.0, "npi": [1598719346]}, {"billed_charge": 315.0, "npi": [1598719346]}, {"billed_charge": 342.0, "npi": [1235183542]}, {"billed_charge": 342.0, "npi": [1902858152]}, {"billed_charge": 315.0, "npi": [1902858152]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["5976"], "providers": [{"billed_charge": 315.0, "npi": [1235183542]}, {"billed_charge": 342.0, "npi": [1598719346]}, {"billed_charge": 315.0, "npi": [1598719346]}, {"billed_charge": 342.0, "npi": [1235183542]}, {"billed_charge": 342.0, "npi": [1902858152]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["5977"], "providers": [{"billed_charge": 342.0, "npi": [1902858152]}]}]}]}, {"name": "US BREAST UNI REAL TIME WITH IMAGE LIMITED", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "76642", "description": "US BREAST UNI REAL TIME WITH IMAGE LIMITED", "allowed_amounts": [{"tin": {"type": "ein", "value": "310745303"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 30.86, "billing_code_modifier": ["26LT"], "providers": [{"billed_charge": 141.0, "npi": [1669408159]}]}, {"allowed_amount": 30.86, "billing_code_modifier": ["26RT"], "providers": [{"billed_charge": 141.0, "npi": [1669408159]}]}, {"allowed_amount": 46.05, "billing_code_modifier": ["2650"], "providers": [{"billed_charge": 282.0, "npi": [1669408159]}]}, {"allowed_amount": 30.7, "billing_code_modifier": ["26LT"], "providers": [{"billed_charge": 141.0, "npi": [1669408159]}]}, {"allowed_amount": 46.29, "billing_code_modifier": ["2650"], "providers": [{"billed_charge": 282.0, "npi": [1669408159]}]}, {"allowed_amount": 30.7, "billing_code_modifier": ["26RT"], "providers": [{"billed_charge": 141.0, "npi": [1669408159]}]}]}]}, {"name": "IV Therapy -General", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0260", "description": "IV Therapy", "allowed_amounts": [{"tin": {"type": "ein", "value": "314391798"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 61.64, "billing_code_modifier": [""], "providers": [{"billed_charge": 175.0, "npi": [1346247350]}, {"billed_charge": 191.0, "npi": [1346247350]}, {"billed_charge": 196.0, "npi": [1346247350]}]}, {"allowed_amount": 278.81, "billing_code_modifier": [""], "providers": [{"billed_charge": 545.0, "npi": [1346247350]}, {"billed_charge": 360.0, "npi": [1346247350]}]}, {"allowed_amount": 61.39, "billing_code_modifier": [""], "providers": [{"billed_charge": 175.0, "npi": [1346247350]}, {"billed_charge": 196.0, "npi": [1346247350]}]}, {"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 175.0, "npi": [1346247350]}, {"billed_charge": 166.0, "npi": [1346247350]}, {"billed_charge": 360.0, "npi": [1346247350]}, {"billed_charge": 163.0, "npi": [1346247350]}, {"billed_charge": 196.0, "npi": [1346247350]}]}, {"allowed_amount": 271.05, "billing_code_modifier": [""], "providers": [{"billed_charge": 360.0, "npi": [1346247350]}]}, {"allowed_amount": 281.48, "billing_code_modifier": [""], "providers": [{"billed_charge": 545.0, "npi": [1346247350]}, {"billed_charge": 360.0, "npi": [1346247350]}, {"billed_charge": 653.0, "npi": [1346247350]}]}, {"allowed_amount": 278.81, "billing_code_modifier": ["XU"], "providers": [{"billed_charge": 360.0, "npi": [1346247350]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["XU"], "providers": [{"billed_charge": 166.0, "npi": [1346247350]}, {"billed_charge": 360.0, "npi": [1346247350]}, {"billed_charge": 163.0, "npi": [1346247350]}, {"billed_charge": 196.0, "npi": [1346247350]}]}, {"allowed_amount": 59.36, "billing_code_modifier": [""], "providers": [{"billed_charge": 196.0, "npi": [1346247350]}]}, {"allowed_amount": 278.81, "billing_code_modifier": ["59"], "providers": [{"billed_charge": 360.0, "npi": [1346247350]}]}, {"allowed_amount": 281.48, "billing_code_modifier": ["XU"], "providers": [{"billed_charge": 360.0, "npi": [1346247350]}]}, {"allowed_amount": 61.64, "billing_code_modifier": ["XU"], "providers": [{"billed_charge": 196.0, "npi": [1346247350]}]}, {"allowed_amount": 61.39, "billing_code_modifier": ["59"], "providers": [{"billed_charge": 196.0, "npi": [1346247350]}]}, {"allowed_amount": 61.3867, "billing_code_modifier": [""], "providers": [{"billed_charge": 196.0, "npi": [1346247350]}]}, {"allowed_amount": 61.3867, "billing_code_modifier": ["XU"], "providers": [{"billed_charge": 196.0, "npi": [1346247350]}]}, {"allowed_amount": 61.385, "billing_code_modifier": [""], "providers": [{"billed_charge": 196.0, "npi": [1346247350]}]}]}]}, {"name": "EKG/ECG (Electrocardiogram) - General", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0730", "description": "EKG/ECG (Electrocardiogram)", "allowed_amounts": [{"tin": {"type": "ein", "value": "340714612"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 375.0, "npi": [1841299039]}, {"billed_charge": 390.0, "npi": [1841299039]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["59"], "providers": [{"billed_charge": 375.0, "npi": [1841299039]}, {"billed_charge": 390.0, "npi": [1841299039]}]}]}]}, {"name": "Pharmacy - General", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0250", "description": "Pharmacy (also see 063x, an extension of 025x)", "allowed_amounts": [{"tin": {"type": "ein", "value": "340714684"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 2.175, "npi": [1194763045]}, {"billed_charge": 3.874, "npi": [1194763045]}, {"billed_charge": 2.2667, "npi": [1194763045]}, {"billed_charge": 2.1563, "npi": [1194763045]}, {"billed_charge": 2.3125, "npi": [1194763045]}, {"billed_charge": 2.6833, "npi": [1194763045]}, {"billed_charge": 4.765, "npi": [1194763045]}, {"billed_charge": 7.75, "npi": [1194763045]}, {"billed_charge": 2.6, "npi": [1194763045]}, {"billed_charge": 18.05, "npi": [1194763045]}, {"billed_charge": 3.073, "npi": [1194763045]}, {"billed_charge": 3.15, "npi": [1194763045]}, {"billed_charge": 2.0, "npi": [1194763045]}, {"billed_charge": 10.3136, "npi": [1194763045]}, {"billed_charge": 4.675, "npi": [1194763045]}, {"billed_charge": 3.1167, "npi": [1194763045]}, {"billed_charge": 3.8, "npi": [1194763045]}, {"billed_charge": 23.3, "npi": [1194763045]}, {"billed_charge": 2.05, "npi": [1194763045]}, {"billed_charge": 6.2625, "npi": [1194763045]}, {"billed_charge": 14.35, "npi": [1194763045]}, {"billed_charge": 15.4083, "npi": [1194763045]}, {"billed_charge": 11.35, "npi": [1194763045]}, {"billed_charge": 3.025, "npi": [1194763045]}, {"billed_charge": 4.3929, "npi": [1194763045]}, {"billed_charge": 10.625, "npi": [1194763045]}, {"billed_charge": 2.375, "npi": [1194763045]}, {"billed_charge": 4.7917, "npi": [1194763045]}, {"billed_charge": 14.05, "npi": [1194763045]}, {"billed_charge": 28.7, "npi": [1194763045]}, {"billed_charge": 8.2, "npi": [1194763045]}, {"billed_charge": 4.7286, "npi": [1194763045]}, {"billed_charge": 2.35, "npi": [1194763045]}, {"billed_charge": 2.4333, "npi": [1194763045]}, {"billed_charge": 10.5689, "npi": [1194763045]}, {"billed_charge": 4.125, "npi": [1194763045]}, {"billed_charge": 2.45, "npi": [1194763045]}, {"billed_charge": 6.4, "npi": [1194763045]}, {"billed_charge": 2.5935, "npi": [1194763045]}, {"billed_charge": 14.95, "npi": [1194763045]}, {"billed_charge": 4.3716, "npi": [1194763045]}, {"billed_charge": 2.0667, "npi": [1194763045]}, {"billed_charge": 3.018, "npi": [1194763045]}, {"billed_charge": 8.4955, "npi": [1194763045]}, {"billed_charge": 4.875, "npi": [1194763045]}, {"billed_charge": 3.6786, "npi": [1194763045]}, {"billed_charge": 5.0, "npi": [1194763045]}, {"billed_charge": 2.3, "npi": [1194763045]}, {"billed_charge": 3.9163, "npi": [1194763045]}]}, {"allowed_amount": 283.8783, "billing_code_modifier": [""], "providers": [{"billed_charge": 28.7, "npi": [1194763045]}]}]}]}, {"name": "RADEX SHOULDER COMPLETE MINIMUM 2 VIEWS", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "73030", "description": "RADEX SHOULDER COMPLETE MINIMUM 2 VIEWS", "allowed_amounts": [{"tin": {"type": "ein", "value": "310745303"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 8.83, "billing_code_modifier": ["26RT77"], "providers": [{"billed_charge": 161.0, "npi": [1669408159]}]}, {"allowed_amount": 8.51, "billing_code_modifier": ["26RT77"], "providers": [{"billed_charge": 153.0, "npi": [1669408159]}]}, {"allowed_amount": 8.83, "billing_code_modifier": ["26RT"], "providers": [{"billed_charge": 161.0, "npi": [1669408159]}]}, {"allowed_amount": 8.83, "billing_code_modifier": ["26LT"], "providers": [{"billed_charge": 161.0, "npi": [1669408159]}]}, {"allowed_amount": 8.51, "billing_code_modifier": ["26LT"], "providers": [{"billed_charge": 161.0, "npi": [1669408159]}, {"billed_charge": 153.0, "npi": [1669408159]}]}, {"allowed_amount": 8.51, "billing_code_modifier": ["26RT"], "providers": [{"billed_charge": 161.0, "npi": [1669408159]}, {"billed_charge": 153.0, "npi": [1669408159]}]}, {"allowed_amount": 8.51, "billing_code_modifier": ["26LT77"], "providers": [{"billed_charge": 153.0, "npi": [1669408159]}]}]}]}, {"name": "Pharmacy - General", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0250", "description": "Pharmacy (also see 063x, an extension of 025x)", "allowed_amounts": [{"tin": {"type": "ein", "value": "340714612"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 3.1289, "npi": [1841299039]}, {"billed_charge": 1.8457, "npi": [1841299039]}, {"billed_charge": 4.85, "npi": [1841299039]}, {"billed_charge": 1.8434, "npi": [1841299039]}, {"billed_charge": 1.6776, "npi": [1841299039]}, {"billed_charge": 6.45, "npi": [1841299039]}, {"billed_charge": 3.3326, "npi": [1841299039]}, {"billed_charge": 6.47, "npi": [1841299039]}, {"billed_charge": 3.2333, "npi": [1841299039]}, {"billed_charge": 2.6856, "npi": [1841299039]}, {"billed_charge": 1.34, "npi": [1841299039]}, {"billed_charge": 6.6464, "npi": [1841299039]}, {"billed_charge": 8.4483, "npi": [1841299039]}, {"billed_charge": 3.23, "npi": [1841299039]}, {"billed_charge": 31.68, "npi": [1841299039]}, {"billed_charge": 1.0767, "npi": [1841299039]}, {"billed_charge": 1.292, "npi": [1841299039]}, {"billed_charge": 20.455, "npi": [1841299039]}, {"billed_charge": 5.857, "npi": [1841299039]}, {"billed_charge": 1.615, "npi": [1841299039]}, {"billed_charge": 60.13, "npi": [1841299039]}, {"billed_charge": 2.1533, "npi": [1841299039]}, {"billed_charge": 13.2035, "npi": [1841299039]}, {"billed_charge": 2.8385, "npi": [1841299039]}, {"billed_charge": 1.8263, "npi": [1841299039]}, {"billed_charge": 1.4131, "npi": [1841299039]}, {"billed_charge": 1.2039, "npi": [1841299039]}]}]}]}, {"name": "Laboratory - General", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0300", "description": "Laboratory", "allowed_amounts": [{"tin": {"type": "ein", "value": "341105619"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 35.5714, "npi": [1811939887]}, {"billed_charge": 107.0, "npi": [1811939887]}, {"billed_charge": 29.0, "npi": [1811939887]}, {"billed_charge": 112.0, "npi": [1811939887]}, {"billed_charge": 63.3333, "npi": [1811939887]}, {"billed_charge": 59.4, "npi": [1811939887]}, {"billed_charge": 135.0, "npi": [1811939887]}, {"billed_charge": 45.0, "npi": [1811939887]}, {"billed_charge": 115.875, "npi": [1811939887]}, {"billed_charge": 67.1111, "npi": [1811939887]}, {"billed_charge": 46.0, "npi": [1811939887]}, {"billed_charge": 117.0, "npi": [1811939887]}, {"billed_charge": 36.1667, "npi": [1811939887]}, {"billed_charge": 71.0, "npi": [1811939887]}, {"billed_charge": 21.0, "npi": [1811939887]}, {"billed_charge": 81.6667, "npi": [1811939887]}, {"billed_charge": 106.5, "npi": [1811939887]}, {"billed_charge": 110.0, "npi": [1811939887]}, {"billed_charge": 87.0, "npi": [1811939887]}, {"billed_charge": 50.3333, "npi": [1811939887]}, {"billed_charge": 144.0, "npi": [1811939887]}, {"billed_charge": 59.0, "npi": [1811939887]}, {"billed_charge": 287.0, "npi": [1811939887]}, {"billed_charge": 130.2857, "npi": [1811939887]}, {"billed_charge": 141.0, "npi": [1811939887]}, {"billed_charge": 137.0, "npi": [1811939887]}, {"billed_charge": 40.9, "npi": [1811939887]}, {"billed_charge": 82.5, "npi": [1811939887]}, {"billed_charge": 111.0, "npi": [1811939887]}, {"billed_charge": 116.0, "npi": [1811939887]}, {"billed_charge": 103.6136, "npi": [1811939887]}, {"billed_charge": 101.8571, "npi": [1811939887]}, {"billed_charge": 20.0, "npi": [1811939887]}, {"billed_charge": 129.0, "npi": [1811939887]}, {"billed_charge": 71.4667, "npi": [1811939887]}, {"billed_charge": 63.25, "npi": [1811939887]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["91"], "providers": [{"billed_charge": 117.0, "npi": [1811939887]}, {"billed_charge": 111.0, "npi": [1811939887]}]}]}]}, {"name": "EKG/ECG (Electrocardiogram) - General", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0730", "description": "EKG/ECG (Electrocardiogram)", "allowed_amounts": [{"tin": {"type": "ein", "value": "340714585"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 322.7143, "npi": [1679525919]}, {"billed_charge": 342.0, "npi": [1679525919]}, {"billed_charge": 315.0, "npi": [1679525919]}]}]}]}, {"name": "Laboratory - Hematology", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0305", "description": "Laboratory", "allowed_amounts": [{"tin": {"type": "ein", "value": "550357050"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 63.215, "npi": [1164492195]}, {"billed_charge": 67.4171, "npi": [1164492195]}, {"billed_charge": 59.3875, "npi": [1164492195]}, {"billed_charge": 31.68, "npi": [1164492195]}, {"billed_charge": 89.74, "npi": [1164492195]}, {"billed_charge": 42.23, "npi": [1164492195]}, {"billed_charge": 67.57, "npi": [1164492195]}, {"billed_charge": 53.84, "npi": [1164492195]}]}]}]}, {"name": "SBSQ HOSPITAL IP/OBS CARE MOD MDM 35 MINUTES", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "99232", "description": "SBSQ HOSPITAL IP/OBS CARE MOD MDM 35 MINUTES", "allowed_amounts": [{"tin": {"type": "ein", "value": "341658315"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 87.11, "billing_code_modifier": [""], "providers": [{"billed_charge": 113.0, "npi": [1487641783]}]}, {"allowed_amount": 89.56, "billing_code_modifier": [""], "providers": [{"billed_charge": 113.0, "npi": [1487641783]}]}]}]}, {"name": "IV Therapy -General", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0260", "description": "IV Therapy", "allowed_amounts": [{"tin": {"type": "ein", "value": "341567805"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 578.0, "npi": [1043397292]}, {"billed_charge": 436.5, "npi": [1043397292]}, {"billed_charge": 775.0, "npi": [1043397292]}, {"billed_charge": 806.0, "npi": [1043397292]}, {"billed_charge": 506.0, "npi": [1043397292]}, {"billed_charge": 385.0, "npi": [1043397292]}, {"billed_charge": 420.0, "npi": [1043397292]}, {"billed_charge": 167.0, "npi": [1043397292]}, {"billed_charge": 550.0769, "npi": [1043397292]}, {"billed_charge": 551.8, "npi": [1043397292]}, {"billed_charge": 534.5, "npi": [1043397292]}, {"billed_charge": 595.0, "npi": [1043397292]}, {"billed_charge": 854.0, "npi": [1043397292]}, {"billed_charge": 487.0, "npi": [1043397292]}, {"billed_charge": 888.0, "npi": [1043397292]}, {"billed_charge": 353.0, "npi": [1043397292]}, {"billed_charge": 379.0, "npi": [1043397292]}]}, {"allowed_amount": 263.68, "billing_code_modifier": ["59"], "providers": [{"billed_charge": 811.0, "npi": [1043397292]}, {"billed_charge": 353.0, "npi": [1043397292]}]}, {"allowed_amount": 57.74, "billing_code_modifier": ["59"], "providers": [{"billed_charge": 379.0, "npi": [1043397292]}]}, {"allowed_amount": 51.97, "billing_code_modifier": [""], "providers": [{"billed_charge": 379.0, "npi": [1043397292]}]}, {"allowed_amount": 61.725, "billing_code_modifier": [""], "providers": [{"billed_charge": 907.0, "npi": [1043397292]}, {"billed_charge": 506.0, "npi": [1043397292]}, {"billed_charge": 394.0, "npi": [1043397292]}]}, {"allowed_amount": 57.74, "billing_code_modifier": [""], "providers": [{"billed_charge": 487.0, "npi": [1043397292]}, {"billed_charge": 379.0, "npi": [1043397292]}]}, {"allowed_amount": 280.35, "billing_code_modifier": [""], "providers": [{"billed_charge": 367.0, "npi": [1043397292]}, {"billed_charge": 563.0, "npi": [1043397292]}, {"billed_charge": 843.0, "npi": [1043397292]}]}, {"allowed_amount": 280.35, "billing_code_modifier": ["59"], "providers": [{"billed_charge": 367.0, "npi": [1043397292]}, {"billed_charge": 563.0, "npi": [1043397292]}, {"billed_charge": 843.0, "npi": [1043397292]}]}, {"allowed_amount": 263.68, "billing_code_modifier": [""], "providers": [{"billed_charge": 541.0, "npi": [1043397292]}, {"billed_charge": 811.0, "npi": [1043397292]}, {"billed_charge": 353.0, "npi": [1043397292]}]}, {"allowed_amount": 61.73, "billing_code_modifier": [""], "providers": [{"billed_charge": 506.0, "npi": [1043397292]}, {"billed_charge": 394.0, "npi": [1043397292]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["59"], "providers": [{"billed_charge": 834.0, "npi": [1043397292]}, {"billed_charge": 775.0, "npi": [1043397292]}, {"billed_charge": 394.0, "npi": [1043397292]}, {"billed_charge": 811.0, "npi": [1043397292]}, {"billed_charge": 487.0, "npi": [1043397292]}, {"billed_charge": 353.0, "npi": [1043397292]}, {"billed_charge": 379.0, "npi": [1043397292]}, {"billed_charge": 843.0, "npi": [1043397292]}]}, {"allowed_amount": 94.89, "billing_code_modifier": [""], "providers": [{"billed_charge": 888.0, "npi": [1043397292]}]}, {"allowed_amount": 61.73, "billing_code_modifier": ["59"], "providers": [{"billed_charge": 394.0, "npi": [1043397292]}]}]}]}, {"name": "CT Scan - Body Scan", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0352", "description": "CT Scan", "allowed_amounts": [{"tin": {"type": "ein", "value": "340714612"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 222.79, "billing_code_modifier": [""], "providers": [{"billed_charge": 2757.0, "npi": [1841299039]}]}, {"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 3197.0, "npi": [1841299039]}, {"billed_charge": 3246.0, "npi": [1841299039]}, {"billed_charge": 3048.5, "npi": [1841299039]}, {"billed_charge": 2330.0, "npi": [1841299039]}, {"billed_charge": 2655.0, "npi": [1841299039]}, {"billed_charge": 2011.0, "npi": [1841299039]}, {"billed_charge": 2240.0, "npi": [1841299039]}, {"billed_charge": 3325.0, "npi": [1841299039]}, {"billed_charge": 2026.0, "npi": [1841299039]}, {"billed_charge": 2091.0, "npi": [1841299039]}, {"billed_charge": 3096.0, "npi": [1841299039]}]}, {"allowed_amount": 459.82, "billing_code_modifier": [""], "providers": [{"billed_charge": 3325.0, "npi": [1841299039]}]}, {"allowed_amount": 314.48, "billing_code_modifier": [""], "providers": [{"billed_charge": 3225.0, "npi": [1841299039]}]}, {"allowed_amount": 446.94, "billing_code_modifier": [""], "providers": [{"billed_charge": 3197.0, "npi": [1841299039]}]}]}]}, {"name": "SCREENING MAMMOGRAPHY BI 2-VIEW BREAST INC CAD", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "77067", "description": "SCREENING MAMMOGRAPHY BI 2-VIEW BREAST INC CAD", "allowed_amounts": [{"tin": {"type": "ein", "value": "310745303"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 17.09, "billing_code_modifier": ["2652"], "providers": [{"billed_charge": 135.0, "npi": [1669408159]}]}, {"allowed_amount": 34.47, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 135.0, "npi": [1669408159]}]}, {"allowed_amount": 34.17, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 135.0, "npi": [1669408159]}]}]}]}, {"name": "COMPUTED TOMOGRAPHY THORAX LW DOSE LNG CA SCR C-", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "71271", "description": "COMPUTED TOMOGRAPHY THORAX LW DOSE LNG CA SCR C-", "allowed_amounts": [{"tin": {"type": "ein", "value": "310745303"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 48.62, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 1030.0, "npi": [1669408159]}]}, {"allowed_amount": 45.69, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 981.0, "npi": [1669408159]}]}, {"allowed_amount": 48.1, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 1030.0, "npi": [1669408159]}, {"billed_charge": 981.0, "npi": [1669408159]}]}]}]}, {"name": "Emergency Room - General", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0450", "description": "Emergency Room", "allowed_amounts": [{"tin": {"type": "ein", "value": "340714684"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 202.37, "billing_code_modifier": [""], "providers": [{"billed_charge": 1093.0, "npi": [1194763045]}]}, {"allowed_amount": 8621.85, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 5814.0, "npi": [1194763045]}]}, {"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 4230.0, "npi": [1194763045]}, {"billed_charge": 2714.5, "npi": [1194763045]}, {"billed_charge": 5073.0, "npi": [1194763045]}]}, {"allowed_amount": 359.79, "billing_code_modifier": [""], "providers": [{"billed_charge": 1911.0, "npi": [1194763045]}]}, {"allowed_amount": 300.21, "billing_code_modifier": ["RT"], "providers": [{"billed_charge": 971.0, "npi": [1194763045]}]}, {"allowed_amount": 1054.53, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 5073.0, "npi": [1194763045]}]}, {"allowed_amount": 767.3, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 3672.0, "npi": [1194763045]}]}, {"allowed_amount": 202.37, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 1093.0, "npi": [1194763045]}]}, {"allowed_amount": 346.53, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 1632.0, "npi": [1194763045]}]}, {"allowed_amount": 198.19, "billing_code_modifier": [""], "providers": [{"billed_charge": 935.0, "npi": [1194763045]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["RT"], "providers": [{"billed_charge": 593.0, "npi": [1194763045]}]}, {"allowed_amount": 359.79, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 1911.0, "npi": [1194763045]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 4230.0, "npi": [1194763045]}]}, {"allowed_amount": 532.91, "billing_code_modifier": [""], "providers": [{"billed_charge": 2533.0, "npi": [1194763045]}]}, {"allowed_amount": 452.97, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 2533.0, "npi": [1194763045]}]}, {"allowed_amount": 784.92, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 4230.0, "npi": [1194763045]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["LT"], "providers": [{"billed_charge": 593.0, "npi": [1194763045]}]}, {"allowed_amount": 325.12, "billing_code_modifier": ["RT"], "providers": [{"billed_charge": 1103.0, "npi": [1194763045]}]}, {"allowed_amount": 3447.28, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 5814.0, "npi": [1194763045]}]}, {"allowed_amount": 532.91, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 2533.0, "npi": [1194763045]}]}, {"allowed_amount": 111.15, "billing_code_modifier": [""], "providers": [{"billed_charge": 608.0, "npi": [1194763045]}]}, {"allowed_amount": 1088.71, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 5814.0, "npi": [1194763045]}]}, {"allowed_amount": 346.53, "billing_code_modifier": [""], "providers": [{"billed_charge": 1632.0, "npi": [1194763045]}]}, {"allowed_amount": 549.96, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 2938.0, "npi": [1194763045]}]}, {"allowed_amount": 549.96, "billing_code_modifier": [""], "providers": [{"billed_charge": 2938.0, "npi": [1194763045]}]}]}]}, {"name": "CT Scan - Body Scan", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0352", "description": "CT Scan", "allowed_amounts": [{"tin": {"type": "ein", "value": "341425870"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 3325.0, "npi": [1972689172]}, {"billed_charge": 2446.5, "npi": [1972689172]}, {"billed_charge": 3197.0, "npi": [1972689172]}, {"billed_charge": 2827.5, "npi": [1972689172]}, {"billed_charge": 2240.0, "npi": [1972689172]}, {"billed_charge": 3096.0, "npi": [1972689172]}, {"billed_charge": 2091.0, "npi": [1972689172]}, {"billed_charge": 1857.0, "npi": [1972689172]}, {"billed_charge": 2867.0, "npi": [1972689172]}, {"billed_charge": 3225.0, "npi": [1972689172]}, {"billed_charge": 2332.3333, "npi": [1972689172]}]}, {"allowed_amount": 214.54, "billing_code_modifier": [""], "providers": [{"billed_charge": 2867.0, "npi": [1972689172]}]}, {"allowed_amount": 525.77, "billing_code_modifier": [""], "providers": [{"billed_charge": 2867.0, "npi": [1972689172]}]}, {"allowed_amount": 302.51, "billing_code_modifier": [""], "providers": [{"billed_charge": 3101.0, "npi": [1972689172]}]}, {"allowed_amount": 291.3, "billing_code_modifier": [""], "providers": [{"billed_charge": 3225.0, "npi": [1972689172]}]}, {"allowed_amount": 214.67, "billing_code_modifier": [""], "providers": [{"billed_charge": 2867.0, "npi": [1972689172]}]}, {"allowed_amount": 127.96, "billing_code_modifier": ["RT"], "providers": [{"billed_charge": 1830.0, "npi": [1972689172]}]}, {"allowed_amount": 446.94, "billing_code_modifier": [""], "providers": [{"billed_charge": 3197.0, "npi": [1972689172]}]}, {"allowed_amount": 292.02, "billing_code_modifier": [""], "providers": [{"billed_charge": 3225.0, "npi": [1972689172]}]}, {"allowed_amount": 426.97, "billing_code_modifier": [""], "providers": [{"billed_charge": 3474.0, "npi": [1972689172]}, {"billed_charge": 3325.0, "npi": [1972689172]}]}]}]}, {"name": "Laboratory - Bacteriology & Microbiology", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0306", "description": "Laboratory", "allowed_amounts": [{"tin": {"type": "ein", "value": "341425870"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 123.0, "npi": [1972689172]}, {"billed_charge": 96.0, "npi": [1972689172]}, {"billed_charge": 231.0, "npi": [1972689172]}, {"billed_charge": 113.0, "npi": [1972689172]}, {"billed_charge": 160.6, "npi": [1972689172]}, {"billed_charge": 162.0, "npi": [1972689172]}, {"billed_charge": 168.0, "npi": [1972689172]}, {"billed_charge": 216.0, "npi": [1972689172]}, {"billed_charge": 101.0, "npi": [1972689172]}, {"billed_charge": 166.4167, "npi": [1972689172]}, {"billed_charge": 118.0, "npi": [1972689172]}, {"billed_charge": 193.0, "npi": [1972689172]}, {"billed_charge": 222.0, "npi": [1972689172]}, {"billed_charge": 225.0, "npi": [1972689172]}, {"billed_charge": 201.0, "npi": [1972689172]}, {"billed_charge": 88.0, "npi": [1972689172]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["59"], "providers": [{"billed_charge": 162.0, "npi": [1972689172]}, {"billed_charge": 193.0, "npi": [1972689172]}, {"billed_charge": 163.0, "npi": [1972689172]}, {"billed_charge": 201.0, "npi": [1972689172]}, {"billed_charge": 188.0, "npi": [1972689172]}]}]}]}, {"name": "Radiology - Diagnostic - Chest X-ray", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0324", "description": "Radiology - Diagnostic", "allowed_amounts": [{"tin": {"type": "ein", "value": "340714612"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 488.0, "npi": [1841299039]}, {"billed_charge": 375.0, "npi": [1841299039]}, {"billed_charge": 469.0, "npi": [1841299039]}, {"billed_charge": 390.0, "npi": [1841299039]}]}, {"allowed_amount": 114.28, "billing_code_modifier": [""], "providers": [{"billed_charge": 488.0, "npi": [1841299039]}]}, {"allowed_amount": 114.69, "billing_code_modifier": [""], "providers": [{"billed_charge": 488.0, "npi": [1841299039]}, {"billed_charge": 390.0, "npi": [1841299039]}]}, {"allowed_amount": 110.2, "billing_code_modifier": [""], "providers": [{"billed_charge": 375.0, "npi": [1841299039]}, {"billed_charge": 469.0, "npi": [1841299039]}]}]}]}, {"name": "Treatment or Observation Room - Observation Hours", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0762", "description": "Specialty Services", "allowed_amounts": [{"tin": {"type": "ein", "value": "340714593"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 139.6515, "npi": [1235183542]}, {"billed_charge": 174.8095, "npi": [1235183542]}, {"billed_charge": 146.4878, "npi": [1235183542]}, {"billed_charge": 149.8846, "npi": [1598719346]}, {"billed_charge": 133.0, "npi": [1235183542]}, {"billed_charge": 161.7143, "npi": [1598719346]}, {"billed_charge": 184.6471, "npi": [1235183542]}, {"billed_charge": 181.0714, "npi": [1235183542]}, {"billed_charge": 156.7297, "npi": [1235183542]}, {"billed_charge": 181.7778, "npi": [1235183542]}, {"billed_charge": 150.56, "npi": [1235183542]}, {"billed_charge": 166.7692, "npi": [1598719346]}, {"billed_charge": 154.95, "npi": [1235183542]}, {"billed_charge": 200.5385, "npi": [1598719346]}, {"billed_charge": 160.4375, "npi": [1598719346]}, {"billed_charge": 168.12, "npi": [1235183542]}, {"billed_charge": 146.9365, "npi": [1598719346]}, {"billed_charge": 147.1613, "npi": [1235183542]}, {"billed_charge": 149.2258, "npi": [1598719346]}, {"billed_charge": 161.3226, "npi": [1598719346]}, {"billed_charge": 185.5385, "npi": [1235183542]}, {"billed_charge": 136.1129, "npi": [1598719346]}, {"billed_charge": 156.1053, "npi": [1235183542]}, {"billed_charge": 144.1667, "npi": [1235183542]}, {"billed_charge": 150.1, "npi": [1598719346]}, {"billed_charge": 3675.0, "npi": [1598719346]}, {"billed_charge": 195.7143, "npi": [1235183542]}, {"billed_charge": 159.6061, "npi": [1235183542]}]}]}]}, {"name": "Pharmacy - General", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0250", "description": "Pharmacy (also see 063x, an extension of 025x)", "allowed_amounts": [{"tin": {"type": "ein", "value": "310538525"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 4.41, "npi": [1780633289]}, {"billed_charge": 20.69, "npi": [1780633289]}, {"billed_charge": 22.56, "npi": [1780633289]}, {"billed_charge": 2.055, "npi": [1780633289]}, {"billed_charge": 8.38, "npi": [1780633289]}, {"billed_charge": 11.995, "npi": [1780633289]}, {"billed_charge": 78.13, "npi": [1780633289]}, {"billed_charge": 0.06, "npi": [1780633289]}, {"billed_charge": 74.78, "npi": [1780633289]}, {"billed_charge": 23.21, "npi": [1780633289]}, {"billed_charge": 0.5867, "npi": [1780633289]}, {"billed_charge": 25.11, "npi": [1780633289]}, {"billed_charge": 0.5033, "npi": [1780633289]}, {"billed_charge": 0.0738, "npi": [1780633289]}, {"billed_charge": 3.6, "npi": [1780633289]}, {"billed_charge": 3.89, "npi": [1780633289]}, {"billed_charge": 16.01, "npi": [1780633289]}, {"billed_charge": 17.76, "npi": [1780633289]}, {"billed_charge": 0.6033, "npi": [1780633289]}, {"billed_charge": 1.765, "npi": [1780633289]}, {"billed_charge": 4.6, "npi": [1780633289]}, {"billed_charge": 2.185, "npi": [1780633289]}, {"billed_charge": 2.04, "npi": [1780633289]}, {"billed_charge": 16.85, "npi": [1780633289]}, {"billed_charge": 0.4869, "npi": [1780633289]}, {"billed_charge": 3.78, "npi": [1780633289]}, {"billed_charge": 0.2595, "npi": [1780633289]}, {"billed_charge": 2.778, "npi": [1780633289]}, {"billed_charge": 2.17, "npi": [1780633289]}, {"billed_charge": 8.37, "npi": [1780633289]}, {"billed_charge": 22.47, "npi": [1780633289]}, {"billed_charge": 21.82, "npi": [1780633289]}, {"billed_charge": 2.21, "npi": [1780633289]}, {"billed_charge": 0.5018, "npi": [1780633289]}, {"billed_charge": 4.92, "npi": [1780633289]}, {"billed_charge": 2.225, "npi": [1780633289]}]}]}]}, {"name": "Pharmacy - Extension of 25X - Drug Requiring Detailed Coding", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0636", "description": "Pharmacy - Extension of 25x", "allowed_amounts": [{"tin": {"type": "ein", "value": "384105653"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.49, "billing_code_modifier": [""], "providers": [{"billed_charge": 17.625, "npi": [1326020447]}]}, {"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 8.75, "npi": [1326020447]}, {"billed_charge": 0.47, "npi": [1326020447]}, {"billed_charge": 0.134, "npi": [1326020447]}, {"billed_charge": 36.4, "npi": [1326020447]}, {"billed_charge": 4.9569, "npi": [1326020447]}, {"billed_charge": 0.4413, "npi": [1326020447]}, {"billed_charge": 9.27, "npi": [1326020447]}, {"billed_charge": 1.31, "npi": [1326020447]}, {"billed_charge": 0.1238, "npi": [1326020447]}, {"billed_charge": 6.965, "npi": [1326020447]}, {"billed_charge": 67.15, "npi": [1326020447]}, {"billed_charge": 0.3755, "npi": [1326020447]}, {"billed_charge": 143.55, "npi": [1326020447]}, {"billed_charge": 3.81, "npi": [1326020447]}, {"billed_charge": 35.4, "npi": [1326020447]}, {"billed_charge": 8.6875, "npi": [1326020447]}, {"billed_charge": 34.825, "npi": [1326020447]}, {"billed_charge": 28.0333, "npi": [1326020447]}, {"billed_charge": 79.7, "npi": [1326020447]}, {"billed_charge": 1.705, "npi": [1326020447]}, {"billed_charge": 4.5833, "npi": [1326020447]}, {"billed_charge": 52.05, "npi": [1326020447]}, {"billed_charge": 19.625, "npi": [1326020447]}, {"billed_charge": 2.3067, "npi": [1326020447]}, {"billed_charge": 46.55, "npi": [1326020447]}]}, {"allowed_amount": 0.48, "billing_code_modifier": [""], "providers": [{"billed_charge": 34.9, "npi": [1326020447]}]}]}]}, {"name": "IV Therapy -General", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0260", "description": "IV Therapy", "allowed_amounts": [{"tin": {"type": "ein", "value": "314394942"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 108.51, "billing_code_modifier": [""], "providers": [{"billed_charge": 281.0, "npi": [1255377149]}]}, {"allowed_amount": 285.73, "billing_code_modifier": [""], "providers": [{"billed_charge": 349.0, "npi": [1255377149]}]}, {"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 319.0, "npi": [1255377149]}, {"billed_charge": 402.6667, "npi": [1255377149]}, {"billed_charge": 281.0, "npi": [1255377149]}, {"billed_charge": 218.0, "npi": [1255377149]}, {"billed_charge": 268.0625, "npi": [1255377149]}, {"billed_charge": 237.0, "npi": [1255377149]}, {"billed_charge": 267.0, "npi": [1255377149]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["XU"], "providers": [{"billed_charge": 319.0, "npi": [1255377149]}, {"billed_charge": 666.0, "npi": [1255377149]}]}, {"allowed_amount": 281.08, "billing_code_modifier": [""], "providers": [{"billed_charge": 349.0, "npi": [1255377149]}]}, {"allowed_amount": 70.35, "billing_code_modifier": [""], "providers": [{"billed_charge": 193.0, "npi": [1255377149]}]}, {"allowed_amount": 285.73, "billing_code_modifier": ["59"], "providers": [{"billed_charge": 349.0, "npi": [1255377149]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["59"], "providers": [{"billed_charge": 349.0, "npi": [1255377149]}, {"billed_charge": 319.0, "npi": [1255377149]}, {"billed_charge": 193.0, "npi": [1255377149]}, {"billed_charge": 237.0, "npi": [1255377149]}]}, {"allowed_amount": 62.9, "billing_code_modifier": ["59"], "providers": [{"billed_charge": 319.0, "npi": [1255377149]}]}, {"allowed_amount": 285.73, "billing_code_modifier": ["XU"], "providers": [{"billed_charge": 349.0, "npi": [1255377149]}]}, {"allowed_amount": 62.9, "billing_code_modifier": [""], "providers": [{"billed_charge": 319.0, "npi": [1255377149]}, {"billed_charge": 193.0, "npi": [1255377149]}]}, {"allowed_amount": 61.56, "billing_code_modifier": [""], "providers": [{"billed_charge": 319.0, "npi": [1255377149]}, {"billed_charge": 193.0, "npi": [1255377149]}]}]}]}, {"name": "Radiology - Diagnostic - Chest X-ray", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0324", "description": "Radiology - Diagnostic", "allowed_amounts": [{"tin": {"type": "ein", "value": "340714456"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 295.0, "npi": [1790837235]}, {"billed_charge": 331.0, "npi": [1790837235]}, {"billed_charge": 325.0, "npi": [1790837235]}]}, {"allowed_amount": 107.48, "billing_code_modifier": [""], "providers": [{"billed_charge": 364.0, "npi": [1790837235]}, {"billed_charge": 331.0, "npi": [1790837235]}]}, {"allowed_amount": 113.27, "billing_code_modifier": [""], "providers": [{"billed_charge": 295.0, "npi": [1790837235]}, {"billed_charge": 325.0, "npi": [1790837235]}]}]}]}, {"name": "SCREENING DIGITAL BREAST TOMOSYNTHESIS BI", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "77063", "description": "SCREENING DIGITAL BREAST TOMOSYNTHESIS BI", "allowed_amounts": [{"tin": {"type": "ein", "value": "310983140"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 29.58, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 117.0, "npi": [1093718496]}]}, {"allowed_amount": 26.89, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 117.0, "npi": [1093718496]}, {"billed_charge": 123.0, "npi": [1093718496]}]}, {"allowed_amount": 27.26, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 135.0, "npi": [1093718496]}, {"billed_charge": 117.0, "npi": [1093718496]}, {"billed_charge": 123.0, "npi": [1093718496]}]}, {"allowed_amount": 13.63, "billing_code_modifier": ["2652"], "providers": [{"billed_charge": 117.0, "npi": [1093718496]}]}, {"allowed_amount": 29.99, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 117.0, "npi": [1093718496]}]}]}]}, {"name": "Pharmacy - General", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0250", "description": "Pharmacy (also see 063x, an extension of 025x)", "allowed_amounts": [{"tin": {"type": "ein", "value": "340714581"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 72.95, "npi": [1942385794]}, {"billed_charge": 2.1, "npi": [1942385794]}, {"billed_charge": 22.4284, "npi": [1942385794]}, {"billed_charge": 1.75, "npi": [1942385794]}, {"billed_charge": 9.2, "npi": [1942385794]}, {"billed_charge": 0.9, "npi": [1942385794]}, {"billed_charge": 0.88, "npi": [1942385794]}, {"billed_charge": 1.8, "npi": [1942385794]}, {"billed_charge": 2.85, "npi": [1942385794]}, {"billed_charge": 0.95, "npi": [1942385794]}, {"billed_charge": 4.9, "npi": [1942385794]}, {"billed_charge": 6.8756, "npi": [1942385794]}, {"billed_charge": 0.93, "npi": [1942385794]}, {"billed_charge": 1.5, "npi": [1942385794]}, {"billed_charge": 0.42, "npi": [1942385794]}, {"billed_charge": 1.85, "npi": [1942385794]}, {"billed_charge": 10.7, "npi": [1942385794]}]}]}]}, {"name": "Recovery Room - Other Recovery Room", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0710", "description": "Recovery Room", "allowed_amounts": [{"tin": {"type": "ein", "value": "340714585"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 396.0, "npi": [1679525919]}, {"billed_charge": 185.125, "npi": [1679525919]}, {"billed_charge": 323.5, "npi": [1679525919]}, {"billed_charge": 480.5, "npi": [1679525919]}, {"billed_charge": 508.0, "npi": [1679525919]}, {"billed_charge": 262.0, "npi": [1679525919]}, {"billed_charge": 309.6, "npi": [1679525919]}, {"billed_charge": 249.75, "npi": [1679525919]}, {"billed_charge": 283.0, "npi": [1679525919]}]}]}]}, {"name": "EMERGENCY DEPARTMENT VISIT MODERATE MDM", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "99284", "description": "EMERGENCY DEPARTMENT VISIT MODERATE MDM", "allowed_amounts": [{"tin": {"type": "ein", "value": "311597469"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 129.37, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 1026.0, "npi": [1841232196]}]}, {"allowed_amount": 133.61, "billing_code_modifier": ["SA"], "providers": [{"billed_charge": 1026.0, "npi": [1841232196]}]}, {"allowed_amount": 129.37, "billing_code_modifier": [""], "providers": [{"billed_charge": 1026.0, "npi": [1841232196]}]}, {"allowed_amount": 133.61, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 1026.0, "npi": [1841232196]}]}, {"allowed_amount": 133.61, "billing_code_modifier": [""], "providers": [{"billed_charge": 1026.0, "npi": [1841232196]}]}]}]}, {"name": "Pharmacy - Extension of 25X - Drug Requiring Detailed Coding", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0636", "description": "Pharmacy - Extension of 25x", "allowed_amounts": [{"tin": {"type": "ein", "value": "314394942"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 0.47, "npi": [1255377149]}, {"billed_charge": 0.439, "npi": [1255377149]}, {"billed_charge": 2.0651, "npi": [1467484972]}, {"billed_charge": 11.61, "npi": [1255377149]}, {"billed_charge": 6.21, "npi": [1467484972]}, {"billed_charge": 2.631, "npi": [1467484972]}, {"billed_charge": 8.6125, "npi": [1467484972]}, {"billed_charge": 3.5147, "npi": [1255377149]}, {"billed_charge": 9.1125, "npi": [1255377149]}, {"billed_charge": 39.0, "npi": [1255377149]}, {"billed_charge": 52.05, "npi": [1255377149]}, {"billed_charge": 8.6875, "npi": [1255377149]}, {"billed_charge": 8.8, "npi": [1255377149]}, {"billed_charge": 25.0, "npi": [1255377149]}, {"billed_charge": 43.85, "npi": [1255377149]}, {"billed_charge": 9.3435, "npi": [1255377149]}, {"billed_charge": 23.075, "npi": [1255377149]}, {"billed_charge": 3.6153, "npi": [1467484972]}, {"billed_charge": 0.6065, "npi": [1467484972]}, {"billed_charge": 36.65, "npi": [1255377149]}, {"billed_charge": 17.1375, "npi": [1467484972]}, {"billed_charge": 4.8062, "npi": [1467484972]}, {"billed_charge": 3.87, "npi": [1255377149]}, {"billed_charge": 71.35, "npi": [1467484972]}, {"billed_charge": 126.5, "npi": [1467484972]}, {"billed_charge": 0.0975, "npi": [1255377149]}, {"billed_charge": 2.4117, "npi": [1255377149]}, {"billed_charge": 0.47, "npi": [1467484972]}, {"billed_charge": 1.1517, "npi": [1467484972]}, {"billed_charge": 2.4454, "npi": [1255377149]}, {"billed_charge": 5.3778, "npi": [1255377149]}, {"billed_charge": 9.51, "npi": [1255377149]}, {"billed_charge": 17.225, "npi": [1255377149]}, {"billed_charge": 3.0462, "npi": [1255377149]}, {"billed_charge": 3.4227, "npi": [1255377149]}, {"billed_charge": 62.95, "npi": [1467484972]}, {"billed_charge": 3.65, "npi": [1467484972]}, {"billed_charge": 17.975, "npi": [1467484972]}, {"billed_charge": 5.34, "npi": [1467484972]}, {"billed_charge": 9.5, "npi": [1255377149]}, {"billed_charge": 0.6295, "npi": [1467484972]}, {"billed_charge": 36.6, "npi": [1255377149]}, {"billed_charge": 67.15, "npi": [1255377149]}, {"billed_charge": 54.3, "npi": [1467484972]}, {"billed_charge": 8.7, "npi": [1255377149]}, {"billed_charge": 35.4, "npi": [1255377149]}, {"billed_charge": 9.1125, "npi": [1467484972]}, {"billed_charge": 6.0616, "npi": [1467484972]}, {"billed_charge": 9.65, "npi": [1467484972]}, {"billed_charge": 2.2082, "npi": [1255377149]}, {"billed_charge": 11.6625, "npi": [1467484972]}, {"billed_charge": 0.595, "npi": [1255377149]}]}, {"allowed_amount": 0.425, "billing_code_modifier": [""], "providers": [{"billed_charge": 17.575, "npi": [1255377149]}]}, {"allowed_amount": 0.46, "billing_code_modifier": [""], "providers": [{"billed_charge": 34.55, "npi": [1255377149]}, {"billed_charge": 34.1, "npi": [1255377149]}, {"billed_charge": 36.0, "npi": [1255377149]}, {"billed_charge": 34.5, "npi": [1255377149]}]}, {"allowed_amount": 0.48, "billing_code_modifier": [""], "providers": [{"billed_charge": 34.5, "npi": [1255377149]}]}, {"allowed_amount": 0.47, "billing_code_modifier": [""], "providers": [{"billed_charge": 17.575, "npi": [1255377149]}]}, {"allowed_amount": 0.485, "billing_code_modifier": [""], "providers": [{"billed_charge": 18.05, "npi": [1255377149]}]}]}]}, {"name": "Laboratory - Bacteriology & Microbiology", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0306", "description": "Laboratory", "allowed_amounts": [{"tin": {"type": "ein", "value": "340714612"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 113.0, "npi": [1841299039]}, {"billed_charge": 105.0, "npi": [1841299039]}, {"billed_charge": 85.0, "npi": [1841299039]}, {"billed_charge": 128.0, "npi": [1841299039]}, {"billed_charge": 168.0, "npi": [1841299039]}, {"billed_charge": 222.0, "npi": [1841299039]}, {"billed_charge": 157.2632, "npi": [1841299039]}, {"billed_charge": 225.0, "npi": [1841299039]}, {"billed_charge": 118.0, "npi": [1841299039]}, {"billed_charge": 231.0, "npi": [1841299039]}, {"billed_charge": 182.25, "npi": [1841299039]}, {"billed_charge": 216.0, "npi": [1841299039]}, {"billed_charge": 162.0, "npi": [1841299039]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["59"], "providers": [{"billed_charge": 193.0, "npi": [1841299039]}]}]}]}, {"name": "Laboratory - Hematology", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0305", "description": "Laboratory", "allowed_amounts": [{"tin": {"type": "ein", "value": "340714538"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 47.0, "npi": [1356366991]}, {"billed_charge": 51.6667, "npi": [1356366991]}, {"billed_charge": 28.0, "npi": [1356366991]}, {"billed_charge": 64.0, "npi": [1356366991]}, {"billed_charge": 50.0, "npi": [1356366991]}, {"billed_charge": 30.0, "npi": [1356366991]}, {"billed_charge": 104.0, "npi": [1356366991]}, {"billed_charge": 80.4, "npi": [1356366991]}, {"billed_charge": 86.0, "npi": [1356366991]}, {"billed_charge": 90.0, "npi": [1356366991]}, {"billed_charge": 97.0, "npi": [1356366991]}]}]}]}, {"name": "Laboratory - Chemistry", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0301", "description": "Laboratory", "allowed_amounts": [{"tin": {"type": "ein", "value": "340714456"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 5.11, "billing_code_modifier": [""], "providers": [{"billed_charge": 14.0, "npi": [1790837235]}, {"billed_charge": 15.0, "npi": [1790837235]}]}, {"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 58.0, "npi": [1790837235]}, {"billed_charge": 76.0, "npi": [1790837235]}, {"billed_charge": 84.1786, "npi": [1790837235]}, {"billed_charge": 64.0, "npi": [1790837235]}, {"billed_charge": 12.0, "npi": [1790837235]}, {"billed_charge": 313.0, "npi": [1790837235]}, {"billed_charge": 52.0, "npi": [1790837235]}, {"billed_charge": 211.0, "npi": [1790837235]}, {"billed_charge": 78.0, "npi": [1790837235]}, {"billed_charge": 261.0, "npi": [1790837235]}, {"billed_charge": 39.0, "npi": [1790837235]}, {"billed_charge": 73.5, "npi": [1790837235]}, {"billed_charge": 60.0, "npi": [1790837235]}, {"billed_charge": 84.0, "npi": [1790837235]}, {"billed_charge": 68.0, "npi": [1790837235]}, {"billed_charge": 14.0, "npi": [1790837235]}, {"billed_charge": 90.0, "npi": [1790837235]}, {"billed_charge": 79.0, "npi": [1790837235]}, {"billed_charge": 142.0, "npi": [1790837235]}, {"billed_charge": 63.1, "npi": [1790837235]}, {"billed_charge": 109.0, "npi": [1790837235]}, {"billed_charge": 121.0, "npi": [1790837235]}, {"billed_charge": 67.5909, "npi": [1790837235]}, {"billed_charge": 47.0, "npi": [1790837235]}, {"billed_charge": 149.0, "npi": [1790837235]}, {"billed_charge": 124.0, "npi": [1790837235]}, {"billed_charge": 106.0, "npi": [1790837235]}, {"billed_charge": 62.0, "npi": [1790837235]}, {"billed_charge": 122.0, "npi": [1790837235]}, {"billed_charge": 91.0, "npi": [1790837235]}, {"billed_charge": 73.25, "npi": [1790837235]}, {"billed_charge": 80.125, "npi": [1790837235]}, {"billed_charge": 15.0, "npi": [1790837235]}, {"billed_charge": 314.0, "npi": [1790837235]}, {"billed_charge": 82.1875, "npi": [1790837235]}, {"billed_charge": 72.9565, "npi": [1790837235]}, {"billed_charge": 86.7692, "npi": [1790837235]}, {"billed_charge": 55.0, "npi": [1790837235]}, {"billed_charge": 230.0, "npi": [1790837235]}, {"billed_charge": 70.0, "npi": [1790837235]}, {"billed_charge": 88.0, "npi": [1790837235]}, {"billed_charge": 107.0, "npi": [1790837235]}, {"billed_charge": 89.0, "npi": [1790837235]}, {"billed_charge": 77.0, "npi": [1790837235]}, {"billed_charge": 74.0, "npi": [1790837235]}, {"billed_charge": 86.8, "npi": [1790837235]}, {"billed_charge": 323.0, "npi": [1790837235]}, {"billed_charge": 88.5, "npi": [1790837235]}, {"billed_charge": 71.0952, "npi": [1790837235]}, {"billed_charge": 75.0, "npi": [1790837235]}, {"billed_charge": 111.0, "npi": [1790837235]}, {"billed_charge": 60.7727, "npi": [1790837235]}, {"billed_charge": 156.0, "npi": [1790837235]}, {"billed_charge": 118.0, "npi": [1790837235]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["XU"], "providers": [{"billed_charge": 14.0, "npi": [1790837235]}]}, {"allowed_amount": 5.31, "billing_code_modifier": [""], "providers": [{"billed_charge": 12.0, "npi": [1790837235]}]}, {"allowed_amount": 5.11, "billing_code_modifier": ["XU"], "providers": [{"billed_charge": 15.0, "npi": [1790837235]}]}, {"allowed_amount": 17.54, "billing_code_modifier": [""], "providers": [{"billed_charge": 79.0, "npi": [1790837235]}]}]}]}, {"name": "Laboratory - Chemistry", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0301", "description": "Laboratory", "allowed_amounts": [{"tin": {"type": "ein", "value": "550675666"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 330.58, "npi": [1073518007]}, {"billed_charge": 315.536, "npi": [1073518007]}, {"billed_charge": 196.88, "npi": [1073518007]}, {"billed_charge": 129.0, "npi": [1073518007]}, {"billed_charge": 120.18, "npi": [1073518007]}, {"billed_charge": 173.08, "npi": [1073518007]}, {"billed_charge": 146.92, "npi": [1073518007]}, {"billed_charge": 104.91, "npi": [1073518007]}, {"billed_charge": 257.41, "npi": [1073518007]}, {"billed_charge": 498.46, "npi": [1073518007]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["91"], "providers": [{"billed_charge": 120.18, "npi": [1073518007]}, {"billed_charge": 146.92, "npi": [1073518007]}]}]}]}, {"name": "Laboratory - Bacteriology & Microbiology", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0306", "description": "Laboratory", "allowed_amounts": [{"tin": {"type": "ein", "value": "341567805"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 162.0, "npi": [1043397292]}, {"billed_charge": 131.0, "npi": [1043397292]}, {"billed_charge": 113.0, "npi": [1043397292]}, {"billed_charge": 67.0, "npi": [1043397292]}, {"billed_charge": 222.0, "npi": [1043397292]}, {"billed_charge": 154.0, "npi": [1043397292]}, {"billed_charge": 370.0, "npi": [1043397292]}, {"billed_charge": 85.0, "npi": [1043397292]}, {"billed_charge": 292.4, "npi": [1043397292]}, {"billed_charge": 215.0, "npi": [1043397292]}, {"billed_charge": 216.0, "npi": [1043397292]}, {"billed_charge": 182.0, "npi": [1043397292]}, {"billed_charge": 695.0, "npi": [1043397292]}, {"billed_charge": 148.0, "npi": [1043397292]}, {"billed_charge": 118.0, "npi": [1043397292]}, {"billed_charge": 225.0, "npi": [1043397292]}, {"billed_charge": 220.0, "npi": [1043397292]}, {"billed_charge": 141.0, "npi": [1043397292]}, {"billed_charge": 139.0, "npi": [1043397292]}, {"billed_charge": 132.129, "npi": [1043397292]}, {"billed_charge": 245.0, "npi": [1043397292]}, {"billed_charge": 249.0, "npi": [1043397292]}, {"billed_charge": 207.0, "npi": [1043397292]}, {"billed_charge": 106.0, "npi": [1043397292]}, {"billed_charge": 235.4444, "npi": [1043397292]}, {"billed_charge": 182.5714, "npi": [1043397292]}, {"billed_charge": 94.0, "npi": [1043397292]}, {"billed_charge": 135.7037, "npi": [1043397292]}, {"billed_charge": 168.0, "npi": [1043397292]}, {"billed_charge": 46.0, "npi": [1043397292]}, {"billed_charge": 231.0, "npi": [1043397292]}, {"billed_charge": 136.0, "npi": [1043397292]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["59"], "providers": [{"billed_charge": 67.0, "npi": [1043397292]}, {"billed_charge": 70.0, "npi": [1043397292]}, {"billed_charge": 370.0, "npi": [1043397292]}, {"billed_charge": 215.0, "npi": [1043397292]}, {"billed_charge": 207.0, "npi": [1043397292]}, {"billed_charge": 174.0, "npi": [1043397292]}]}]}]}, {"name": "EMERGENCY DEPARTMENT VISIT HIGH MDM", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "99285", "description": "EMERGENCY DEPARTMENT VISIT HIGH MDM", "allowed_amounts": [{"tin": {"type": "ein", "value": "341786357"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 208.79, "billing_code_modifier": [""], "providers": [{"billed_charge": 1699.88, "npi": [1932152584]}, {"billed_charge": 1750.88, "npi": [1932152584]}]}, {"allowed_amount": 493.38, "billing_code_modifier": [""], "providers": [{"billed_charge": 1699.88, "npi": [1932152584]}, {"billed_charge": 1750.88, "npi": [1932152584]}]}, {"allowed_amount": 208.79, "billing_code_modifier": ["UD"], "providers": [{"billed_charge": 1699.88, "npi": [1932152584]}]}, {"allowed_amount": 195.99, "billing_code_modifier": [""], "providers": [{"billed_charge": 1750.88, "npi": [1932152584]}]}, {"allowed_amount": 208.79, "billing_code_modifier": ["GC"], "providers": [{"billed_charge": 1699.88, "npi": [1932152584]}]}, {"allowed_amount": 195.99, "billing_code_modifier": ["UD"], "providers": [{"billed_charge": 1750.88, "npi": [1932152584]}]}, {"allowed_amount": 493.38, "billing_code_modifier": ["UD"], "providers": [{"billed_charge": 1699.88, "npi": [1932152584]}]}, {"allowed_amount": 480.65, "billing_code_modifier": [""], "providers": [{"billed_charge": 1699.88, "npi": [1932152584]}]}]}]}, {"name": "Radiology - Diagnostic - General", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0320", "description": "Radiology - Diagnostic", "allowed_amounts": [{"tin": {"type": "ein", "value": "340714684"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 679.0, "npi": [1194763045]}, {"billed_charge": 734.0, "npi": [1194763045]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["RT"], "providers": [{"billed_charge": 562.0, "npi": [1194763045]}, {"billed_charge": 608.0, "npi": [1194763045]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["50"], "providers": [{"billed_charge": 1124.0, "npi": [1194763045]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["LT"], "providers": [{"billed_charge": 679.0, "npi": [1194763045]}, {"billed_charge": 562.0, "npi": [1194763045]}, {"billed_charge": 608.0, "npi": [1194763045]}, {"billed_charge": 734.0, "npi": [1194763045]}]}]}]}, {"name": "Laboratory - Chemistry", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0301", "description": "Laboratory", "allowed_amounts": [{"tin": {"type": "ein", "value": "264827222"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 5.31, "billing_code_modifier": ["59"], "providers": [{"billed_charge": 58.0, "npi": [1609189604]}]}, {"allowed_amount": 18.75, "billing_code_modifier": [""], "providers": [{"billed_charge": 191.0, "npi": [1609189604]}]}, {"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 146.0, "npi": [1609189604]}, {"billed_charge": 97.0, "npi": [1609189604]}, {"billed_charge": 147.0, "npi": [1609189604]}, {"billed_charge": 254.0, "npi": [1609189604]}, {"billed_charge": 156.0952, "npi": [1609189604]}, {"billed_charge": 115.0, "npi": [1609189604]}, {"billed_charge": 158.0, "npi": [1609189604]}, {"billed_charge": 302.0, "npi": [1609189604]}, {"billed_charge": 290.0, "npi": [1609189604]}, {"billed_charge": 275.0, "npi": [1609189604]}, {"billed_charge": 130.0, "npi": [1609189604]}, {"billed_charge": 108.0, "npi": [1609189604]}, {"billed_charge": 104.0, "npi": [1609189604]}, {"billed_charge": 212.1818, "npi": [1609189604]}, {"billed_charge": 434.0, "npi": [1609189604]}, {"billed_charge": 78.0, "npi": [1609189604]}, {"billed_charge": 264.0, "npi": [1609189604]}, {"billed_charge": 179.0, "npi": [1609189604]}, {"billed_charge": 152.0, "npi": [1609189604]}, {"billed_charge": 219.0, "npi": [1609189604]}, {"billed_charge": 135.0, "npi": [1609189604]}, {"billed_charge": 172.0, "npi": [1609189604]}, {"billed_charge": 114.1786, "npi": [1609189604]}, {"billed_charge": 837.0, "npi": [1609189604]}, {"billed_charge": 164.0, "npi": [1609189604]}, {"billed_charge": 113.3051, "npi": [1609189604]}, {"billed_charge": 101.0, "npi": [1609189604]}, {"billed_charge": 329.0, "npi": [1609189604]}, {"billed_charge": 153.0, "npi": [1609189604]}, {"billed_charge": 74.0, "npi": [1609189604]}, {"billed_charge": 102.6875, "npi": [1609189604]}, {"billed_charge": 93.0, "npi": [1609189604]}]}, {"allowed_amount": 5.31, "billing_code_modifier": ["91"], "providers": [{"billed_charge": 58.0, "npi": [1609189604]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["59"], "providers": [{"billed_charge": 76.0, "npi": [1609189604]}, {"billed_charge": 73.0, "npi": [1609189604]}, {"billed_charge": 80.0, "npi": [1609189604]}, {"billed_charge": 77.0, "npi": [1609189604]}, {"billed_charge": 57.0, "npi": [1609189604]}, {"billed_charge": 55.0, "npi": [1609189604]}]}, {"allowed_amount": 5.5, "billing_code_modifier": ["59"], "providers": [{"billed_charge": 60.0, "npi": [1609189604]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["91"], "providers": [{"billed_charge": 182.0, "npi": [1609189604]}, {"billed_charge": 108.0, "npi": [1609189604]}, {"billed_charge": 179.0, "npi": [1609189604]}, {"billed_charge": 172.0, "npi": [1609189604]}]}, {"allowed_amount": 5.5, "billing_code_modifier": ["91"], "providers": [{"billed_charge": 60.0, "npi": [1609189604]}]}]}]}, {"name": "Laboratory - General", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0300", "description": "Laboratory", "allowed_amounts": [{"tin": {"type": "ein", "value": "461393755"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 18.75, "billing_code_modifier": [""], "providers": [{"billed_charge": 77.55, "npi": [1457243586]}]}, {"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 40.75, "npi": [1457243586]}, {"billed_charge": 127.25, "npi": [1457243586]}, {"billed_charge": 89.1, "npi": [1457243586]}, {"billed_charge": 139.95, "npi": [1457243586]}, {"billed_charge": 144.2, "npi": [1457243586]}, {"billed_charge": 78.25, "npi": [1457243586]}, {"billed_charge": 234.15, "npi": [1457243586]}, {"billed_charge": 108.7, "npi": [1457243586]}, {"billed_charge": 128.55, "npi": [1457243586]}, {"billed_charge": 112.7, "npi": [1457243586]}, {"billed_charge": 121.2, "npi": [1457243586]}, {"billed_charge": 223.0, "npi": [1457243586]}, {"billed_charge": 93.8, "npi": [1457243586]}, {"billed_charge": 79.8, "npi": [1457243586]}, {"billed_charge": 52.15, "npi": [1457243586]}, {"billed_charge": 38.5, "npi": [1457243586]}, {"billed_charge": 102.15, "npi": [1457243586]}, {"billed_charge": 151.4, "npi": [1457243586]}, {"billed_charge": 32.2, "npi": [1457243586]}, {"billed_charge": 205.4, "npi": [1457243586]}, {"billed_charge": 43.35, "npi": [1457243586]}, {"billed_charge": 65.0, "npi": [1457243586]}, {"billed_charge": 67.9, "npi": [1457243586]}, {"billed_charge": 152.65, "npi": [1457243586]}, {"billed_charge": 74.55, "npi": [1457243586]}, {"billed_charge": 59.95, "npi": [1457243586]}, {"billed_charge": 71.3, "npi": [1457243586]}, {"billed_charge": 54.75, "npi": [1457243586]}, {"billed_charge": 118.35, "npi": [1457243586]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["59"], "providers": [{"billed_charge": 37.8, "npi": [1457243586]}, {"billed_charge": 43.35, "npi": [1457243586]}]}]}]}, {"name": "Laboratory - Chemistry", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0301", "description": "Laboratory", "allowed_amounts": [{"tin": {"type": "ein", "value": "314379491"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 73.0, "npi": [1942256888]}, {"billed_charge": 121.0, "npi": [1942256888]}, {"billed_charge": 138.0, "npi": [1942256888]}, {"billed_charge": 165.0, "npi": [1942256888]}, {"billed_charge": 72.0, "npi": [1942256888]}, {"billed_charge": 103.0, "npi": [1942256888]}, {"billed_charge": 127.0, "npi": [1942256888]}, {"billed_charge": 172.0, "npi": [1942256888]}, {"billed_charge": 216.0, "npi": [1942256888]}, {"billed_charge": 163.0, "npi": [1942256888]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["9159"], "providers": [{"billed_charge": 66.0, "npi": [1942256888]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["59"], "providers": [{"billed_charge": 66.0, "npi": [1942256888]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["91"], "providers": [{"billed_charge": 121.0, "npi": [1942256888]}, {"billed_charge": 163.0, "npi": [1942256888]}]}]}]}, {"name": "Laboratory - Hematology", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0305", "description": "Laboratory", "allowed_amounts": [{"tin": {"type": "ein", "value": "311724085"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 33.79, "billing_code_modifier": [""], "providers": [{"billed_charge": 88.0, "npi": [1669410940]}]}, {"allowed_amount": 49.14, "billing_code_modifier": [""], "providers": [{"billed_charge": 128.0, "npi": [1669410940]}]}, {"allowed_amount": 14.35, "billing_code_modifier": ["91"], "providers": [{"billed_charge": 36.0, "npi": [1669410940]}]}, {"allowed_amount": 25.73, "billing_code_modifier": [""], "providers": [{"billed_charge": 67.0, "npi": [1669410940]}]}, {"allowed_amount": 34.68, "billing_code_modifier": [""], "providers": [{"billed_charge": 87.0, "npi": [1669410940]}]}, {"allowed_amount": 32.63, "billing_code_modifier": [""], "providers": [{"billed_charge": 85.0, "npi": [1669410940]}]}]}]}, {"name": "IV Therapy -General", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0260", "description": "IV Therapy", "allowed_amounts": [{"tin": {"type": "ein", "value": "340714458"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 1363.34, "billing_code_modifier": [""], "providers": [{"billed_charge": 294.0, "npi": [1942248737]}]}, {"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 318.0, "npi": [1942248737]}, {"billed_charge": 563.2, "npi": [1942248737]}, {"billed_charge": 644.5, "npi": [1942248737]}, {"billed_charge": 696.6667, "npi": [1942248737]}, {"billed_charge": 531.6, "npi": [1942248737]}, {"billed_charge": 545.2, "npi": [1942248737]}, {"billed_charge": 645.25, "npi": [1942248737]}, {"billed_charge": 637.3333, "npi": [1942248737]}, {"billed_charge": 754.3333, "npi": [1942248737]}, {"billed_charge": 584.6, "npi": [1942248737]}, {"billed_charge": 435.0, "npi": [1942248737]}, {"billed_charge": 602.0, "npi": [1942248737]}, {"billed_charge": 886.0, "npi": [1942248737]}, {"billed_charge": 461.1111, "npi": [1942248737]}, {"billed_charge": 294.0, "npi": [1942248737]}, {"billed_charge": 491.0, "npi": [1942248737]}, {"billed_charge": 1454.0, "npi": [1942248737]}, {"billed_charge": 762.0, "npi": [1942248737]}, {"billed_charge": 488.0, "npi": [1942248737]}, {"billed_charge": 634.0, "npi": [1942248737]}, {"billed_charge": 1324.0, "npi": [1942248737]}]}, {"allowed_amount": 263.68, "billing_code_modifier": ["59"], "providers": [{"billed_charge": 1324.0, "npi": [1942248737]}]}, {"allowed_amount": 11454.56, "billing_code_modifier": [""], "providers": [{"billed_charge": 1454.0, "npi": [1942248737]}]}, {"allowed_amount": 61.7258, "billing_code_modifier": [""], "providers": [{"billed_charge": 318.0, "npi": [1942248737]}]}, {"allowed_amount": 57.74, "billing_code_modifier": ["59"], "providers": [{"billed_charge": 294.0, "npi": [1942248737]}]}, {"allowed_amount": 61.725, "billing_code_modifier": [""], "providers": [{"billed_charge": 318.0, "npi": [1942248737]}]}, {"allowed_amount": 57.74, "billing_code_modifier": [""], "providers": [{"billed_charge": 294.0, "npi": [1942248737]}]}, {"allowed_amount": 280.35, "billing_code_modifier": [""], "providers": [{"billed_charge": 1454.0, "npi": [1942248737]}]}, {"allowed_amount": 280.35, "billing_code_modifier": ["59"], "providers": [{"billed_charge": 1454.0, "npi": [1942248737]}]}, {"allowed_amount": 263.68, "billing_code_modifier": [""], "providers": [{"billed_charge": 1324.0, "npi": [1942248737]}]}, {"allowed_amount": 6141.13, "billing_code_modifier": [""], "providers": [{"billed_charge": 488.0, "npi": [1942248737]}]}, {"allowed_amount": 61.73, "billing_code_modifier": [""], "providers": [{"billed_charge": 318.0, "npi": [1942248737]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["59"], "providers": [{"billed_charge": 435.0, "npi": [1942248737]}, {"billed_charge": 294.0, "npi": [1942248737]}, {"billed_charge": 1454.0, "npi": [1942248737]}, {"billed_charge": 488.0, "npi": [1942248737]}, {"billed_charge": 1324.0, "npi": [1942248737]}]}, {"allowed_amount": 61.725, "billing_code_modifier": ["59"], "providers": [{"billed_charge": 318.0, "npi": [1942248737]}]}, {"allowed_amount": 2083.1071, "billing_code_modifier": [""], "providers": [{"billed_charge": 318.0, "npi": [1942248737]}]}, {"allowed_amount": 61.73, "billing_code_modifier": ["59"], "providers": [{"billed_charge": 318.0, "npi": [1942248737]}]}]}]}, {"name": "Laboratory - General", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0300", "description": "Laboratory", "allowed_amounts": [{"tin": {"type": "ein", "value": "341567805"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 192.55, "billing_code_modifier": [""], "providers": [{"billed_charge": 384.0, "npi": [1043397292]}]}, {"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 60.0, "npi": [1043397292]}, {"billed_charge": 68.4444, "npi": [1043397292]}, {"billed_charge": 29.0, "npi": [1043397292]}, {"billed_charge": 54.25, "npi": [1043397292]}, {"billed_charge": 641.0, "npi": [1043397292]}, {"billed_charge": 617.0, "npi": [1043397292]}, {"billed_charge": 130.0, "npi": [1043397292]}, {"billed_charge": 72.0, "npi": [1043397292]}, {"billed_charge": 64.6, "npi": [1043397292]}, {"billed_charge": 62.6364, "npi": [1043397292]}, {"billed_charge": 169.7273, "npi": [1043397292]}, {"billed_charge": 194.0, "npi": [1043397292]}, {"billed_charge": 59.0, "npi": [1043397292]}, {"billed_charge": 125.0, "npi": [1043397292]}, {"billed_charge": 104.8, "npi": [1043397292]}, {"billed_charge": 135.0, "npi": [1043397292]}, {"billed_charge": 164.8571, "npi": [1043397292]}, {"billed_charge": 130.7143, "npi": [1043397292]}, {"billed_charge": 140.0, "npi": [1043397292]}, {"billed_charge": 30.0, "npi": [1043397292]}, {"billed_charge": 336.0, "npi": [1043397292]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["59"], "providers": [{"billed_charge": 336.0, "npi": [1043397292]}]}]}]}, {"name": "Pharmacy - Extension of 25X - Drug Requiring Detailed Coding", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0636", "description": "Pharmacy - Extension of 25x", "allowed_amounts": [{"tin": {"type": "ein", "value": "310653685"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.406, "billing_code_modifier": [""], "providers": [{"billed_charge": 1.0, "npi": [1225053119]}]}, {"allowed_amount": 13.9925, "billing_code_modifier": ["JZ"], "providers": [{"billed_charge": 34.4625, "npi": [1225053119]}]}, {"allowed_amount": 0.0698, "billing_code_modifier": ["JZ"], "providers": [{"billed_charge": 0.162, "npi": [1225053119]}]}, {"allowed_amount": 0.81, "billing_code_modifier": ["JZSE"], "providers": [{"billed_charge": 2.0, "npi": [1225053119]}]}, {"allowed_amount": 5.47, "billing_code_modifier": ["JZSE"], "providers": [{"billed_charge": 13.48, "npi": [1225053119]}]}, {"allowed_amount": 0.405, "billing_code_modifier": ["JZ"], "providers": [{"billed_charge": 1.0, "npi": [1225053119]}]}, {"allowed_amount": 4.87, "billing_code_modifier": [""], "providers": [{"billed_charge": 12.0, "npi": [1225053119]}]}, {"allowed_amount": 0.405, "billing_code_modifier": ["JZSE"], "providers": [{"billed_charge": 1.0, "npi": [1225053119]}]}, {"allowed_amount": 0.2333, "billing_code_modifier": ["JWSE"], "providers": [{"billed_charge": 0.576, "npi": [1225053119]}]}, {"allowed_amount": 1.62, "billing_code_modifier": [""], "providers": [{"billed_charge": 4.0, "npi": [1225053119]}]}, {"allowed_amount": 0.4824, "billing_code_modifier": ["JWSE"], "providers": [{"billed_charge": 1.1877, "npi": [1225053119]}]}, {"allowed_amount": 0.162, "billing_code_modifier": ["SE"], "providers": [{"billed_charge": 0.4, "npi": [1225053119]}]}, {"allowed_amount": 0.774, "billing_code_modifier": ["JZ"], "providers": [{"billed_charge": 1.8004, "npi": [1225053119]}]}, {"allowed_amount": 20.3, "billing_code_modifier": [""], "providers": [{"billed_charge": 50.0, "npi": [1225053119]}]}, {"allowed_amount": 6.82, "billing_code_modifier": ["JZSE"], "providers": [{"billed_charge": 16.78, "npi": [1225053119]}]}, {"allowed_amount": 0.2865, "billing_code_modifier": [""], "providers": [{"billed_charge": 0.6667, "npi": [1225053119]}]}, {"allowed_amount": 1.022, "billing_code_modifier": ["JZSE"], "providers": [{"billed_charge": 2.516, "npi": [1225053119]}]}, {"allowed_amount": 0.4058, "billing_code_modifier": ["JZ"], "providers": [{"billed_charge": 1.0, "npi": [1225053119]}]}, {"allowed_amount": 0.81, "billing_code_modifier": [""], "providers": [{"billed_charge": 2.0, "npi": [1225053119]}, {"billed_charge": 1.992, "npi": [1225053119]}]}, {"allowed_amount": 4.87, "billing_code_modifier": ["SE"], "providers": [{"billed_charge": 12.0, "npi": [1225053119]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["JZ"], "providers": [{"billed_charge": 2.0, "npi": [1225053119]}]}, {"allowed_amount": 0.544, "billing_code_modifier": [""], "providers": [{"billed_charge": 1.262, "npi": [1225053119]}]}, {"allowed_amount": 1.62, "billing_code_modifier": ["JW"], "providers": [{"billed_charge": 4.0, "npi": [1225053119]}]}, {"allowed_amount": 0.85, "billing_code_modifier": ["JZ"], "providers": [{"billed_charge": 2.0, "npi": [1225053119]}]}, {"allowed_amount": 0.0203, "billing_code_modifier": ["JZSE"], "providers": [{"billed_charge": 0.05, "npi": [1225053119]}]}, {"allowed_amount": 0.2707, "billing_code_modifier": [""], "providers": [{"billed_charge": 0.6667, "npi": [1225053119]}]}, {"allowed_amount": 0.5292, "billing_code_modifier": ["SE"], "providers": [{"billed_charge": 1.304, "npi": [1225053119]}]}, {"allowed_amount": 0.81, "billing_code_modifier": ["JW"], "providers": [{"billed_charge": 2.0, "npi": [1225053119]}, {"billed_charge": 1.992, "npi": [1225053119]}]}]}]}, {"name": "EMERGENCY DEPARTMENT VISIT MODERATE MDM", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "99284", "description": "EMERGENCY DEPARTMENT VISIT MODERATE MDM", "allowed_amounts": [{"tin": {"type": "ein", "value": "341786357"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 143.9, "billing_code_modifier": ["GC"], "providers": [{"billed_charge": 1186.31, "npi": [1932152584]}]}, {"allowed_amount": 143.9, "billing_code_modifier": [""], "providers": [{"billed_charge": 1151.76, "npi": [1932152584]}, {"billed_charge": 1186.31, "npi": [1932152584]}]}, {"allowed_amount": 330.7, "billing_code_modifier": [""], "providers": [{"billed_charge": 1151.76, "npi": [1932152584]}]}, {"allowed_amount": 135.25, "billing_code_modifier": [""], "providers": [{"billed_charge": 1186.31, "npi": [1932152584]}]}, {"allowed_amount": 143.9, "billing_code_modifier": ["57"], "providers": [{"billed_charge": 1151.76, "npi": [1932152584]}]}, {"allowed_amount": 143.9, "billing_code_modifier": ["UD"], "providers": [{"billed_charge": 1151.76, "npi": [1932152584]}]}, {"allowed_amount": 339.46, "billing_code_modifier": [""], "providers": [{"billed_charge": 1151.76, "npi": [1932152584]}]}, {"allowed_amount": 135.25, "billing_code_modifier": ["UD"], "providers": [{"billed_charge": 1186.31, "npi": [1932152584]}]}, {"allowed_amount": 143.9, "billing_code_modifier": ["25GC"], "providers": [{"billed_charge": 1186.31, "npi": [1932152584]}]}]}]}, {"name": "Pharmacy - Extension of 25X - Drug Requiring Detailed Coding", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0636", "description": "Pharmacy - Extension of 25x", "allowed_amounts": [{"tin": {"type": "ein", "value": "344430849"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 15.0, "npi": [1851338149]}, {"billed_charge": 9.0, "npi": [1851338149]}, {"billed_charge": 27.0, "npi": [1851338149]}, {"billed_charge": 1.25, "npi": [1851338149]}, {"billed_charge": 0.28, "npi": [1851338149]}, {"billed_charge": 10.0, "npi": [1851338149]}, {"billed_charge": 0.22, "npi": [1851338149]}, {"billed_charge": 373.0, "npi": [1851338149]}, {"billed_charge": 144.0, "npi": [1851338149]}, {"billed_charge": 1.5, "npi": [1851338149]}]}, {"allowed_amount": 0.435, "billing_code_modifier": ["JZ"], "providers": [{"billed_charge": 8.0, "npi": [1851338149]}]}, {"allowed_amount": 0.41, "billing_code_modifier": ["JZ"], "providers": [{"billed_charge": 8.0, "npi": [1851338149]}]}, {"allowed_amount": 0.43, "billing_code_modifier": ["JZ"], "providers": [{"billed_charge": 8.0, "npi": [1851338149]}]}, {"allowed_amount": 0.4075, "billing_code_modifier": ["JZ"], "providers": [{"billed_charge": 2.5, "npi": [1851338149]}]}, {"allowed_amount": 0.4325, "billing_code_modifier": ["JZ"], "providers": [{"billed_charge": 2.5, "npi": [1851338149]}]}]}]}, {"name": "IV Therapy -General", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0260", "description": "IV Therapy", "allowed_amounts": [{"tin": {"type": "ein", "value": "344428256"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 1141.5, "npi": [1407854771]}, {"billed_charge": 1918.0, "npi": [1407854771]}, {"billed_charge": 1181.0, "npi": [1407854771]}, {"billed_charge": 330.0, "npi": [1407854771]}, {"billed_charge": 394.0, "npi": [1407854771]}, {"billed_charge": 313.0, "npi": [1407854771]}, {"billed_charge": 1067.0, "npi": [1407854771]}, {"billed_charge": 716.25, "npi": [1407854771]}, {"billed_charge": 859.3333, "npi": [1407854771]}, {"billed_charge": 459.1429, "npi": [1407854771]}, {"billed_charge": 1821.0, "npi": [1407854771]}, {"billed_charge": 501.5, "npi": [1407854771]}]}, {"allowed_amount": 63.38, "billing_code_modifier": [""], "providers": [{"billed_charge": 330.0, "npi": [1407854771]}]}, {"allowed_amount": 287.87, "billing_code_modifier": [""], "providers": [{"billed_charge": 1918.0, "npi": [1407854771]}, {"billed_charge": 1181.0, "npi": [1407854771]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["59"], "providers": [{"billed_charge": 1918.0, "npi": [1407854771]}, {"billed_charge": 330.0, "npi": [1407854771]}, {"billed_charge": 462.0, "npi": [1407854771]}, {"billed_charge": 313.0, "npi": [1407854771]}, {"billed_charge": 1821.0, "npi": [1407854771]}]}, {"allowed_amount": 278.64, "billing_code_modifier": [""], "providers": [{"billed_charge": 1821.0, "npi": [1407854771]}]}, {"allowed_amount": 61.03, "billing_code_modifier": [""], "providers": [{"billed_charge": 313.0, "npi": [1407854771]}]}]}]}, {"name": "Radiology - Diagnostic - General", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0320", "description": "Radiology - Diagnostic", "allowed_amounts": [{"tin": {"type": "ein", "value": "341105619"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 941.0, "npi": [1811939887]}, {"billed_charge": 571.0, "npi": [1811939887]}, {"billed_charge": 566.0, "npi": [1811939887]}, {"billed_charge": 603.0, "npi": [1811939887]}, {"billed_charge": 565.0, "npi": [1811939887]}, {"billed_charge": 360.0, "npi": [1811939887]}, {"billed_charge": 737.0, "npi": [1811939887]}]}, {"allowed_amount": 115.75, "billing_code_modifier": [""], "providers": [{"billed_charge": 343.0, "npi": [1811939887]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["RT"], "providers": [{"billed_charge": 774.0, "npi": [1811939887]}, {"billed_charge": 663.0, "npi": [1811939887]}, {"billed_charge": 711.0, "npi": [1811939887]}, {"billed_charge": 696.0, "npi": [1811939887]}, {"billed_charge": 854.0, "npi": [1811939887]}, {"billed_charge": 678.0, "npi": [1811939887]}, {"billed_charge": 506.0, "npi": [1811939887]}, {"billed_charge": 712.0, "npi": [1811939887]}, {"billed_charge": 788.0, "npi": [1811939887]}, {"billed_charge": 747.0, "npi": [1811939887]}, {"billed_charge": 792.0, "npi": [1811939887]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["LT"], "providers": [{"billed_charge": 571.0, "npi": [1811939887]}, {"billed_charge": 711.0, "npi": [1811939887]}, {"billed_charge": 696.0, "npi": [1811939887]}, {"billed_charge": 633.0, "npi": [1811939887]}, {"billed_charge": 854.0, "npi": [1811939887]}, {"billed_charge": 678.0, "npi": [1811939887]}, {"billed_charge": 596.0, "npi": [1811939887]}, {"billed_charge": 712.0, "npi": [1811939887]}, {"billed_charge": 747.0, "npi": [1811939887]}, {"billed_charge": 820.0, "npi": [1811939887]}, {"billed_charge": 737.0, "npi": [1811939887]}, {"billed_charge": 600.0, "npi": [1811939887]}]}]}]}, {"name": "Laboratory - Chemistry", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0301", "description": "Laboratory", "allowed_amounts": [{"tin": {"type": "ein", "value": "344428218"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 282.2, "npi": [1801884655]}, {"billed_charge": 114.8, "npi": [1801884655]}, {"billed_charge": 84.0, "npi": [1801884655]}, {"billed_charge": 64.6, "npi": [1801884655]}, {"billed_charge": 66.6, "npi": [1801884655]}, {"billed_charge": 204.5, "npi": [1801884655]}, {"billed_charge": 123.8, "npi": [1801884655]}, {"billed_charge": 65.5, "npi": [1801884655]}, {"billed_charge": 180.7, "npi": [1801884655]}, {"billed_charge": 77.6, "npi": [1801884655]}, {"billed_charge": 63.7, "npi": [1801884655]}, {"billed_charge": 49.2333, "npi": [1801884655]}, {"billed_charge": 92.8824, "npi": [1801884655]}, {"billed_charge": 109.9, "npi": [1801884655]}, {"billed_charge": 193.475, "npi": [1801884655]}, {"billed_charge": 81.1, "npi": [1801884655]}, {"billed_charge": 171.5, "npi": [1801884655]}, {"billed_charge": 143.0, "npi": [1801884655]}, {"billed_charge": 20.2, "npi": [1801884655]}, {"billed_charge": 80.4, "npi": [1801884655]}, {"billed_charge": 245.3, "npi": [1801884655]}, {"billed_charge": 68.4, "npi": [1801884655]}, {"billed_charge": 118.5, "npi": [1801884655]}, {"billed_charge": 234.7, "npi": [1801884655]}, {"billed_charge": 61.8, "npi": [1801884655]}, {"billed_charge": 172.9, "npi": [1801884655]}]}]}]}, {"name": "Pharmacy - General", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0250", "description": "Pharmacy (also see 063x, an extension of 025x)", "allowed_amounts": [{"tin": {"type": "ein", "value": "341105619"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 10.607, "npi": [1811939887]}, {"billed_charge": 20.9593, "npi": [1811939887]}, {"billed_charge": 9.0087, "npi": [1811939887]}, {"billed_charge": 125.0, "npi": [1811939887]}, {"billed_charge": 108.3333, "npi": [1811939887]}, {"billed_charge": 228.85, "npi": [1811939887]}, {"billed_charge": 7.4582, "npi": [1811939887]}, {"billed_charge": 2.6667, "npi": [1811939887]}, {"billed_charge": 124.8089, "npi": [1811939887]}, {"billed_charge": 6.5277, "npi": [1811939887]}, {"billed_charge": 14.1621, "npi": [1811939887]}, {"billed_charge": 9.6246, "npi": [1811939887]}, {"billed_charge": 54.1667, "npi": [1811939887]}, {"billed_charge": 5.5757, "npi": [1811939887]}, {"billed_charge": 8.1434, "npi": [1811939887]}, {"billed_charge": 45.0, "npi": [1811939887]}, {"billed_charge": 68.75, "npi": [1811939887]}, {"billed_charge": 16.4864, "npi": [1811939887]}, {"billed_charge": 11.5818, "npi": [1811939887]}, {"billed_charge": 12.2451, "npi": [1811939887]}, {"billed_charge": 6.9229, "npi": [1811939887]}, {"billed_charge": 12.5, "npi": [1811939887]}, {"billed_charge": 6.7549, "npi": [1811939887]}, {"billed_charge": 14.9296, "npi": [1811939887]}, {"billed_charge": 98.2143, "npi": [1811939887]}, {"billed_charge": 25.2826, "npi": [1811939887]}, {"billed_charge": 100.0, "npi": [1811939887]}, {"billed_charge": 12.8149, "npi": [1811939887]}, {"billed_charge": 87.5, "npi": [1811939887]}, {"billed_charge": 18.0648, "npi": [1811939887]}, {"billed_charge": 75.0, "npi": [1811939887]}, {"billed_charge": 3.6073, "npi": [1811939887]}, {"billed_charge": 3.4977, "npi": [1811939887]}, {"billed_charge": 13.2708, "npi": [1811939887]}, {"billed_charge": 542.1, "npi": [1811939887]}, {"billed_charge": 27.4191, "npi": [1811939887]}, {"billed_charge": 55.0, "npi": [1811939887]}, {"billed_charge": 5.1765, "npi": [1811939887]}, {"billed_charge": 4.8857, "npi": [1811939887]}, {"billed_charge": 9.4928, "npi": [1811939887]}, {"billed_charge": 10.3347, "npi": [1811939887]}, {"billed_charge": 67.6, "npi": [1811939887]}]}]}]}, {"name": "EKG/ECG (Electrocardiogram) - General", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0730", "description": "EKG/ECG (Electrocardiogram)", "allowed_amounts": [{"tin": {"type": "ein", "value": "340714618"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 315.0, "npi": [1215989611]}, {"billed_charge": 342.0, "npi": [1215989611]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["5977"], "providers": [{"billed_charge": 342.0, "npi": [1215989611]}]}]}]}, {"name": "Radiology - Diagnostic - General", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0320", "description": "Radiology - Diagnostic", "allowed_amounts": [{"tin": {"type": "ein", "value": "340714585"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 562.0, "npi": [1679525919]}, {"billed_charge": 734.0, "npi": [1679525919]}, {"billed_charge": 591.44, "npi": [1679525919]}, {"billed_charge": 848.5, "npi": [1679525919]}, {"billed_charge": 679.0, "npi": [1679525919]}, {"billed_charge": 2882.0, "npi": [1679525919]}, {"billed_charge": 601.0, "npi": [1679525919]}, {"billed_charge": 1118.6667, "npi": [1679525919]}, {"billed_charge": 478.6667, "npi": [1679525919]}, {"billed_charge": 1011.5, "npi": [1679525919]}, {"billed_charge": 606.9286, "npi": [1679525919]}, {"billed_charge": 608.0, "npi": [1679525919]}, {"billed_charge": 591.25, "npi": [1679525919]}, {"billed_charge": 2127.0, "npi": [1679525919]}, {"billed_charge": 671.0, "npi": [1679525919]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["RT"], "providers": [{"billed_charge": 562.0, "npi": [1679525919]}, {"billed_charge": 679.0, "npi": [1679525919]}, {"billed_charge": 608.0, "npi": [1679525919]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["50"], "providers": [{"billed_charge": 1216.0, "npi": [1679525919]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["LT"], "providers": [{"billed_charge": 562.0, "npi": [1679525919]}, {"billed_charge": 734.0, "npi": [1679525919]}, {"billed_charge": 679.0, "npi": [1679525919]}, {"billed_charge": 608.0, "npi": [1679525919]}]}]}]}, {"name": "Laboratory - General", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0300", "description": "Laboratory", "allowed_amounts": [{"tin": {"type": "ein", "value": "340714618"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 64.0, "npi": [1215989611]}, {"billed_charge": 52.0, "npi": [1215989611]}, {"billed_charge": 58.0, "npi": [1215989611]}, {"billed_charge": 63.0, "npi": [1215989611]}, {"billed_charge": 56.7143, "npi": [1215989611]}, {"billed_charge": 21.0, "npi": [1215989611]}, {"billed_charge": 124.0625, "npi": [1215989611]}, {"billed_charge": 44.0, "npi": [1215989611]}, {"billed_charge": 20.0, "npi": [1215989611]}, {"billed_charge": 1055.0, "npi": [1215989611]}, {"billed_charge": 59.5556, "npi": [1215989611]}, {"billed_charge": 47.5, "npi": [1215989611]}, {"billed_charge": 119.3438, "npi": [1215989611]}, {"billed_charge": 53.3125, "npi": [1215989611]}, {"billed_charge": 55.4545, "npi": [1215989611]}, {"billed_charge": 67.0, "npi": [1215989611]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["59"], "providers": [{"billed_charge": 15.0, "npi": [1215989611]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["91"], "providers": [{"billed_charge": 32.0, "npi": [1215989611]}, {"billed_charge": 30.0, "npi": [1215989611]}]}, {"allowed_amount": 13.08, "billing_code_modifier": [""], "providers": [{"billed_charge": 63.0, "npi": [1215989611]}]}]}]}, {"name": "Laboratory - General", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0300", "description": "Laboratory", "allowed_amounts": [{"tin": {"type": "ein", "value": "340714538"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 29.0, "npi": [1356366991]}, {"billed_charge": 30.0, "npi": [1356366991]}, {"billed_charge": 89.0, "npi": [1356366991]}, {"billed_charge": 23.0, "npi": [1356366991]}]}]}]}, {"name": "Emergency Room - General", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0450", "description": "Emergency Room", "allowed_amounts": [{"tin": {"type": "ein", "value": "474442902"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 202.37, "billing_code_modifier": [""], "providers": [{"billed_charge": 1093.0, "npi": [1346607017]}]}, {"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 596.0, "npi": [1346607017]}, {"billed_charge": 5073.0, "npi": [1346607017]}, {"billed_charge": 4230.0, "npi": [1346607017]}]}, {"allowed_amount": 359.79, "billing_code_modifier": [""], "providers": [{"billed_charge": 1911.0, "npi": [1346607017]}]}, {"allowed_amount": 1074.22, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 3672.0, "npi": [1346607017]}]}, {"allowed_amount": 767.3, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 3672.0, "npi": [1346607017]}]}, {"allowed_amount": 532.91, "billing_code_modifier": [""], "providers": [{"billed_charge": 2533.0, "npi": [1346607017]}]}, {"allowed_amount": 784.92, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 4230.0, "npi": [1346607017]}]}, {"allowed_amount": 3447.28, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 4230.0, "npi": [1346607017]}]}, {"allowed_amount": 532.91, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 2533.0, "npi": [1346607017]}]}, {"allowed_amount": 346.53, "billing_code_modifier": [""], "providers": [{"billed_charge": 1632.0, "npi": [1346607017]}]}, {"allowed_amount": 549.96, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 2938.0, "npi": [1346607017]}]}]}]}, {"name": "Pharmacy - General", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0250", "description": "Pharmacy (also see 063x, an extension of 025x)", "allowed_amounts": [{"tin": {"type": "ein", "value": "340714458"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 1.9, "npi": [1942248737]}, {"billed_charge": 8.5192, "npi": [1942248737]}, {"billed_charge": 20.4, "npi": [1942248737]}, {"billed_charge": 5.0005, "npi": [1942248737]}, {"billed_charge": 2.0894, "npi": [1942248737]}, {"billed_charge": 2.6, "npi": [1942248737]}, {"billed_charge": 5.6, "npi": [1942248737]}, {"billed_charge": 7.875, "npi": [1942248737]}, {"billed_charge": 9.0096, "npi": [1942248737]}, {"billed_charge": 2.2167, "npi": [1942248737]}, {"billed_charge": 25.9786, "npi": [1942248737]}, {"billed_charge": 21.5, "npi": [1942248737]}, {"billed_charge": 36.4, "npi": [1942248737]}, {"billed_charge": 5.0, "npi": [1942248737]}, {"billed_charge": 11.1167, "npi": [1942248737]}, {"billed_charge": 4.8, "npi": [1942248737]}, {"billed_charge": 18.2417, "npi": [1942248737]}, {"billed_charge": 8.2, "npi": [1942248737]}, {"billed_charge": 3.65, "npi": [1942248737]}, {"billed_charge": 42.6154, "npi": [1942248737]}, {"billed_charge": 14.35, "npi": [1942248737]}, {"billed_charge": 2.325, "npi": [1942248737]}, {"billed_charge": 16.25, "npi": [1942248737]}, {"billed_charge": 22.1625, "npi": [1942248737]}, {"billed_charge": 70.2889, "npi": [1942248737]}, {"billed_charge": 7.0, "npi": [1942248737]}, {"billed_charge": 8.0, "npi": [1942248737]}, {"billed_charge": 3.2, "npi": [1942248737]}, {"billed_charge": 6.6964, "npi": [1942248737]}, {"billed_charge": 2.3266, "npi": [1942248737]}, {"billed_charge": 2.7, "npi": [1942248737]}, {"billed_charge": 11.631, "npi": [1942248737]}, {"billed_charge": 2.2636, "npi": [1942248737]}, {"billed_charge": 3.6658, "npi": [1942248737]}, {"billed_charge": 2.3069, "npi": [1942248737]}, {"billed_charge": 2.0, "npi": [1942248737]}, {"billed_charge": 1.4125, "npi": [1942248737]}, {"billed_charge": 6.5517, "npi": [1942248737]}, {"billed_charge": 2.4, "npi": [1942248737]}, {"billed_charge": 3.8, "npi": [1942248737]}, {"billed_charge": 16.2, "npi": [1942248737]}, {"billed_charge": 7.75, "npi": [1942248737]}, {"billed_charge": 7.1833, "npi": [1942248737]}, {"billed_charge": 29.975, "npi": [1942248737]}, {"billed_charge": 12.0, "npi": [1942248737]}, {"billed_charge": 7.3238, "npi": [1942248737]}, {"billed_charge": 11.4795, "npi": [1942248737]}, {"billed_charge": 2.6878, "npi": [1942248737]}, {"billed_charge": 2.1625, "npi": [1942248737]}, {"billed_charge": 8.5333, "npi": [1942248737]}, {"billed_charge": 1.1563, "npi": [1942248737]}, {"billed_charge": 11.745, "npi": [1942248737]}, {"billed_charge": 5.5175, "npi": [1942248737]}, {"billed_charge": 8.0857, "npi": [1942248737]}, {"billed_charge": 12.8278, "npi": [1942248737]}, {"billed_charge": 15.45, "npi": [1942248737]}, {"billed_charge": 2.6389, "npi": [1942248737]}]}]}]}, {"name": "IV Therapy -General", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0260", "description": "IV Therapy", "allowed_amounts": [{"tin": {"type": "ein", "value": "340714593"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 89.075, "billing_code_modifier": [""], "providers": [{"billed_charge": 435.0, "npi": [1598719346]}]}, {"allowed_amount": 89.07, "billing_code_modifier": ["59"], "providers": [{"billed_charge": 435.0, "npi": [1598719346]}]}, {"allowed_amount": 6227.51, "billing_code_modifier": [""], "providers": [{"billed_charge": 1454.0, "npi": [1598719346]}]}, {"allowed_amount": 10745.86, "billing_code_modifier": ["59"], "providers": [{"billed_charge": 1454.0, "npi": [1235183542]}]}, {"allowed_amount": 61.7267, "billing_code_modifier": [""], "providers": [{"billed_charge": 318.0, "npi": [1902858152]}, {"billed_charge": 318.0, "npi": [1235183542]}, {"billed_charge": 318.0, "npi": [1598719346]}]}, {"allowed_amount": 0.3, "billing_code_modifier": [""], "providers": [{"billed_charge": 318.0, "npi": [1902858152]}]}, {"allowed_amount": 61.7264, "billing_code_modifier": [""], "providers": [{"billed_charge": 318.0, "npi": [1235183542]}]}, {"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 435.0, "npi": [1902858152]}, {"billed_charge": 318.0, "npi": [1902858152]}, {"billed_charge": 706.0, "npi": [1598719346]}, {"billed_charge": 491.0, "npi": [1235183542]}, {"billed_charge": 886.0, "npi": [1902858152]}, {"billed_charge": 294.0, "npi": [1235183542]}, {"billed_charge": 452.0, "npi": [1235183542]}, {"billed_charge": 294.0, "npi": [1598719346]}, {"billed_charge": 972.5, "npi": [1598719346]}, {"billed_charge": 294.0, "npi": [1902858152]}, {"billed_charge": 1324.0, "npi": [1902858152]}, {"billed_charge": 888.0, "npi": [1235183542]}, {"billed_charge": 809.0, "npi": [1235183542]}, {"billed_charge": 1324.0, "npi": [1598719346]}, {"billed_charge": 1324.0, "npi": [1235183542]}, {"billed_charge": 488.0, "npi": [1235183542]}, {"billed_charge": 1454.0, "npi": [1598719346]}, {"billed_charge": 1454.0, "npi": [1902858152]}, {"billed_charge": 435.0, "npi": [1235183542]}, {"billed_charge": 318.0, "npi": [1235183542]}, {"billed_charge": 528.2, "npi": [1902858152]}, {"billed_charge": 491.0, "npi": [1902858152]}, {"billed_charge": 706.0, "npi": [1235183542]}, {"billed_charge": 435.0, "npi": [1598719346]}, {"billed_charge": 318.0, "npi": [1598719346]}, {"billed_charge": 762.0, "npi": [1598719346]}, {"billed_charge": 886.0, "npi": [1235183542]}, {"billed_charge": 689.75, "npi": [1235183542]}, {"billed_charge": 637.3333, "npi": [1902858152]}, {"billed_charge": 1454.0, "npi": [1235183542]}, {"billed_charge": 452.0, "npi": [1598719346]}, {"billed_charge": 886.0, "npi": [1598719346]}, {"billed_charge": 491.0, "npi": [1598719346]}, {"billed_charge": 488.0, "npi": [1902858152]}, {"billed_charge": 452.0, "npi": [1902858152]}, {"billed_charge": 488.0, "npi": [1598719346]}]}, {"allowed_amount": 263.68, "billing_code_modifier": ["59"], "providers": [{"billed_charge": 1324.0, "npi": [1902858152]}, {"billed_charge": 1324.0, "npi": [1598719346]}, {"billed_charge": 1324.0, "npi": [1235183542]}]}, {"allowed_amount": 0.26, "billing_code_modifier": [""], "providers": [{"billed_charge": 1454.0, "npi": [1902858152]}]}, {"allowed_amount": 2370.0325, "billing_code_modifier": [""], "providers": [{"billed_charge": 294.0, "npi": [1902858152]}]}, {"allowed_amount": 57.74, "billing_code_modifier": ["59"], "providers": [{"billed_charge": 294.0, "npi": [1235183542]}, {"billed_charge": 294.0, "npi": [1598719346]}, {"billed_charge": 294.0, "npi": [1902858152]}]}, {"allowed_amount": 766.273, "billing_code_modifier": [""], "providers": [{"billed_charge": 318.0, "npi": [1598719346]}]}, {"allowed_amount": 61.725, "billing_code_modifier": [""], "providers": [{"billed_charge": 318.0, "npi": [1902858152]}, {"billed_charge": 318.0, "npi": [1235183542]}, {"billed_charge": 318.0, "npi": [1598719346]}]}, {"allowed_amount": 57.74, "billing_code_modifier": [""], "providers": [{"billed_charge": 294.0, "npi": [1235183542]}, {"billed_charge": 294.0, "npi": [1598719346]}, {"billed_charge": 294.0, "npi": [1902858152]}]}, {"allowed_amount": 89.07, "billing_code_modifier": [""], "providers": [{"billed_charge": 435.0, "npi": [1902858152]}, {"billed_charge": 435.0, "npi": [1235183542]}]}, {"allowed_amount": 280.35, "billing_code_modifier": [""], "providers": [{"billed_charge": 1454.0, "npi": [1598719346]}, {"billed_charge": 1454.0, "npi": [1902858152]}, {"billed_charge": 1454.0, "npi": [1235183542]}]}, {"allowed_amount": 1067.4429, "billing_code_modifier": [""], "providers": [{"billed_charge": 318.0, "npi": [1235183542]}]}, {"allowed_amount": 443.475, "billing_code_modifier": [""], "providers": [{"billed_charge": 318.0, "npi": [1902858152]}]}, {"allowed_amount": 280.35, "billing_code_modifier": ["59"], "providers": [{"billed_charge": 1454.0, "npi": [1598719346]}, {"billed_charge": 1454.0, "npi": [1902858152]}, {"billed_charge": 1454.0, "npi": [1235183542]}]}, {"allowed_amount": 1511.842, "billing_code_modifier": [""], "providers": [{"billed_charge": 488.0, "npi": [1598719346]}]}, {"allowed_amount": 61.7267, "billing_code_modifier": ["59"], "providers": [{"billed_charge": 318.0, "npi": [1902858152]}]}, {"allowed_amount": 57.7391, "billing_code_modifier": [""], "providers": [{"billed_charge": 294.0, "npi": [1902858152]}]}, {"allowed_amount": 263.68, "billing_code_modifier": [""], "providers": [{"billed_charge": 1324.0, "npi": [1902858152]}, {"billed_charge": 1324.0, "npi": [1598719346]}, {"billed_charge": 1324.0, "npi": [1235183542]}]}, {"allowed_amount": 884.8613, "billing_code_modifier": [""], "providers": [{"billed_charge": 294.0, "npi": [1598719346]}]}, {"allowed_amount": 61.73, "billing_code_modifier": [""], "providers": [{"billed_charge": 318.0, "npi": [1902858152]}, {"billed_charge": 318.0, "npi": [1235183542]}, {"billed_charge": 318.0, "npi": [1598719346]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["59"], "providers": [{"billed_charge": 435.0, "npi": [1902858152]}, {"billed_charge": 318.0, "npi": [1902858152]}, {"billed_charge": 491.0, "npi": [1235183542]}, {"billed_charge": 294.0, "npi": [1598719346]}, {"billed_charge": 1324.0, "npi": [1598719346]}, {"billed_charge": 1324.0, "npi": [1235183542]}, {"billed_charge": 488.0, "npi": [1235183542]}, {"billed_charge": 1454.0, "npi": [1598719346]}, {"billed_charge": 1454.0, "npi": [1902858152]}, {"billed_charge": 435.0, "npi": [1235183542]}, {"billed_charge": 318.0, "npi": [1235183542]}, {"billed_charge": 491.0, "npi": [1902858152]}, {"billed_charge": 318.0, "npi": [1598719346]}, {"billed_charge": 1454.0, "npi": [1235183542]}, {"billed_charge": 452.0, "npi": [1598719346]}, {"billed_charge": 491.0, "npi": [1598719346]}, {"billed_charge": 488.0, "npi": [1902858152]}, {"billed_charge": 452.0, "npi": [1902858152]}, {"billed_charge": 488.0, "npi": [1598719346]}]}, {"allowed_amount": 94.89, "billing_code_modifier": [""], "providers": [{"billed_charge": 491.0, "npi": [1598719346]}]}, {"allowed_amount": 61.725, "billing_code_modifier": ["59"], "providers": [{"billed_charge": 318.0, "npi": [1902858152]}, {"billed_charge": 318.0, "npi": [1598719346]}]}, {"allowed_amount": 61.7257, "billing_code_modifier": [""], "providers": [{"billed_charge": 318.0, "npi": [1235183542]}]}, {"allowed_amount": 61.73, "billing_code_modifier": ["59"], "providers": [{"billed_charge": 318.0, "npi": [1902858152]}, {"billed_charge": 318.0, "npi": [1235183542]}, {"billed_charge": 318.0, "npi": [1598719346]}]}]}]}, {"name": "Laboratory - Chemistry", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0301", "description": "Laboratory", "allowed_amounts": [{"tin": {"type": "ein", "value": "310538525"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 153.5, "npi": [1780633289]}, {"billed_charge": 148.0, "npi": [1780633289]}, {"billed_charge": 124.0, "npi": [1780633289]}, {"billed_charge": 78.0, "npi": [1780633289]}, {"billed_charge": 88.0, "npi": [1780633289]}, {"billed_charge": 107.0, "npi": [1780633289]}, {"billed_charge": 102.0, "npi": [1780633289]}, {"billed_charge": 116.0, "npi": [1780633289]}, {"billed_charge": 271.0, "npi": [1780633289]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["91"], "providers": [{"billed_charge": 37.0, "npi": [1780633289]}, {"billed_charge": 78.0, "npi": [1780633289]}, {"billed_charge": 36.0, "npi": [1780633289]}, {"billed_charge": 30.0, "npi": [1780633289]}, {"billed_charge": 38.0, "npi": [1780633289]}]}, {"allowed_amount": 5.5, "billing_code_modifier": ["91"], "providers": [{"billed_charge": 20.0, "npi": [1780633289]}]}]}]}, {"name": "Laboratory - Hematology", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0305", "description": "Laboratory", "allowed_amounts": [{"tin": {"type": "ein", "value": "340714456"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 59.0, "npi": [1790837235]}, {"billed_charge": 41.9474, "npi": [1790837235]}, {"billed_charge": 15.7727, "npi": [1790837235]}, {"billed_charge": 31.0, "npi": [1790837235]}, {"billed_charge": 33.3333, "npi": [1790837235]}, {"billed_charge": 52.0, "npi": [1790837235]}, {"billed_charge": 33.5, "npi": [1790837235]}, {"billed_charge": 30.0, "npi": [1790837235]}, {"billed_charge": 35.0, "npi": [1790837235]}, {"billed_charge": 17.25, "npi": [1790837235]}, {"billed_charge": 29.4, "npi": [1790837235]}, {"billed_charge": 17.7368, "npi": [1790837235]}, {"billed_charge": 10.0, "npi": [1790837235]}, {"billed_charge": 39.2, "npi": [1790837235]}, {"billed_charge": 155.0, "npi": [1790837235]}, {"billed_charge": 36.5, "npi": [1790837235]}, {"billed_charge": 31.25, "npi": [1790837235]}, {"billed_charge": 29.5455, "npi": [1790837235]}, {"billed_charge": 32.0, "npi": [1790837235]}, {"billed_charge": 25.0, "npi": [1790837235]}, {"billed_charge": 32.5, "npi": [1790837235]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["XU"], "providers": [{"billed_charge": 10.0, "npi": [1790837235]}]}]}]}, {"name": "Radiology - Diagnostic - General", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0320", "description": "Radiology - Diagnostic", "allowed_amounts": [{"tin": {"type": "ein", "value": "340714456"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 522.0, "npi": [1790837235]}, {"billed_charge": 349.0, "npi": [1790837235]}, {"billed_charge": 268.0, "npi": [1790837235]}, {"billed_charge": 375.125, "npi": [1790837235]}, {"billed_charge": 393.0, "npi": [1790837235]}, {"billed_charge": 344.0, "npi": [1790837235]}, {"billed_charge": 353.6667, "npi": [1790837235]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["RT"], "providers": [{"billed_charge": 391.0, "npi": [1790837235]}, {"billed_charge": 502.0, "npi": [1790837235]}, {"billed_charge": 360.0, "npi": [1790837235]}, {"billed_charge": 452.0, "npi": [1790837235]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["LT"], "providers": [{"billed_charge": 349.0, "npi": [1790837235]}, {"billed_charge": 352.0, "npi": [1790837235]}, {"billed_charge": 507.0, "npi": [1790837235]}, {"billed_charge": 391.0, "npi": [1790837235]}, {"billed_charge": 395.0, "npi": [1790837235]}, {"billed_charge": 526.0, "npi": [1790837235]}, {"billed_charge": 502.0, "npi": [1790837235]}, {"billed_charge": 531.0, "npi": [1790837235]}]}]}]}, {"name": "EMERGENCY DEPARTMENT VISIT HIGH MDM", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "99285", "description": "EMERGENCY DEPARTMENT VISIT HIGH MDM", "allowed_amounts": [{"tin": {"type": "ein", "value": "264094289"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 540.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 540.0, "npi": [1275773301]}]}, {"allowed_amount": 540.0, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 540.0, "npi": [1275773301]}]}, {"allowed_amount": 540.0, "billing_code_modifier": ["25FS"], "providers": [{"billed_charge": 540.0, "npi": [1275773301]}]}, {"allowed_amount": 540.0, "billing_code_modifier": ["FS25"], "providers": [{"billed_charge": 540.0, "npi": [1275773301]}]}]}]}, {"name": "Laboratory - Hematology", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0305", "description": "Laboratory", "allowed_amounts": [{"tin": {"type": "ein", "value": "264827222"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 125.2, "npi": [1609189604]}, {"billed_charge": 174.2593, "npi": [1609189604]}, {"billed_charge": 134.0, "npi": [1609189604]}, {"billed_charge": 100.0, "npi": [1609189604]}, {"billed_charge": 121.0, "npi": [1609189604]}, {"billed_charge": 124.6, "npi": [1609189604]}, {"billed_charge": 208.0, "npi": [1609189604]}, {"billed_charge": 104.0, "npi": [1609189604]}, {"billed_charge": 139.0, "npi": [1609189604]}, {"billed_charge": 125.5, "npi": [1609189604]}, {"billed_charge": 116.0, "npi": [1609189604]}, {"billed_charge": 216.0, "npi": [1609189604]}, {"billed_charge": 49.0, "npi": [1609189604]}, {"billed_charge": 173.0, "npi": [1609189604]}, {"billed_charge": 109.875, "npi": [1609189604]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["59"], "providers": [{"billed_charge": 70.0, "npi": [1609189604]}, {"billed_charge": 121.0, "npi": [1609189604]}, {"billed_charge": 67.0, "npi": [1609189604]}]}]}]}, {"name": "Pharmacy - Extension of 25X - Drug Requiring Detailed Coding", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0636", "description": "Pharmacy - Extension of 25x", "allowed_amounts": [{"tin": {"type": "ein", "value": "341105619"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": ["SEJW"], "providers": [{"billed_charge": 434.8, "npi": [1811939887]}]}, {"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 4.82, "npi": [1811939887]}, {"billed_charge": 2.305, "npi": [1811939887]}, {"billed_charge": 0.2088, "npi": [1811939887]}, {"billed_charge": 434.8, "npi": [1811939887]}, {"billed_charge": 214.65, "npi": [1811939887]}, {"billed_charge": 92.05, "npi": [1811939887]}, {"billed_charge": 48.8, "npi": [1811939887]}, {"billed_charge": 1.637, "npi": [1811939887]}, {"billed_charge": 8.1, "npi": [1811939887]}, {"billed_charge": 117.0, "npi": [1811939887]}, {"billed_charge": 12.54, "npi": [1811939887]}, {"billed_charge": 0.77, "npi": [1811939887]}, {"billed_charge": 7.5, "npi": [1811939887]}, {"billed_charge": 0.5, "npi": [1811939887]}, {"billed_charge": 13.5, "npi": [1811939887]}, {"billed_charge": 0.2205, "npi": [1811939887]}, {"billed_charge": 17.1, "npi": [1811939887]}, {"billed_charge": 0.7704, "npi": [1811939887]}, {"billed_charge": 5.0, "npi": [1811939887]}, {"billed_charge": 2.185, "npi": [1811939887]}, {"billed_charge": 2.3025, "npi": [1811939887]}, {"billed_charge": 0.3, "npi": [1811939887]}, {"billed_charge": 6.675, "npi": [1811939887]}, {"billed_charge": 6.68, "npi": [1811939887]}, {"billed_charge": 97.05, "npi": [1811939887]}, {"billed_charge": 6.4, "npi": [1811939887]}]}, {"allowed_amount": 0.47, "billing_code_modifier": ["JZ"], "providers": [{"billed_charge": 33.15, "npi": [1811939887]}, {"billed_charge": 55.6, "npi": [1811939887]}]}, {"allowed_amount": 0.294, "billing_code_modifier": ["JZ"], "providers": [{"billed_charge": 4.784, "npi": [1811939887]}]}, {"allowed_amount": 0.46, "billing_code_modifier": ["JZ"], "providers": [{"billed_charge": 17.1, "npi": [1811939887]}, {"billed_charge": 55.6, "npi": [1811939887]}]}, {"allowed_amount": 0.42, "billing_code_modifier": ["JZ"], "providers": [{"billed_charge": 52.8, "npi": [1811939887]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["JZ"], "providers": [{"billed_charge": 9.75, "npi": [1811939887]}, {"billed_charge": 15.0, "npi": [1811939887]}, {"billed_charge": 21.5, "npi": [1811939887]}, {"billed_charge": 3.75, "npi": [1811939887]}, {"billed_charge": 56.0, "npi": [1811939887]}, {"billed_charge": 9.25, "npi": [1811939887]}, {"billed_charge": 721.5, "npi": [1811939887]}, {"billed_charge": 33.3, "npi": [1811939887]}, {"billed_charge": 6.25, "npi": [1811939887]}, {"billed_charge": 20.7, "npi": [1811939887]}, {"billed_charge": 8.1, "npi": [1811939887]}, {"billed_charge": 15.6, "npi": [1811939887]}, {"billed_charge": 2.925, "npi": [1811939887]}, {"billed_charge": 44.8, "npi": [1811939887]}, {"billed_charge": 11.7, "npi": [1811939887]}, {"billed_charge": 42.9, "npi": [1811939887]}, {"billed_charge": 36.1, "npi": [1811939887]}, {"billed_charge": 5.85, "npi": [1811939887]}, {"billed_charge": 7.5, "npi": [1811939887]}, {"billed_charge": 15.36, "npi": [1811939887]}, {"billed_charge": 28.0, "npi": [1811939887]}, {"billed_charge": 4.81, "npi": [1811939887]}, {"billed_charge": 304.2, "npi": [1811939887]}, {"billed_charge": 16.2, "npi": [1811939887]}, {"billed_charge": 9.4556, "npi": [1811939887]}, {"billed_charge": 28.525, "npi": [1811939887]}, {"billed_charge": 5.925, "npi": [1811939887]}, {"billed_charge": 142.0, "npi": [1811939887]}, {"billed_charge": 22.1875, "npi": [1811939887]}, {"billed_charge": 396.3, "npi": [1811939887]}, {"billed_charge": 54.8, "npi": [1811939887]}, {"billed_charge": 62.65, "npi": [1811939887]}, {"billed_charge": 288.6, "npi": [1811939887]}, {"billed_charge": 12.2, "npi": [1811939887]}, {"billed_charge": 17.6, "npi": [1811939887]}, {"billed_charge": 89.6, "npi": [1811939887]}, {"billed_charge": 23.0, "npi": [1811939887]}, {"billed_charge": 19.12, "npi": [1811939887]}, {"billed_charge": 51.9, "npi": [1811939887]}, {"billed_charge": 48.95, "npi": [1811939887]}, {"billed_charge": 11.656, "npi": [1811939887]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["JW"], "providers": [{"billed_charge": 4.82, "npi": [1811939887]}, {"billed_charge": 434.8, "npi": [1811939887]}, {"billed_charge": 8.1, "npi": [1811939887]}, {"billed_charge": 20.25, "npi": [1811939887]}, {"billed_charge": 5.1571, "npi": [1811939887]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["SE"], "providers": [{"billed_charge": 434.8, "npi": [1811939887]}]}, {"allowed_amount": 0.425, "billing_code_modifier": ["JZ"], "providers": [{"billed_charge": 52.75, "npi": [1811939887]}, {"billed_charge": 55.6, "npi": [1811939887]}]}]}]}, {"name": "Pharmacy - General", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0250", "description": "Pharmacy (also see 063x, an extension of 025x)", "allowed_amounts": [{"tin": {"type": "ein", "value": "461393755"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 4.1, "npi": [1457243586]}, {"billed_charge": 6.75, "npi": [1457243586]}, {"billed_charge": 60.0, "npi": [1457243586]}, {"billed_charge": 1.75, "npi": [1457243586]}, {"billed_charge": 2.9, "npi": [1457243586]}, {"billed_charge": 8.65, "npi": [1457243586]}, {"billed_charge": 11.9, "npi": [1457243586]}, {"billed_charge": 34.35, "npi": [1457243586]}, {"billed_charge": 10.25, "npi": [1457243586]}, {"billed_charge": 0.95, "npi": [1457243586]}, {"billed_charge": 1.05, "npi": [1457243586]}, {"billed_charge": 1.6, "npi": [1457243586]}, {"billed_charge": 2.6, "npi": [1457243586]}, {"billed_charge": 7.5, "npi": [1457243586]}, {"billed_charge": 2.2, "npi": [1457243586]}, {"billed_charge": 2.15, "npi": [1457243586]}, {"billed_charge": 8.6, "npi": [1457243586]}, {"billed_charge": 2.4, "npi": [1457243586]}, {"billed_charge": 1.3, "npi": [1457243586]}, {"billed_charge": 1.4, "npi": [1457243586]}]}]}]}, {"name": "Laboratory - Urology", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0307", "description": "Laboratory", "allowed_amounts": [{"tin": {"type": "ein", "value": "340714538"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 40.0, "npi": [1356366991]}, {"billed_charge": 62.0, "npi": [1356366991]}, {"billed_charge": 122.0, "npi": [1356366991]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["59"], "providers": [{"billed_charge": 62.0, "npi": [1356366991]}]}]}]}, {"name": "ECG ROUTINE ECG W/LEAST 12 LDS I and R ONLY", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "93010", "description": "ECG ROUTINE ECG W/LEAST 12 LDS I and R ONLY", "allowed_amounts": [{"tin": {"type": "ein", "value": "463160463"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 10.24, "billing_code_modifier": [""], "providers": [{"billed_charge": 85.75, "npi": [1154763944]}]}, {"allowed_amount": 10.24, "billing_code_modifier": ["76"], "providers": [{"billed_charge": 85.75, "npi": [1154763944]}]}, {"allowed_amount": 9.12, "billing_code_modifier": ["59"], "providers": [{"billed_charge": 85.75, "npi": [1154763944]}]}, {"allowed_amount": 10.24, "billing_code_modifier": ["59"], "providers": [{"billed_charge": 85.75, "npi": [1154763944]}]}, {"allowed_amount": 9.12, "billing_code_modifier": [""], "providers": [{"billed_charge": 85.75, "npi": [1154763944]}, {"billed_charge": 83.25, "npi": [1154763944]}]}]}]}, {"name": "Anesthesia - General", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0370", "description": "Anesthesia", "allowed_amounts": [{"tin": {"type": "ein", "value": "340714585"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 413.0, "npi": [1679525919]}, {"billed_charge": 395.5098, "npi": [1679525919]}, {"billed_charge": 417.6667, "npi": [1679525919]}, {"billed_charge": 424.6154, "npi": [1679525919]}, {"billed_charge": 425.5217, "npi": [1679525919]}, {"billed_charge": 382.0, "npi": [1679525919]}, {"billed_charge": 380.7697, "npi": [1679525919]}, {"billed_charge": 387.0, "npi": [1679525919]}, {"billed_charge": 413.5185, "npi": [1679525919]}, {"billed_charge": 456.0, "npi": [1679525919]}, {"billed_charge": 422.0, "npi": [1679525919]}]}]}]}, {"name": "Laboratory - Chemistry", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0301", "description": "Laboratory", "allowed_amounts": [{"tin": {"type": "ein", "value": "316402480"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 72.0, "npi": [1720159338]}, {"billed_charge": 33.0, "npi": [1720159338]}, {"billed_charge": 87.0, "npi": [1720159338]}, {"billed_charge": 130.0, "npi": [1720159338]}, {"billed_charge": 34.0, "npi": [1720159338]}, {"billed_charge": 88.0, "npi": [1720159338]}, {"billed_charge": 235.0, "npi": [1720159338]}, {"billed_charge": 75.0, "npi": [1720159338]}, {"billed_charge": 146.0, "npi": [1720159338]}, {"billed_charge": 95.0, "npi": [1720159338]}, {"billed_charge": 69.0, "npi": [1720159338]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["91"], "providers": [{"billed_charge": 146.0, "npi": [1720159338]}]}]}]}, {"name": "GROUND MILEAGE PER STATUTE MILE", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "A0425", "description": "GROUND MILEAGE PER STATUTE MILE", "allowed_amounts": [{"tin": {"type": "ein", "value": "346000646"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 9.3286, "billing_code_modifier": ["SH"], "providers": [{"billed_charge": 16.0381, "npi": [1699867077]}]}, {"allowed_amount": 9.3333, "billing_code_modifier": ["HH"], "providers": [{"billed_charge": 16.0333, "npi": [1699867077]}]}, {"allowed_amount": 9.33, "billing_code_modifier": ["RH"], "providers": [{"billed_charge": 16.04, "npi": [1699867077]}]}, {"allowed_amount": 7.045, "billing_code_modifier": ["JH"], "providers": [{"billed_charge": 16.04, "npi": [1699867077]}]}, {"allowed_amount": 9.33, "billing_code_modifier": ["NH"], "providers": [{"billed_charge": 16.04, "npi": [1699867077]}]}, {"allowed_amount": 9.15, "billing_code_modifier": ["RH"], "providers": [{"billed_charge": 16.0412, "npi": [1699867077]}, {"billed_charge": 16.04, "npi": [1699867077]}]}, {"allowed_amount": 9.33, "billing_code_modifier": ["EH"], "providers": [{"billed_charge": 16.04, "npi": [1699867077]}]}, {"allowed_amount": 9.15, "billing_code_modifier": ["EH"], "providers": [{"billed_charge": 16.04, "npi": [1699867077]}]}, {"allowed_amount": 9.33, "billing_code_modifier": ["SH"], "providers": [{"billed_charge": 16.04, "npi": [1699867077]}]}, {"allowed_amount": 9.3308, "billing_code_modifier": ["RH"], "providers": [{"billed_charge": 16.0385, "npi": [1699867077]}]}, {"allowed_amount": 9.1524, "billing_code_modifier": ["SH"], "providers": [{"billed_charge": 16.0381, "npi": [1699867077]}]}, {"allowed_amount": 9.3294, "billing_code_modifier": ["RH"], "providers": [{"billed_charge": 16.0412, "npi": [1699867077]}]}, {"allowed_amount": 9.15, "billing_code_modifier": ["HH"], "providers": [{"billed_charge": 16.04, "npi": [1699867077]}]}, {"allowed_amount": 9.15, "billing_code_modifier": ["PH"], "providers": [{"billed_charge": 16.04, "npi": [1699867077]}]}, {"allowed_amount": 9.33, "billing_code_modifier": ["PH"], "providers": [{"billed_charge": 16.04, "npi": [1699867077]}]}, {"allowed_amount": 7.184, "billing_code_modifier": ["JH"], "providers": [{"billed_charge": 16.04, "npi": [1699867077]}]}, {"allowed_amount": 9.1514, "billing_code_modifier": ["RH"], "providers": [{"billed_charge": 16.04, "npi": [1699867077]}]}, {"allowed_amount": 9.3333, "billing_code_modifier": ["RH"], "providers": [{"billed_charge": 16.0417, "npi": [1699867077]}]}, {"allowed_amount": 9.15, "billing_code_modifier": ["NH"], "providers": [{"billed_charge": 16.04, "npi": [1699867077]}]}, {"allowed_amount": 9.15, "billing_code_modifier": ["SH"], "providers": [{"billed_charge": 16.04, "npi": [1699867077]}]}]}]}, {"name": "Laboratory - General", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0300", "description": "Laboratory", "allowed_amounts": [{"tin": {"type": "ein", "value": "340714684"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 63.0, "npi": [1194763045]}, {"billed_charge": 68.0, "npi": [1194763045]}, {"billed_charge": 58.0, "npi": [1194763045]}, {"billed_charge": 45.95, "npi": [1194763045]}, {"billed_charge": 67.0, "npi": [1194763045]}, {"billed_charge": 52.0, "npi": [1194763045]}, {"billed_charge": 21.0, "npi": [1194763045]}, {"billed_charge": 46.7647, "npi": [1194763045]}, {"billed_charge": 49.0, "npi": [1194763045]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["91"], "providers": [{"billed_charge": 30.0, "npi": [1194763045]}, {"billed_charge": 32.0, "npi": [1194763045]}]}, {"allowed_amount": 5105.92, "billing_code_modifier": [""], "providers": [{"billed_charge": 58.0, "npi": [1194763045]}]}]}]}, {"name": "Laboratory - Urology", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0307", "description": "Laboratory", "allowed_amounts": [{"tin": {"type": "ein", "value": "340714618"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 56.0, "npi": [1215989611]}, {"billed_charge": 59.0, "npi": [1215989611]}, {"billed_charge": 21.0, "npi": [1215989611]}, {"billed_charge": 40.5, "npi": [1215989611]}, {"billed_charge": 22.0, "npi": [1215989611]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["59"], "providers": [{"billed_charge": 21.0, "npi": [1215989611]}, {"billed_charge": 22.0, "npi": [1215989611]}]}]}]}, {"name": "Pharmacy - Drugs Incident to Radiology", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0255", "description": "Pharmacy (also see 063x, an extension of 025x)", "allowed_amounts": [{"tin": {"type": "ein", "value": "341567805"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 0.8085, "npi": [1043397292]}, {"billed_charge": 0.9171, "npi": [1043397292]}, {"billed_charge": 0.6755, "npi": [1043397292]}, {"billed_charge": 0.5635, "npi": [1043397292]}, {"billed_charge": 0.4023, "npi": [1043397292]}, {"billed_charge": 0.7643, "npi": [1043397292]}, {"billed_charge": 0.8086, "npi": [1043397292]}, {"billed_charge": 0.917, "npi": [1043397292]}, {"billed_charge": 0.6754, "npi": [1043397292]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["SE"], "providers": [{"billed_charge": 0.8085, "npi": [1043397292]}, {"billed_charge": 0.6755, "npi": [1043397292]}, {"billed_charge": 0.6754, "npi": [1043397292]}]}]}]}, {"name": "Laboratory - Chemistry", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0301", "description": "Laboratory", "allowed_amounts": [{"tin": {"type": "ein", "value": "340714585"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 23.52, "billing_code_modifier": [""], "providers": [{"billed_charge": 116.0, "npi": [1679525919]}]}, {"allowed_amount": 14.78, "billing_code_modifier": [""], "providers": [{"billed_charge": 73.0, "npi": [1679525919]}]}, {"allowed_amount": 7.03, "billing_code_modifier": ["91"], "providers": [{"billed_charge": 35.0, "npi": [1679525919]}]}, {"allowed_amount": 19.15, "billing_code_modifier": [""], "providers": [{"billed_charge": 87.0, "npi": [1679525919]}]}, {"allowed_amount": 43.37, "billing_code_modifier": [""], "providers": [{"billed_charge": 214.0, "npi": [1679525919]}]}, {"allowed_amount": 18.75, "billing_code_modifier": [""], "providers": [{"billed_charge": 92.0, "npi": [1679525919]}]}, {"allowed_amount": 20.58, "billing_code_modifier": [""], "providers": [{"billed_charge": 101.0, "npi": [1679525919]}]}, {"allowed_amount": 41.44, "billing_code_modifier": [""], "providers": [{"billed_charge": 204.0, "npi": [1679525919]}]}, {"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 128.0, "npi": [1679525919]}, {"billed_charge": 45.0, "npi": [1679525919]}, {"billed_charge": 255.0, "npi": [1679525919]}, {"billed_charge": 42.0, "npi": [1679525919]}, {"billed_charge": 34.0, "npi": [1679525919]}, {"billed_charge": 112.0, "npi": [1679525919]}, {"billed_charge": 102.0667, "npi": [1679525919]}, {"billed_charge": 85.375, "npi": [1679525919]}, {"billed_charge": 58.7857, "npi": [1679525919]}, {"billed_charge": 54.0161, "npi": [1679525919]}, {"billed_charge": 76.4793, "npi": [1679525919]}, {"billed_charge": 63.0, "npi": [1679525919]}, {"billed_charge": 81.0, "npi": [1679525919]}, {"billed_charge": 28.0, "npi": [1679525919]}, {"billed_charge": 80.0, "npi": [1679525919]}, {"billed_charge": 121.0, "npi": [1679525919]}, {"billed_charge": 44.0, "npi": [1679525919]}, {"billed_charge": 116.0, "npi": [1679525919]}, {"billed_charge": 55.0, "npi": [1679525919]}, {"billed_charge": 75.6667, "npi": [1679525919]}, {"billed_charge": 43.0, "npi": [1679525919]}, {"billed_charge": 75.2353, "npi": [1679525919]}, {"billed_charge": 73.0, "npi": [1679525919]}, {"billed_charge": 52.3581, "npi": [1679525919]}, {"billed_charge": 89.0, "npi": [1679525919]}, {"billed_charge": 81.7391, "npi": [1679525919]}, {"billed_charge": 75.0, "npi": [1679525919]}, {"billed_charge": 131.0, "npi": [1679525919]}, {"billed_charge": 95.2883, "npi": [1679525919]}, {"billed_charge": 98.0, "npi": [1679525919]}, {"billed_charge": 112.1718, "npi": [1679525919]}, {"billed_charge": 403.0, "npi": [1679525919]}, {"billed_charge": 56.0, "npi": [1679525919]}, {"billed_charge": 77.3103, "npi": [1679525919]}, {"billed_charge": 48.0, "npi": [1679525919]}, {"billed_charge": 53.0, "npi": [1679525919]}, {"billed_charge": 180.0, "npi": [1679525919]}, {"billed_charge": 66.6429, "npi": [1679525919]}, {"billed_charge": 84.555, "npi": [1679525919]}, {"billed_charge": 86.8333, "npi": [1679525919]}, {"billed_charge": 36.0, "npi": [1679525919]}, {"billed_charge": 44.2907, "npi": [1679525919]}, {"billed_charge": 56.7836, "npi": [1679525919]}, {"billed_charge": 83.0, "npi": [1679525919]}, {"billed_charge": 32.3793, "npi": [1679525919]}, {"billed_charge": 90.12, "npi": [1679525919]}, {"billed_charge": 23.6471, "npi": [1679525919]}, {"billed_charge": 108.8626, "npi": [1679525919]}, {"billed_charge": 94.0, "npi": [1679525919]}, {"billed_charge": 111.7506, "npi": [1679525919]}, {"billed_charge": 92.8095, "npi": [1679525919]}, {"billed_charge": 271.0, "npi": [1679525919]}, {"billed_charge": 429.0, "npi": [1679525919]}, {"billed_charge": 96.2344, "npi": [1679525919]}, {"billed_charge": 188.0, "npi": [1679525919]}, {"billed_charge": 59.2371, "npi": [1679525919]}, {"billed_charge": 70.4545, "npi": [1679525919]}, {"billed_charge": 57.0, "npi": [1679525919]}, {"billed_charge": 90.375, "npi": [1679525919]}, {"billed_charge": 60.0, "npi": [1679525919]}, {"billed_charge": 58.0, "npi": [1679525919]}, {"billed_charge": 31.0, "npi": [1679525919]}, {"billed_charge": 50.4438, "npi": [1679525919]}, {"billed_charge": 22.0, "npi": [1679525919]}, {"billed_charge": 23.0, "npi": [1679525919]}, {"billed_charge": 86.0, "npi": [1679525919]}, {"billed_charge": 97.1538, "npi": [1679525919]}, {"billed_charge": 89.2727, "npi": [1679525919]}, {"billed_charge": 109.0, "npi": [1679525919]}, {"billed_charge": 544.0, "npi": [1679525919]}, {"billed_charge": 69.0, "npi": [1679525919]}, {"billed_charge": 104.0, "npi": [1679525919]}, {"billed_charge": 46.0, "npi": [1679525919]}, {"billed_charge": 119.0, "npi": [1679525919]}, {"billed_charge": 30.0, "npi": [1679525919]}]}, {"allowed_amount": 35.74, "billing_code_modifier": [""], "providers": [{"billed_charge": 176.0, "npi": [1679525919]}]}, {"allowed_amount": 22.68, "billing_code_modifier": [""], "providers": [{"billed_charge": 109.0, "npi": [1679525919]}]}, {"allowed_amount": 54.96, "billing_code_modifier": [""], "providers": [{"billed_charge": 271.0, "npi": [1679525919]}]}, {"allowed_amount": 14.26, "billing_code_modifier": [""], "providers": [{"billed_charge": 69.0, "npi": [1679525919]}]}, {"allowed_amount": 13.59, "billing_code_modifier": [""], "providers": [{"billed_charge": 67.0, "npi": [1679525919]}]}, {"allowed_amount": 19.08, "billing_code_modifier": [""], "providers": [{"billed_charge": 94.0, "npi": [1679525919]}]}, {"allowed_amount": 21.11, "billing_code_modifier": [""], "providers": [{"billed_charge": 104.0, "npi": [1679525919]}]}, {"allowed_amount": 13.11, "billing_code_modifier": [""], "providers": [{"billed_charge": 63.0, "npi": [1679525919]}]}, {"allowed_amount": 33.73, "billing_code_modifier": [""], "providers": [{"billed_charge": 166.0, "npi": [1679525919]}]}, {"allowed_amount": 9.65, "billing_code_modifier": [""], "providers": [{"billed_charge": 48.0, "npi": [1679525919]}]}, {"allowed_amount": 39.96, "billing_code_modifier": [""], "providers": [{"billed_charge": 192.0, "npi": [1679525919]}]}, {"allowed_amount": 10.08, "billing_code_modifier": [""], "providers": [{"billed_charge": 50.0, "npi": [1679525919]}]}, {"allowed_amount": 37.31, "billing_code_modifier": [""], "providers": [{"billed_charge": 184.0, "npi": [1679525919]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["91"], "providers": [{"billed_charge": 45.0, "npi": [1679525919]}, {"billed_charge": 34.0, "npi": [1679525919]}, {"billed_charge": 81.0, "npi": [1679525919]}, {"billed_charge": 80.0, "npi": [1679525919]}, {"billed_charge": 44.0, "npi": [1679525919]}, {"billed_charge": 55.0, "npi": [1679525919]}, {"billed_charge": 75.0, "npi": [1679525919]}, {"billed_charge": 180.0, "npi": [1679525919]}, {"billed_charge": 22.0, "npi": [1679525919]}, {"billed_charge": 23.0, "npi": [1679525919]}, {"billed_charge": 86.0, "npi": [1679525919]}, {"billed_charge": 69.0, "npi": [1679525919]}, {"billed_charge": 46.0, "npi": [1679525919]}]}, {"allowed_amount": 15.95, "billing_code_modifier": [""], "providers": [{"billed_charge": 79.0, "npi": [1679525919]}]}, {"allowed_amount": 18.08, "billing_code_modifier": [""], "providers": [{"billed_charge": 87.0, "npi": [1679525919]}]}, {"allowed_amount": 11.84, "billing_code_modifier": [""], "providers": [{"billed_charge": 58.0, "npi": [1679525919]}]}, {"allowed_amount": 7.03, "billing_code_modifier": [""], "providers": [{"billed_charge": 35.0, "npi": [1679525919]}]}, {"allowed_amount": 17.37, "billing_code_modifier": [""], "providers": [{"billed_charge": 86.0, "npi": [1679525919]}]}, {"allowed_amount": 20.32, "billing_code_modifier": [""], "providers": [{"billed_charge": 98.0, "npi": [1679525919]}]}]}]}, {"name": "Laboratory - General", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0300", "description": "Laboratory", "allowed_amounts": [{"tin": {"type": "ein", "value": "340714612"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 165.0, "npi": [1841299039]}, {"billed_charge": 122.5, "npi": [1841299039]}, {"billed_charge": 130.0, "npi": [1841299039]}, {"billed_charge": 119.9167, "npi": [1841299039]}, {"billed_charge": 182.0, "npi": [1841299039]}, {"billed_charge": 172.0, "npi": [1841299039]}, {"billed_charge": 30.0, "npi": [1841299039]}, {"billed_charge": 86.0, "npi": [1841299039]}, {"billed_charge": 29.0, "npi": [1841299039]}, {"billed_charge": 239.1818, "npi": [1841299039]}, {"billed_charge": 118.3333, "npi": [1841299039]}, {"billed_charge": 64.5, "npi": [1841299039]}]}, {"allowed_amount": 199.68, "billing_code_modifier": [""], "providers": [{"billed_charge": 399.0, "npi": [1841299039]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["59"], "providers": [{"billed_charge": 30.0, "npi": [1841299039]}]}]}]}, {"name": "EKG/ECG (Electrocardiogram) - General", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0730", "description": "EKG/ECG (Electrocardiogram)", "allowed_amounts": [{"tin": {"type": "ein", "value": "264827222"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 390.0, "npi": [1609189604]}, {"billed_charge": 375.0, "npi": [1609189604]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["76"], "providers": [{"billed_charge": 390.0, "npi": [1609189604]}, {"billed_charge": 375.0, "npi": [1609189604]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["59"], "providers": [{"billed_charge": 390.0, "npi": [1609189604]}]}]}]}, {"name": "Radiology - Diagnostic - Chest X-ray", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0324", "description": "Radiology - Diagnostic", "allowed_amounts": [{"tin": {"type": "ein", "value": "341425870"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 375.0, "npi": [1972689172]}, {"billed_charge": 390.0, "npi": [1972689172]}, {"billed_charge": 488.0, "npi": [1972689172]}]}, {"allowed_amount": 106.5, "billing_code_modifier": [""], "providers": [{"billed_charge": 390.0, "npi": [1972689172]}, {"billed_charge": 488.0, "npi": [1972689172]}]}, {"allowed_amount": 110.2, "billing_code_modifier": [""], "providers": [{"billed_charge": 375.0, "npi": [1972689172]}, {"billed_charge": 469.0, "npi": [1972689172]}]}]}]}, {"name": "Pharmacy - General", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0250", "description": "Pharmacy (also see 063x, an extension of 025x)", "allowed_amounts": [{"tin": {"type": "ein", "value": "340714755"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 2.0, "npi": [1396765681]}, {"billed_charge": 1.8333, "npi": [1396765681]}, {"billed_charge": 13.0, "npi": [1396765681]}, {"billed_charge": 1.4, "npi": [1396765681]}, {"billed_charge": 2.875, "npi": [1396765681]}, {"billed_charge": 6.0, "npi": [1396765681]}, {"billed_charge": 3.8636, "npi": [1396765681]}, {"billed_charge": 2.5625, "npi": [1396765681]}, {"billed_charge": 19.25, "npi": [1396765681]}, {"billed_charge": 43.3078, "npi": [1396765681]}, {"billed_charge": 110.0, "npi": [1396765681]}, {"billed_charge": 1.25, "npi": [1396765681]}, {"billed_charge": 4.0, "npi": [1396765681]}, {"billed_charge": 1.6667, "npi": [1396765681]}, {"billed_charge": 2.5, "npi": [1396765681]}]}]}]}, {"name": "Pharmacy - General", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0250", "description": "Pharmacy (also see 063x, an extension of 025x)", "allowed_amounts": [{"tin": {"type": "ein", "value": "340714593"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 3.55, "npi": [1598719346]}, {"billed_charge": 2.0, "npi": [1902858152]}, {"billed_charge": 6.08, "npi": [1235183542]}, {"billed_charge": 2.0667, "npi": [1598719346]}, {"billed_charge": 3.8625, "npi": [1902858152]}, {"billed_charge": 2.0083, "npi": [1235183542]}, {"billed_charge": 5.9167, "npi": [1598719346]}, {"billed_charge": 5.6592, "npi": [1902858152]}, {"billed_charge": 2.8, "npi": [1235183542]}, {"billed_charge": 8.4692, "npi": [1235183542]}, {"billed_charge": 1.58, "npi": [1598719346]}, {"billed_charge": 9.4031, "npi": [1235183542]}, {"billed_charge": 38.8, "npi": [1902858152]}, {"billed_charge": 5.0, "npi": [1902858152]}, {"billed_charge": 40.2, "npi": [1598719346]}, {"billed_charge": 3.3667, "npi": [1598719346]}, {"billed_charge": 8.93, "npi": [1598719346]}, {"billed_charge": 3.8, "npi": [1902858152]}, {"billed_charge": 2.6, "npi": [1235183542]}, {"billed_charge": 3.1167, "npi": [1902858152]}, {"billed_charge": 8.5625, "npi": [1598719346]}, {"billed_charge": 13.4828, "npi": [1902858152]}, {"billed_charge": 15.25, "npi": [1598719346]}, {"billed_charge": 2.45, "npi": [1902858152]}, {"billed_charge": 9.45, "npi": [1235183542]}, {"billed_charge": 23.3, "npi": [1235183542]}, {"billed_charge": 4.875, "npi": [1598719346]}, {"billed_charge": 21.5, "npi": [1235183542]}, {"billed_charge": 24.15, "npi": [1235183542]}, {"billed_charge": 8.1, "npi": [1235183542]}, {"billed_charge": 2.8, "npi": [1598719346]}, {"billed_charge": 2.45, "npi": [1235183542]}, {"billed_charge": 2.2167, "npi": [1235183542]}, {"billed_charge": 1.8429, "npi": [1902858152]}, {"billed_charge": 4.4833, "npi": [1235183542]}, {"billed_charge": 7.25, "npi": [1598719346]}, {"billed_charge": 2.025, "npi": [1598719346]}, {"billed_charge": 3.7167, "npi": [1598719346]}, {"billed_charge": 23.3, "npi": [1598719346]}, {"billed_charge": 8.6231, "npi": [1235183542]}, {"billed_charge": 14.35, "npi": [1235183542]}, {"billed_charge": 15.8576, "npi": [1598719346]}, {"billed_charge": 20.65, "npi": [1902858152]}, {"billed_charge": 180.0, "npi": [1235183542]}, {"billed_charge": 7.7117, "npi": [1902858152]}, {"billed_charge": 19.8167, "npi": [1598719346]}, {"billed_charge": 15.1357, "npi": [1235183542]}, {"billed_charge": 3.9095, "npi": [1598719346]}, {"billed_charge": 13.95, "npi": [1598719346]}, {"billed_charge": 5.9344, "npi": [1235183542]}, {"billed_charge": 9.95, "npi": [1902858152]}, {"billed_charge": 8.2036, "npi": [1235183542]}, {"billed_charge": 6.4, "npi": [1235183542]}, {"billed_charge": 2.39, "npi": [1902858152]}, {"billed_charge": 179.7, "npi": [1902858152]}, {"billed_charge": 4.2417, "npi": [1235183542]}, {"billed_charge": 2.8833, "npi": [1235183542]}, {"billed_charge": 2.4, "npi": [1598719346]}, {"billed_charge": 11.625, "npi": [1235183542]}, {"billed_charge": 2.9889, "npi": [1598719346]}, {"billed_charge": 7.75, "npi": [1902858152]}, {"billed_charge": 93.15, "npi": [1235183542]}, {"billed_charge": 10.7398, "npi": [1598719346]}, {"billed_charge": 9.8333, "npi": [1902858152]}, {"billed_charge": 2.475, "npi": [1598719346]}, {"billed_charge": 8.8, "npi": [1235183542]}, {"billed_charge": 6.8, "npi": [1598719346]}, {"billed_charge": 5.7, "npi": [1902858152]}, {"billed_charge": 16.2, "npi": [1235183542]}, {"billed_charge": 5.8, "npi": [1598719346]}, {"billed_charge": 6.675, "npi": [1902858152]}, {"billed_charge": 3.225, "npi": [1902858152]}, {"billed_charge": 4.15, "npi": [1235183542]}, {"billed_charge": 6.1667, "npi": [1598719346]}, {"billed_charge": 10.8831, "npi": [1235183542]}, {"billed_charge": 2.3, "npi": [1235183542]}, {"billed_charge": 2.6667, "npi": [1598719346]}, {"billed_charge": 13.6447, "npi": [1902858152]}, {"billed_charge": 2.655, "npi": [1235183542]}, {"billed_charge": 2.0, "npi": [1598719346]}, {"billed_charge": 2.625, "npi": [1235183542]}, {"billed_charge": 3.2909, "npi": [1902858152]}, {"billed_charge": 11.1, "npi": [1235183542]}, {"billed_charge": 14.84, "npi": [1235183542]}, {"billed_charge": 2.0, "npi": [1235183542]}, {"billed_charge": 13.75, "npi": [1235183542]}, {"billed_charge": 15.74, "npi": [1598719346]}, {"billed_charge": 28.0, "npi": [1235183542]}, {"billed_charge": 100.3417, "npi": [1902858152]}, {"billed_charge": 7.5167, "npi": [1235183542]}, {"billed_charge": 2.4, "npi": [1235183542]}, {"billed_charge": 4.0333, "npi": [1902858152]}, {"billed_charge": 10.35, "npi": [1598719346]}, {"billed_charge": 2.2, "npi": [1598719346]}, {"billed_charge": 2.1, "npi": [1598719346]}, {"billed_charge": 4.2627, "npi": [1235183542]}, {"billed_charge": 3.0321, "npi": [1902858152]}, {"billed_charge": 6.5333, "npi": [1235183542]}, {"billed_charge": 7.75, "npi": [1598719346]}, {"billed_charge": 3.9167, "npi": [1598719346]}, {"billed_charge": 25.2, "npi": [1902858152]}, {"billed_charge": 2.7625, "npi": [1235183542]}, {"billed_charge": 44.6, "npi": [1598719346]}, {"billed_charge": 5.2, "npi": [1235183542]}, {"billed_charge": 2.55, "npi": [1235183542]}, {"billed_charge": 3.8, "npi": [1235183542]}, {"billed_charge": 4.4625, "npi": [1902858152]}, {"billed_charge": 4.0, "npi": [1598719346]}, {"billed_charge": 2.82, "npi": [1902858152]}, {"billed_charge": 17.25, "npi": [1235183542]}, {"billed_charge": 2.2167, "npi": [1902858152]}, {"billed_charge": 4.52, "npi": [1598719346]}, {"billed_charge": 44.6, "npi": [1235183542]}, {"billed_charge": 16.125, "npi": [1902858152]}, {"billed_charge": 3.3833, "npi": [1598719346]}, {"billed_charge": 2.7, "npi": [1598719346]}, {"billed_charge": 2.15, "npi": [1235183542]}, {"billed_charge": 13.3214, "npi": [1598719346]}, {"billed_charge": 7.5333, "npi": [1235183542]}, {"billed_charge": 12.85, "npi": [1235183542]}, {"billed_charge": 2.95, "npi": [1235183542]}, {"billed_charge": 3.0167, "npi": [1598719346]}, {"billed_charge": 2.35, "npi": [1598719346]}, {"billed_charge": 2.828, "npi": [1902858152]}, {"billed_charge": 20.7125, "npi": [1235183542]}, {"billed_charge": 5.15, "npi": [1235183542]}, {"billed_charge": 18.6833, "npi": [1235183542]}, {"billed_charge": 9.05, "npi": [1235183542]}, {"billed_charge": 50.2778, "npi": [1902858152]}, {"billed_charge": 4.2361, "npi": [1902858152]}, {"billed_charge": 4.5902, "npi": [1598719346]}, {"billed_charge": 3.1545, "npi": [1235183542]}, {"billed_charge": 4.85, "npi": [1235183542]}, {"billed_charge": 7.75, "npi": [1235183542]}, {"billed_charge": 8.9308, "npi": [1598719346]}, {"billed_charge": 2.65, "npi": [1235183542]}, {"billed_charge": 19.75, "npi": [1598719346]}, {"billed_charge": 3.7136, "npi": [1598719346]}, {"billed_charge": 3.225, "npi": [1598719346]}, {"billed_charge": 5.925, "npi": [1235183542]}, {"billed_charge": 3.3375, "npi": [1598719346]}, {"billed_charge": 1.7375, "npi": [1598719346]}, {"billed_charge": 4.5955, "npi": [1235183542]}, {"billed_charge": 10.15, "npi": [1235183542]}, {"billed_charge": 9.45, "npi": [1598719346]}, {"billed_charge": 8.15, "npi": [1598719346]}, {"billed_charge": 1.9, "npi": [1902858152]}, {"billed_charge": 11.3273, "npi": [1235183542]}, {"billed_charge": 3.3083, "npi": [1598719346]}, {"billed_charge": 7.0, "npi": [1598719346]}, {"billed_charge": 3.3682, "npi": [1598719346]}, {"billed_charge": 8.4107, "npi": [1598719346]}, {"billed_charge": 4.5, "npi": [1235183542]}, {"billed_charge": 5.4667, "npi": [1235183542]}, {"billed_charge": 2.2667, "npi": [1902858152]}, {"billed_charge": 4.0571, "npi": [1235183542]}, {"billed_charge": 5.7091, "npi": [1235183542]}, {"billed_charge": 3.7742, "npi": [1598719346]}, {"billed_charge": 10.1333, "npi": [1235183542]}, {"billed_charge": 16.3406, "npi": [1235183542]}, {"billed_charge": 2.7, "npi": [1235183542]}, {"billed_charge": 7.0, "npi": [1902858152]}, {"billed_charge": 2.1625, "npi": [1235183542]}, {"billed_charge": 11.4429, "npi": [1598719346]}, {"billed_charge": 2.95, "npi": [1598719346]}, {"billed_charge": 4.33, "npi": [1598719346]}, {"billed_charge": 14.13, "npi": [1598719346]}, {"billed_charge": 5.8033, "npi": [1235183542]}]}, {"allowed_amount": 1040.4185, "billing_code_modifier": [""], "providers": [{"billed_charge": 8.9308, "npi": [1598719346]}]}, {"allowed_amount": 5873.09, "billing_code_modifier": [""], "providers": [{"billed_charge": 25.2, "npi": [1902858152]}]}, {"allowed_amount": 401.0013, "billing_code_modifier": [""], "providers": [{"billed_charge": 8.93, "npi": [1598719346]}]}]}]}, {"name": "CT Scan - Body Scan", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0352", "description": "CT Scan", "allowed_amounts": [{"tin": {"type": "ein", "value": "341567805"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 231.18, "billing_code_modifier": [""], "providers": [{"billed_charge": 2238.0, "npi": [1043397292]}, {"billed_charge": 3197.0, "npi": [1043397292]}]}, {"allowed_amount": 222.79, "billing_code_modifier": [""], "providers": [{"billed_charge": 3074.0, "npi": [1043397292]}]}, {"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 1795.0, "npi": [1043397292]}, {"billed_charge": 2182.0, "npi": [1043397292]}, {"billed_charge": 3137.0, "npi": [1043397292]}, {"billed_charge": 1843.0, "npi": [1043397292]}, {"billed_charge": 2198.0, "npi": [1043397292]}, {"billed_charge": 3262.0, "npi": [1043397292]}, {"billed_charge": 2053.0, "npi": [1043397292]}, {"billed_charge": 1974.0, "npi": [1043397292]}, {"billed_charge": 2286.0, "npi": [1043397292]}, {"billed_charge": 3534.5, "npi": [1043397292]}, {"billed_charge": 3074.0, "npi": [1043397292]}, {"billed_charge": 2774.0, "npi": [1043397292]}, {"billed_charge": 2011.5, "npi": [1043397292]}, {"billed_charge": 2265.25, "npi": [1043397292]}]}, {"allowed_amount": 459.82, "billing_code_modifier": [""], "providers": [{"billed_charge": 3262.0, "npi": [1043397292]}, {"billed_charge": 3872.0, "npi": [1043397292]}]}, {"allowed_amount": 137.8, "billing_code_modifier": [""], "providers": [{"billed_charge": 2053.0, "npi": [1043397292]}]}, {"allowed_amount": 446.94, "billing_code_modifier": [""], "providers": [{"billed_charge": 3137.0, "npi": [1043397292]}, {"billed_charge": 3723.0, "npi": [1043397292]}]}, {"allowed_amount": 133.08, "billing_code_modifier": ["RT"], "providers": [{"billed_charge": 1853.0, "npi": [1043397292]}]}]}]}, {"name": "CT Scan - Head Scan", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0351", "description": "CT Scan", "allowed_amounts": [{"tin": {"type": "ein", "value": "341567805"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 566.22, "billing_code_modifier": [""], "providers": [{"billed_charge": 1644.0, "npi": [1043397292]}]}, {"allowed_amount": 291.65, "billing_code_modifier": [""], "providers": [{"billed_charge": 1644.0, "npi": [1043397292]}]}, {"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 2840.0, "npi": [1043397292]}, {"billed_charge": 1644.0, "npi": [1043397292]}, {"billed_charge": 1706.0, "npi": [1043397292]}, {"billed_charge": 1640.0, "npi": [1043397292]}, {"billed_charge": 2179.6, "npi": [1043397292]}, {"billed_charge": 1581.0, "npi": [1043397292]}, {"billed_charge": 3197.0, "npi": [1043397292]}, {"billed_charge": 2954.0, "npi": [1043397292]}]}, {"allowed_amount": 544.55, "billing_code_modifier": [""], "providers": [{"billed_charge": 1581.0, "npi": [1043397292]}]}, {"allowed_amount": 133.08, "billing_code_modifier": [""], "providers": [{"billed_charge": 1581.0, "npi": [1043397292]}]}, {"allowed_amount": 281.03, "billing_code_modifier": [""], "providers": [{"billed_charge": 1581.0, "npi": [1043397292]}]}, {"allowed_amount": 544.55, "billing_code_modifier": ["59"], "providers": [{"billed_charge": 1581.0, "npi": [1043397292]}]}]}]}, {"name": "Pharmacy - Extension of 25X - Drug Requiring Detailed Coding", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0636", "description": "Pharmacy - Extension of 25x", "allowed_amounts": [{"tin": {"type": "ein", "value": "340898745"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.105, "billing_code_modifier": [""], "providers": [{"billed_charge": 0.35, "npi": [1275533226]}]}, {"allowed_amount": 0.5075, "billing_code_modifier": [""], "providers": [{"billed_charge": 1.75, "npi": [1275533226]}]}, {"allowed_amount": 0.525, "billing_code_modifier": [""], "providers": [{"billed_charge": 1.75, "npi": [1275533226]}]}, {"allowed_amount": 0.54, "billing_code_modifier": [""], "providers": [{"billed_charge": 1.8, "npi": [1275533226]}]}, {"allowed_amount": 0.505, "billing_code_modifier": [""], "providers": [{"billed_charge": 1.75, "npi": [1275533226]}]}, {"allowed_amount": 3.3, "billing_code_modifier": [""], "providers": [{"billed_charge": 11.0, "npi": [1275533226]}]}, {"allowed_amount": 0.5225, "billing_code_modifier": [""], "providers": [{"billed_charge": 1.75, "npi": [1275533226]}]}, {"allowed_amount": 4772.09, "billing_code_modifier": ["JZ"], "providers": [{"billed_charge": 16513.0, "npi": [1275533226]}]}, {"allowed_amount": 0.7513, "billing_code_modifier": [""], "providers": [{"billed_charge": 2.5, "npi": [1275533226]}]}, {"allowed_amount": 478.0, "billing_code_modifier": ["JZ"], "providers": [{"billed_charge": 1654.0, "npi": [1275533226]}]}, {"allowed_amount": 1.35, "billing_code_modifier": [""], "providers": [{"billed_charge": 4.5, "npi": [1275533226]}]}, {"allowed_amount": 0.0048, "billing_code_modifier": [""], "providers": [{"billed_charge": 0.0167, "npi": [1275533226]}]}, {"allowed_amount": 0.12, "billing_code_modifier": [""], "providers": [{"billed_charge": 0.4, "npi": [1275533226]}]}, {"allowed_amount": 0.675, "billing_code_modifier": [""], "providers": [{"billed_charge": 2.25, "npi": [1275533226]}]}, {"allowed_amount": 71.96, "billing_code_modifier": [""], "providers": [{"billed_charge": 249.0, "npi": [1275533226]}]}, {"allowed_amount": 2.1775, "billing_code_modifier": [""], "providers": [{"billed_charge": 7.25, "npi": [1275533226]}]}, {"allowed_amount": 3.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 10.0, "npi": [1275533226]}]}, {"allowed_amount": 0.7204, "billing_code_modifier": ["JZ"], "providers": [{"billed_charge": 2.4, "npi": [1275533226]}]}, {"allowed_amount": 0.209, "billing_code_modifier": [""], "providers": [{"billed_charge": 0.7, "npi": [1275533226]}]}, {"allowed_amount": 0.0193, "billing_code_modifier": [""], "providers": [{"billed_charge": 0.0667, "npi": [1275533226]}]}, {"allowed_amount": 0.202, "billing_code_modifier": [""], "providers": [{"billed_charge": 0.7, "npi": [1275533226]}]}, {"allowed_amount": 1.74, "billing_code_modifier": ["JZ"], "providers": [{"billed_charge": 6.0, "npi": [1275533226]}]}]}]}, {"name": "CT ANGIOGRAPHY CHEST W/CONTRAST/NONCONTRAST", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "71275", "description": "CT ANGIOGRAPHY CHEST W/CONTRAST/NONCONTRAST", "allowed_amounts": [{"tin": {"type": "ein", "value": "310745303"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 81.37, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 1915.0, "npi": [1669408159]}, {"billed_charge": 1665.0, "npi": [1669408159]}]}, {"allowed_amount": 78.03, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 1915.0, "npi": [1669408159]}]}, {"allowed_amount": 77.3, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 1915.0, "npi": [1669408159]}, {"billed_charge": 1665.0, "npi": [1669408159]}]}, {"allowed_amount": 82.14, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 1915.0, "npi": [1669408159]}]}]}]}, {"name": "Laboratory - Chemistry", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0301", "description": "Laboratory", "allowed_amounts": [{"tin": {"type": "ein", "value": "310537486"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 6.13, "billing_code_modifier": [""], "providers": [{"billed_charge": 17.96, "npi": [1508835828]}]}, {"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 31.94, "npi": [1508835828]}, {"billed_charge": 106.89, "npi": [1508835828]}, {"billed_charge": 39.905, "npi": [1508835828]}, {"billed_charge": 17.34, "npi": [1508835828]}, {"billed_charge": 48.13, "npi": [1508835828]}, {"billed_charge": 82.7857, "npi": [1508835828]}, {"billed_charge": 31.37, "npi": [1508835828]}, {"billed_charge": 37.27, "npi": [1508835828]}]}]}]}, {"name": "Respiratory Services - General", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0410", "description": "Respiratory Services", "allowed_amounts": [{"tin": {"type": "ein", "value": "340714585"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 506.8284, "npi": [1679525919]}, {"billed_charge": 10080.0, "npi": [1679525919]}, {"billed_charge": 2013.3077, "npi": [1679525919]}, {"billed_charge": 941.299, "npi": [1679525919]}, {"billed_charge": 2520.0, "npi": [1679525919]}, {"billed_charge": 1127.7368, "npi": [1679525919]}, {"billed_charge": 1260.6364, "npi": [1679525919]}, {"billed_charge": 1601.8889, "npi": [1679525919]}, {"billed_charge": 1951.0, "npi": [1679525919]}, {"billed_charge": 2041.4516, "npi": [1679525919]}, {"billed_charge": 483.0, "npi": [1679525919]}, {"billed_charge": 1205.0, "npi": [1679525919]}, {"billed_charge": 936.0, "npi": [1679525919]}, {"billed_charge": 813.0, "npi": [1679525919]}, {"billed_charge": 1248.2, "npi": [1679525919]}, {"billed_charge": 1003.125, "npi": [1679525919]}, {"billed_charge": 5040.0, "npi": [1679525919]}]}, {"allowed_amount": 288.61, "billing_code_modifier": [""], "providers": [{"billed_charge": 936.0, "npi": [1679525919]}]}]}]}, {"name": "Emergency Room - General", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0450", "description": "Emergency Room", "allowed_amounts": [{"tin": {"type": "ein", "value": "340714618"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 202.37, "billing_code_modifier": [""], "providers": [{"billed_charge": 1093.0, "npi": [1215989611]}]}, {"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 596.0, "npi": [1215989611]}, {"billed_charge": 526.0, "npi": [1215989611]}, {"billed_charge": 7270.0, "npi": [1215989611]}, {"billed_charge": 5073.0, "npi": [1215989611]}, {"billed_charge": 4230.0, "npi": [1215989611]}, {"billed_charge": 5814.0, "npi": [1215989611]}, {"billed_charge": 3672.0, "npi": [1215989611]}]}, {"allowed_amount": 359.79, "billing_code_modifier": [""], "providers": [{"billed_charge": 1911.0, "npi": [1215989611]}]}, {"allowed_amount": 767.3, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 3672.0, "npi": [1215989611]}]}, {"allowed_amount": 401.63, "billing_code_modifier": [""], "providers": [{"billed_charge": 1399.0, "npi": [1215989611]}]}, {"allowed_amount": 111.15, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 608.0, "npi": [1215989611]}]}, {"allowed_amount": 3313.64, "billing_code_modifier": [""], "providers": [{"billed_charge": 3672.0, "npi": [1215989611]}]}, {"allowed_amount": 359.79, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 1911.0, "npi": [1215989611]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 2938.0, "npi": [1215989611]}, {"billed_charge": 4230.0, "npi": [1215989611]}]}, {"allowed_amount": 214.19, "billing_code_modifier": ["RT"], "providers": [{"billed_charge": 726.0, "npi": [1215989611]}]}, {"allowed_amount": 300.21, "billing_code_modifier": ["LT"], "providers": [{"billed_charge": 971.0, "npi": [1215989611]}]}, {"allowed_amount": 535.79, "billing_code_modifier": [""], "providers": [{"billed_charge": 1199.0, "npi": [1215989611]}]}, {"allowed_amount": 532.91, "billing_code_modifier": [""], "providers": [{"billed_charge": 2533.0, "npi": [1215989611]}]}, {"allowed_amount": 784.92, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 4230.0, "npi": [1215989611]}]}, {"allowed_amount": 3447.28, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 4230.0, "npi": [1215989611]}]}, {"allowed_amount": 2119.36, "billing_code_modifier": ["LT"], "providers": [{"billed_charge": 7362.0, "npi": [1215989611]}]}, {"allowed_amount": 532.91, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 2533.0, "npi": [1215989611]}]}, {"allowed_amount": 3313.64, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 5073.0, "npi": [1215989611]}, {"billed_charge": 3672.0, "npi": [1215989611]}]}, {"allowed_amount": 412.47, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 2938.0, "npi": [1215989611]}]}, {"allowed_amount": 346.53, "billing_code_modifier": [""], "providers": [{"billed_charge": 1632.0, "npi": [1215989611]}]}, {"allowed_amount": 549.96, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 2938.0, "npi": [1215989611]}]}, {"allowed_amount": 549.96, "billing_code_modifier": [""], "providers": [{"billed_charge": 2938.0, "npi": [1215989611]}]}, {"allowed_amount": 110.2, "billing_code_modifier": [""], "providers": [{"billed_charge": 508.0, "npi": [1215989611]}]}]}]}, {"name": "EKG/ECG (Electrocardiogram) - General", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0730", "description": "EKG/ECG (Electrocardiogram)", "allowed_amounts": [{"tin": {"type": "ein", "value": "341567805"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 407.0, "npi": [1043397292]}, {"billed_charge": 399.0, "npi": [1043397292]}, {"billed_charge": 391.0, "npi": [1043397292]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["76"], "providers": [{"billed_charge": 391.0, "npi": [1043397292]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["59"], "providers": [{"billed_charge": 407.0, "npi": [1043397292]}, {"billed_charge": 391.0, "npi": [1043397292]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["77"], "providers": [{"billed_charge": 391.0, "npi": [1043397292]}]}]}]}, {"name": "Pharmacy - Extension of 25X - Drug Requiring Detailed Coding", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0636", "description": "Pharmacy - Extension of 25x", "allowed_amounts": [{"tin": {"type": "ein", "value": "474442902"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 13.0375, "npi": [1346607017]}, {"billed_charge": 1.3, "npi": [1346607017]}, {"billed_charge": 0.4, "npi": [1346607017]}, {"billed_charge": 0.0531, "npi": [1346607017]}, {"billed_charge": 1.45, "npi": [1346607017]}, {"billed_charge": 10.05, "npi": [1346607017]}, {"billed_charge": 44.2, "npi": [1346607017]}, {"billed_charge": 12.05, "npi": [1346607017]}, {"billed_charge": 3.48, "npi": [1346607017]}, {"billed_charge": 5.25, "npi": [1346607017]}, {"billed_charge": 3.756, "npi": [1346607017]}, {"billed_charge": 5.49, "npi": [1346607017]}, {"billed_charge": 20.1, "npi": [1346607017]}, {"billed_charge": 15.35, "npi": [1346607017]}, {"billed_charge": 0.1, "npi": [1346607017]}, {"billed_charge": 1.3938, "npi": [1346607017]}, {"billed_charge": 5.5, "npi": [1346607017]}, {"billed_charge": 12.3333, "npi": [1346607017]}, {"billed_charge": 0.1075, "npi": [1346607017]}, {"billed_charge": 1.0298, "npi": [1346607017]}]}, {"allowed_amount": 0.41, "billing_code_modifier": ["JZ"], "providers": [{"billed_charge": 3.65, "npi": [1346607017]}, {"billed_charge": 9.5, "npi": [1346607017]}]}, {"allowed_amount": 0.47, "billing_code_modifier": ["JZ"], "providers": [{"billed_charge": 3.65, "npi": [1346607017]}]}, {"allowed_amount": 0.46, "billing_code_modifier": ["JZ"], "providers": [{"billed_charge": 3.65, "npi": [1346607017]}, {"billed_charge": 9.5, "npi": [1346607017]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["JZ"], "providers": [{"billed_charge": 1.5417, "npi": [1346607017]}, {"billed_charge": 1.542, "npi": [1346607017]}]}]}]}, {"name": "Room & Board - Semiprivate - 2 Beds - General", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0120", "description": "Room & Board - Semi-private (Two Beds)", "allowed_amounts": [{"tin": {"type": "ein", "value": "340714458"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 2125.495, "billing_code_modifier": [""], "providers": [{"billed_charge": 3675.0, "npi": [1942248737]}]}, {"allowed_amount": 4606.9825, "billing_code_modifier": [""], "providers": [{"billed_charge": 3403.0, "npi": [1942248737]}]}, {"allowed_amount": 1775.34, "billing_code_modifier": [""], "providers": [{"billed_charge": 3675.0, "npi": [1942248737]}]}, {"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 3675.0, "npi": [1942248737]}]}, {"allowed_amount": 3303.37, "billing_code_modifier": [""], "providers": [{"billed_charge": 3675.0, "npi": [1942248737]}]}, {"allowed_amount": 2946.575, "billing_code_modifier": [""], "providers": [{"billed_charge": 3675.0, "npi": [1942248737]}]}, {"allowed_amount": 1214.5686, "billing_code_modifier": [""], "providers": [{"billed_charge": 3403.0, "npi": [1942248737]}]}, {"allowed_amount": 4941.6233, "billing_code_modifier": [""], "providers": [{"billed_charge": 3675.0, "npi": [1942248737]}]}, {"allowed_amount": 6089.505, "billing_code_modifier": [""], "providers": [{"billed_charge": 3403.0, "npi": [1942248737]}]}, {"allowed_amount": 4309.698, "billing_code_modifier": [""], "providers": [{"billed_charge": 3675.0, "npi": [1942248737]}]}, {"allowed_amount": 1178.63, "billing_code_modifier": [""], "providers": [{"billed_charge": 3675.0, "npi": [1942248737]}]}, {"allowed_amount": 6661.095, "billing_code_modifier": [""], "providers": [{"billed_charge": 3403.0, "npi": [1942248737]}]}, {"allowed_amount": 7971.86, "billing_code_modifier": [""], "providers": [{"billed_charge": 3403.0, "npi": [1942248737]}]}, {"allowed_amount": 6890.005, "billing_code_modifier": [""], "providers": [{"billed_charge": 3675.0, "npi": [1942248737]}]}, {"allowed_amount": 1479.168, "billing_code_modifier": [""], "providers": [{"billed_charge": 3403.0, "npi": [1942248737]}]}, {"allowed_amount": 3123.4, "billing_code_modifier": [""], "providers": [{"billed_charge": 3675.0, "npi": [1942248737]}]}, {"allowed_amount": 1231.37, "billing_code_modifier": [""], "providers": [{"billed_charge": 3403.0, "npi": [1942248737]}]}, {"allowed_amount": 9407.174, "billing_code_modifier": [""], "providers": [{"billed_charge": 3403.0, "npi": [1942248737]}]}, {"allowed_amount": 1473.2875, "billing_code_modifier": [""], "providers": [{"billed_charge": 3675.0, "npi": [1942248737]}]}, {"allowed_amount": 1395.81, "billing_code_modifier": [""], "providers": [{"billed_charge": 3403.0, "npi": [1942248737]}]}, {"allowed_amount": 3715.335, "billing_code_modifier": [""], "providers": [{"billed_charge": 3675.0, "npi": [1942248737]}]}]}]}, {"name": "AMB SERVICE ALS EMERGENCY TRANSPORT LEVEL 1", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "A0427", "description": "AMB SERVICE ALS EMERGENCY TRANSPORT LEVEL 1", "allowed_amounts": [{"tin": {"type": "ein", "value": "346000646"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 517.89, "billing_code_modifier": ["RH"], "providers": [{"billed_charge": 889.2, "npi": [1699867077]}]}, {"allowed_amount": 517.89, "billing_code_modifier": ["SH"], "providers": [{"billed_charge": 889.2, "npi": [1699867077]}]}, {"allowed_amount": 506.98, "billing_code_modifier": ["NH"], "providers": [{"billed_charge": 889.2, "npi": [1699867077]}]}, {"allowed_amount": 517.89, "billing_code_modifier": ["JH"], "providers": [{"billed_charge": 889.2, "npi": [1699867077]}]}, {"allowed_amount": 517.89, "billing_code_modifier": ["HH"], "providers": [{"billed_charge": 889.2, "npi": [1699867077]}]}, {"allowed_amount": 506.98, "billing_code_modifier": ["RH"], "providers": [{"billed_charge": 889.2, "npi": [1699867077]}]}, {"allowed_amount": 506.98, "billing_code_modifier": ["SH"], "providers": [{"billed_charge": 889.2, "npi": [1699867077]}]}, {"allowed_amount": 517.89, "billing_code_modifier": ["PH"], "providers": [{"billed_charge": 889.2, "npi": [1699867077]}]}, {"allowed_amount": 506.98, "billing_code_modifier": ["JH"], "providers": [{"billed_charge": 889.2, "npi": [1699867077]}]}, {"allowed_amount": 506.98, "billing_code_modifier": ["PH"], "providers": [{"billed_charge": 889.2, "npi": [1699867077]}]}]}]}, {"name": "EKG/ECG (Electrocardiogram) - General", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0730", "description": "EKG/ECG (Electrocardiogram)", "allowed_amounts": [{"tin": {"type": "ein", "value": "341260978"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 390.0, "npi": [1841264868]}, {"billed_charge": 375.0, "npi": [1841264868]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["76"], "providers": [{"billed_charge": 390.0, "npi": [1841264868]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["59"], "providers": [{"billed_charge": 390.0, "npi": [1841264868]}, {"billed_charge": 375.0, "npi": [1841264868]}]}]}]}, {"name": "Laboratory - General", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0300", "description": "Laboratory", "allowed_amounts": [{"tin": {"type": "ein", "value": "344440884"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 65.1, "npi": [1790751253]}, {"billed_charge": 88.68, "npi": [1790751253]}, {"billed_charge": 52.45, "npi": [1790751253]}, {"billed_charge": 50.69, "npi": [1790751253]}, {"billed_charge": 109.41, "npi": [1790751253]}, {"billed_charge": 43.76, "npi": [1790751253]}, {"billed_charge": 128.15, "npi": [1790751253]}, {"billed_charge": 57.06, "npi": [1790751253]}, {"billed_charge": 44.92, "npi": [1790751253]}, {"billed_charge": 52.96, "npi": [1790751253]}, {"billed_charge": 25.23, "npi": [1790751253]}, {"billed_charge": 81.51, "npi": [1790751253]}, {"billed_charge": 39.76, "npi": [1790751253]}, {"billed_charge": 133.92, "npi": [1790751253]}, {"billed_charge": 102.53, "npi": [1790751253]}, {"billed_charge": 17.25, "npi": [1790751253]}, {"billed_charge": 116.34, "npi": [1790751253]}, {"billed_charge": 162.75, "npi": [1790751253]}, {"billed_charge": 74.4, "npi": [1790751253]}, {"billed_charge": 118.11, "npi": [1790751253]}, {"billed_charge": 65.66, "npi": [1790751253]}, {"billed_charge": 107.14, "npi": [1790751253]}, {"billed_charge": 69.75, "npi": [1790751253]}, {"billed_charge": 74.31, "npi": [1790751253]}, {"billed_charge": 80.63, "npi": [1790751253]}, {"billed_charge": 41.93, "npi": [1790751253]}, {"billed_charge": 54.13, "npi": [1790751253]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["59"], "providers": [{"billed_charge": 44.92, "npi": [1790751253]}]}]}]}, {"name": "Pharmacy - General", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0250", "description": "Pharmacy (also see 063x, an extension of 025x)", "allowed_amounts": [{"tin": {"type": "ein", "value": "340714456"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 0.15, "npi": [1790837235]}, {"billed_charge": 2.6, "npi": [1790837235]}, {"billed_charge": 8.5, "npi": [1790837235]}, {"billed_charge": 0.25, "npi": [1790837235]}, {"billed_charge": 0.4, "npi": [1790837235]}, {"billed_charge": 5.8, "npi": [1790837235]}, {"billed_charge": 9.1072, "npi": [1790837235]}, {"billed_charge": 2.9, "npi": [1790837235]}, {"billed_charge": 10.05, "npi": [1790837235]}, {"billed_charge": 14.3635, "npi": [1790837235]}, {"billed_charge": 4.1463, "npi": [1790837235]}, {"billed_charge": 67.15, "npi": [1790837235]}, {"billed_charge": 5.15, "npi": [1790837235]}, {"billed_charge": 2.7951, "npi": [1790837235]}, {"billed_charge": 64.1, "npi": [1790837235]}, {"billed_charge": 7.3, "npi": [1790837235]}, {"billed_charge": 28.0, "npi": [1790837235]}, {"billed_charge": 0.7, "npi": [1790837235]}, {"billed_charge": 3.3, "npi": [1790837235]}, {"billed_charge": 12.4212, "npi": [1790837235]}, {"billed_charge": 1.05, "npi": [1790837235]}, {"billed_charge": 9.25, "npi": [1790837235]}, {"billed_charge": 5.25, "npi": [1790837235]}, {"billed_charge": 3.275, "npi": [1790837235]}, {"billed_charge": 2.65, "npi": [1790837235]}, {"billed_charge": 0.2, "npi": [1790837235]}, {"billed_charge": 5.5, "npi": [1790837235]}, {"billed_charge": 71.75, "npi": [1790837235]}, {"billed_charge": 66.3, "npi": [1790837235]}, {"billed_charge": 4.8, "npi": [1790837235]}, {"billed_charge": 2.675, "npi": [1790837235]}, {"billed_charge": 9.65, "npi": [1790837235]}, {"billed_charge": 662.15, "npi": [1790837235]}, {"billed_charge": 23.5119, "npi": [1790837235]}, {"billed_charge": 20.8, "npi": [1790837235]}, {"billed_charge": 5.65, "npi": [1790837235]}, {"billed_charge": 5.5313, "npi": [1790837235]}, {"billed_charge": 2.925, "npi": [1790837235]}, {"billed_charge": 12.5786, "npi": [1790837235]}, {"billed_charge": 5.3, "npi": [1790837235]}, {"billed_charge": 5.05, "npi": [1790837235]}, {"billed_charge": 13.6, "npi": [1790837235]}, {"billed_charge": 0.1, "npi": [1790837235]}, {"billed_charge": 8.6, "npi": [1790837235]}, {"billed_charge": 4.837, "npi": [1790837235]}, {"billed_charge": 8.9622, "npi": [1790837235]}, {"billed_charge": 4.7, "npi": [1790837235]}, {"billed_charge": 16.8667, "npi": [1790837235]}, {"billed_charge": 0.05, "npi": [1790837235]}, {"billed_charge": 7.7233, "npi": [1790837235]}, {"billed_charge": 0.1125, "npi": [1790837235]}, {"billed_charge": 3.9234, "npi": [1790837235]}, {"billed_charge": 9.0, "npi": [1790837235]}, {"billed_charge": 6.0, "npi": [1790837235]}, {"billed_charge": 9.7813, "npi": [1790837235]}, {"billed_charge": 3.0, "npi": [1790837235]}]}]}]}, {"name": "Pharmacy - Extension of 25X - Drug Requiring Detailed Coding", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0636", "description": "Pharmacy - Extension of 25x", "allowed_amounts": [{"tin": {"type": "ein", "value": "340714581"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 9.5661, "npi": [1942385794]}, {"billed_charge": 132.4, "npi": [1942385794]}, {"billed_charge": 76.9, "npi": [1942385794]}, {"billed_charge": 4.1582, "npi": [1942385794]}, {"billed_charge": 0.8716, "npi": [1942385794]}, {"billed_charge": 6.0, "npi": [1942385794]}, {"billed_charge": 41.65, "npi": [1942385794]}, {"billed_charge": 0.96, "npi": [1942385794]}, {"billed_charge": 6.03, "npi": [1942385794]}, {"billed_charge": 4.44, "npi": [1942385794]}, {"billed_charge": 33.7, "npi": [1942385794]}, {"billed_charge": 8.4, "npi": [1942385794]}]}, {"allowed_amount": 0.435, "billing_code_modifier": ["JZ"], "providers": [{"billed_charge": 3.02, "npi": [1942385794]}]}, {"allowed_amount": 0.41, "billing_code_modifier": ["JZ"], "providers": [{"billed_charge": 3.02, "npi": [1942385794]}]}, {"allowed_amount": 0.2836, "billing_code_modifier": ["JZ"], "providers": [{"billed_charge": 2.12, "npi": [1942385794]}, {"billed_charge": 0.93, "npi": [1942385794]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["JZ"], "providers": [{"billed_charge": 71.8, "npi": [1942385794]}, {"billed_charge": 1.98, "npi": [1942385794]}, {"billed_charge": 16.45, "npi": [1942385794]}, {"billed_charge": 4.22, "npi": [1942385794]}, {"billed_charge": 0.79, "npi": [1942385794]}, {"billed_charge": 19.05, "npi": [1942385794]}, {"billed_charge": 1.54, "npi": [1942385794]}, {"billed_charge": 3.15, "npi": [1942385794]}, {"billed_charge": 4.95, "npi": [1942385794]}, {"billed_charge": 16.15, "npi": [1942385794]}, {"billed_charge": 59.1, "npi": [1942385794]}, {"billed_charge": 5.05, "npi": [1942385794]}, {"billed_charge": 3.04, "npi": [1942385794]}, {"billed_charge": 1.04, "npi": [1942385794]}, {"billed_charge": 46.7, "npi": [1942385794]}, {"billed_charge": 19.5, "npi": [1942385794]}, {"billed_charge": 0.93, "npi": [1942385794]}, {"billed_charge": 0.82, "npi": [1942385794]}, {"billed_charge": 52.95, "npi": [1942385794]}, {"billed_charge": 0.1, "npi": [1942385794]}, {"billed_charge": 6.7, "npi": [1942385794]}]}, {"allowed_amount": 0.4325, "billing_code_modifier": ["JZ"], "providers": [{"billed_charge": 1.77, "npi": [1942385794]}]}]}]}, {"name": "Emergency Room - General", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0450", "description": "Emergency Room", "allowed_amounts": [{"tin": {"type": "ein", "value": "314446959"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 552.01, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 2341.0, "npi": [1710913462]}]}, {"allowed_amount": 361.11, "billing_code_modifier": [""], "providers": [{"billed_charge": 1417.0, "npi": [1710913462]}]}, {"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 3356.0, "npi": [1710913462]}]}, {"allowed_amount": 381.48, "billing_code_modifier": [""], "providers": [{"billed_charge": 1417.0, "npi": [1710913462]}]}, {"allowed_amount": 787.84, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 3356.0, "npi": [1710913462]}]}, {"allowed_amount": 361.11, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 1417.0, "npi": [1710913462]}]}, {"allowed_amount": 844.7, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 3356.0, "npi": [1710913462]}]}, {"allowed_amount": 586.67, "billing_code_modifier": [""], "providers": [{"billed_charge": 2341.0, "npi": [1710913462]}]}, {"allowed_amount": 203.13, "billing_code_modifier": [""], "providers": [{"billed_charge": 894.0, "npi": [1710913462]}]}, {"allowed_amount": 586.67, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 2341.0, "npi": [1710913462]}]}, {"allowed_amount": 381.48, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 1417.0, "npi": [1710913462]}]}, {"allowed_amount": 218.17, "billing_code_modifier": [""], "providers": [{"billed_charge": 894.0, "npi": [1710913462]}]}]}]}, {"name": "US SOFT TISSUE HEAD  AND  NECK REAL TIME IMGE DOCM", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "76536", "description": "US SOFT TISSUE HEAD  AND  NECK REAL TIME IMGE DOCM", "allowed_amounts": [{"tin": {"type": "ein", "value": "310745303"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 25.3, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 401.0, "npi": [1669408159]}]}, {"allowed_amount": 25.91, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 401.0, "npi": [1669408159]}]}]}]}, {"name": "Laboratory - Hematology", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0305", "description": "Laboratory", "allowed_amounts": [{"tin": {"type": "ein", "value": "314379509"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 63.66, "npi": [1215936927]}, {"billed_charge": 79.24, "npi": [1215936927]}, {"billed_charge": 205.14, "npi": [1215936927]}, {"billed_charge": 59.42, "npi": [1215936927]}, {"billed_charge": 32.53, "npi": [1215936927]}, {"billed_charge": 84.88, "npi": [1215936927]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["QW"], "providers": [{"billed_charge": 66.49, "npi": [1215936927]}, {"billed_charge": 79.24, "npi": [1215936927]}]}, {"allowed_amount": 8.41, "billing_code_modifier": [""], "providers": [{"billed_charge": 79.24, "npi": [1215936927]}]}]}]}, {"name": "Pharmacy - Extension of 25X - Drug Requiring Detailed Coding", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0636", "description": "Pharmacy - Extension of 25x", "allowed_amounts": [{"tin": {"type": "ein", "value": "314391798"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 3.675, "npi": [1346247350]}, {"billed_charge": 8.7625, "npi": [1346247350]}, {"billed_charge": 0.8835, "npi": [1346247350]}, {"billed_charge": 8.8, "npi": [1346247350]}, {"billed_charge": 11.6625, "npi": [1346247350]}, {"billed_charge": 46.55, "npi": [1346247350]}, {"billed_charge": 0.776, "npi": [1346247350]}, {"billed_charge": 14.7813, "npi": [1346247350]}, {"billed_charge": 36.4, "npi": [1346247350]}, {"billed_charge": 35.4, "npi": [1346247350]}, {"billed_charge": 0.4413, "npi": [1346247350]}, {"billed_charge": 33.55, "npi": [1346247350]}, {"billed_charge": 57.7, "npi": [1346247350]}, {"billed_charge": 79.7, "npi": [1346247350]}, {"billed_charge": 0.47, "npi": [1346247350]}, {"billed_charge": 0.666, "npi": [1346247350]}, {"billed_charge": 8.68, "npi": [1346247350]}, {"billed_charge": 16.575, "npi": [1346247350]}, {"billed_charge": 17.975, "npi": [1346247350]}, {"billed_charge": 71.9, "npi": [1346247350]}, {"billed_charge": 5.38, "npi": [1346247350]}, {"billed_charge": 101.3, "npi": [1346247350]}, {"billed_charge": 4.195, "npi": [1346247350]}, {"billed_charge": 0.995, "npi": [1346247350]}, {"billed_charge": 47.9158, "npi": [1346247350]}, {"billed_charge": 42.15, "npi": [1346247350]}, {"billed_charge": 9.7875, "npi": [1346247350]}, {"billed_charge": 0.671, "npi": [1346247350]}, {"billed_charge": 2.65, "npi": [1346247350]}, {"billed_charge": 23.075, "npi": [1346247350]}, {"billed_charge": 0.4465, "npi": [1346247350]}, {"billed_charge": 4.6813, "npi": [1346247350]}, {"billed_charge": 0.6065, "npi": [1346247350]}, {"billed_charge": 0.1363, "npi": [1346247350]}, {"billed_charge": 0.167, "npi": [1346247350]}, {"billed_charge": 0.3951, "npi": [1346247350]}, {"billed_charge": 0.1438, "npi": [1346247350]}, {"billed_charge": 2.3067, "npi": [1346247350]}, {"billed_charge": 71.35, "npi": [1346247350]}, {"billed_charge": 43.85, "npi": [1346247350]}, {"billed_charge": 0.746, "npi": [1346247350]}, {"billed_charge": 40.75, "npi": [1346247350]}, {"billed_charge": 12.6125, "npi": [1346247350]}, {"billed_charge": 2.1, "npi": [1346247350]}, {"billed_charge": 0.4545, "npi": [1346247350]}, {"billed_charge": 7.0688, "npi": [1346247350]}, {"billed_charge": 2.822, "npi": [1346247350]}, {"billed_charge": 60.6, "npi": [1346247350]}]}, {"allowed_amount": 1.8694, "billing_code_modifier": [""], "providers": [{"billed_charge": 6.0171, "npi": [1346247350]}]}, {"allowed_amount": 0.41, "billing_code_modifier": [""], "providers": [{"billed_charge": 34.5, "npi": [1346247350]}, {"billed_charge": 18.05, "npi": [1346247350]}, {"billed_charge": 34.1, "npi": [1346247350]}]}, {"allowed_amount": 0.43, "billing_code_modifier": ["SE"], "providers": [{"billed_charge": 34.05, "npi": [1346247350]}]}, {"allowed_amount": 0.435, "billing_code_modifier": [""], "providers": [{"billed_charge": 18.05, "npi": [1346247350]}, {"billed_charge": 17.575, "npi": [1346247350]}]}, {"allowed_amount": 0.43, "billing_code_modifier": [""], "providers": [{"billed_charge": 34.5, "npi": [1346247350]}]}, {"allowed_amount": 0.4325, "billing_code_modifier": [""], "providers": [{"billed_charge": 9.3375, "npi": [1346247350]}]}, {"allowed_amount": 0.435, "billing_code_modifier": ["SE"], "providers": [{"billed_charge": 18.05, "npi": [1346247350]}]}, {"allowed_amount": 0.39, "billing_code_modifier": [""], "providers": [{"billed_charge": 34.5, "npi": [1346247350]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["SE"], "providers": [{"billed_charge": 8.7625, "npi": [1346247350]}, {"billed_charge": 2.822, "npi": [1346247350]}]}, {"allowed_amount": 0.395, "billing_code_modifier": [""], "providers": [{"billed_charge": 18.05, "npi": [1346247350]}]}]}]}, {"name": "Pharmacy - Extension of 25X - Drug Requiring Detailed Coding", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0636", "description": "Pharmacy - Extension of 25x", "allowed_amounts": [{"tin": {"type": "ein", "value": "341883132"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 10.0, "npi": [1598765539]}, {"billed_charge": 7.25, "npi": [1598765539]}, {"billed_charge": 2.5, "npi": [1598765539]}, {"billed_charge": 3.0, "npi": [1598765539]}, {"billed_charge": 7.0, "npi": [1598765539]}, {"billed_charge": 3.2, "npi": [1598765539]}, {"billed_charge": 2.25, "npi": [1598765539]}, {"billed_charge": 13.0, "npi": [1598765539]}, {"billed_charge": 1.0, "npi": [1598765539]}, {"billed_charge": 1.405, "npi": [1598765539]}, {"billed_charge": 8.0, "npi": [1598765539]}, {"billed_charge": 0.3, "npi": [1598765539]}, {"billed_charge": 5.0, "npi": [1598765539]}]}, {"allowed_amount": 0.42, "billing_code_modifier": [""], "providers": [{"billed_charge": 3.0, "npi": [1598765539]}]}, {"allowed_amount": 0.46, "billing_code_modifier": [""], "providers": [{"billed_charge": 3.0, "npi": [1598765539]}, {"billed_charge": 2.0, "npi": [1598765539]}]}, {"allowed_amount": 0.46, "billing_code_modifier": ["JW"], "providers": [{"billed_charge": 9.0, "npi": [1598765539]}]}, {"allowed_amount": 0.42, "billing_code_modifier": ["JW"], "providers": [{"billed_charge": 9.0, "npi": [1598765539]}]}, {"allowed_amount": 0.425, "billing_code_modifier": ["JZ"], "providers": [{"billed_charge": 2.5, "npi": [1598765539]}]}]}]}, {"name": "RADEX FOOT COMPLETE MINIMUM 3 VIEWS", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "73630", "description": "RADEX FOOT COMPLETE MINIMUM 3 VIEWS", "allowed_amounts": [{"tin": {"type": "ein", "value": "310745303"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 7.6, "billing_code_modifier": ["26LT"], "providers": [{"billed_charge": 127.0, "npi": [1669408159]}, {"billed_charge": 133.0, "npi": [1669408159]}]}, {"allowed_amount": 7.88, "billing_code_modifier": ["26LT"], "providers": [{"billed_charge": 133.0, "npi": [1669408159]}]}, {"allowed_amount": 7.88, "billing_code_modifier": ["26RT"], "providers": [{"billed_charge": 133.0, "npi": [1669408159]}]}, {"allowed_amount": 7.6, "billing_code_modifier": ["26RT"], "providers": [{"billed_charge": 127.0, "npi": [1669408159]}, {"billed_charge": 133.0, "npi": [1669408159]}]}]}]}, {"name": "Pharmacy - Extension of 25X - Drug Requiring Detailed Coding", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0636", "description": "Pharmacy - Extension of 25x", "allowed_amounts": [{"tin": {"type": "ein", "value": "332621724"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.335, "billing_code_modifier": [""], "providers": [{"billed_charge": 5.25, "npi": [1235940909]}]}, {"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 0.72, "npi": [1235940909]}, {"billed_charge": 16.38, "npi": [1235940909]}, {"billed_charge": 32.625, "npi": [1235940909]}, {"billed_charge": 1.08, "npi": [1235940909]}, {"billed_charge": 34.36, "npi": [1235940909]}, {"billed_charge": 2.6646, "npi": [1235940909]}, {"billed_charge": 1.95, "npi": [1235940909]}, {"billed_charge": 2.25, "npi": [1235940909]}, {"billed_charge": 54.0, "npi": [1235940909]}, {"billed_charge": 72.6, "npi": [1235940909]}, {"billed_charge": 0.2154, "npi": [1235940909]}, {"billed_charge": 10.74, "npi": [1235940909]}, {"billed_charge": 1.455, "npi": [1235940909]}]}, {"allowed_amount": 0.515, "billing_code_modifier": [""], "providers": [{"billed_charge": 7.56, "npi": [1235940909]}, {"billed_charge": 5.25, "npi": [1235940909]}]}, {"allowed_amount": 0.565, "billing_code_modifier": [""], "providers": [{"billed_charge": 2.235, "npi": [1235940909]}]}]}]}, {"name": "RADIOLOGIC EXAM CHEST SINGLE VIEW", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "71045", "description": "RADIOLOGIC EXAM CHEST SINGLE VIEW", "allowed_amounts": [{"tin": {"type": "ein", "value": "310745303"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 8.22, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 176.0, "npi": [1669408159]}, {"billed_charge": 202.0, "npi": [1669408159]}]}, {"allowed_amount": 8.22, "billing_code_modifier": ["2676"], "providers": [{"billed_charge": 202.0, "npi": [1669408159]}]}, {"allowed_amount": 8.22, "billing_code_modifier": ["2677"], "providers": [{"billed_charge": 176.0, "npi": [1669408159]}, {"billed_charge": 202.0, "npi": [1669408159]}]}]}]}, {"name": "Laboratory - Chemistry", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0301", "description": "Laboratory", "allowed_amounts": [{"tin": {"type": "ein", "value": "340714581"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 231.0, "npi": [1942385794]}, {"billed_charge": 186.0, "npi": [1942385794]}, {"billed_charge": 53.0, "npi": [1942385794]}, {"billed_charge": 63.0, "npi": [1942385794]}, {"billed_charge": 99.4667, "npi": [1942385794]}, {"billed_charge": 26.0, "npi": [1942385794]}, {"billed_charge": 87.0, "npi": [1942385794]}, {"billed_charge": 109.4737, "npi": [1942385794]}, {"billed_charge": 101.0, "npi": [1942385794]}, {"billed_charge": 59.0, "npi": [1942385794]}, {"billed_charge": 58.0, "npi": [1942385794]}, {"billed_charge": 98.0, "npi": [1942385794]}, {"billed_charge": 114.6667, "npi": [1942385794]}, {"billed_charge": 104.0, "npi": [1942385794]}, {"billed_charge": 135.0, "npi": [1942385794]}, {"billed_charge": 80.0, "npi": [1942385794]}, {"billed_charge": 111.0, "npi": [1942385794]}, {"billed_charge": 134.0, "npi": [1942385794]}]}]}]}, {"name": "Laboratory - Chemistry", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0301", "description": "Laboratory", "allowed_amounts": [{"tin": {"type": "ein", "value": "340714458"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 45.0, "npi": [1942248737]}, {"billed_charge": 75.0, "npi": [1942248737]}, {"billed_charge": 109.0, "npi": [1942248737]}, {"billed_charge": 118.6667, "npi": [1942248737]}, {"billed_charge": 44.95, "npi": [1942248737]}, {"billed_charge": 135.0, "npi": [1942248737]}, {"billed_charge": 56.0, "npi": [1942248737]}, {"billed_charge": 104.0, "npi": [1942248737]}, {"billed_charge": 52.7647, "npi": [1942248737]}, {"billed_charge": 116.0, "npi": [1942248737]}, {"billed_charge": 119.0, "npi": [1942248737]}, {"billed_charge": 23.0, "npi": [1942248737]}, {"billed_charge": 52.1429, "npi": [1942248737]}, {"billed_charge": 98.0, "npi": [1942248737]}, {"billed_charge": 255.0, "npi": [1942248737]}, {"billed_charge": 101.5, "npi": [1942248737]}, {"billed_charge": 89.0, "npi": [1942248737]}, {"billed_charge": 103.5556, "npi": [1942248737]}, {"billed_charge": 81.0, "npi": [1942248737]}, {"billed_charge": 46.0, "npi": [1942248737]}, {"billed_charge": 124.9, "npi": [1942248737]}, {"billed_charge": 80.0, "npi": [1942248737]}, {"billed_charge": 123.8571, "npi": [1942248737]}, {"billed_charge": 43.0, "npi": [1942248737]}, {"billed_charge": 57.0, "npi": [1942248737]}, {"billed_charge": 43.8167, "npi": [1942248737]}, {"billed_charge": 45.7273, "npi": [1942248737]}, {"billed_charge": 58.0, "npi": [1942248737]}, {"billed_charge": 48.0, "npi": [1942248737]}, {"billed_charge": 42.3205, "npi": [1942248737]}, {"billed_charge": 44.0, "npi": [1942248737]}, {"billed_charge": 60.0, "npi": [1942248737]}, {"billed_charge": 33.0, "npi": [1942248737]}, {"billed_charge": 403.0, "npi": [1942248737]}, {"billed_charge": 63.0, "npi": [1942248737]}, {"billed_charge": 94.0, "npi": [1942248737]}, {"billed_charge": 429.0, "npi": [1942248737]}, {"billed_charge": 67.0, "npi": [1942248737]}, {"billed_charge": 86.0, "npi": [1942248737]}, {"billed_charge": 115.1, "npi": [1942248737]}, {"billed_charge": 511.0, "npi": [1942248737]}, {"billed_charge": 101.0, "npi": [1942248737]}, {"billed_charge": 177.0, "npi": [1942248737]}, {"billed_charge": 58.4048, "npi": [1942248737]}, {"billed_charge": 112.0, "npi": [1942248737]}, {"billed_charge": 129.0, "npi": [1942248737]}, {"billed_charge": 55.0, "npi": [1942248737]}, {"billed_charge": 54.0, "npi": [1942248737]}, {"billed_charge": 73.0, "npi": [1942248737]}, {"billed_charge": 85.0, "npi": [1942248737]}, {"billed_charge": 70.5417, "npi": [1942248737]}, {"billed_charge": 54.8333, "npi": [1942248737]}, {"billed_charge": 69.0, "npi": [1942248737]}, {"billed_charge": 271.0, "npi": [1942248737]}, {"billed_charge": 62.0, "npi": [1942248737]}, {"billed_charge": 544.0, "npi": [1942248737]}, {"billed_charge": 204.0, "npi": [1942248737]}, {"billed_charge": 188.0, "npi": [1942248737]}, {"billed_charge": 110.1818, "npi": [1942248737]}, {"billed_charge": 22.0, "npi": [1942248737]}, {"billed_charge": 53.0, "npi": [1942248737]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["91"], "providers": [{"billed_charge": 75.0, "npi": [1942248737]}, {"billed_charge": 23.0, "npi": [1942248737]}, {"billed_charge": 32.0, "npi": [1942248737]}, {"billed_charge": 81.0, "npi": [1942248737]}, {"billed_charge": 80.0, "npi": [1942248737]}, {"billed_charge": 36.0, "npi": [1942248737]}, {"billed_charge": 31.0, "npi": [1942248737]}, {"billed_charge": 35.0, "npi": [1942248737]}, {"billed_charge": 33.0, "npi": [1942248737]}, {"billed_charge": 37.0, "npi": [1942248737]}, {"billed_charge": 86.0, "npi": [1942248737]}, {"billed_charge": 34.0, "npi": [1942248737]}, {"billed_charge": 22.0, "npi": [1942248737]}]}, {"allowed_amount": 18.08, "billing_code_modifier": [""], "providers": [{"billed_charge": 87.0, "npi": [1942248737]}]}]}]}, {"name": "EMERGENCY DEPARTMENT VISIT HIGH MDM", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "99285", "description": "EMERGENCY DEPARTMENT VISIT HIGH MDM", "allowed_amounts": [{"tin": {"type": "ein", "value": "463160463"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 493.38, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 1750.88, "npi": [1154763944]}]}, {"allowed_amount": 493.38, "billing_code_modifier": [""], "providers": [{"billed_charge": 1699.88, "npi": [1154763944]}, {"billed_charge": 1750.88, "npi": [1154763944]}]}, {"allowed_amount": 213.04, "billing_code_modifier": ["UD"], "providers": [{"billed_charge": 1750.88, "npi": [1154763944]}]}, {"allowed_amount": 200.44, "billing_code_modifier": [""], "providers": [{"billed_charge": 1699.88, "npi": [1154763944]}, {"billed_charge": 1750.88, "npi": [1154763944]}]}, {"allowed_amount": 213.04, "billing_code_modifier": ["57"], "providers": [{"billed_charge": 1750.88, "npi": [1154763944]}]}, {"allowed_amount": 200.44, "billing_code_modifier": ["UD"], "providers": [{"billed_charge": 1699.88, "npi": [1154763944]}, {"billed_charge": 1750.88, "npi": [1154763944]}]}, {"allowed_amount": 200.44, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 1750.88, "npi": [1154763944]}]}, {"allowed_amount": 213.04, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 1750.88, "npi": [1154763944]}]}, {"allowed_amount": 493.38, "billing_code_modifier": ["UD"], "providers": [{"billed_charge": 1699.88, "npi": [1154763944]}]}, {"allowed_amount": 200.44, "billing_code_modifier": ["UD25"], "providers": [{"billed_charge": 1750.88, "npi": [1154763944]}]}, {"allowed_amount": 213.04, "billing_code_modifier": [""], "providers": [{"billed_charge": 1750.88, "npi": [1154763944]}]}]}]}, {"name": "Laboratory - General", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0300", "description": "Laboratory", "allowed_amounts": [{"tin": {"type": "ein", "value": "344428256"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 273.8182, "npi": [1407854771]}, {"billed_charge": 150.0, "npi": [1407854771]}, {"billed_charge": 400.0, "npi": [1407854771]}, {"billed_charge": 211.0, "npi": [1407854771]}, {"billed_charge": 212.0, "npi": [1407854771]}, {"billed_charge": 432.6667, "npi": [1407854771]}, {"billed_charge": 405.2, "npi": [1407854771]}, {"billed_charge": 30.0, "npi": [1407854771]}, {"billed_charge": 32.0, "npi": [1407854771]}, {"billed_charge": 447.2, "npi": [1407854771]}, {"billed_charge": 271.0, "npi": [1407854771]}, {"billed_charge": 341.3902, "npi": [1407854771]}, {"billed_charge": 213.0, "npi": [1407854771]}, {"billed_charge": 284.6667, "npi": [1407854771]}, {"billed_charge": 126.0, "npi": [1407854771]}, {"billed_charge": 143.0, "npi": [1407854771]}, {"billed_charge": 417.0, "npi": [1407854771]}, {"billed_charge": 368.0, "npi": [1407854771]}, {"billed_charge": 155.0, "npi": [1407854771]}, {"billed_charge": 383.1667, "npi": [1407854771]}, {"billed_charge": 210.75, "npi": [1407854771]}, {"billed_charge": 363.2857, "npi": [1407854771]}, {"billed_charge": 482.0, "npi": [1407854771]}, {"billed_charge": 444.25, "npi": [1407854771]}, {"billed_charge": 459.0, "npi": [1407854771]}, {"billed_charge": 386.0, "npi": [1407854771]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["59"], "providers": [{"billed_charge": 105.0, "npi": [1407854771]}]}, {"allowed_amount": 368.19, "billing_code_modifier": [""], "providers": [{"billed_charge": 459.0, "npi": [1407854771]}]}]}]}, {"name": "Laboratory - Hematology", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0305", "description": "Laboratory", "allowed_amounts": [{"tin": {"type": "ein", "value": "340714581"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 80.1667, "npi": [1942385794]}, {"billed_charge": 96.0, "npi": [1942385794]}, {"billed_charge": 83.75, "npi": [1942385794]}, {"billed_charge": 47.0, "npi": [1942385794]}, {"billed_charge": 79.2222, "npi": [1942385794]}, {"billed_charge": 91.0, "npi": [1942385794]}, {"billed_charge": 51.0, "npi": [1942385794]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["59"], "providers": [{"billed_charge": 47.0, "npi": [1942385794]}]}]}]}, {"name": "Laboratory - General", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0300", "description": "Laboratory", "allowed_amounts": [{"tin": {"type": "ein", "value": "344428218"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 107.8, "npi": [1801884655]}, {"billed_charge": 195.6, "npi": [1801884655]}, {"billed_charge": 67.3, "npi": [1801884655]}, {"billed_charge": 103.2, "npi": [1801884655]}, {"billed_charge": 24.0, "npi": [1801884655]}, {"billed_charge": 54.125, "npi": [1801884655]}, {"billed_charge": 23.0, "npi": [1801884655]}, {"billed_charge": 70.3, "npi": [1801884655]}]}, {"allowed_amount": 192.55, "billing_code_modifier": ["QW"], "providers": [{"billed_charge": 526.7, "npi": [1801884655]}]}]}]}, {"name": "IADNA SARSCOV2  and  INF A and B  and  RSV MULT AMP PROBE", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "87637", "description": "IADNA SARSCOV2  and  INF A and B  and  RSV MULT AMP PROBE", "allowed_amounts": [{"tin": {"type": "ein", "value": "341567805"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 192.55, "billing_code_modifier": [""], "providers": [{"billed_charge": 384.0, "npi": [1043397292]}]}, {"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 384.0, "npi": [1043397292]}, {"billed_charge": 399.0, "npi": [1043397292]}]}, {"allowed_amount": 199.68, "billing_code_modifier": [""], "providers": [{"billed_charge": 399.0, "npi": [1043397292]}]}]}]}, {"name": "Pharmacy - Extension of 25X - Drug Requiring Detailed Coding", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0636", "description": "Pharmacy - Extension of 25x", "allowed_amounts": [{"tin": {"type": "ein", "value": "314446959"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 9.51, "npi": [1710913462]}, {"billed_charge": 36.8, "npi": [1710913462]}, {"billed_charge": 48.6, "npi": [1710913462]}, {"billed_charge": 1.5842, "npi": [1710913462]}, {"billed_charge": 1.5058, "npi": [1710913462]}, {"billed_charge": 34.15, "npi": [1710913462]}, {"billed_charge": 15.1833, "npi": [1710913462]}, {"billed_charge": 61.65, "npi": [1710913462]}, {"billed_charge": 90.3, "npi": [1710913462]}, {"billed_charge": 35.4, "npi": [1710913462]}, {"billed_charge": 4.195, "npi": [1710913462]}, {"billed_charge": 8.7625, "npi": [1710913462]}, {"billed_charge": 143.55, "npi": [1710913462]}, {"billed_charge": 23.075, "npi": [1710913462]}, {"billed_charge": 67.15, "npi": [1710913462]}, {"billed_charge": 40.6, "npi": [1710913462]}, {"billed_charge": 5.9764, "npi": [1710913462]}, {"billed_charge": 0.4413, "npi": [1710913462]}, {"billed_charge": 37.4, "npi": [1710913462]}, {"billed_charge": 6.0583, "npi": [1710913462]}, {"billed_charge": 0.4519, "npi": [1710913462]}, {"billed_charge": 47.95, "npi": [1710913462]}, {"billed_charge": 41.3, "npi": [1710913462]}, {"billed_charge": 9.6125, "npi": [1710913462]}, {"billed_charge": 0.47, "npi": [1710913462]}, {"billed_charge": 65.05, "npi": [1710913462]}, {"billed_charge": 2.7905, "npi": [1710913462]}, {"billed_charge": 8.7, "npi": [1710913462]}, {"billed_charge": 2.822, "npi": [1710913462]}, {"billed_charge": 36.65, "npi": [1710913462]}, {"billed_charge": 3.675, "npi": [1710913462]}, {"billed_charge": 3.1779, "npi": [1710913462]}]}, {"allowed_amount": 0.41, "billing_code_modifier": [""], "providers": [{"billed_charge": 34.5, "npi": [1710913462]}, {"billed_charge": 18.05, "npi": [1710913462]}]}, {"allowed_amount": 0.43, "billing_code_modifier": [""], "providers": [{"billed_charge": 34.5, "npi": [1710913462]}, {"billed_charge": 34.1, "npi": [1710913462]}]}]}]}, {"name": "EKG/ECG (Electrocardiogram) - Telemetry", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0732", "description": "EKG/ECG (Electrocardiogram)", "allowed_amounts": [{"tin": {"type": "ein", "value": "340714618"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 289.0, "npi": [1215989611]}, {"billed_charge": 278.5, "npi": [1215989611]}, {"billed_charge": 287.95, "npi": [1215989611]}, {"billed_charge": 268.0, "npi": [1215989611]}]}, {"allowed_amount": 173.23, "billing_code_modifier": [""], "providers": [{"billed_charge": 289.0, "npi": [1215989611]}]}]}]}, {"name": "Laboratory - Hematology", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0305", "description": "Laboratory", "allowed_amounts": [{"tin": {"type": "ein", "value": "341260978"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 139.0, "npi": [1841264868]}, {"billed_charge": 134.0, "npi": [1841264868]}, {"billed_charge": 100.0, "npi": [1841264868]}, {"billed_charge": 94.0714, "npi": [1841264868]}, {"billed_charge": 216.0, "npi": [1841264868]}, {"billed_charge": 49.0, "npi": [1841264868]}, {"billed_charge": 104.0, "npi": [1841264868]}, {"billed_charge": 116.0, "npi": [1841264868]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["59"], "providers": [{"billed_charge": 70.0, "npi": [1841264868]}]}]}]}, {"name": "Laboratory - Immunology", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0302", "description": "Laboratory", "allowed_amounts": [{"tin": {"type": "ein", "value": "340714458"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 153.0, "npi": [1942248737]}, {"billed_charge": 89.0, "npi": [1942248737]}, {"billed_charge": 36.0, "npi": [1942248737]}, {"billed_charge": 95.0, "npi": [1942248737]}, {"billed_charge": 57.6667, "npi": [1942248737]}, {"billed_charge": 171.3333, "npi": [1942248737]}, {"billed_charge": 34.0, "npi": [1942248737]}]}, {"allowed_amount": 17.87, "billing_code_modifier": [""], "providers": [{"billed_charge": 86.0, "npi": [1942248737]}]}, {"allowed_amount": 18.54, "billing_code_modifier": [""], "providers": [{"billed_charge": 91.0, "npi": [1942248737]}]}]}]}, {"name": "Radiology - Diagnostic - General", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0320", "description": "Radiology - Diagnostic", "allowed_amounts": [{"tin": {"type": "ein", "value": "340714458"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 608.0, "npi": [1942248737]}, {"billed_charge": 679.0, "npi": [1942248737]}, {"billed_charge": 762.0, "npi": [1942248737]}, {"billed_charge": 734.0, "npi": [1942248737]}]}, {"allowed_amount": 133.08, "billing_code_modifier": [""], "providers": [{"billed_charge": 679.0, "npi": [1942248737]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["RT"], "providers": [{"billed_charge": 608.0, "npi": [1942248737]}, {"billed_charge": 562.0, "npi": [1942248737]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["50"], "providers": [{"billed_charge": 1124.0, "npi": [1942248737]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["LT"], "providers": [{"billed_charge": 608.0, "npi": [1942248737]}, {"billed_charge": 679.0, "npi": [1942248737]}, {"billed_charge": 562.0, "npi": [1942248737]}]}]}]}, {"name": "RADEX FOOT COMPLETE MINIMUM 3 VIEWS", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "73630", "description": "RADEX FOOT COMPLETE MINIMUM 3 VIEWS", "allowed_amounts": [{"tin": {"type": "ein", "value": "310745303"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 7.6, "billing_code_modifier": ["26LT"], "providers": [{"billed_charge": 127.0, "npi": [1669408159]}, {"billed_charge": 133.0, "npi": [1669408159]}]}, {"allowed_amount": 7.88, "billing_code_modifier": ["26LT"], "providers": [{"billed_charge": 133.0, "npi": [1669408159]}]}, {"allowed_amount": 7.88, "billing_code_modifier": ["26RT"], "providers": [{"billed_charge": 133.0, "npi": [1669408159]}]}, {"allowed_amount": 7.6, "billing_code_modifier": ["26RT"], "providers": [{"billed_charge": 127.0, "npi": [1669408159]}, {"billed_charge": 133.0, "npi": [1669408159]}]}]}]}, {"name": "ADAPTIVE BEHAVIOR TX BY PROTOCOL TECH EA 15 MIN", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "97153", "description": "ADAPTIVE BEHAVIOR TX BY PROTOCOL TECH EA 15 MIN", "allowed_amounts": [{"tin": {"type": "ein", "value": "883143832"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 11.25, "billing_code_modifier": [""], "providers": [{"billed_charge": 37.5, "npi": [1063158475]}]}]}]}, {"name": "Laboratory - Chemistry", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0301", "description": "Laboratory", "allowed_amounts": [{"tin": {"type": "ein", "value": "340714593"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 85.0, "npi": [1598719346]}, {"billed_charge": 57.0, "npi": [1235183542]}, {"billed_charge": 46.0, "npi": [1235183542]}, {"billed_charge": 56.0, "npi": [1235183542]}, {"billed_charge": 59.0, "npi": [1902858152]}, {"billed_charge": 544.0, "npi": [1235183542]}, {"billed_charge": 112.0, "npi": [1235183542]}, {"billed_charge": 88.0, "npi": [1235183542]}, {"billed_charge": 98.0, "npi": [1598719346]}, {"billed_charge": 35.0, "npi": [1598719346]}, {"billed_charge": 63.0, "npi": [1902858152]}, {"billed_charge": 109.0, "npi": [1235183542]}, {"billed_charge": 86.0, "npi": [1902858152]}, {"billed_charge": 53.9286, "npi": [1235183542]}, {"billed_charge": 82.1875, "npi": [1902858152]}, {"billed_charge": 188.0, "npi": [1235183542]}, {"billed_charge": 429.0, "npi": [1235183542]}, {"billed_charge": 40.0, "npi": [1598719346]}, {"billed_charge": 33.0, "npi": [1598719346]}, {"billed_charge": 59.3571, "npi": [1902858152]}, {"billed_charge": 58.0, "npi": [1235183542]}, {"billed_charge": 69.0, "npi": [1598719346]}, {"billed_charge": 101.0, "npi": [1598719346]}, {"billed_charge": 43.0, "npi": [1902858152]}, {"billed_charge": 57.5, "npi": [1235183542]}, {"billed_charge": 57.0, "npi": [1598719346]}, {"billed_charge": 94.0, "npi": [1598719346]}, {"billed_charge": 119.0, "npi": [1235183542]}, {"billed_charge": 42.0, "npi": [1235183542]}, {"billed_charge": 53.0, "npi": [1598719346]}, {"billed_charge": 255.0, "npi": [1902858152]}, {"billed_charge": 69.0, "npi": [1235183542]}, {"billed_charge": 22.0, "npi": [1235183542]}, {"billed_charge": 55.0, "npi": [1902858152]}, {"billed_charge": 36.0, "npi": [1598719346]}, {"billed_charge": 81.0, "npi": [1235183542]}, {"billed_charge": 511.0, "npi": [1598719346]}, {"billed_charge": 95.0, "npi": [1902858152]}, {"billed_charge": 46.0, "npi": [1598719346]}, {"billed_charge": 94.0, "npi": [1235183542]}, {"billed_charge": 135.0, "npi": [1902858152]}, {"billed_charge": 59.7143, "npi": [1235183542]}, {"billed_charge": 33.0, "npi": [1235183542]}, {"billed_charge": 40.0, "npi": [1902858152]}, {"billed_charge": 511.0, "npi": [1235183542]}, {"billed_charge": 58.0, "npi": [1902858152]}, {"billed_charge": 43.0, "npi": [1598719346]}, {"billed_charge": 255.0, "npi": [1598719346]}, {"billed_charge": 73.0, "npi": [1902858152]}, {"billed_charge": 95.0, "npi": [1598719346]}, {"billed_charge": 48.0, "npi": [1235183542]}, {"billed_charge": 50.0, "npi": [1235183542]}, {"billed_charge": 91.0, "npi": [1598719346]}, {"billed_charge": 86.0, "npi": [1235183542]}, {"billed_charge": 116.0, "npi": [1902858152]}, {"billed_charge": 69.0, "npi": [1902858152]}, {"billed_charge": 23.0, "npi": [1598719346]}, {"billed_charge": 55.0, "npi": [1598719346]}, {"billed_charge": 403.0, "npi": [1235183542]}, {"billed_charge": 109.0, "npi": [1902858152]}, {"billed_charge": 80.0, "npi": [1902858152]}, {"billed_charge": 151.8, "npi": [1598719346]}, {"billed_charge": 84.6716, "npi": [1902858152]}, {"billed_charge": 30.875, "npi": [1598719346]}, {"billed_charge": 22.0, "npi": [1598719346]}, {"billed_charge": 192.0, "npi": [1902858152]}, {"billed_charge": 144.0, "npi": [1598719346]}, {"billed_charge": 30.0, "npi": [1235183542]}, {"billed_charge": 80.0, "npi": [1598719346]}, {"billed_charge": 173.087, "npi": [1902858152]}, {"billed_charge": 44.0, "npi": [1902858152]}, {"billed_charge": 429.0, "npi": [1902858152]}, {"billed_charge": 114.0, "npi": [1235183542]}, {"billed_charge": 544.0, "npi": [1598719346]}, {"billed_charge": 104.0, "npi": [1235183542]}, {"billed_charge": 81.0, "npi": [1598719346]}, {"billed_charge": 63.0, "npi": [1235183542]}, {"billed_charge": 84.0, "npi": [1902858152]}, {"billed_charge": 35.0, "npi": [1902858152]}, {"billed_charge": 67.0, "npi": [1598719346]}, {"billed_charge": 63.0, "npi": [1598719346]}, {"billed_charge": 56.0, "npi": [1598719346]}, {"billed_charge": 116.0, "npi": [1235183542]}, {"billed_charge": 271.0, "npi": [1902858152]}, {"billed_charge": 80.0, "npi": [1235183542]}, {"billed_charge": 45.0, "npi": [1902858152]}, {"billed_charge": 44.0, "npi": [1235183542]}, {"billed_charge": 23.0, "npi": [1235183542]}, {"billed_charge": 75.0, "npi": [1598719346]}, {"billed_charge": 116.0, "npi": [1598719346]}, {"billed_charge": 53.0, "npi": [1235183542]}, {"billed_charge": 58.0, "npi": [1598719346]}, {"billed_charge": 31.0, "npi": [1235183542]}, {"billed_charge": 271.0, "npi": [1235183542]}, {"billed_charge": 89.0, "npi": [1598719346]}, {"billed_charge": 88.0, "npi": [1598719346]}, {"billed_charge": 85.0, "npi": [1235183542]}, {"billed_charge": 86.0, "npi": [1598719346]}, {"billed_charge": 108.5333, "npi": [1235183542]}, {"billed_charge": 48.0, "npi": [1598719346]}, {"billed_charge": 23.0, "npi": [1902858152]}, {"billed_charge": 81.0, "npi": [1902858152]}, {"billed_charge": 75.0, "npi": [1235183542]}, {"billed_charge": 30.0, "npi": [1598719346]}, {"billed_charge": 46.0, "npi": [1902858152]}, {"billed_charge": 112.0, "npi": [1598719346]}, {"billed_charge": 124.2727, "npi": [1598719346]}, {"billed_charge": 54.0, "npi": [1598719346]}, {"billed_charge": 75.0, "npi": [1902858152]}, {"billed_charge": 31.0455, "npi": [1902858152]}, {"billed_charge": 89.0, "npi": [1235183542]}, {"billed_charge": 33.0, "npi": [1902858152]}, {"billed_charge": 66.6, "npi": [1902858152]}, {"billed_charge": 119.0, "npi": [1598719346]}, {"billed_charge": 133.5, "npi": [1598719346]}, {"billed_charge": 53.0, "npi": [1902858152]}, {"billed_charge": 65.3636, "npi": [1902858152]}, {"billed_charge": 403.0, "npi": [1598719346]}, {"billed_charge": 112.0, "npi": [1902858152]}, {"billed_charge": 73.0, "npi": [1235183542]}, {"billed_charge": 115.6667, "npi": [1902858152]}, {"billed_charge": 104.0, "npi": [1902858152]}, {"billed_charge": 255.0, "npi": [1235183542]}, {"billed_charge": 45.0, "npi": [1598719346]}, {"billed_charge": 55.0, "npi": [1235183542]}, {"billed_charge": 70.8333, "npi": [1235183542]}, {"billed_charge": 53.4583, "npi": [1235183542]}, {"billed_charge": 271.0, "npi": [1598719346]}, {"billed_charge": 113.1212, "npi": [1598719346]}, {"billed_charge": 73.0, "npi": [1598719346]}, {"billed_charge": 31.0, "npi": [1598719346]}, {"billed_charge": 54.0, "npi": [1235183542]}, {"billed_charge": 22.0, "npi": [1902858152]}, {"billed_charge": 60.0, "npi": [1235183542]}, {"billed_charge": 34.0, "npi": [1902858152]}, {"billed_charge": 34.0, "npi": [1598719346]}, {"billed_charge": 48.0, "npi": [1902858152]}, {"billed_charge": 104.0, "npi": [1598719346]}, {"billed_charge": 70.5, "npi": [1235183542]}, {"billed_charge": 403.0, "npi": [1902858152]}, {"billed_charge": 45.0, "npi": [1235183542]}, {"billed_charge": 169.0, "npi": [1902858152]}, {"billed_charge": 429.0, "npi": [1598719346]}, {"billed_charge": 44.0, "npi": [1598719346]}, {"billed_charge": 109.0, "npi": [1598719346]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["91"], "providers": [{"billed_charge": 46.0, "npi": [1235183542]}, {"billed_charge": 86.0, "npi": [1902858152]}, {"billed_charge": 33.0, "npi": [1598719346]}, {"billed_charge": 69.0, "npi": [1598719346]}, {"billed_charge": 32.0, "npi": [1235183542]}, {"billed_charge": 94.0, "npi": [1598719346]}, {"billed_charge": 69.0, "npi": [1235183542]}, {"billed_charge": 22.0, "npi": [1235183542]}, {"billed_charge": 81.0, "npi": [1235183542]}, {"billed_charge": 46.0, "npi": [1598719346]}, {"billed_charge": 33.0, "npi": [1235183542]}, {"billed_charge": 86.0, "npi": [1235183542]}, {"billed_charge": 23.0, "npi": [1598719346]}, {"billed_charge": 55.0, "npi": [1598719346]}, {"billed_charge": 80.0, "npi": [1902858152]}, {"billed_charge": 22.0, "npi": [1598719346]}, {"billed_charge": 80.0, "npi": [1598719346]}, {"billed_charge": 81.0, "npi": [1598719346]}, {"billed_charge": 80.0, "npi": [1235183542]}, {"billed_charge": 23.0, "npi": [1235183542]}, {"billed_charge": 75.0, "npi": [1598719346]}, {"billed_charge": 58.0, "npi": [1598719346]}, {"billed_charge": 31.0, "npi": [1235183542]}, {"billed_charge": 86.0, "npi": [1598719346]}, {"billed_charge": 23.0, "npi": [1902858152]}, {"billed_charge": 81.0, "npi": [1902858152]}, {"billed_charge": 75.0, "npi": [1235183542]}, {"billed_charge": 89.0, "npi": [1235183542]}, {"billed_charge": 33.0, "npi": [1902858152]}, {"billed_charge": 32.0, "npi": [1598719346]}, {"billed_charge": 45.0, "npi": [1598719346]}, {"billed_charge": 73.0, "npi": [1598719346]}, {"billed_charge": 31.0, "npi": [1598719346]}, {"billed_charge": 22.0, "npi": [1902858152]}, {"billed_charge": 44.0, "npi": [1598719346]}]}, {"allowed_amount": 18.08, "billing_code_modifier": [""], "providers": [{"billed_charge": 87.0, "npi": [1902858152]}]}]}]}, {"name": "Intensive Care - Intermediate  (ICU)", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0206", "description": "Intensive Care Unit", "allowed_amounts": [{"tin": {"type": "ein", "value": "340714585"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 5671.0, "npi": [1679525919]}, {"billed_charge": 6125.0, "npi": [1679525919]}]}, {"allowed_amount": 7933.655, "billing_code_modifier": [""], "providers": [{"billed_charge": 6125.0, "npi": [1679525919]}]}, {"allowed_amount": 1755.4963, "billing_code_modifier": [""], "providers": [{"billed_charge": 5671.0, "npi": [1679525919]}]}, {"allowed_amount": 4224.815, "billing_code_modifier": [""], "providers": [{"billed_charge": 5671.0, "npi": [1679525919]}]}, {"allowed_amount": 33416.78, "billing_code_modifier": [""], "providers": [{"billed_charge": 5671.0, "npi": [1679525919]}]}, {"allowed_amount": 2353.856, "billing_code_modifier": [""], "providers": [{"billed_charge": 5671.0, "npi": [1679525919]}]}, {"allowed_amount": 2098.9378, "billing_code_modifier": [""], "providers": [{"billed_charge": 6125.0, "npi": [1679525919]}]}]}]}, {"name": "Pharmacy - Extension of 25X - Drug Requiring Detailed Coding", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0636", "description": "Pharmacy - Extension of 25x", "allowed_amounts": [{"tin": {"type": "ein", "value": "340714755"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 1.055, "npi": [1396765681]}, {"billed_charge": 11.0, "npi": [1396765681]}, {"billed_charge": 0.2, "npi": [1396765681]}, {"billed_charge": 5.35, "npi": [1396765681]}, {"billed_charge": 1.55, "npi": [1396765681]}, {"billed_charge": 19.625, "npi": [1396765681]}, {"billed_charge": 2.8125, "npi": [1396765681]}, {"billed_charge": 0.295, "npi": [1396765681]}, {"billed_charge": 0.4875, "npi": [1396765681]}, {"billed_charge": 4.75, "npi": [1396765681]}, {"billed_charge": 0.8625, "npi": [1396765681]}, {"billed_charge": 100.0, "npi": [1396765681]}, {"billed_charge": 12.125, "npi": [1396765681]}, {"billed_charge": 1.25, "npi": [1396765681]}, {"billed_charge": 17.75, "npi": [1396765681]}, {"billed_charge": 1.0533, "npi": [1396765681]}, {"billed_charge": 1.0567, "npi": [1396765681]}, {"billed_charge": 18.5, "npi": [1396765681]}, {"billed_charge": 1.875, "npi": [1396765681]}, {"billed_charge": 41.75, "npi": [1396765681]}, {"billed_charge": 4.8125, "npi": [1396765681]}, {"billed_charge": 4.625, "npi": [1396765681]}, {"billed_charge": 57.75, "npi": [1396765681]}, {"billed_charge": 4.4, "npi": [1396765681]}, {"billed_charge": 4.4063, "npi": [1396765681]}, {"billed_charge": 0.4983, "npi": [1396765681]}, {"billed_charge": 38.5, "npi": [1396765681]}, {"billed_charge": 273.5, "npi": [1396765681]}]}, {"allowed_amount": 0.47, "billing_code_modifier": ["JZ"], "providers": [{"billed_charge": 2.875, "npi": [1396765681]}]}, {"allowed_amount": 0.46, "billing_code_modifier": ["JZ"], "providers": [{"billed_charge": 5.75, "npi": [1396765681]}, {"billed_charge": 16.0, "npi": [1396765681]}]}, {"allowed_amount": 0.42, "billing_code_modifier": ["JZ"], "providers": [{"billed_charge": 16.0, "npi": [1396765681]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["JZ"], "providers": [{"billed_charge": 100.0, "npi": [1396765681]}, {"billed_charge": 2.825, "npi": [1396765681]}, {"billed_charge": 5.5875, "npi": [1396765681]}]}]}]}, {"name": "Pharmacy - General", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0250", "description": "Pharmacy (also see 063x, an extension of 025x)", "allowed_amounts": [{"tin": {"type": "ein", "value": "314391798"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 13.0, "npi": [1346247350]}, {"billed_charge": 9.55, "npi": [1346247350]}, {"billed_charge": 0.05, "npi": [1346247350]}, {"billed_charge": 5.05, "npi": [1346247350]}, {"billed_charge": 5.3, "npi": [1346247350]}, {"billed_charge": 15.65, "npi": [1346247350]}, {"billed_charge": 6.5, "npi": [1346247350]}, {"billed_charge": 1.925, "npi": [1346247350]}, {"billed_charge": 662.15, "npi": [1346247350]}, {"billed_charge": 5.8, "npi": [1346247350]}, {"billed_charge": 5.15, "npi": [1346247350]}, {"billed_charge": 3.45, "npi": [1346247350]}, {"billed_charge": 10.6, "npi": [1346247350]}, {"billed_charge": 6.1, "npi": [1346247350]}, {"billed_charge": 4.95, "npi": [1346247350]}, {"billed_charge": 40.95, "npi": [1346247350]}, {"billed_charge": 71.75, "npi": [1346247350]}, {"billed_charge": 9.25, "npi": [1346247350]}, {"billed_charge": 6.05, "npi": [1346247350]}, {"billed_charge": 258.45, "npi": [1346247350]}, {"billed_charge": 3.05, "npi": [1346247350]}, {"billed_charge": 3.2192, "npi": [1346247350]}, {"billed_charge": 70.95, "npi": [1346247350]}, {"billed_charge": 5.2, "npi": [1346247350]}, {"billed_charge": 10.25, "npi": [1346247350]}, {"billed_charge": 5.6, "npi": [1346247350]}, {"billed_charge": 3.0, "npi": [1346247350]}, {"billed_charge": 0.95, "npi": [1346247350]}, {"billed_charge": 0.75, "npi": [1346247350]}, {"billed_charge": 0.1, "npi": [1346247350]}, {"billed_charge": 17.15, "npi": [1346247350]}, {"billed_charge": 30.0, "npi": [1346247350]}, {"billed_charge": 66.7, "npi": [1346247350]}, {"billed_charge": 2.9, "npi": [1346247350]}]}]}]}, {"name": "IV Therapy -General", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0260", "description": "IV Therapy", "allowed_amounts": [{"tin": {"type": "ein", "value": "340714612"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 364.5, "npi": [1841299039]}, {"billed_charge": 811.0, "npi": [1841299039]}, {"billed_charge": 359.0, "npi": [1841299039]}, {"billed_charge": 375.5, "npi": [1841299039]}, {"billed_charge": 494.2, "npi": [1841299039]}, {"billed_charge": 450.0, "npi": [1841299039]}, {"billed_charge": 583.0, "npi": [1841299039]}, {"billed_charge": 345.0, "npi": [1841299039]}, {"billed_charge": 225.0, "npi": [1841299039]}, {"billed_charge": 370.0, "npi": [1841299039]}, {"billed_charge": 446.0, "npi": [1841299039]}, {"billed_charge": 331.0, "npi": [1841299039]}, {"billed_charge": 394.0, "npi": [1841299039]}, {"billed_charge": 343.0, "npi": [1841299039]}]}, {"allowed_amount": 263.68, "billing_code_modifier": ["59"], "providers": [{"billed_charge": 811.0, "npi": [1841299039]}, {"billed_charge": 379.0, "npi": [1841299039]}, {"billed_charge": 885.0, "npi": [1841299039]}]}, {"allowed_amount": 57.74, "billing_code_modifier": ["59"], "providers": [{"billed_charge": 343.0, "npi": [1841299039]}]}, {"allowed_amount": 61.725, "billing_code_modifier": [""], "providers": [{"billed_charge": 506.0, "npi": [1841299039]}, {"billed_charge": 357.0, "npi": [1841299039]}]}, {"allowed_amount": 57.74, "billing_code_modifier": [""], "providers": [{"billed_charge": 331.0, "npi": [1841299039]}, {"billed_charge": 487.0, "npi": [1841299039]}, {"billed_charge": 343.0, "npi": [1841299039]}]}, {"allowed_amount": 280.35, "billing_code_modifier": [""], "providers": [{"billed_charge": 843.0, "npi": [1841299039]}, {"billed_charge": 394.0, "npi": [1841299039]}]}, {"allowed_amount": 280.35, "billing_code_modifier": ["59"], "providers": [{"billed_charge": 843.0, "npi": [1841299039]}, {"billed_charge": 394.0, "npi": [1841299039]}]}, {"allowed_amount": 263.68, "billing_code_modifier": [""], "providers": [{"billed_charge": 811.0, "npi": [1841299039]}, {"billed_charge": 379.0, "npi": [1841299039]}, {"billed_charge": 885.0, "npi": [1841299039]}]}, {"allowed_amount": 61.73, "billing_code_modifier": [""], "providers": [{"billed_charge": 506.0, "npi": [1841299039]}, {"billed_charge": 357.0, "npi": [1841299039]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["59"], "providers": [{"billed_charge": 811.0, "npi": [1841299039]}, {"billed_charge": 359.0, "npi": [1841299039]}, {"billed_charge": 379.0, "npi": [1841299039]}, {"billed_charge": 225.0, "npi": [1841299039]}, {"billed_charge": 487.0, "npi": [1841299039]}, {"billed_charge": 394.0, "npi": [1841299039]}, {"billed_charge": 216.0, "npi": [1841299039]}, {"billed_charge": 343.0, "npi": [1841299039]}]}]}]}, {"name": "US ABDOMINAL REAL TIME W/IMAGE LIMITED", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "76705", "description": "US ABDOMINAL REAL TIME W/IMAGE LIMITED", "allowed_amounts": [{"tin": {"type": "ein", "value": "310745303"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 24.96, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 462.0, "npi": [1669408159]}]}, {"allowed_amount": 26.92, "billing_code_modifier": ["26XU"], "providers": [{"billed_charge": 462.0, "npi": [1669408159]}]}, {"allowed_amount": 26.92, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 462.0, "npi": [1669408159]}]}, {"allowed_amount": 25.57, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 462.0, "npi": [1669408159]}]}, {"allowed_amount": 26.28, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 462.0, "npi": [1669408159]}]}, {"allowed_amount": 26.28, "billing_code_modifier": ["26XU"], "providers": [{"billed_charge": 462.0, "npi": [1669408159]}]}]}]}, {"name": "Pharmacy - Extension of 25X - Drug Requiring Detailed Coding", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0636", "description": "Pharmacy - Extension of 25x", "allowed_amounts": [{"tin": {"type": "ein", "value": "314379491"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 32.55, "npi": [1942256888]}, {"billed_charge": 48.8, "npi": [1942256888]}, {"billed_charge": 1.5, "npi": [1942256888]}, {"billed_charge": 2.7, "npi": [1942256888]}, {"billed_charge": 2.42, "npi": [1942256888]}, {"billed_charge": 2.25, "npi": [1942256888]}, {"billed_charge": 3.0, "npi": [1942256888]}, {"billed_charge": 26.5, "npi": [1942256888]}, {"billed_charge": 3.1, "npi": [1942256888]}]}, {"allowed_amount": 0.435, "billing_code_modifier": ["JZ"], "providers": [{"billed_charge": 7.375, "npi": [1942256888]}]}, {"allowed_amount": 0.41, "billing_code_modifier": ["JZ"], "providers": [{"billed_charge": 7.375, "npi": [1942256888]}]}, {"allowed_amount": 0.2836, "billing_code_modifier": ["JZ"], "providers": [{"billed_charge": 1.816, "npi": [1942256888]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["JZ"], "providers": [{"billed_charge": 83.7, "npi": [1942256888]}, {"billed_charge": 12.2, "npi": [1942256888]}, {"billed_charge": 10.406, "npi": [1942256888]}, {"billed_charge": 137.85, "npi": [1942256888]}, {"billed_charge": 18.2, "npi": [1942256888]}, {"billed_charge": 77.8, "npi": [1942256888]}, {"billed_charge": 101.5, "npi": [1942256888]}, {"billed_charge": 34.975, "npi": [1942256888]}, {"billed_charge": 10.405, "npi": [1942256888]}, {"billed_charge": 73.2, "npi": [1942256888]}, {"billed_charge": 3.8063, "npi": [1942256888]}, {"billed_charge": 38.15, "npi": [1942256888]}, {"billed_charge": 32.3375, "npi": [1942256888]}, {"billed_charge": 3.4, "npi": [1942256888]}, {"billed_charge": 21.15, "npi": [1942256888]}, {"billed_charge": 50.75, "npi": [1942256888]}, {"billed_charge": 9.47, "npi": [1942256888]}]}]}]}, {"name": "Laboratory - Hematology", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0305", "description": "Laboratory", "allowed_amounts": [{"tin": {"type": "ein", "value": "340714755"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 100.75, "npi": [1396765681]}, {"billed_charge": 95.75, "npi": [1396765681]}, {"billed_charge": 114.9483, "npi": [1396765681]}, {"billed_charge": 91.5, "npi": [1396765681]}]}]}]}, {"name": "Laboratory - Hematology", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0305", "description": "Laboratory", "allowed_amounts": [{"tin": {"type": "ein", "value": "341924226"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 121.0, "npi": [1669562864]}, {"billed_charge": 100.0, "npi": [1669562864]}, {"billed_charge": 96.0, "npi": [1669562864]}, {"billed_charge": 134.0, "npi": [1669562864]}, {"billed_charge": 116.0, "npi": [1669562864]}, {"billed_charge": 249.0, "npi": [1669562864]}, {"billed_charge": 208.0, "npi": [1669562864]}, {"billed_charge": 49.0, "npi": [1669562864]}, {"billed_charge": 104.0, "npi": [1669562864]}, {"billed_charge": 70.0, "npi": [1669562864]}, {"billed_charge": 139.0, "npi": [1669562864]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["59"], "providers": [{"billed_charge": 116.0, "npi": [1669562864]}, {"billed_charge": 70.0, "npi": [1669562864]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["91"], "providers": [{"billed_charge": 100.0, "npi": [1669562864]}, {"billed_charge": 249.0, "npi": [1669562864]}]}]}]}, {"name": "Pharmacy - Extension of 25X - Drug Requiring Detailed Coding", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0636", "description": "Pharmacy - Extension of 25x", "allowed_amounts": [{"tin": {"type": "ein", "value": "340714456"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.4075, "billing_code_modifier": [""], "providers": [{"billed_charge": 9.825, "npi": [1790837235]}]}, {"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 36.85, "npi": [1790837235]}, {"billed_charge": 62.95, "npi": [1790837235]}, {"billed_charge": 7.09, "npi": [1790837235]}, {"billed_charge": 41.3, "npi": [1790837235]}, {"billed_charge": 90.3, "npi": [1790837235]}, {"billed_charge": 3.675, "npi": [1790837235]}, {"billed_charge": 69.2, "npi": [1790837235]}, {"billed_charge": 65.05, "npi": [1790837235]}, {"billed_charge": 8.75, "npi": [1790837235]}, {"billed_charge": 67.15, "npi": [1790837235]}, {"billed_charge": 7.5, "npi": [1790837235]}, {"billed_charge": 34.15, "npi": [1790837235]}, {"billed_charge": 36.65, "npi": [1790837235]}, {"billed_charge": 9.51, "npi": [1790837235]}, {"billed_charge": 0.3585, "npi": [1790837235]}, {"billed_charge": 9.1125, "npi": [1790837235]}, {"billed_charge": 51.3, "npi": [1790837235]}, {"billed_charge": 1.8072, "npi": [1790837235]}, {"billed_charge": 1.5591, "npi": [1790837235]}, {"billed_charge": 4.286, "npi": [1790837235]}, {"billed_charge": 6.9569, "npi": [1790837235]}, {"billed_charge": 46.55, "npi": [1790837235]}, {"billed_charge": 17.675, "npi": [1790837235]}, {"billed_charge": 19.05, "npi": [1790837235]}, {"billed_charge": 23.3434, "npi": [1790837235]}, {"billed_charge": 65.9, "npi": [1790837235]}, {"billed_charge": 0.5965, "npi": [1790837235]}, {"billed_charge": 8.7, "npi": [1790837235]}, {"billed_charge": 14.0167, "npi": [1790837235]}, {"billed_charge": 47.95, "npi": [1790837235]}, {"billed_charge": 3.1473, "npi": [1790837235]}, {"billed_charge": 0.5138, "npi": [1790837235]}, {"billed_charge": 9.375, "npi": [1790837235]}, {"billed_charge": 17.7432, "npi": [1790837235]}, {"billed_charge": 2.2972, "npi": [1790837235]}, {"billed_charge": 27.55, "npi": [1790837235]}, {"billed_charge": 37.775, "npi": [1790837235]}, {"billed_charge": 4.9348, "npi": [1790837235]}, {"billed_charge": 1.301, "npi": [1790837235]}, {"billed_charge": 0.6065, "npi": [1790837235]}, {"billed_charge": 17.85, "npi": [1790837235]}, {"billed_charge": 221.85, "npi": [1790837235]}, {"billed_charge": 51.75, "npi": [1790837235]}, {"billed_charge": 34.08, "npi": [1790837235]}, {"billed_charge": 38.2, "npi": [1790837235]}, {"billed_charge": 93.3833, "npi": [1790837235]}, {"billed_charge": 0.4413, "npi": [1790837235]}, {"billed_charge": 34.75, "npi": [1790837235]}, {"billed_charge": 65.75, "npi": [1790837235]}, {"billed_charge": 9.8391, "npi": [1790837235]}, {"billed_charge": 0.699, "npi": [1790837235]}, {"billed_charge": 2.8737, "npi": [1790837235]}, {"billed_charge": 4.6813, "npi": [1790837235]}, {"billed_charge": 7.0063, "npi": [1790837235]}, {"billed_charge": 220.05, "npi": [1790837235]}, {"billed_charge": 1.31, "npi": [1790837235]}, {"billed_charge": 2.277, "npi": [1790837235]}, {"billed_charge": 0.2783, "npi": [1790837235]}, {"billed_charge": 3.4319, "npi": [1790837235]}, {"billed_charge": 23.075, "npi": [1790837235]}, {"billed_charge": 0.47, "npi": [1790837235]}, {"billed_charge": 7.15, "npi": [1790837235]}, {"billed_charge": 40.15, "npi": [1790837235]}, {"billed_charge": 25.0, "npi": [1790837235]}, {"billed_charge": 9.0094, "npi": [1790837235]}, {"billed_charge": 1.0883, "npi": [1790837235]}, {"billed_charge": 25.85, "npi": [1790837235]}, {"billed_charge": 3.955, "npi": [1790837235]}, {"billed_charge": 1.222, "npi": [1790837235]}, {"billed_charge": 0.2868, "npi": [1790837235]}, {"billed_charge": 0.7216, "npi": [1790837235]}, {"billed_charge": 11.6625, "npi": [1790837235]}, {"billed_charge": 5.5554, "npi": [1790837235]}, {"billed_charge": 35.4, "npi": [1790837235]}, {"billed_charge": 0.4252, "npi": [1790837235]}]}, {"allowed_amount": 0.41, "billing_code_modifier": [""], "providers": [{"billed_charge": 18.05, "npi": [1790837235]}, {"billed_charge": 34.5, "npi": [1790837235]}]}, {"allowed_amount": 0.43, "billing_code_modifier": [""], "providers": [{"billed_charge": 34.5, "npi": [1790837235]}, {"billed_charge": 34.05, "npi": [1790837235]}]}, {"allowed_amount": 0.435, "billing_code_modifier": [""], "providers": [{"billed_charge": 18.05, "npi": [1790837235]}]}, {"allowed_amount": 423.47, "billing_code_modifier": [""], "providers": [{"billed_charge": 1407.6, "npi": [1790837235]}]}, {"allowed_amount": 377.805, "billing_code_modifier": ["JW"], "providers": [{"billed_charge": 1161.825, "npi": [1790837235]}]}, {"allowed_amount": 0.41, "billing_code_modifier": ["SE"], "providers": [{"billed_charge": 34.5, "npi": [1790837235]}]}, {"allowed_amount": 0.43, "billing_code_modifier": ["JW"], "providers": [{"billed_charge": 34.5, "npi": [1790837235]}]}, {"allowed_amount": 377.8025, "billing_code_modifier": [""], "providers": [{"billed_charge": 1149.4813, "npi": [1790837235]}]}]}]}, {"name": "Laboratory - Chemistry", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0301", "description": "Laboratory", "allowed_amounts": [{"tin": {"type": "ein", "value": "340827442"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 76.0, "npi": [1164481677]}, {"billed_charge": 135.0, "npi": [1164481677]}, {"billed_charge": 264.0, "npi": [1164481677]}, {"billed_charge": 108.0, "npi": [1164481677]}, {"billed_charge": 434.0, "npi": [1164481677]}, {"billed_charge": 275.0, "npi": [1164481677]}, {"billed_charge": 164.0, "npi": [1164481677]}, {"billed_charge": 254.0, "npi": [1164481677]}, {"billed_charge": 80.0, "npi": [1164481677]}, {"billed_charge": 152.0, "npi": [1164481677]}, {"billed_charge": 130.2083, "npi": [1164481677]}, {"billed_charge": 158.0, "npi": [1164481677]}, {"billed_charge": 417.0, "npi": [1164481677]}, {"billed_charge": 97.0, "npi": [1164481677]}, {"billed_charge": 302.0, "npi": [1164481677]}, {"billed_charge": 57.0, "npi": [1164481677]}, {"billed_charge": 179.0, "npi": [1164481677]}, {"billed_charge": 101.0, "npi": [1164481677]}, {"billed_charge": 93.0, "npi": [1164481677]}, {"billed_charge": 147.3846, "npi": [1164481677]}, {"billed_charge": 104.0, "npi": [1164481677]}, {"billed_charge": 146.0, "npi": [1164481677]}]}, {"allowed_amount": 5.5, "billing_code_modifier": [""], "providers": [{"billed_charge": 60.0, "npi": [1164481677]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["59"], "providers": [{"billed_charge": 76.0, "npi": [1164481677]}, {"billed_charge": 80.0, "npi": [1164481677]}, {"billed_charge": 57.0, "npi": [1164481677]}]}, {"allowed_amount": 5.5, "billing_code_modifier": ["59"], "providers": [{"billed_charge": 60.0, "npi": [1164481677]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["91"], "providers": [{"billed_charge": 179.0, "npi": [1164481677]}]}]}]}, {"name": "EMERGENCY DEPARTMENT VISIT HIGH MDM", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "99285", "description": "EMERGENCY DEPARTMENT VISIT HIGH MDM", "allowed_amounts": [{"tin": {"type": "ein", "value": "311603722"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 208.79, "billing_code_modifier": [""], "providers": [{"billed_charge": 1923.0, "npi": [1386691780]}]}, {"allowed_amount": 204.52, "billing_code_modifier": [""], "providers": [{"billed_charge": 1923.0, "npi": [1386691780]}]}]}]}, {"name": "Laboratory - Hematology", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0305", "description": "Laboratory", "allowed_amounts": [{"tin": {"type": "ein", "value": "340827442"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 70.0, "npi": [1164481677]}, {"billed_charge": 216.0, "npi": [1164481677]}, {"billed_charge": 121.0, "npi": [1164481677]}, {"billed_charge": 116.0, "npi": [1164481677]}, {"billed_charge": 122.375, "npi": [1164481677]}, {"billed_charge": 113.0, "npi": [1164481677]}, {"billed_charge": 139.0, "npi": [1164481677]}, {"billed_charge": 134.0, "npi": [1164481677]}, {"billed_charge": 49.0, "npi": [1164481677]}, {"billed_charge": 97.0, "npi": [1164481677]}, {"billed_charge": 104.0, "npi": [1164481677]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["59"], "providers": [{"billed_charge": 70.0, "npi": [1164481677]}]}]}]}, {"name": "EKG/ECG (Electrocardiogram) - General", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0730", "description": "EKG/ECG (Electrocardiogram)", "allowed_amounts": [{"tin": {"type": "ein", "value": "341105619"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 281.0, "npi": [1811939887]}, {"billed_charge": 295.0, "npi": [1811939887]}, {"billed_charge": 288.0, "npi": [1811939887]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["XU"], "providers": [{"billed_charge": 295.0, "npi": [1811939887]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["76"], "providers": [{"billed_charge": 281.0, "npi": [1811939887]}]}]}]}, {"name": "Laboratory - Chemistry", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0301", "description": "Laboratory", "allowed_amounts": [{"tin": {"type": "ein", "value": "340718390"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 56.69, "billing_code_modifier": [""], "providers": [{"billed_charge": 177.0, "npi": [1801807870]}]}, {"allowed_amount": 15.27, "billing_code_modifier": [""], "providers": [{"billed_charge": 46.0, "npi": [1801807870]}]}, {"allowed_amount": 14.09, "billing_code_modifier": [""], "providers": [{"billed_charge": 44.0, "npi": [1801807870]}]}, {"allowed_amount": 28.56, "billing_code_modifier": [""], "providers": [{"billed_charge": 86.0, "npi": [1801807870]}]}, {"allowed_amount": 28.56, "billing_code_modifier": ["91"], "providers": [{"billed_charge": 86.0, "npi": [1801807870]}]}, {"allowed_amount": 24.23, "billing_code_modifier": [""], "providers": [{"billed_charge": 73.0, "npi": [1801807870]}]}, {"allowed_amount": 7.63, "billing_code_modifier": [""], "providers": [{"billed_charge": 23.0, "npi": [1801807870]}]}, {"allowed_amount": 163.63, "billing_code_modifier": [""], "providers": [{"billed_charge": 511.0, "npi": [1801807870]}]}, {"allowed_amount": 25.93, "billing_code_modifier": [""], "providers": [{"billed_charge": 81.0, "npi": [1801807870]}]}, {"allowed_amount": 24.02, "billing_code_modifier": ["91"], "providers": [{"billed_charge": 75.0, "npi": [1801807870]}]}, {"allowed_amount": 28.5, "billing_code_modifier": [""], "providers": [{"billed_charge": 89.0, "npi": [1801807870]}]}, {"allowed_amount": 25.93, "billing_code_modifier": ["91"], "providers": [{"billed_charge": 81.0, "npi": [1801807870]}]}, {"allowed_amount": 25.62, "billing_code_modifier": [""], "providers": [{"billed_charge": 80.0, "npi": [1801807870]}]}, {"allowed_amount": 24.02, "billing_code_modifier": [""], "providers": [{"billed_charge": 75.0, "npi": [1801807870]}]}, {"allowed_amount": 8.33, "billing_code_modifier": ["91"], "providers": [{"billed_charge": 26.0, "npi": [1801807870]}]}, {"allowed_amount": 9.92, "billing_code_modifier": ["91"], "providers": [{"billed_charge": 31.0, "npi": [1801807870]}]}, {"allowed_amount": 17.62, "billing_code_modifier": [""], "providers": [{"billed_charge": 55.0, "npi": [1801807870]}]}, {"allowed_amount": 10.25, "billing_code_modifier": ["91"], "providers": [{"billed_charge": 32.0, "npi": [1801807870]}]}, {"allowed_amount": 81.66, "billing_code_modifier": [""], "providers": [{"billed_charge": 255.0, "npi": [1801807870]}]}, {"allowed_amount": 17.29, "billing_code_modifier": [""], "providers": [{"billed_charge": 54.0, "npi": [1801807870]}]}]}]}, {"name": "Emergency Room - General", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0450", "description": "Emergency Room", "allowed_amounts": [{"tin": {"type": "ein", "value": "344430849"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 3310.0, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 1660.0, "npi": [1851338149]}]}, {"allowed_amount": 532.33, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 1252.0, "npi": [1851338149]}]}, {"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 3333.0, "npi": [1851338149]}, {"billed_charge": 1252.0, "npi": [1851338149]}]}, {"allowed_amount": 346.15, "billing_code_modifier": [""], "providers": [{"billed_charge": 1077.0, "npi": [1851338149]}]}, {"allowed_amount": 510.68, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 1300.0, "npi": [1851338149]}]}, {"allowed_amount": 510.68, "billing_code_modifier": [""], "providers": [{"billed_charge": 1300.0, "npi": [1851338149]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 1077.0, "npi": [1851338149]}]}, {"allowed_amount": 197.96, "billing_code_modifier": [""], "providers": [{"billed_charge": 671.0, "npi": [1851338149]}]}, {"allowed_amount": 334.09, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 1118.0, "npi": [1851338149]}]}, {"allowed_amount": 728.86, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 1723.0, "npi": [1851338149]}]}, {"allowed_amount": 1010.95, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 3460.0, "npi": [1851338149]}]}, {"allowed_amount": 197.96, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 671.0, "npi": [1851338149]}]}, {"allowed_amount": 346.15, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 1077.0, "npi": [1851338149]}]}]}]}, {"name": "Pharmacy - General", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0250", "description": "Pharmacy (also see 063x, an extension of 025x)", "allowed_amounts": [{"tin": {"type": "ein", "value": "310537486"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 5.54, "npi": [1508835828]}, {"billed_charge": 13.8, "npi": [1508835828]}, {"billed_charge": 4.0167, "npi": [1508835828]}, {"billed_charge": 4.44, "npi": [1508835828]}, {"billed_charge": 3.98, "npi": [1508835828]}, {"billed_charge": 7.6, "npi": [1508835828]}, {"billed_charge": 3.92, "npi": [1508835828]}, {"billed_charge": 2.327, "npi": [1508835828]}, {"billed_charge": 19.307, "npi": [1508835828]}, {"billed_charge": 1.86, "npi": [1508835828]}, {"billed_charge": 26.77, "npi": [1508835828]}, {"billed_charge": 2.64, "npi": [1508835828]}, {"billed_charge": 4.36, "npi": [1508835828]}, {"billed_charge": 1.025, "npi": [1508835828]}, {"billed_charge": 23.64, "npi": [1508835828]}, {"billed_charge": 2.26, "npi": [1508835828]}, {"billed_charge": 5.36, "npi": [1508835828]}, {"billed_charge": 6.71, "npi": [1508835828]}, {"billed_charge": 66.85, "npi": [1508835828]}, {"billed_charge": 66.88, "npi": [1508835828]}]}]}]}, {"name": "Emergency Room - General", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0450", "description": "Emergency Room", "allowed_amounts": [{"tin": {"type": "ein", "value": "340714581"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 531.16, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 826.0, "npi": [1942385794]}]}, {"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 267.0, "npi": [1942385794]}, {"billed_charge": 1504.0, "npi": [1942385794]}, {"billed_charge": 560.0, "npi": [1942385794]}, {"billed_charge": 1123.0, "npi": [1942385794]}, {"billed_charge": 1106.0, "npi": [1942385794]}]}, {"allowed_amount": 196.82, "billing_code_modifier": ["LT"], "providers": [{"billed_charge": 451.0, "npi": [1942385794]}]}, {"allowed_amount": 197.53, "billing_code_modifier": [""], "providers": [{"billed_charge": 247.0, "npi": [1942385794]}]}, {"allowed_amount": 197.53, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 247.0, "npi": [1942385794]}]}, {"allowed_amount": 510.68, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 1123.0, "npi": [1942385794]}]}, {"allowed_amount": 345.38, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 421.0, "npi": [1942385794]}]}, {"allowed_amount": 334.09, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 573.0, "npi": [1942385794]}]}, {"allowed_amount": 728.86, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 1504.0, "npi": [1942385794]}]}, {"allowed_amount": 531.16, "billing_code_modifier": [""], "providers": [{"billed_charge": 826.0, "npi": [1942385794]}]}, {"allowed_amount": 764.76, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 1106.0, "npi": [1942385794]}]}, {"allowed_amount": 334.09, "billing_code_modifier": [""], "providers": [{"billed_charge": 573.0, "npi": [1942385794]}]}]}]}, {"name": "EKG/ECG (Electrocardiogram) - Telemetry", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0732", "description": "EKG/ECG (Electrocardiogram)", "allowed_amounts": [{"tin": {"type": "ein", "value": "340714593"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 289.0, "npi": [1598719346]}, {"billed_charge": 268.0, "npi": [1598719346]}, {"billed_charge": 289.0, "npi": [1235183542]}, {"billed_charge": 268.0, "npi": [1235183542]}]}, {"allowed_amount": 195.8, "billing_code_modifier": [""], "providers": [{"billed_charge": 268.0, "npi": [1598719346]}]}]}]}, {"name": "IADNA SARSCOV2  and  INF A and B  and  RSV MULT AMP PROBE", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "87637", "description": "IADNA SARSCOV2  and  INF A and B  and  RSV MULT AMP PROBE", "allowed_amounts": [{"tin": {"type": "ein", "value": "340714585"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 192.55, "billing_code_modifier": [""], "providers": [{"billed_charge": 925.0, "npi": [1679525919]}]}, {"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 925.0, "npi": [1679525919]}]}, {"allowed_amount": 199.68, "billing_code_modifier": [""], "providers": [{"billed_charge": 925.0, "npi": [1679525919]}, {"billed_charge": 984.0, "npi": [1679525919]}]}]}]}, {"name": "Laboratory - Hematology", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0305", "description": "Laboratory", "allowed_amounts": [{"tin": {"type": "ein", "value": "340714478"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 70.0, "npi": [1821035940]}, {"billed_charge": 24.6757, "npi": [1821035940]}, {"billed_charge": 28.0, "npi": [1821035940]}, {"billed_charge": 54.0, "npi": [1821035940]}, {"billed_charge": 45.0, "npi": [1821035940]}, {"billed_charge": 42.0, "npi": [1821035940]}, {"billed_charge": 51.0, "npi": [1821035940]}, {"billed_charge": 40.2857, "npi": [1821035940]}, {"billed_charge": 40.1667, "npi": [1821035940]}, {"billed_charge": 39.0, "npi": [1821035940]}, {"billed_charge": 16.0, "npi": [1821035940]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["91"], "providers": [{"billed_charge": 16.0, "npi": [1821035940]}]}]}]}, {"name": "SCREENING DIGITAL BREAST TOMOSYNTHESIS BI", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "77063", "description": "SCREENING DIGITAL BREAST TOMOSYNTHESIS BI", "allowed_amounts": [{"tin": {"type": "ein", "value": "310983140"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 29.58, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 117.0, "npi": [1093718496]}]}, {"allowed_amount": 26.89, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 117.0, "npi": [1093718496]}, {"billed_charge": 123.0, "npi": [1093718496]}]}, {"allowed_amount": 27.26, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 135.0, "npi": [1093718496]}, {"billed_charge": 117.0, "npi": [1093718496]}, {"billed_charge": 123.0, "npi": [1093718496]}]}, {"allowed_amount": 13.63, "billing_code_modifier": ["2652"], "providers": [{"billed_charge": 117.0, "npi": [1093718496]}]}, {"allowed_amount": 29.99, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 117.0, "npi": [1093718496]}]}]}]}, {"name": "CT CERVICAL SPINE W/O CONTRAST MATERIAL", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "72125", "description": "CT CERVICAL SPINE W/O CONTRAST MATERIAL", "allowed_amounts": [{"tin": {"type": "ein", "value": "310745303"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 42.07, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 722.0, "npi": [1669408159]}, {"billed_charge": 830.0, "npi": [1669408159]}]}, {"allowed_amount": 42.08, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 830.0, "npi": [1669408159]}]}, {"allowed_amount": 44.29, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 722.0, "npi": [1669408159]}, {"billed_charge": 830.0, "npi": [1669408159]}]}, {"allowed_amount": 45.65, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 830.0, "npi": [1669408159]}]}, {"allowed_amount": 43.36, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 830.0, "npi": [1669408159]}]}, {"allowed_amount": 43.37, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 830.0, "npi": [1669408159]}]}, {"allowed_amount": 41.82, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 830.0, "npi": [1669408159]}]}]}]}, {"name": "CT Scan - Body Scan", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0352", "description": "CT Scan", "allowed_amounts": [{"tin": {"type": "ein", "value": "340714538"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 231.18, "billing_code_modifier": [""], "providers": [{"billed_charge": 1769.0, "npi": [1356366991]}, {"billed_charge": 2255.0, "npi": [1356366991]}, {"billed_charge": 2158.0, "npi": [1356366991]}]}, {"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 2272.0, "npi": [1356366991]}, {"billed_charge": 1257.0, "npi": [1356366991]}, {"billed_charge": 1682.0, "npi": [1356366991]}, {"billed_charge": 3186.0, "npi": [1356366991]}, {"billed_charge": 1297.0, "npi": [1356366991]}, {"billed_charge": 1365.0, "npi": [1356366991]}, {"billed_charge": 3354.0, "npi": [1356366991]}]}, {"allowed_amount": 459.82, "billing_code_modifier": [""], "providers": [{"billed_charge": 3186.0, "npi": [1356366991]}]}, {"allowed_amount": 230.29, "billing_code_modifier": [""], "providers": [{"billed_charge": 1862.0, "npi": [1356366991]}]}, {"allowed_amount": 459.82, "billing_code_modifier": ["RT"], "providers": [{"billed_charge": 1162.0, "npi": [1356366991]}]}, {"allowed_amount": 314.48, "billing_code_modifier": [""], "providers": [{"billed_charge": 1594.0, "npi": [1356366991]}]}, {"allowed_amount": 461.97, "billing_code_modifier": [""], "providers": [{"billed_charge": 3354.0, "npi": [1356366991]}]}, {"allowed_amount": 137.56, "billing_code_modifier": [""], "providers": [{"billed_charge": 1323.0, "npi": [1356366991]}]}]}]}, {"name": "SCREENING MAMMOGRAPHY BI 2-VIEW BREAST INC CAD", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "77067", "description": "SCREENING MAMMOGRAPHY BI 2-VIEW BREAST INC CAD", "allowed_amounts": [{"tin": {"type": "ein", "value": "310983140"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 37.92, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 221.0, "npi": [1093718496]}]}, {"allowed_amount": 17.24, "billing_code_modifier": ["2652"], "providers": [{"billed_charge": 221.0, "npi": [1093718496]}]}, {"allowed_amount": 37.59, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 221.0, "npi": [1093718496]}]}, {"allowed_amount": 34.47, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 221.0, "npi": [1093718496]}, {"billed_charge": 232.0, "npi": [1093718496]}, {"billed_charge": 255.0, "npi": [1093718496]}]}, {"allowed_amount": 34.17, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 221.0, "npi": [1093718496]}, {"billed_charge": 232.0, "npi": [1093718496]}]}]}]}, {"name": "Laboratory - Hematology", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0305", "description": "Laboratory", "allowed_amounts": [{"tin": {"type": "ein", "value": "340714612"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 153.0, "npi": [1841299039]}, {"billed_charge": 164.4737, "npi": [1841299039]}, {"billed_charge": 172.9286, "npi": [1841299039]}, {"billed_charge": 134.0, "npi": [1841299039]}, {"billed_charge": 85.4167, "npi": [1841299039]}, {"billed_charge": 208.0, "npi": [1841299039]}, {"billed_charge": 100.0, "npi": [1841299039]}, {"billed_charge": 119.0, "npi": [1841299039]}, {"billed_charge": 116.0, "npi": [1841299039]}, {"billed_charge": 99.375, "npi": [1841299039]}, {"billed_charge": 49.0, "npi": [1841299039]}, {"billed_charge": 121.0, "npi": [1841299039]}, {"billed_charge": 139.0, "npi": [1841299039]}, {"billed_charge": 216.0, "npi": [1841299039]}, {"billed_charge": 104.0, "npi": [1841299039]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["59"], "providers": [{"billed_charge": 67.0, "npi": [1841299039]}, {"billed_charge": 153.0, "npi": [1841299039]}, {"billed_charge": 116.0, "npi": [1841299039]}, {"billed_charge": 70.0, "npi": [1841299039]}]}]}]}, {"name": "Pharmacy - Extension of 25X - Drug Requiring Detailed Coding", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0636", "description": "Pharmacy - Extension of 25x", "allowed_amounts": [{"tin": {"type": "ein", "value": "264827222"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 1.282, "npi": [1609189604]}, {"billed_charge": 10.28, "npi": [1609189604]}, {"billed_charge": 0.178, "npi": [1609189604]}, {"billed_charge": 7.8, "npi": [1609189604]}, {"billed_charge": 3.23, "npi": [1609189604]}, {"billed_charge": 0.8075, "npi": [1609189604]}, {"billed_charge": 33.36, "npi": [1609189604]}, {"billed_charge": 18.89, "npi": [1609189604]}, {"billed_charge": 3.98, "npi": [1609189604]}, {"billed_charge": 1.145, "npi": [1609189604]}, {"billed_charge": 14.1738, "npi": [1609189604]}, {"billed_charge": 14.79, "npi": [1609189604]}, {"billed_charge": 9.86, "npi": [1609189604]}, {"billed_charge": 0.4117, "npi": [1609189604]}, {"billed_charge": 25.825, "npi": [1609189604]}, {"billed_charge": 2.6875, "npi": [1609189604]}, {"billed_charge": 17.26, "npi": [1609189604]}, {"billed_charge": 0.4038, "npi": [1609189604]}, {"billed_charge": 0.1554, "npi": [1609189604]}, {"billed_charge": 22.31, "npi": [1609189604]}, {"billed_charge": 16.03, "npi": [1609189604]}, {"billed_charge": 9.63, "npi": [1609189604]}, {"billed_charge": 0.0404, "npi": [1609189604]}, {"billed_charge": 28.35, "npi": [1609189604]}, {"billed_charge": 1.615, "npi": [1609189604]}, {"billed_charge": 0.6418, "npi": [1609189604]}, {"billed_charge": 7.87, "npi": [1609189604]}, {"billed_charge": 4.0, "npi": [1609189604]}]}, {"allowed_amount": 0.41, "billing_code_modifier": ["JZ"], "providers": [{"billed_charge": 1.615, "npi": [1609189604]}]}, {"allowed_amount": 0.46, "billing_code_modifier": [""], "providers": [{"billed_charge": 3.23, "npi": [1609189604]}]}, {"allowed_amount": 0.41, "billing_code_modifier": ["JW"], "providers": [{"billed_charge": 1.58, "npi": [1609189604]}]}, {"allowed_amount": 0.41, "billing_code_modifier": [""], "providers": [{"billed_charge": 3.23, "npi": [1609189604]}]}, {"allowed_amount": 0.47, "billing_code_modifier": ["JZ"], "providers": [{"billed_charge": 1.615, "npi": [1609189604]}]}, {"allowed_amount": 0.46, "billing_code_modifier": ["JW"], "providers": [{"billed_charge": 1.58, "npi": [1609189604]}]}]}]}, {"name": "Laboratory - Chemistry", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0301", "description": "Laboratory", "allowed_amounts": [{"tin": {"type": "ein", "value": "340714618"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 23.52, "billing_code_modifier": [""], "providers": [{"billed_charge": 116.0, "npi": [1215989611]}]}, {"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 56.0, "npi": [1215989611]}, {"billed_charge": 109.7656, "npi": [1215989611]}, {"billed_charge": 81.0, "npi": [1215989611]}, {"billed_charge": 86.0417, "npi": [1215989611]}, {"billed_charge": 80.0, "npi": [1215989611]}, {"billed_charge": 55.8293, "npi": [1215989611]}, {"billed_charge": 58.0, "npi": [1215989611]}, {"billed_charge": 63.0, "npi": [1215989611]}, {"billed_charge": 60.0, "npi": [1215989611]}, {"billed_charge": 69.0, "npi": [1215989611]}, {"billed_charge": 44.0, "npi": [1215989611]}, {"billed_charge": 511.0, "npi": [1215989611]}, {"billed_charge": 43.0, "npi": [1215989611]}, {"billed_charge": 65.6154, "npi": [1215989611]}, {"billed_charge": 54.23, "npi": [1215989611]}, {"billed_charge": 46.0, "npi": [1215989611]}, {"billed_charge": 112.0, "npi": [1215989611]}, {"billed_charge": 75.0, "npi": [1215989611]}, {"billed_charge": 117.0, "npi": [1215989611]}, {"billed_charge": 271.0, "npi": [1215989611]}, {"billed_charge": 55.0, "npi": [1215989611]}, {"billed_charge": 85.0, "npi": [1215989611]}, {"billed_charge": 54.0, "npi": [1215989611]}, {"billed_charge": 77.9655, "npi": [1215989611]}, {"billed_charge": 23.0, "npi": [1215989611]}, {"billed_charge": 48.0, "npi": [1215989611]}, {"billed_charge": 119.0, "npi": [1215989611]}, {"billed_charge": 94.0, "npi": [1215989611]}, {"billed_charge": 57.0, "npi": [1215989611]}, {"billed_charge": 86.4444, "npi": [1215989611]}, {"billed_charge": 45.0, "npi": [1215989611]}, {"billed_charge": 58.2375, "npi": [1215989611]}, {"billed_charge": 281.0, "npi": [1215989611]}, {"billed_charge": 544.0, "npi": [1215989611]}, {"billed_charge": 73.0, "npi": [1215989611]}, {"billed_charge": 177.0, "npi": [1215989611]}, {"billed_charge": 91.0, "npi": [1215989611]}, {"billed_charge": 255.0, "npi": [1215989611]}, {"billed_charge": 86.0, "npi": [1215989611]}, {"billed_charge": 268.0, "npi": [1215989611]}, {"billed_charge": 104.0, "npi": [1215989611]}, {"billed_charge": 31.0, "npi": [1215989611]}, {"billed_charge": 81.9333, "npi": [1215989611]}, {"billed_charge": 42.0, "npi": [1215989611]}, {"billed_charge": 403.0, "npi": [1215989611]}, {"billed_charge": 152.0, "npi": [1215989611]}, {"billed_charge": 67.0, "npi": [1215989611]}, {"billed_charge": 89.0, "npi": [1215989611]}, {"billed_charge": 68.9636, "npi": [1215989611]}, {"billed_charge": 44.0816, "npi": [1215989611]}, {"billed_charge": 97.2581, "npi": [1215989611]}, {"billed_charge": 22.0, "npi": [1215989611]}, {"billed_charge": 429.0, "npi": [1215989611]}, {"billed_charge": 121.5, "npi": [1215989611]}, {"billed_charge": 101.0, "npi": [1215989611]}, {"billed_charge": 188.0, "npi": [1215989611]}]}, {"allowed_amount": 5.31, "billing_code_modifier": ["91"], "providers": [{"billed_charge": 26.0, "npi": [1215989611]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["91"], "providers": [{"billed_charge": 81.0, "npi": [1215989611]}, {"billed_charge": 69.0, "npi": [1215989611]}, {"billed_charge": 36.0, "npi": [1215989611]}, {"billed_charge": 75.0, "npi": [1215989611]}, {"billed_charge": 23.0, "npi": [1215989611]}, {"billed_charge": 32.0, "npi": [1215989611]}, {"billed_charge": 86.0, "npi": [1215989611]}, {"billed_charge": 33.0, "npi": [1215989611]}, {"billed_charge": 31.0, "npi": [1215989611]}, {"billed_charge": 22.0, "npi": [1215989611]}]}, {"allowed_amount": 18.08, "billing_code_modifier": [""], "providers": [{"billed_charge": 87.0, "npi": [1215989611]}]}, {"allowed_amount": 5.5, "billing_code_modifier": ["91"], "providers": [{"billed_charge": 27.0, "npi": [1215989611]}]}]}]}, {"name": "Laboratory - Urology", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0307", "description": "Laboratory", "allowed_amounts": [{"tin": {"type": "ein", "value": "341105619"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 126.0, "npi": [1811939887]}, {"billed_charge": 132.0, "npi": [1811939887]}, {"billed_charge": 98.0, "npi": [1811939887]}, {"billed_charge": 68.0, "npi": [1811939887]}, {"billed_charge": 71.0, "npi": [1811939887]}, {"billed_charge": 113.0, "npi": [1811939887]}, {"billed_charge": 59.0, "npi": [1811939887]}, {"billed_charge": 93.5, "npi": [1811939887]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["XU"], "providers": [{"billed_charge": 132.0, "npi": [1811939887]}, {"billed_charge": 68.0, "npi": [1811939887]}, {"billed_charge": 71.0, "npi": [1811939887]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["91"], "providers": [{"billed_charge": 126.0, "npi": [1811939887]}, {"billed_charge": 132.0, "npi": [1811939887]}]}]}]}, {"name": "Laboratory - Urology", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0307", "description": "Laboratory", "allowed_amounts": [{"tin": {"type": "ein", "value": "340714585"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 3.04, "billing_code_modifier": [""], "providers": [{"billed_charge": 15.0, "npi": [1679525919]}]}, {"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 18.0, "npi": [1679525919]}, {"billed_charge": 19.0, "npi": [1679525919]}, {"billed_charge": 56.0, "npi": [1679525919]}, {"billed_charge": 21.0, "npi": [1679525919]}, {"billed_charge": 20.0, "npi": [1679525919]}, {"billed_charge": 59.0, "npi": [1679525919]}, {"billed_charge": 22.0, "npi": [1679525919]}, {"billed_charge": 15.0, "npi": [1679525919]}, {"billed_charge": 38.5, "npi": [1679525919]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["59"], "providers": [{"billed_charge": 21.0, "npi": [1679525919]}, {"billed_charge": 22.0, "npi": [1679525919]}]}]}]}]}