{"reporting_entity_name": "Molina-Healthcare-of-Texas", "reporting_entity_type": "health insurance issuer", "last_updated_on": "2026-08-14", "version": "2.0.0", "out_of_network": [{"name": "Laboratory - General", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0300", "description": "Laboratory", "allowed_amounts": [{"tin": {"type": "ein", "value": "751037591"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 106.6456, "npi": [1124305065]}, {"billed_charge": 220.305, "npi": [1124305065]}, {"billed_charge": 75.6, "npi": [1124305065]}, {"billed_charge": 43.875, "npi": [1124305065]}, {"billed_charge": 108.3736, "npi": [1124305065]}, {"billed_charge": 40.0, "npi": [1124305065]}, {"billed_charge": 47.75, "npi": [1124305065]}, {"billed_charge": 392.86, "npi": [1124305065]}, {"billed_charge": 143.25, "npi": [1124305065]}]}]}]}, {"name": "Laboratory - Hematology", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0305", "description": "Laboratory", "allowed_amounts": [{"tin": {"type": "ein", "value": "751837454"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 177.9983, "npi": [1447250253]}, {"billed_charge": 170.114, "npi": [1447250253]}, {"billed_charge": 148.2414, "npi": [1447250253]}, {"billed_charge": 116.719, "npi": [1447250253]}, {"billed_charge": 165.9357, "npi": [1447250253]}, {"billed_charge": 176.23, "npi": [1447250253]}, {"billed_charge": 146.11, "npi": [1447250253]}, {"billed_charge": 168.8108, "npi": [1447250253]}, {"billed_charge": 110.87, "npi": [1447250253]}, {"billed_charge": 342.42, "npi": [1447250253]}, {"billed_charge": 191.3475, "npi": [1447250253]}, {"billed_charge": 130.574, "npi": [1447250253]}, {"billed_charge": 131.628, "npi": [1447250253]}, {"billed_charge": 219.0694, "npi": [1447250253]}, {"billed_charge": 170.2567, "npi": [1447250253]}, {"billed_charge": 148.348, "npi": [1447250253]}, {"billed_charge": 153.9117, "npi": [1447250253]}, {"billed_charge": 140.91, "npi": [1447250253]}, {"billed_charge": 133.5872, "npi": [1447250253]}, {"billed_charge": 153.3914, "npi": [1447250253]}, {"billed_charge": 248.29, "npi": [1447250253]}, {"billed_charge": 135.2233, "npi": [1447250253]}, {"billed_charge": 176.4629, "npi": [1447250253]}, {"billed_charge": 155.9836, "npi": [1447250253]}, {"billed_charge": 149.84, "npi": [1447250253]}, {"billed_charge": 183.63, "npi": [1447250253]}, {"billed_charge": 166.735, "npi": [1447250253]}, {"billed_charge": 93.56, "npi": [1447250253]}, {"billed_charge": 176.872, "npi": [1447250253]}, {"billed_charge": 149.7757, "npi": [1447250253]}, {"billed_charge": 133.46, "npi": [1447250253]}, {"billed_charge": 166.8086, "npi": [1447250253]}, {"billed_charge": 205.354, "npi": [1447250253]}, {"billed_charge": 176.51, "npi": [1447250253]}, {"billed_charge": 167.582, "npi": [1447250253]}, {"billed_charge": 146.6526, "npi": [1447250253]}, {"billed_charge": 134.7988, "npi": [1447250253]}, {"billed_charge": 161.8763, "npi": [1447250253]}, {"billed_charge": 153.322, "npi": [1447250253]}, {"billed_charge": 164.5025, "npi": [1447250253]}, {"billed_charge": 217.5643, "npi": [1447250253]}]}]}]}, {"name": "Emergency Room - General", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0450", "description": "Emergency Room", "allowed_amounts": [{"tin": {"type": "ein", "value": "752678857"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 779.25, "npi": [1417980202]}, {"billed_charge": 939.5, "npi": [1417980202]}, {"billed_charge": 2758.25, "npi": [1417980202]}, {"billed_charge": 254.75, "npi": [1417980202]}, {"billed_charge": 413.9167, "npi": [1417980202]}]}, {"allowed_amount": 308.82, "billing_code_modifier": ["59"], "providers": [{"billed_charge": 333.25, "npi": [1417980202]}, {"billed_charge": 779.25, "npi": [1417980202]}]}, {"allowed_amount": 396.31, "billing_code_modifier": [""], "providers": [{"billed_charge": 1042.5, "npi": [1417980202]}]}, {"allowed_amount": 864.64, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 2758.25, "npi": [1417980202]}]}, {"allowed_amount": 605.81, "billing_code_modifier": [""], "providers": [{"billed_charge": 1521.25, "npi": [1417980202]}]}, {"allowed_amount": 122.42, "billing_code_modifier": [""], "providers": [{"billed_charge": 332.25, "npi": [1417980202]}]}, {"allowed_amount": 605.81, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 1521.25, "npi": [1417980202]}]}, {"allowed_amount": 3797.35, "billing_code_modifier": ["2725"], "providers": [{"billed_charge": 2758.25, "npi": [1417980202]}]}, {"allowed_amount": 222.92, "billing_code_modifier": [""], "providers": [{"billed_charge": 537.75, "npi": [1417980202]}]}, {"allowed_amount": 67.99, "billing_code_modifier": [""], "providers": [{"billed_charge": 103.5, "npi": [1417980202]}, {"billed_charge": 333.25, "npi": [1417980202]}]}, {"allowed_amount": 308.82, "billing_code_modifier": [""], "providers": [{"billed_charge": 333.25, "npi": [1417980202]}]}]}]}, {"name": "Pharmacy - Extension of 25X - Drug Requiring Detailed Coding", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0636", "description": "Pharmacy - Extension of 25x", "allowed_amounts": [{"tin": {"type": "ein", "value": "752678857"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 50.0, "npi": [1417980202]}, {"billed_charge": 3.75, "npi": [1417980202]}, {"billed_charge": 2.5, "npi": [1417980202]}, {"billed_charge": 9.0, "npi": [1417980202]}, {"billed_charge": 10.3467, "npi": [1417980202]}, {"billed_charge": 7.2623, "npi": [1417980202]}, {"billed_charge": 12.5, "npi": [1417980202]}, {"billed_charge": 2.007, "npi": [1417980202]}, {"billed_charge": 0.165, "npi": [1417980202]}, {"billed_charge": 2.5331, "npi": [1417980202]}, {"billed_charge": 15.38, "npi": [1417980202]}]}, {"allowed_amount": 0.485, "billing_code_modifier": ["JZ"], "providers": [{"billed_charge": 5.0, "npi": [1417980202]}]}, {"allowed_amount": 0.48, "billing_code_modifier": [""], "providers": [{"billed_charge": 10.0, "npi": [1417980202]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["JZ"], "providers": [{"billed_charge": 13.09, "npi": [1417980202]}, {"billed_charge": 0.4305, "npi": [1417980202]}, {"billed_charge": 0.8345, "npi": [1417980202]}, {"billed_charge": 0.7843, "npi": [1417980202]}, {"billed_charge": 0.6384, "npi": [1417980202]}, {"billed_charge": 11.4575, "npi": [1417980202]}, {"billed_charge": 0.2577, "npi": [1417980202]}, {"billed_charge": 0.985, "npi": [1417980202]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["JW"], "providers": [{"billed_charge": 9.0, "npi": [1417980202]}]}, {"allowed_amount": 0.48, "billing_code_modifier": ["JW"], "providers": [{"billed_charge": 10.0, "npi": [1417980202]}]}]}]}, {"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": "751844139"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 773.0, "npi": [1265430177]}, {"billed_charge": 697.72, "npi": [1265430177]}, {"billed_charge": 1007.06, "npi": [1265430177]}, {"billed_charge": 449.05, "npi": [1265430177]}, {"billed_charge": 412.73, "npi": [1265430177]}, {"billed_charge": 493.42, "npi": [1265430177]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["RT"], "providers": [{"billed_charge": 493.74, "npi": [1265430177]}, {"billed_charge": 493.42, "npi": [1265430177]}, {"billed_charge": 532.06, "npi": [1265430177]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["LT"], "providers": [{"billed_charge": 493.42, "npi": [1265430177]}, {"billed_charge": 515.52, "npi": [1265430177]}, {"billed_charge": 515.76, "npi": [1265430177]}]}]}]}, {"name": "Laboratory - Chemistry", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0301", "description": "Laboratory", "allowed_amounts": [{"tin": {"type": "ein", "value": "752770738"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 335.75, "npi": [1770514077]}, {"billed_charge": 324.5, "npi": [1770514077]}, {"billed_charge": 328.75, "npi": [1770514077]}, {"billed_charge": 153.5, "npi": [1770514077]}, {"billed_charge": 210.75, "npi": [1770514077]}, {"billed_charge": 679.25, "npi": [1770514077]}, {"billed_charge": 565.0, "npi": [1770514077]}, {"billed_charge": 334.25, "npi": [1770514077]}, {"billed_charge": 229.25, "npi": [1770514077]}, {"billed_charge": 377.8281, "npi": [1770514077]}, {"billed_charge": 561.75, "npi": [1770514077]}, {"billed_charge": 169.2407, "npi": [1770514077]}, {"billed_charge": 141.5049, "npi": [1770514077]}, {"billed_charge": 278.25, "npi": [1770514077]}, {"billed_charge": 348.5, "npi": [1770514077]}, {"billed_charge": 410.0, "npi": [1770514077]}, {"billed_charge": 222.25, "npi": [1770514077]}, {"billed_charge": 133.0, "npi": [1770514077]}, {"billed_charge": 384.0645, "npi": [1770514077]}, {"billed_charge": 257.75, "npi": [1770514077]}, {"billed_charge": 312.9552, "npi": [1770514077]}, {"billed_charge": 49.25, "npi": [1770514077]}, {"billed_charge": 671.0, "npi": [1770514077]}, {"billed_charge": 161.0, "npi": [1770514077]}, {"billed_charge": 225.75, "npi": [1770514077]}, {"billed_charge": 340.0, "npi": [1770514077]}, {"billed_charge": 66.0, "npi": [1770514077]}, {"billed_charge": 393.4853, "npi": [1770514077]}, {"billed_charge": 308.0, "npi": [1770514077]}, {"billed_charge": 306.2353, "npi": [1770514077]}, {"billed_charge": 442.5, "npi": [1770514077]}, {"billed_charge": 364.4435, "npi": [1770514077]}, {"billed_charge": 360.2722, "npi": [1770514077]}]}, {"allowed_amount": 19.42, "billing_code_modifier": [""], "providers": [{"billed_charge": 679.25, "npi": [1770514077]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["91"], "providers": [{"billed_charge": 335.75, "npi": [1770514077]}, {"billed_charge": 247.0, "npi": [1770514077]}]}]}]}, {"name": "Other Imaging Services - Ultrasound", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0402", "description": "Other Imaging Services", "allowed_amounts": [{"tin": {"type": "ein", "value": "751837454"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 151.54, "billing_code_modifier": [""], "providers": [{"billed_charge": 1049.03, "npi": [1447250253]}, {"billed_charge": 1072.02, "npi": [1447250253]}, {"billed_charge": 933.75, "npi": [1447250253]}, {"billed_charge": 1101.64, "npi": [1447250253]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["U6"], "providers": [{"billed_charge": 765.0, "npi": [1447250253]}]}, {"allowed_amount": 151.54, "billing_code_modifier": ["XS"], "providers": [{"billed_charge": 1269.06, "npi": [1447250253]}]}, {"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 1049.03, "npi": [1447250253]}, {"billed_charge": 527.09, "npi": [1447250253]}, {"billed_charge": 1072.02, "npi": [1447250253]}, {"billed_charge": 765.0, "npi": [1447250253]}, {"billed_charge": 945.11, "npi": [1447250253]}, {"billed_charge": 1053.25, "npi": [1447250253]}, {"billed_charge": 997.07, "npi": [1447250253]}, {"billed_charge": 1020.91, "npi": [1447250253]}, {"billed_charge": 1152.88, "npi": [1447250253]}, {"billed_charge": 848.33, "npi": [1447250253]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["XS"], "providers": [{"billed_charge": 1269.06, "npi": [1447250253]}]}, {"allowed_amount": 151.54, "billing_code_modifier": ["U6"], "providers": [{"billed_charge": 1152.88, "npi": [1447250253]}]}]}]}, {"name": "Emergency Room - General", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0450", "description": "Emergency Room", "allowed_amounts": [{"tin": {"type": "ein", "value": "202848116"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 308.31, "billing_code_modifier": [""], "providers": [{"billed_charge": 333.25, "npi": [1629138029]}, {"billed_charge": 779.25, "npi": [1629138029]}]}, {"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 2758.25, "npi": [1629138029]}, {"billed_charge": 254.75, "npi": [1629138029]}, {"billed_charge": 333.25, "npi": [1629138029]}, {"billed_charge": 1521.25, "npi": [1629138029]}]}, {"allowed_amount": 67.875, "billing_code_modifier": [""], "providers": [{"billed_charge": 333.25, "npi": [1629138029]}]}, {"allowed_amount": 67.875, "billing_code_modifier": ["59"], "providers": [{"billed_charge": 333.25, "npi": [1629138029]}]}, {"allowed_amount": 222.56, "billing_code_modifier": [""], "providers": [{"billed_charge": 537.75, "npi": [1629138029]}]}, {"allowed_amount": 3791.1, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 2758.25, "npi": [1629138029]}]}, {"allowed_amount": 67.87, "billing_code_modifier": [""], "providers": [{"billed_charge": 333.25, "npi": [1629138029]}, {"billed_charge": 103.5, "npi": [1629138029]}]}, {"allowed_amount": 395.66, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 1042.5, "npi": [1629138029]}]}, {"allowed_amount": 395.66, "billing_code_modifier": [""], "providers": [{"billed_charge": 1042.5, "npi": [1629138029]}]}, {"allowed_amount": 863.2, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 2758.25, "npi": [1629138029]}]}, {"allowed_amount": 308.31, "billing_code_modifier": ["59"], "providers": [{"billed_charge": 333.25, "npi": [1629138029]}, {"billed_charge": 779.25, "npi": [1629138029]}]}, {"allowed_amount": 122.22, "billing_code_modifier": [""], "providers": [{"billed_charge": 874.75, "npi": [1629138029]}, {"billed_charge": 332.25, "npi": [1629138029]}]}, {"allowed_amount": 67.87, "billing_code_modifier": ["59"], "providers": [{"billed_charge": 103.5, "npi": [1629138029]}]}, {"allowed_amount": 604.81, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 1521.25, "npi": [1629138029]}]}]}]}, {"name": "IV Therapy -General", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0260", "description": "IV Therapy", "allowed_amounts": [{"tin": {"type": "ein", "value": "751037591"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 308.31, "billing_code_modifier": [""], "providers": [{"billed_charge": 902.11, "npi": [1124305065]}]}, {"allowed_amount": 308.31, "billing_code_modifier": ["XS"], "providers": [{"billed_charge": 524.33, "npi": [1124305065]}]}, {"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 330.56, "npi": [1124305065]}, {"billed_charge": 392.06, "npi": [1124305065]}, {"billed_charge": 468.18, "npi": [1124305065]}, {"billed_charge": 902.11, "npi": [1124305065]}, {"billed_charge": 317.78, "npi": [1124305065]}, {"billed_charge": 361.12, "npi": [1124305065]}]}, {"allowed_amount": 67.875, "billing_code_modifier": [""], "providers": [{"billed_charge": 392.06, "npi": [1124305065]}, {"billed_charge": 317.78, "npi": [1124305065]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["XS"], "providers": [{"billed_charge": 524.33, "npi": [1124305065]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["XU"], "providers": [{"billed_charge": 392.06, "npi": [1124305065]}, {"billed_charge": 361.12, "npi": [1124305065]}]}, {"allowed_amount": 67.87, "billing_code_modifier": [""], "providers": [{"billed_charge": 392.06, "npi": [1124305065]}]}, {"allowed_amount": 67.8742, "billing_code_modifier": [""], "providers": [{"billed_charge": 317.78, "npi": [1124305065]}]}]}]}, {"name": "Laboratory - Urology", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0307", "description": "Laboratory", "allowed_amounts": [{"tin": {"type": "ein", "value": "756001743"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 187.0, "npi": [1336172105]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["59"], "providers": [{"billed_charge": 187.0, "npi": [1336172105]}]}]}]}, {"name": "Emergency Room - General", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0450", "description": "Emergency Room", "allowed_amounts": [{"tin": {"type": "ein", "value": "260194016"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 308.31, "billing_code_modifier": [""], "providers": [{"billed_charge": 524.33, "npi": [1205018439]}, {"billed_charge": 814.34, "npi": [1205018439]}, {"billed_charge": 902.11, "npi": [1205018439]}]}, {"allowed_amount": 222.56, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 782.31, "npi": [1205018439]}]}, {"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 524.33, "npi": [1205018439]}, {"billed_charge": 317.78, "npi": [1205018439]}, {"billed_charge": 2202.0, "npi": [1205018439]}, {"billed_charge": 2122.8, "npi": [1205018439]}, {"billed_charge": 1129.1383, "npi": [1205018439]}, {"billed_charge": 361.12, "npi": [1205018439]}, {"billed_charge": 321.2, "npi": [1205018439]}, {"billed_charge": 321.05, "npi": [1205018439]}, {"billed_charge": 877.9063, "npi": [1205018439]}, {"billed_charge": 1468.57, "npi": [1205018439]}, {"billed_charge": 392.06, "npi": [1205018439]}, {"billed_charge": 806.34, "npi": [1205018439]}]}, {"allowed_amount": 67.875, "billing_code_modifier": [""], "providers": [{"billed_charge": 317.78, "npi": [1205018439]}, {"billed_charge": 392.06, "npi": [1205018439]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["XS"], "providers": [{"billed_charge": 524.33, "npi": [1205018439]}]}, {"allowed_amount": 604.81, "billing_code_modifier": [""], "providers": [{"billed_charge": 2122.8, "npi": [1205018439]}]}, {"allowed_amount": 67.87, "billing_code_modifier": ["XU"], "providers": [{"billed_charge": 392.06, "npi": [1205018439]}]}, {"allowed_amount": 222.56, "billing_code_modifier": [""], "providers": [{"billed_charge": 782.31, "npi": [1205018439]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["XU"], "providers": [{"billed_charge": 321.2, "npi": [1205018439]}, {"billed_charge": 902.11, "npi": [1205018439]}]}, {"allowed_amount": 67.874, "billing_code_modifier": [""], "providers": [{"billed_charge": 392.06, "npi": [1205018439]}]}, {"allowed_amount": 164.41, "billing_code_modifier": [""], "providers": [{"billed_charge": 524.33, "npi": [1205018439]}]}, {"allowed_amount": 3791.1, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 4233.71, "npi": [1205018439]}, {"billed_charge": 3879.67, "npi": [1205018439]}]}, {"allowed_amount": 589.22, "billing_code_modifier": [""], "providers": [{"billed_charge": 1304.97, "npi": [1205018439]}]}, {"allowed_amount": 67.87, "billing_code_modifier": [""], "providers": [{"billed_charge": 317.78, "npi": [1205018439]}, {"billed_charge": 330.56, "npi": [1205018439]}, {"billed_charge": 392.06, "npi": [1205018439]}]}, {"allowed_amount": 290.83, "billing_code_modifier": [""], "providers": [{"billed_charge": 994.45, "npi": [1205018439]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 2122.8, "npi": [1205018439]}]}, {"allowed_amount": 67.8733, "billing_code_modifier": [""], "providers": [{"billed_charge": 317.78, "npi": [1205018439]}, {"billed_charge": 392.06, "npi": [1205018439]}]}, {"allowed_amount": 395.66, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 1283.4, "npi": [1205018439]}]}, {"allowed_amount": 395.66, "billing_code_modifier": [""], "providers": [{"billed_charge": 1283.4, "npi": [1205018439]}]}, {"allowed_amount": 308.31, "billing_code_modifier": ["XU"], "providers": [{"billed_charge": 524.33, "npi": [1205018439]}, {"billed_charge": 814.34, "npi": [1205018439]}, {"billed_charge": 902.11, "npi": [1205018439]}]}, {"allowed_amount": 863.2, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 3879.67, "npi": [1205018439]}]}, {"allowed_amount": 44.12, "billing_code_modifier": [""], "providers": [{"billed_charge": 392.06, "npi": [1205018439]}]}, {"allowed_amount": 104.36, "billing_code_modifier": [""], "providers": [{"billed_charge": 468.18, "npi": [1205018439]}]}, {"allowed_amount": 122.22, "billing_code_modifier": [""], "providers": [{"billed_charge": 478.23, "npi": [1205018439]}]}, {"allowed_amount": 604.81, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 2122.8, "npi": [1205018439]}, {"billed_charge": 3901.19, "npi": [1205018439]}]}, {"allowed_amount": 1197.29, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 4233.71, "npi": [1205018439]}]}]}]}, {"name": "Pharmacy - General", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0250", "description": "Pharmacy (also see 063x, an extension of 025x)", "allowed_amounts": [{"tin": {"type": "ein", "value": "751047527"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 1.055, "npi": [1396779948]}, {"billed_charge": 8.0651, "npi": [1396779948]}, {"billed_charge": 5.2085, "npi": [1396779948]}, {"billed_charge": 1.0567, "npi": [1396779948]}, {"billed_charge": 6.3, "npi": [1396779948]}, {"billed_charge": 14.6819, "npi": [1396779948]}, {"billed_charge": 1.5183, "npi": [1396779948]}, {"billed_charge": 1.99, "npi": [1396779948]}, {"billed_charge": 3.43, "npi": [1396779948]}, {"billed_charge": 1.5, "npi": [1396779948]}, {"billed_charge": 1.1943, "npi": [1396779948]}, {"billed_charge": 2.0, "npi": [1396779948]}, {"billed_charge": 2.4325, "npi": [1396779948]}, {"billed_charge": 0.8571, "npi": [1396779948]}, {"billed_charge": 1.2564, "npi": [1396779948]}, {"billed_charge": 88.2, "npi": [1396779948]}, {"billed_charge": 0.882, "npi": [1396779948]}, {"billed_charge": 2.595, "npi": [1396779948]}, {"billed_charge": 1.3333, "npi": [1396779948]}, {"billed_charge": 4.0168, "npi": [1396779948]}, {"billed_charge": 3.5125, "npi": [1396779948]}, {"billed_charge": 1.65, "npi": [1396779948]}, {"billed_charge": 6.4744, "npi": [1396779948]}, {"billed_charge": 0.815, "npi": [1396779948]}, {"billed_charge": 3.1406, "npi": [1396779948]}, {"billed_charge": 29.7325, "npi": [1396779948]}, {"billed_charge": 35.2963, "npi": [1396779948]}, {"billed_charge": 2.2, "npi": [1396779948]}, {"billed_charge": 0.625, "npi": [1396779948]}, {"billed_charge": 6.9464, "npi": [1396779948]}, {"billed_charge": 15.4378, "npi": [1396779948]}, {"billed_charge": 16.0183, "npi": [1396779948]}, {"billed_charge": 3.3112, "npi": [1396779948]}, {"billed_charge": 7.98, "npi": [1396779948]}, {"billed_charge": 2.525, "npi": [1396779948]}, {"billed_charge": 20.86, "npi": [1396779948]}, {"billed_charge": 12.11, "npi": [1396779948]}, {"billed_charge": 6.9557, "npi": [1396779948]}, {"billed_charge": 0.25, "npi": [1396779948]}, {"billed_charge": 0.5, "npi": [1396779948]}, {"billed_charge": 13.7658, "npi": [1396779948]}, {"billed_charge": 1.0, "npi": [1396779948]}]}]}]}, {"name": "Radiology - Diagnostic - General", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0320", "description": "Radiology - Diagnostic", "allowed_amounts": [{"tin": {"type": "ein", "value": "752770738"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 644.75, "npi": [1770514077]}, {"billed_charge": 664.25, "npi": [1770514077]}, {"billed_charge": 719.25, "npi": [1770514077]}, {"billed_charge": 684.8214, "npi": [1770514077]}, {"billed_charge": 588.0, "npi": [1770514077]}]}, {"allowed_amount": 126.14, "billing_code_modifier": [""], "providers": [{"billed_charge": 792.25, "npi": [1770514077]}, {"billed_charge": 664.25, "npi": [1770514077]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["RT76"], "providers": [{"billed_charge": 701.0, "npi": [1770514077]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["RT"], "providers": [{"billed_charge": 701.0, "npi": [1770514077]}, {"billed_charge": 644.75, "npi": [1770514077]}, {"billed_charge": 599.5, "npi": [1770514077]}, {"billed_charge": 489.25, "npi": [1770514077]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["LT"], "providers": [{"billed_charge": 644.75, "npi": [1770514077]}, {"billed_charge": 511.25, "npi": [1770514077]}, {"billed_charge": 608.5, "npi": [1770514077]}, {"billed_charge": 489.25, "npi": [1770514077]}]}]}]}, {"name": "LEVEL IV SURG PATHOLOGY GROSS AND MICROSCOPIC EXAM", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "88305", "description": "LEVEL IV SURG PATHOLOGY GROSS AND MICROSCOPIC EXAM", "allowed_amounts": [{"tin": {"type": "ein", "value": "453710597"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 42.24, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 125.0, "npi": [1225423502]}]}]}]}, {"name": "Pharmacy - General", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0250", "description": "Pharmacy (also see 063x, an extension of 025x)", "allowed_amounts": [{"tin": {"type": "ein", "value": "751837454"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 1.45, "npi": [1447250253]}, {"billed_charge": 2.984, "npi": [1447250253]}, {"billed_charge": 11.3771, "npi": [1447250253]}, {"billed_charge": 0.3725, "npi": [1447250253]}, {"billed_charge": 10.4625, "npi": [1447250253]}, {"billed_charge": 15.72, "npi": [1447250253]}, {"billed_charge": 14.6067, "npi": [1447250253]}, {"billed_charge": 3.918, "npi": [1447250253]}, {"billed_charge": 1.0144, "npi": [1447250253]}, {"billed_charge": 1.1012, "npi": [1447250253]}, {"billed_charge": 2.2933, "npi": [1447250253]}, {"billed_charge": 12.005, "npi": [1447250253]}, {"billed_charge": 1.7642, "npi": [1447250253]}, {"billed_charge": 6.4892, "npi": [1447250253]}, {"billed_charge": 16.6039, "npi": [1447250253]}, {"billed_charge": 18.12, "npi": [1447250253]}, {"billed_charge": 1.66, "npi": [1447250253]}, {"billed_charge": 0.6167, "npi": [1447250253]}, {"billed_charge": 84.12, "npi": [1447250253]}, {"billed_charge": 5.3115, "npi": [1447250253]}, {"billed_charge": 1.63, "npi": [1447250253]}, {"billed_charge": 0.7977, "npi": [1447250253]}, {"billed_charge": 7.97, "npi": [1447250253]}, {"billed_charge": 1.645, "npi": [1447250253]}, {"billed_charge": 0.9608, "npi": [1447250253]}, {"billed_charge": 0.8756, "npi": [1447250253]}, {"billed_charge": 21.45, "npi": [1447250253]}, {"billed_charge": 1.6857, "npi": [1447250253]}, {"billed_charge": 2.0219, "npi": [1447250253]}, {"billed_charge": 2.1633, "npi": [1447250253]}, {"billed_charge": 0.7583, "npi": [1447250253]}, {"billed_charge": 1.01, "npi": [1447250253]}, {"billed_charge": 0.92, "npi": [1447250253]}, {"billed_charge": 2.8625, "npi": [1447250253]}, {"billed_charge": 5.2688, "npi": [1447250253]}, {"billed_charge": 7.795, "npi": [1447250253]}, {"billed_charge": 31.38, "npi": [1447250253]}, {"billed_charge": 7.585, "npi": [1447250253]}, {"billed_charge": 1.3258, "npi": [1447250253]}, {"billed_charge": 0.24, "npi": [1447250253]}, {"billed_charge": 0.505, "npi": [1447250253]}, {"billed_charge": 2.7729, "npi": [1447250253]}, {"billed_charge": 0.6467, "npi": [1447250253]}, {"billed_charge": 10.2516, "npi": [1447250253]}, {"billed_charge": 11.2275, "npi": [1447250253]}, {"billed_charge": 1.845, "npi": [1447250253]}, {"billed_charge": 2.9281, "npi": [1447250253]}, {"billed_charge": 5.09, "npi": [1447250253]}, {"billed_charge": 24.4496, "npi": [1447250253]}, {"billed_charge": 0.02, "npi": [1447250253]}, {"billed_charge": 15.1567, "npi": [1447250253]}, {"billed_charge": 1.005, "npi": [1447250253]}, {"billed_charge": 2.105, "npi": [1447250253]}, {"billed_charge": 0.5, "npi": [1447250253]}, {"billed_charge": 17.36, "npi": [1447250253]}, {"billed_charge": 14.7486, "npi": [1447250253]}, {"billed_charge": 30.13, "npi": [1447250253]}, {"billed_charge": 0.45, "npi": [1447250253]}, {"billed_charge": 2.6, "npi": [1447250253]}, {"billed_charge": 1.19, "npi": [1447250253]}, {"billed_charge": 77.695, "npi": [1447250253]}, {"billed_charge": 0.214, "npi": [1447250253]}, {"billed_charge": 1.04, "npi": [1447250253]}, {"billed_charge": 27.75, "npi": [1447250253]}, {"billed_charge": 10.8114, "npi": [1447250253]}, {"billed_charge": 1.4948, "npi": [1447250253]}, {"billed_charge": 0.17, "npi": [1447250253]}, {"billed_charge": 0.6616, "npi": [1447250253]}, {"billed_charge": 3.5185, "npi": [1447250253]}, {"billed_charge": 0.1333, "npi": [1447250253]}, {"billed_charge": 1.3167, "npi": [1447250253]}, {"billed_charge": 22.65, "npi": [1447250253]}, {"billed_charge": 11.38, "npi": [1447250253]}, {"billed_charge": 1.3567, "npi": [1447250253]}, {"billed_charge": 9.2267, "npi": [1447250253]}, {"billed_charge": 0.63, "npi": [1447250253]}, {"billed_charge": 0.3533, "npi": [1447250253]}, {"billed_charge": 0.3133, "npi": [1447250253]}, {"billed_charge": 1.6765, "npi": [1447250253]}, {"billed_charge": 0.9627, "npi": [1447250253]}, {"billed_charge": 9.0138, "npi": [1447250253]}, {"billed_charge": 8.7675, "npi": [1447250253]}, {"billed_charge": 1.795, "npi": [1447250253]}, {"billed_charge": 16.4814, "npi": [1447250253]}, {"billed_charge": 5.7, "npi": [1447250253]}, {"billed_charge": 2.9969, "npi": [1447250253]}, {"billed_charge": 0.6143, "npi": [1447250253]}, {"billed_charge": 2.3988, "npi": [1447250253]}, {"billed_charge": 1.4529, "npi": [1447250253]}, {"billed_charge": 0.9807, "npi": [1447250253]}, {"billed_charge": 3.2937, "npi": [1447250253]}, {"billed_charge": 1.06, "npi": [1447250253]}, {"billed_charge": 4.966, "npi": [1447250253]}, {"billed_charge": 6.4217, "npi": [1447250253]}, {"billed_charge": 27.3, "npi": [1447250253]}, {"billed_charge": 14.7825, "npi": [1447250253]}, {"billed_charge": 0.9667, "npi": [1447250253]}, {"billed_charge": 207.4136, "npi": [1447250253]}, {"billed_charge": 2.46, "npi": [1447250253]}, {"billed_charge": 4.2409, "npi": [1447250253]}, {"billed_charge": 7.0686, "npi": [1447250253]}, {"billed_charge": 7.6383, "npi": [1447250253]}, {"billed_charge": 14.2875, "npi": [1447250253]}, {"billed_charge": 1.88, "npi": [1447250253]}, {"billed_charge": 0.35, "npi": [1447250253]}, {"billed_charge": 1.9325, "npi": [1447250253]}, {"billed_charge": 1.6057, "npi": [1447250253]}, {"billed_charge": 0.502, "npi": [1447250253]}, {"billed_charge": 0.9117, "npi": [1447250253]}, {"billed_charge": 0.035, "npi": [1447250253]}, {"billed_charge": 11.3625, "npi": [1447250253]}, {"billed_charge": 0.911, "npi": [1447250253]}, {"billed_charge": 10.7625, "npi": [1447250253]}, {"billed_charge": 6.8611, "npi": [1447250253]}, {"billed_charge": 2.7426, "npi": [1447250253]}, {"billed_charge": 8.09, "npi": [1447250253]}, {"billed_charge": 0.9247, "npi": [1447250253]}, {"billed_charge": 1.2963, "npi": [1447250253]}, {"billed_charge": 0.3417, "npi": [1447250253]}, {"billed_charge": 0.6617, "npi": [1447250253]}, {"billed_charge": 0.075, "npi": [1447250253]}, {"billed_charge": 13.2814, "npi": [1447250253]}, {"billed_charge": 1.714, "npi": [1447250253]}, {"billed_charge": 6.9414, "npi": [1447250253]}, {"billed_charge": 2.3, "npi": [1447250253]}, {"billed_charge": 8.0964, "npi": [1447250253]}, {"billed_charge": 0.1325, "npi": [1447250253]}, {"billed_charge": 0.1067, "npi": [1447250253]}, {"billed_charge": 0.6538, "npi": [1447250253]}, {"billed_charge": 1.6, "npi": [1447250253]}, {"billed_charge": 12.0775, "npi": [1447250253]}, {"billed_charge": 139.598, "npi": [1447250253]}, {"billed_charge": 46.2533, "npi": [1447250253]}, {"billed_charge": 1.985, "npi": [1447250253]}, {"billed_charge": 1.2543, "npi": [1447250253]}, {"billed_charge": 3.2533, "npi": [1447250253]}, {"billed_charge": 0.49, "npi": [1447250253]}, {"billed_charge": 1.0845, "npi": [1447250253]}, {"billed_charge": 10.0027, "npi": [1447250253]}, {"billed_charge": 3.5135, "npi": [1447250253]}, {"billed_charge": 0.1625, "npi": [1447250253]}, {"billed_charge": 0.8286, "npi": [1447250253]}, {"billed_charge": 0.285, "npi": [1447250253]}, {"billed_charge": 5.25, "npi": [1447250253]}, {"billed_charge": 4.1638, "npi": [1447250253]}, {"billed_charge": 2.1725, "npi": [1447250253]}, {"billed_charge": 0.4467, "npi": [1447250253]}, {"billed_charge": 128.0413, "npi": [1447250253]}, {"billed_charge": 2.14, "npi": [1447250253]}, {"billed_charge": 2.2702, "npi": [1447250253]}, {"billed_charge": 3.1903, "npi": [1447250253]}, {"billed_charge": 1.525, "npi": [1447250253]}, {"billed_charge": 2.0092, "npi": [1447250253]}, {"billed_charge": 3.04, "npi": [1447250253]}, {"billed_charge": 1.304, "npi": [1447250253]}, {"billed_charge": 1.95, "npi": [1447250253]}, {"billed_charge": 24.2242, "npi": [1447250253]}, {"billed_charge": 0.07, "npi": [1447250253]}, {"billed_charge": 20.34, "npi": [1447250253]}, {"billed_charge": 0.8263, "npi": [1447250253]}, {"billed_charge": 3.7825, "npi": [1447250253]}, {"billed_charge": 8.9104, "npi": [1447250253]}, {"billed_charge": 10.4733, "npi": [1447250253]}, {"billed_charge": 3.2933, "npi": [1447250253]}, {"billed_charge": 0.6383, "npi": [1447250253]}, {"billed_charge": 0.9333, "npi": [1447250253]}, {"billed_charge": 11.6409, "npi": [1447250253]}, {"billed_charge": 10.3544, "npi": [1447250253]}, {"billed_charge": 0.44, "npi": [1447250253]}, {"billed_charge": 4.0877, "npi": [1447250253]}, {"billed_charge": 7.3517, "npi": [1447250253]}, {"billed_charge": 3.9793, "npi": [1447250253]}, {"billed_charge": 7.5, "npi": [1447250253]}, {"billed_charge": 1.0569, "npi": [1447250253]}, {"billed_charge": 1.0125, "npi": [1447250253]}, {"billed_charge": 1.664, "npi": [1447250253]}, {"billed_charge": 0.2717, "npi": [1447250253]}, {"billed_charge": 3.88, "npi": [1447250253]}, {"billed_charge": 1.8878, "npi": [1447250253]}, {"billed_charge": 2.6668, "npi": [1447250253]}, {"billed_charge": 7.63, "npi": [1447250253]}, {"billed_charge": 8.0989, "npi": [1447250253]}, {"billed_charge": 2.02, "npi": [1447250253]}, {"billed_charge": 3.7002, "npi": [1447250253]}, {"billed_charge": 13.6941, "npi": [1447250253]}, {"billed_charge": 1.7993, "npi": [1447250253]}, {"billed_charge": 9.28, "npi": [1447250253]}, {"billed_charge": 6.0633, "npi": [1447250253]}, {"billed_charge": 4.2, "npi": [1447250253]}, {"billed_charge": 11.4786, "npi": [1447250253]}, {"billed_charge": 2.0355, "npi": [1447250253]}, {"billed_charge": 1.1274, "npi": [1447250253]}, {"billed_charge": 0.406, "npi": [1447250253]}, {"billed_charge": 2.5013, "npi": [1447250253]}, {"billed_charge": 0.6667, "npi": [1447250253]}, {"billed_charge": 74.057, "npi": [1447250253]}, {"billed_charge": 0.54, "npi": [1447250253]}, {"billed_charge": 0.8425, "npi": [1447250253]}, {"billed_charge": 5.0357, "npi": [1447250253]}, {"billed_charge": 14.35, "npi": [1447250253]}, {"billed_charge": 0.11, "npi": [1447250253]}, {"billed_charge": 3.5904, "npi": [1447250253]}, {"billed_charge": 5.228, "npi": [1447250253]}, {"billed_charge": 0.492, "npi": [1447250253]}, {"billed_charge": 17.71, "npi": [1447250253]}, {"billed_charge": 2.0267, "npi": [1447250253]}, {"billed_charge": 6.5045, "npi": [1447250253]}, {"billed_charge": 1.11, "npi": [1447250253]}, {"billed_charge": 9.16, "npi": [1447250253]}, {"billed_charge": 11.7115, "npi": [1447250253]}, {"billed_charge": 3.2181, "npi": [1447250253]}]}]}]}, {"name": "Laboratory - Chemistry", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0301", "description": "Laboratory", "allowed_amounts": [{"tin": {"type": "ein", "value": "753175630"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 33.0, "npi": [1285798918]}, {"billed_charge": 152.0, "npi": [1285798918]}, {"billed_charge": 176.5455, "npi": [1285798918]}, {"billed_charge": 85.0, "npi": [1285798918]}, {"billed_charge": 148.0, "npi": [1285798918]}, {"billed_charge": 175.0, "npi": [1285798918]}, {"billed_charge": 157.0, "npi": [1285798918]}, {"billed_charge": 160.9756, "npi": [1285798918]}, {"billed_charge": 162.5, "npi": [1285798918]}, {"billed_charge": 159.0, "npi": [1285798918]}, {"billed_charge": 91.0, "npi": [1285798918]}, {"billed_charge": 115.0, "npi": [1285798918]}, {"billed_charge": 197.0, "npi": [1285798918]}, {"billed_charge": 594.0, "npi": [1285798918]}, {"billed_charge": 92.0, "npi": [1285798918]}, {"billed_charge": 257.0, "npi": [1285798918]}, {"billed_charge": 334.0, "npi": [1285798918]}, {"billed_charge": 139.35, "npi": [1285798918]}, {"billed_charge": 125.0, "npi": [1285798918]}, {"billed_charge": 338.0, "npi": [1285798918]}, {"billed_charge": 137.0, "npi": [1285798918]}, {"billed_charge": 143.0, "npi": [1285798918]}, {"billed_charge": 89.0, "npi": [1285798918]}, {"billed_charge": 73.0, "npi": [1285798918]}, {"billed_charge": 127.0, "npi": [1285798918]}, {"billed_charge": 101.0, "npi": [1285798918]}, {"billed_charge": 123.0, "npi": [1285798918]}]}, {"allowed_amount": 5.32, "billing_code_modifier": [""], "providers": [{"billed_charge": 44.0, "npi": [1285798918]}]}, {"allowed_amount": 19.42, "billing_code_modifier": [""], "providers": [{"billed_charge": 142.0, "npi": [1285798918]}]}, {"allowed_amount": 11.75, "billing_code_modifier": [""], "providers": [{"billed_charge": 407.0, "npi": [1285798918]}]}, {"allowed_amount": 19.76, "billing_code_modifier": [""], "providers": [{"billed_charge": 159.0, "npi": [1285798918]}]}, {"allowed_amount": 7.51, "billing_code_modifier": [""], "providers": [{"billed_charge": 55.0, "npi": [1285798918]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["91"], "providers": [{"billed_charge": 148.0, "npi": [1285798918]}, {"billed_charge": 137.0, "npi": [1285798918]}, {"billed_charge": 143.0, "npi": [1285798918]}]}, {"allowed_amount": 25.04, "billing_code_modifier": [""], "providers": [{"billed_charge": 418.0, "npi": [1285798918]}]}, {"allowed_amount": 15.31, "billing_code_modifier": [""], "providers": [{"billed_charge": 152.0, "npi": [1285798918]}]}, {"allowed_amount": 34.93, "billing_code_modifier": [""], "providers": [{"billed_charge": 483.0, "npi": [1285798918]}]}]}]}, {"name": "Emergency Room - General", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0450", "description": "Emergency Room", "allowed_amounts": [{"tin": {"type": "ein", "value": "751047527"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 308.31, "billing_code_modifier": [""], "providers": [{"billed_charge": 779.25, "npi": [1396779948]}, {"billed_charge": 333.25, "npi": [1396779948]}]}, {"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 1141.5833, "npi": [1396779948]}, {"billed_charge": 1768.75, "npi": [1396779948]}, {"billed_charge": 775.2813, "npi": [1396779948]}, {"billed_charge": 103.5, "npi": [1396779948]}, {"billed_charge": 254.75, "npi": [1396779948]}, {"billed_charge": 542.5, "npi": [1396779948]}, {"billed_charge": 333.25, "npi": [1396779948]}, {"billed_charge": 1264.0833, "npi": [1396779948]}, {"billed_charge": 818.25, "npi": [1396779948]}, {"billed_charge": 2758.25, "npi": [1396779948]}, {"billed_charge": 1545.75, "npi": [1396779948]}]}, {"allowed_amount": 67.875, "billing_code_modifier": [""], "providers": [{"billed_charge": 103.5, "npi": [1396779948]}, {"billed_charge": 333.25, "npi": [1396779948]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["XS"], "providers": [{"billed_charge": 254.75, "npi": [1396779948]}]}, {"allowed_amount": 604.81, "billing_code_modifier": [""], "providers": [{"billed_charge": 1521.25, "npi": [1396779948]}]}, {"allowed_amount": 235.54, "billing_code_modifier": ["LT"], "providers": [{"billed_charge": 334.0, "npi": [1396779948]}]}, {"allowed_amount": 67.875, "billing_code_modifier": ["59"], "providers": [{"billed_charge": 103.5, "npi": [1396779948]}, {"billed_charge": 333.25, "npi": [1396779948]}]}, {"allowed_amount": 222.56, "billing_code_modifier": [""], "providers": [{"billed_charge": 537.75, "npi": [1396779948]}]}, {"allowed_amount": 122.22, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 332.25, "npi": [1396779948]}]}, {"allowed_amount": 67.8733, "billing_code_modifier": ["59"], "providers": [{"billed_charge": 333.25, "npi": [1396779948]}]}, {"allowed_amount": 3791.1, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 2758.25, "npi": [1396779948]}]}, {"allowed_amount": 589.22, "billing_code_modifier": [""], "providers": [{"billed_charge": 840.0, "npi": [1396779948]}]}, {"allowed_amount": 67.87, "billing_code_modifier": [""], "providers": [{"billed_charge": 103.5, "npi": [1396779948]}, {"billed_charge": 333.25, "npi": [1396779948]}]}, {"allowed_amount": 863.2, "billing_code_modifier": [""], "providers": [{"billed_charge": 2758.25, "npi": [1396779948]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 2758.25, "npi": [1396779948]}]}, {"allowed_amount": 67.8733, "billing_code_modifier": [""], "providers": [{"billed_charge": 103.5, "npi": [1396779948]}, {"billed_charge": 333.25, "npi": [1396779948]}]}, {"allowed_amount": 395.66, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 1042.5, "npi": [1396779948]}]}, {"allowed_amount": 395.66, "billing_code_modifier": [""], "providers": [{"billed_charge": 1042.5, "npi": [1396779948]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["59"], "providers": [{"billed_charge": 779.25, "npi": [1396779948]}, {"billed_charge": 103.5, "npi": [1396779948]}, {"billed_charge": 254.75, "npi": [1396779948]}, {"billed_charge": 333.25, "npi": [1396779948]}]}, {"allowed_amount": 863.2, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 2758.25, "npi": [1396779948]}]}, {"allowed_amount": 145.42, "billing_code_modifier": [""], "providers": [{"billed_charge": 811.0, "npi": [1396779948]}]}, {"allowed_amount": 308.31, "billing_code_modifier": ["59"], "providers": [{"billed_charge": 779.25, "npi": [1396779948]}, {"billed_charge": 333.25, "npi": [1396779948]}]}, {"allowed_amount": 104.36, "billing_code_modifier": [""], "providers": [{"billed_charge": 683.75, "npi": [1396779948]}]}, {"allowed_amount": 122.22, "billing_code_modifier": [""], "providers": [{"billed_charge": 332.25, "npi": [1396779948]}]}, {"allowed_amount": 67.87, "billing_code_modifier": ["59"], "providers": [{"billed_charge": 103.5, "npi": [1396779948]}, {"billed_charge": 333.25, "npi": [1396779948]}]}, {"allowed_amount": 604.81, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 1521.25, "npi": [1396779948]}]}]}]}, {"name": "Pharmacy - General", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0250", "description": "Pharmacy (also see 063x, an extension of 025x)", "allowed_amounts": [{"tin": {"type": "ein", "value": "752051646"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.49, "billing_code_modifier": [""], "providers": [{"billed_charge": 20.0, "npi": [1891765178]}]}, {"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 38.75, "npi": [1891765178]}, {"billed_charge": 2.0, "npi": [1891765178]}, {"billed_charge": 13.5, "npi": [1891765178]}, {"billed_charge": 10.0, "npi": [1891765178]}, {"billed_charge": 1.2344, "npi": [1891765178]}, {"billed_charge": 9.6, "npi": [1891765178]}, {"billed_charge": 32.25, "npi": [1891765178]}, {"billed_charge": 3.75, "npi": [1891765178]}, {"billed_charge": 56.75, "npi": [1891765178]}, {"billed_charge": 4.6634, "npi": [1891765178]}, {"billed_charge": 2.6154, "npi": [1891765178]}, {"billed_charge": 27.5, "npi": [1891765178]}, {"billed_charge": 4.0, "npi": [1891765178]}, {"billed_charge": 5.0, "npi": [1891765178]}, {"billed_charge": 87.4421, "npi": [1891765178]}, {"billed_charge": 9.3125, "npi": [1891765178]}, {"billed_charge": 37.75, "npi": [1891765178]}, {"billed_charge": 28.125, "npi": [1891765178]}, {"billed_charge": 583.25, "npi": [1891765178]}]}, {"allowed_amount": 2.043, "billing_code_modifier": ["JZ"], "providers": [{"billed_charge": 14.2775, "npi": [1891765178]}]}]}]}, {"name": "Pharmacy - Extension of 25X - Drug Requiring Detailed Coding", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0636", "description": "Pharmacy - Extension of 25x", "allowed_amounts": [{"tin": {"type": "ein", "value": "751777119"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 1.8, "npi": [1073511762]}, {"billed_charge": 0.678, "npi": [1073511762]}, {"billed_charge": 20.98, "npi": [1073511762]}, {"billed_charge": 20.76, "npi": [1073511762]}, {"billed_charge": 1.29, "npi": [1073511762]}, {"billed_charge": 0.576, "npi": [1073511762]}, {"billed_charge": 0.72, "npi": [1073511762]}, {"billed_charge": 0.866, "npi": [1073511762]}, {"billed_charge": 42.0, "npi": [1073511762]}, {"billed_charge": 12.52, "npi": [1073511762]}, {"billed_charge": 1.7516, "npi": [1073511762]}, {"billed_charge": 276.85, "npi": [1073511762]}]}, {"allowed_amount": 0.48, "billing_code_modifier": [""], "providers": [{"billed_charge": 3.68, "npi": [1073511762]}, {"billed_charge": 1.47, "npi": [1073511762]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["JZ"], "providers": [{"billed_charge": 2.82, "npi": [1073511762]}, {"billed_charge": 1.925, "npi": [1073511762]}, {"billed_charge": 1.02, "npi": [1073511762]}, {"billed_charge": 0.4668, "npi": [1073511762]}]}, {"allowed_amount": 0.48, "billing_code_modifier": ["JW"], "providers": [{"billed_charge": 2.73, "npi": [1073511762]}, {"billed_charge": 6.83, "npi": [1073511762]}]}]}]}, {"name": "CT Scan - General", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0350", "description": "CT Scan", "allowed_amounts": [{"tin": {"type": "ein", "value": "752770738"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 151.54, "billing_code_modifier": [""], "providers": [{"billed_charge": 4150.0, "npi": [1770514077]}]}, {"allowed_amount": 151.54, "billing_code_modifier": ["RT"], "providers": [{"billed_charge": 3452.75, "npi": [1770514077]}]}, {"allowed_amount": 320.73, "billing_code_modifier": [""], "providers": [{"billed_charge": 4150.0, "npi": [1770514077]}]}, {"allowed_amount": 622.69, "billing_code_modifier": [""], "providers": [{"billed_charge": 4150.0, "npi": [1770514077]}, {"billed_charge": 6795.5, "npi": [1770514077]}]}, {"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 5817.25, "npi": [1770514077]}, {"billed_charge": 6795.5, "npi": [1770514077]}, {"billed_charge": 7217.625, "npi": [1770514077]}]}, {"allowed_amount": 345.85, "billing_code_modifier": [""], "providers": [{"billed_charge": 5817.25, "npi": [1770514077]}]}, {"allowed_amount": 505.67, "billing_code_modifier": ["U6"], "providers": [{"billed_charge": 6795.5, "npi": [1770514077]}]}, {"allowed_amount": 505.67, "billing_code_modifier": [""], "providers": [{"billed_charge": 10189.0, "npi": [1770514077]}, {"billed_charge": 6795.5, "npi": [1770514077]}]}]}]}, {"name": "Laboratory - Hematology", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0305", "description": "Laboratory", "allowed_amounts": [{"tin": {"type": "ein", "value": "751748586"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 206.5, "npi": [1508899204]}, {"billed_charge": 233.5, "npi": [1508899204]}, {"billed_charge": 226.7, "npi": [1508899204]}, {"billed_charge": 706.5, "npi": [1508899204]}, {"billed_charge": 226.5, "npi": [1508899204]}]}]}]}, {"name": "Laboratory - Urology", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0307", "description": "Laboratory", "allowed_amounts": [{"tin": {"type": "ein", "value": "751837454"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 129.78, "npi": [1447250253]}, {"billed_charge": 83.58, "npi": [1447250253]}, {"billed_charge": 162.16, "npi": [1447250253]}, {"billed_charge": 106.68, "npi": [1447250253]}, {"billed_charge": 122.87, "npi": [1447250253]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["XU"], "providers": [{"billed_charge": 129.78, "npi": [1447250253]}]}]}]}, {"name": "Laboratory - Chemistry", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0301", "description": "Laboratory", "allowed_amounts": [{"tin": {"type": "ein", "value": "824052186"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 306.86, "npi": [1801826839]}, {"billed_charge": 285.79, "npi": [1801826839]}, {"billed_charge": 459.04, "npi": [1801826839]}, {"billed_charge": 236.1639, "npi": [1801826839]}, {"billed_charge": 205.0717, "npi": [1801826839]}, {"billed_charge": 185.85, "npi": [1801826839]}, {"billed_charge": 153.91, "npi": [1801826839]}, {"billed_charge": 148.33, "npi": [1801826839]}, {"billed_charge": 249.74, "npi": [1801826839]}, {"billed_charge": 56.6, "npi": [1801826839]}, {"billed_charge": 163.41, "npi": [1801826839]}, {"billed_charge": 217.7, "npi": [1801826839]}, {"billed_charge": 229.02, "npi": [1801826839]}, {"billed_charge": 249.48, "npi": [1801826839]}, {"billed_charge": 407.22, "npi": [1801826839]}]}, {"allowed_amount": 19.42, "billing_code_modifier": [""], "providers": [{"billed_charge": 328.07, "npi": [1801826839]}]}]}]}, {"name": "Laboratory - Chemistry", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0301", "description": "Laboratory", "allowed_amounts": [{"tin": {"type": "ein", "value": "010238552"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 117.1, "npi": [1760436216]}, {"billed_charge": 386.3, "npi": [1760436216]}, {"billed_charge": 188.9, "npi": [1760436216]}, {"billed_charge": 116.9, "npi": [1760436216]}, {"billed_charge": 230.05, "npi": [1760436216]}, {"billed_charge": 203.9, "npi": [1760436216]}, {"billed_charge": 270.8, "npi": [1760436216]}, {"billed_charge": 391.7, "npi": [1760436216]}]}, {"allowed_amount": 4.21, "billing_code_modifier": [""], "providers": [{"billed_charge": 107.55, "npi": [1760436216]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["59"], "providers": [{"billed_charge": 91.45, "npi": [1760436216]}]}]}]}, {"name": "US PREG UTERUS REAL TIME F/U TRNSABDL PER FETUS", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "76816", "description": "US PREG UTERUS REAL TIME F/U TRNSABDL PER FETUS", "allowed_amounts": [{"tin": {"type": "ein", "value": "270393689"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 48.91, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 140.0, "npi": [1083969299]}]}, {"allowed_amount": 48.91, "billing_code_modifier": ["5926"], "providers": [{"billed_charge": 140.0, "npi": [1083969299]}]}]}]}, {"name": "MEDICATION TRAINING AND SUPPORT PER 15 MINUTES", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "H0034", "description": "MEDICATION TRAINING AND SUPPORT PER 15 MINUTES", "allowed_amounts": [{"tin": {"type": "ein", "value": "851283674"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 4.5, "billing_code_modifier": ["HQ"], "providers": [{"billed_charge": 15.0, "npi": [1679029136]}]}]}]}, {"name": "Pharmacy - General", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0250", "description": "Pharmacy (also see 063x, an extension of 025x)", "allowed_amounts": [{"tin": {"type": "ein", "value": "260194016"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 21.0575, "npi": [1205018439]}, {"billed_charge": 15.6, "npi": [1205018439]}, {"billed_charge": 0.97, "npi": [1205018439]}, {"billed_charge": 1.5869, "npi": [1205018439]}, {"billed_charge": 0.1267, "npi": [1205018439]}, {"billed_charge": 8.76, "npi": [1205018439]}, {"billed_charge": 2.885, "npi": [1205018439]}, {"billed_charge": 1.56, "npi": [1205018439]}, {"billed_charge": 1.0, "npi": [1205018439]}, {"billed_charge": 2.4331, "npi": [1205018439]}, {"billed_charge": 1.0332, "npi": [1205018439]}, {"billed_charge": 0.9813, "npi": [1205018439]}, {"billed_charge": 2.7929, "npi": [1205018439]}, {"billed_charge": 1.065, "npi": [1205018439]}, {"billed_charge": 0.11, "npi": [1205018439]}, {"billed_charge": 3.88, "npi": [1205018439]}, {"billed_charge": 0.9733, "npi": [1205018439]}, {"billed_charge": 5.3133, "npi": [1205018439]}, {"billed_charge": 3.52, "npi": [1205018439]}, {"billed_charge": 1.4067, "npi": [1205018439]}, {"billed_charge": 304.88, "npi": [1205018439]}, {"billed_charge": 0.73, "npi": [1205018439]}, {"billed_charge": 15.72, "npi": [1205018439]}, {"billed_charge": 0.075, "npi": [1205018439]}, {"billed_charge": 6.2894, "npi": [1205018439]}, {"billed_charge": 1.005, "npi": [1205018439]}, {"billed_charge": 0.92, "npi": [1205018439]}, {"billed_charge": 0.15, "npi": [1205018439]}, {"billed_charge": 0.295, "npi": [1205018439]}, {"billed_charge": 0.38, "npi": [1205018439]}, {"billed_charge": 0.7355, "npi": [1205018439]}, {"billed_charge": 1.7091, "npi": [1205018439]}, {"billed_charge": 0.958, "npi": [1205018439]}, {"billed_charge": 26.5342, "npi": [1205018439]}, {"billed_charge": 0.8167, "npi": [1205018439]}, {"billed_charge": 0.1767, "npi": [1205018439]}, {"billed_charge": 1.1817, "npi": [1205018439]}, {"billed_charge": 0.29, "npi": [1205018439]}, {"billed_charge": 15.66, "npi": [1205018439]}, {"billed_charge": 2.3, "npi": [1205018439]}, {"billed_charge": 2.2987, "npi": [1205018439]}, {"billed_charge": 0.08, "npi": [1205018439]}, {"billed_charge": 1.456, "npi": [1205018439]}, {"billed_charge": 2.4, "npi": [1205018439]}, {"billed_charge": 4.484, "npi": [1205018439]}, {"billed_charge": 1.0599, "npi": [1205018439]}, {"billed_charge": 6.293, "npi": [1205018439]}, {"billed_charge": 5.92, "npi": [1205018439]}, {"billed_charge": 3.7, "npi": [1205018439]}]}]}]}, {"name": "Laboratory - Hematology", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0305", "description": "Laboratory", "allowed_amounts": [{"tin": {"type": "ein", "value": "260194016"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 106.26, "npi": [1205018439]}, {"billed_charge": 171.5545, "npi": [1205018439]}, {"billed_charge": 172.95, "npi": [1205018439]}, {"billed_charge": 149.84, "npi": [1205018439]}, {"billed_charge": 146.11, "npi": [1205018439]}, {"billed_charge": 190.4564, "npi": [1205018439]}, {"billed_charge": 248.29, "npi": [1205018439]}, {"billed_charge": 111.76, "npi": [1205018439]}, {"billed_charge": 93.56, "npi": [1205018439]}, {"billed_charge": 183.63, "npi": [1205018439]}, {"billed_charge": 183.4188, "npi": [1205018439]}, {"billed_charge": 140.91, "npi": [1205018439]}, {"billed_charge": 156.1581, "npi": [1205018439]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["91"], "providers": [{"billed_charge": 183.63, "npi": [1205018439]}]}]}]}, {"name": "IV Therapy -General", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0260", "description": "IV Therapy", "allowed_amounts": [{"tin": {"type": "ein", "value": "260194016"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 317.78, "npi": [1205018439]}, {"billed_charge": 361.12, "npi": [1205018439]}, {"billed_charge": 902.11, "npi": [1205018439]}, {"billed_charge": 392.06, "npi": [1205018439]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["XU"], "providers": [{"billed_charge": 524.33, "npi": [1205018439]}, {"billed_charge": 317.78, "npi": [1205018439]}]}]}]}, {"name": "Emergency Room - General", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0450", "description": "Emergency Room", "allowed_amounts": [{"tin": {"type": "ein", "value": "751837454"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 308.31, "billing_code_modifier": [""], "providers": [{"billed_charge": 814.34, "npi": [1447250253]}, {"billed_charge": 902.11, "npi": [1447250253]}, {"billed_charge": 524.33, "npi": [1447250253]}]}, {"allowed_amount": 222.56, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 782.31, "npi": [1447250253]}, {"billed_charge": 1103.51, "npi": [1447250253]}]}, {"allowed_amount": 308.31, "billing_code_modifier": ["XS"], "providers": [{"billed_charge": 524.33, "npi": [1447250253]}]}, {"allowed_amount": 8282.07, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 3879.67, "npi": [1447250253]}]}, {"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 361.12, "npi": [1447250253]}, {"billed_charge": 1186.844, "npi": [1447250253]}, {"billed_charge": 392.06, "npi": [1447250253]}, {"billed_charge": 1704.1133, "npi": [1447250253]}, {"billed_charge": 1180.656, "npi": [1447250253]}, {"billed_charge": 1297.03, "npi": [1447250253]}, {"billed_charge": 2379.02, "npi": [1447250253]}, {"billed_charge": 814.34, "npi": [1447250253]}, {"billed_charge": 1097.0117, "npi": [1447250253]}, {"billed_charge": 902.11, "npi": [1447250253]}, {"billed_charge": 755.1591, "npi": [1447250253]}, {"billed_charge": 1270.725, "npi": [1447250253]}, {"billed_charge": 1086.324, "npi": [1447250253]}, {"billed_charge": 1391.475, "npi": [1447250253]}, {"billed_charge": 1886.7167, "npi": [1447250253]}, {"billed_charge": 1259.142, "npi": [1447250253]}, {"billed_charge": 2122.8, "npi": [1447250253]}, {"billed_charge": 1281.504, "npi": [1447250253]}, {"billed_charge": 1535.5767, "npi": [1447250253]}, {"billed_charge": 896.4763, "npi": [1447250253]}, {"billed_charge": 1278.46, "npi": [1447250253]}, {"billed_charge": 1427.845, "npi": [1447250253]}, {"billed_charge": 317.78, "npi": [1447250253]}, {"billed_charge": 2567.91, "npi": [1447250253]}, {"billed_charge": 1842.6267, "npi": [1447250253]}, {"billed_charge": 1289.295, "npi": [1447250253]}, {"billed_charge": 753.62, "npi": [1447250253]}, {"billed_charge": 1376.1, "npi": [1447250253]}, {"billed_charge": 3879.67, "npi": [1447250253]}, {"billed_charge": 1157.132, "npi": [1447250253]}, {"billed_charge": 1283.4, "npi": [1447250253]}, {"billed_charge": 1495.3375, "npi": [1447250253]}, {"billed_charge": 339.15, "npi": [1447250253]}, {"billed_charge": 1582.32, "npi": [1447250253]}, {"billed_charge": 1107.0933, "npi": [1447250253]}, {"billed_charge": 2012.6433, "npi": [1447250253]}, {"billed_charge": 321.2, "npi": [1447250253]}, {"billed_charge": 1022.0157, "npi": [1447250253]}, {"billed_charge": 330.56, "npi": [1447250253]}, {"billed_charge": 4233.71, "npi": [1447250253]}, {"billed_charge": 524.33, "npi": [1447250253]}, {"billed_charge": 1101.18, "npi": [1447250253]}, {"billed_charge": 1691.94, "npi": [1447250253]}, {"billed_charge": 1720.198, "npi": [1447250253]}, {"billed_charge": 1573.9267, "npi": [1447250253]}]}, {"allowed_amount": 67.875, "billing_code_modifier": [""], "providers": [{"billed_charge": 392.06, "npi": [1447250253]}, {"billed_charge": 317.78, "npi": [1447250253]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["XS"], "providers": [{"billed_charge": 524.33, "npi": [1447250253]}]}, {"allowed_amount": 604.81, "billing_code_modifier": [""], "providers": [{"billed_charge": 2122.8, "npi": [1447250253]}]}, {"allowed_amount": 67.875, "billing_code_modifier": ["XU"], "providers": [{"billed_charge": 392.06, "npi": [1447250253]}]}, {"allowed_amount": 67.87, "billing_code_modifier": ["XU"], "providers": [{"billed_charge": 392.06, "npi": [1447250253]}, {"billed_charge": 317.78, "npi": [1447250253]}]}, {"allowed_amount": 222.56, "billing_code_modifier": [""], "providers": [{"billed_charge": 782.31, "npi": [1447250253]}]}, {"allowed_amount": 122.22, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 478.23, "npi": [1447250253]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["XU"], "providers": [{"billed_charge": 361.12, "npi": [1447250253]}, {"billed_charge": 392.06, "npi": [1447250253]}, {"billed_charge": 902.11, "npi": [1447250253]}, {"billed_charge": 317.78, "npi": [1447250253]}, {"billed_charge": 321.2, "npi": [1447250253]}, {"billed_charge": 524.33, "npi": [1447250253]}]}, {"allowed_amount": 2330.73, "billing_code_modifier": ["LT"], "providers": [{"billed_charge": 5104.38, "npi": [1447250253]}]}, {"allowed_amount": 247.29, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 2122.8, "npi": [1447250253]}]}, {"allowed_amount": 67.8733, "billing_code_modifier": ["XU"], "providers": [{"billed_charge": 392.06, "npi": [1447250253]}]}, {"allowed_amount": 3791.1, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 2122.8, "npi": [1447250253]}, {"billed_charge": 3879.67, "npi": [1447250253]}, {"billed_charge": 4233.71, "npi": [1447250253]}]}, {"allowed_amount": 222.56, "billing_code_modifier": ["27"], "providers": [{"billed_charge": 782.31, "npi": [1447250253]}]}, {"allowed_amount": 589.22, "billing_code_modifier": [""], "providers": [{"billed_charge": 1075.22, "npi": [1447250253]}]}, {"allowed_amount": 67.87, "billing_code_modifier": [""], "providers": [{"billed_charge": 392.06, "npi": [1447250253]}, {"billed_charge": 317.78, "npi": [1447250253]}, {"billed_charge": 330.56, "npi": [1447250253]}]}, {"allowed_amount": 290.83, "billing_code_modifier": [""], "providers": [{"billed_charge": 994.45, "npi": [1447250253]}]}, {"allowed_amount": 863.2, "billing_code_modifier": [""], "providers": [{"billed_charge": 3879.67, "npi": [1447250253]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 2122.8, "npi": [1447250253]}, {"billed_charge": 3879.67, "npi": [1447250253]}, {"billed_charge": 4233.71, "npi": [1447250253]}]}, {"allowed_amount": 67.8733, "billing_code_modifier": [""], "providers": [{"billed_charge": 392.06, "npi": [1447250253]}, {"billed_charge": 317.78, "npi": [1447250253]}, {"billed_charge": 330.56, "npi": [1447250253]}]}, {"allowed_amount": 395.66, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 2125.51, "npi": [1447250253]}, {"billed_charge": 1283.4, "npi": [1447250253]}]}, {"allowed_amount": 395.66, "billing_code_modifier": [""], "providers": [{"billed_charge": 1283.4, "npi": [1447250253]}]}, {"allowed_amount": 308.31, "billing_code_modifier": ["XU"], "providers": [{"billed_charge": 524.33, "npi": [1447250253]}]}, {"allowed_amount": 231.23, "billing_code_modifier": [""], "providers": [{"billed_charge": 902.11, "npi": [1447250253]}]}, {"allowed_amount": 863.2, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 3879.67, "npi": [1447250253]}]}, {"allowed_amount": 395.66, "billing_code_modifier": ["27"], "providers": [{"billed_charge": 1283.4, "npi": [1447250253]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["XP"], "providers": [{"billed_charge": 814.34, "npi": [1447250253]}]}, {"allowed_amount": 8065.36, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 3879.67, "npi": [1447250253]}]}, {"allowed_amount": 122.22, "billing_code_modifier": [""], "providers": [{"billed_charge": 478.23, "npi": [1447250253]}]}, {"allowed_amount": 604.81, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 2122.8, "npi": [1447250253]}]}, {"allowed_amount": 1197.29, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 4233.71, "npi": [1447250253]}]}, {"allowed_amount": 357.54, "billing_code_modifier": ["LT"], "providers": [{"billed_charge": 1515.14, "npi": [1447250253]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["T5"], "providers": [{"billed_charge": 662.97, "npi": [1447250253]}]}]}]}, {"name": "Laboratory - General", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0300", "description": "Laboratory", "allowed_amounts": [{"tin": {"type": "ein", "value": "752586857"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 82.536, "npi": [1992700983]}, {"billed_charge": 95.5, "npi": [1992700983]}, {"billed_charge": 40.0, "npi": [1992700983]}, {"billed_charge": 93.73, "npi": [1992700983]}, {"billed_charge": 170.1, "npi": [1992700983]}, {"billed_charge": 240.0, "npi": [1992700983]}, {"billed_charge": 47.75, "npi": [1992700983]}, {"billed_charge": 143.25, "npi": [1992700983]}, {"billed_charge": 238.75, "npi": [1992700983]}, {"billed_charge": 222.6, "npi": [1992700983]}, {"billed_charge": 118.6868, "npi": [1992700983]}, {"billed_charge": 392.86, "npi": [1992700983]}, {"billed_charge": 84.2482, "npi": [1992700983]}, {"billed_charge": 91.63, "npi": [1992700983]}, {"billed_charge": 211.0, "npi": [1992700983]}, {"billed_charge": 94.5337, "npi": [1992700983]}, {"billed_charge": 474.94, "npi": [1992700983]}, {"billed_charge": 106.9745, "npi": [1992700983]}, {"billed_charge": 107.6791, "npi": [1992700983]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["91"], "providers": [{"billed_charge": 392.86, "npi": [1992700983]}]}]}]}, {"name": "Laboratory - Urology", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0307", "description": "Laboratory", "allowed_amounts": [{"tin": {"type": "ein", "value": "750800628"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 121.2, "billing_code_modifier": [""], "providers": [{"billed_charge": 202.0, "npi": [1194743013]}]}, {"allowed_amount": 78.78, "billing_code_modifier": [""], "providers": [{"billed_charge": 202.0, "npi": [1194743013]}]}, {"allowed_amount": 95.55, "billing_code_modifier": [""], "providers": [{"billed_charge": 245.0, "npi": [1194743013]}]}, {"allowed_amount": 80.4, "billing_code_modifier": [""], "providers": [{"billed_charge": 134.0, "npi": [1194743013]}]}, {"allowed_amount": 147.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 245.0, "npi": [1194743013]}]}]}]}, {"name": "Laboratory - Chemistry", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0301", "description": "Laboratory", "allowed_amounts": [{"tin": {"type": "ein", "value": "751837454"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 7.42, "billing_code_modifier": [""], "providers": [{"billed_charge": 111.02, "npi": [1447250253]}]}, {"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 98.8724, "npi": [1447250253]}, {"billed_charge": 213.1782, "npi": [1447250253]}, {"billed_charge": 143.5567, "npi": [1447250253]}, {"billed_charge": 258.18, "npi": [1447250253]}, {"billed_charge": 459.04, "npi": [1447250253]}, {"billed_charge": 117.4927, "npi": [1447250253]}, {"billed_charge": 249.48, "npi": [1447250253]}, {"billed_charge": 111.02, "npi": [1447250253]}, {"billed_charge": 246.4388, "npi": [1447250253]}, {"billed_charge": 163.41, "npi": [1447250253]}, {"billed_charge": 80.13, "npi": [1447250253]}, {"billed_charge": 241.4417, "npi": [1447250253]}, {"billed_charge": 122.4954, "npi": [1447250253]}, {"billed_charge": 150.3612, "npi": [1447250253]}, {"billed_charge": 296.8067, "npi": [1447250253]}, {"billed_charge": 295.62, "npi": [1447250253]}, {"billed_charge": 139.5779, "npi": [1447250253]}, {"billed_charge": 147.1656, "npi": [1447250253]}, {"billed_charge": 104.78, "npi": [1447250253]}, {"billed_charge": 108.35, "npi": [1447250253]}, {"billed_charge": 148.33, "npi": [1447250253]}, {"billed_charge": 105.4206, "npi": [1447250253]}, {"billed_charge": 230.2, "npi": [1447250253]}, {"billed_charge": 248.92, "npi": [1447250253]}, {"billed_charge": 97.42, "npi": [1447250253]}, {"billed_charge": 302.19, "npi": [1447250253]}, {"billed_charge": 229.02, "npi": [1447250253]}, {"billed_charge": 196.5725, "npi": [1447250253]}, {"billed_charge": 102.54, "npi": [1447250253]}, {"billed_charge": 124.3211, "npi": [1447250253]}, {"billed_charge": 266.2536, "npi": [1447250253]}, {"billed_charge": 243.23, "npi": [1447250253]}, {"billed_charge": 150.94, "npi": [1447250253]}, {"billed_charge": 136.2479, "npi": [1447250253]}, {"billed_charge": 127.23, "npi": [1447250253]}, {"billed_charge": 241.0513, "npi": [1447250253]}, {"billed_charge": 167.4757, "npi": [1447250253]}, {"billed_charge": 249.74, "npi": [1447250253]}, {"billed_charge": 133.658, "npi": [1447250253]}, {"billed_charge": 134.4417, "npi": [1447250253]}, {"billed_charge": 324.88, "npi": [1447250253]}, {"billed_charge": 230.465, "npi": [1447250253]}, {"billed_charge": 124.74, "npi": [1447250253]}, {"billed_charge": 153.91, "npi": [1447250253]}, {"billed_charge": 234.9225, "npi": [1447250253]}, {"billed_charge": 126.615, "npi": [1447250253]}, {"billed_charge": 432.76, "npi": [1447250253]}, {"billed_charge": 646.14, "npi": [1447250253]}, {"billed_charge": 286.1014, "npi": [1447250253]}, {"billed_charge": 56.6, "npi": [1447250253]}, {"billed_charge": 185.85, "npi": [1447250253]}, {"billed_charge": 217.7, "npi": [1447250253]}, {"billed_charge": 258.5295, "npi": [1447250253]}, {"billed_charge": 292.6078, "npi": [1447250253]}, {"billed_charge": 300.556, "npi": [1447250253]}, {"billed_charge": 131.2811, "npi": [1447250253]}, {"billed_charge": 151.8011, "npi": [1447250253]}, {"billed_charge": 148.7734, "npi": [1447250253]}, {"billed_charge": 87.97, "npi": [1447250253]}, {"billed_charge": 101.57, "npi": [1447250253]}, {"billed_charge": 99.79, "npi": [1447250253]}, {"billed_charge": 173.7226, "npi": [1447250253]}, {"billed_charge": 93.56, "npi": [1447250253]}, {"billed_charge": 126.4253, "npi": [1447250253]}, {"billed_charge": 91.362, "npi": [1447250253]}, {"billed_charge": 96.1, "npi": [1447250253]}, {"billed_charge": 214.55, "npi": [1447250253]}, {"billed_charge": 347.435, "npi": [1447250253]}, {"billed_charge": 272.9191, "npi": [1447250253]}, {"billed_charge": 128.49, "npi": [1447250253]}, {"billed_charge": 253.96, "npi": [1447250253]}, {"billed_charge": 285.79, "npi": [1447250253]}, {"billed_charge": 119.6523, "npi": [1447250253]}, {"billed_charge": 112.7747, "npi": [1447250253]}, {"billed_charge": 103.83, "npi": [1447250253]}, {"billed_charge": 150.7679, "npi": [1447250253]}, {"billed_charge": 70.25, "npi": [1447250253]}, {"billed_charge": 159.62, "npi": [1447250253]}, {"billed_charge": 240.75, "npi": [1447250253]}, {"billed_charge": 154.4836, "npi": [1447250253]}, {"billed_charge": 306.86, "npi": [1447250253]}, {"billed_charge": 233.93, "npi": [1447250253]}, {"billed_charge": 149.7832, "npi": [1447250253]}, {"billed_charge": 186.48, "npi": [1447250253]}, {"billed_charge": 105.46, "npi": [1447250253]}, {"billed_charge": 103.54, "npi": [1447250253]}, {"billed_charge": 88.72, "npi": [1447250253]}, {"billed_charge": 233.718, "npi": [1447250253]}, {"billed_charge": 407.22, "npi": [1447250253]}, {"billed_charge": 214.7413, "npi": [1447250253]}, {"billed_charge": 224.6483, "npi": [1447250253]}, {"billed_charge": 348.57, "npi": [1447250253]}, {"billed_charge": 129.62, "npi": [1447250253]}, {"billed_charge": 105.0771, "npi": [1447250253]}]}, {"allowed_amount": 5.7, "billing_code_modifier": ["XU"], "providers": [{"billed_charge": 99.79, "npi": [1447250253]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["GZ"], "providers": [{"billed_charge": 459.04, "npi": [1447250253]}, {"billed_charge": 99.79, "npi": [1447250253]}]}, {"allowed_amount": 19.42, "billing_code_modifier": [""], "providers": [{"billed_charge": 328.07, "npi": [1447250253]}]}, {"allowed_amount": 5.7, "billing_code_modifier": [""], "providers": [{"billed_charge": 99.79, "npi": [1447250253]}]}]}]}, {"name": "Emergency Room - General", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0450", "description": "Emergency Room", "allowed_amounts": [{"tin": {"type": "ein", "value": "756001743"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 308.31, "billing_code_modifier": [""], "providers": [{"billed_charge": 779.25, "npi": [1336172105]}, {"billed_charge": 333.25, "npi": [1336172105]}]}, {"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 686.0417, "npi": [1336172105]}, {"billed_charge": 1545.75, "npi": [1336172105]}, {"billed_charge": 1290.25, "npi": [1336172105]}, {"billed_charge": 630.25, "npi": [1336172105]}, {"billed_charge": 1065.0, "npi": [1336172105]}, {"billed_charge": 857.0833, "npi": [1336172105]}, {"billed_charge": 1211.3333, "npi": [1336172105]}, {"billed_charge": 254.75, "npi": [1336172105]}, {"billed_charge": 333.25, "npi": [1336172105]}]}, {"allowed_amount": 67.875, "billing_code_modifier": [""], "providers": [{"billed_charge": 103.5, "npi": [1336172105]}, {"billed_charge": 333.25, "npi": [1336172105]}]}, {"allowed_amount": 67.875, "billing_code_modifier": ["59"], "providers": [{"billed_charge": 333.25, "npi": [1336172105]}]}, {"allowed_amount": 2330.73, "billing_code_modifier": ["LT"], "providers": [{"billed_charge": 2017.5, "npi": [1336172105]}]}, {"allowed_amount": 67.87, "billing_code_modifier": [""], "providers": [{"billed_charge": 103.5, "npi": [1336172105]}, {"billed_charge": 333.25, "npi": [1336172105]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 1521.25, "npi": [1336172105]}]}, {"allowed_amount": 395.66, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 1042.5, "npi": [1336172105]}]}, {"allowed_amount": 395.66, "billing_code_modifier": [""], "providers": [{"billed_charge": 1042.5, "npi": [1336172105]}]}, {"allowed_amount": 863.2, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 2758.25, "npi": [1336172105]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["59"], "providers": [{"billed_charge": 103.5, "npi": [1336172105]}, {"billed_charge": 254.75, "npi": [1336172105]}, {"billed_charge": 333.25, "npi": [1336172105]}]}, {"allowed_amount": 733.41, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 1521.25, "npi": [1336172105]}]}, {"allowed_amount": 308.31, "billing_code_modifier": ["59"], "providers": [{"billed_charge": 779.25, "npi": [1336172105]}, {"billed_charge": 333.25, "npi": [1336172105]}]}, {"allowed_amount": 122.22, "billing_code_modifier": [""], "providers": [{"billed_charge": 332.25, "npi": [1336172105]}]}, {"allowed_amount": 67.87, "billing_code_modifier": ["59"], "providers": [{"billed_charge": 333.25, "npi": [1336172105]}]}, {"allowed_amount": 604.81, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 1521.25, "npi": [1336172105]}]}]}]}, {"name": "Pharmacy - IV Solutions", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0258", "description": "Pharmacy (also see 063x, an extension of 025x)", "allowed_amounts": [{"tin": {"type": "ein", "value": "751037591"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 46.9231, "npi": [1124305065]}, {"billed_charge": 50.0, "npi": [1124305065]}]}]}]}, {"name": "AMB SERVICE ALS EMERGENCY TRANSPORT LEVEL 1", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "A0427", "description": "AMB SERVICE ALS EMERGENCY TRANSPORT LEVEL 1", "allowed_amounts": [{"tin": {"type": "ein", "value": "756000508"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 1516.69, "billing_code_modifier": ["PH"], "providers": [{"billed_charge": 1516.69, "npi": [1861530990]}]}, {"allowed_amount": 1518.23, "billing_code_modifier": ["RH"], "providers": [{"billed_charge": 1518.23, "npi": [1861530990]}]}, {"allowed_amount": 1517.44, "billing_code_modifier": ["SH"], "providers": [{"billed_charge": 1517.44, "npi": [1861530990]}]}, {"allowed_amount": 1519.69, "billing_code_modifier": ["PH"], "providers": [{"billed_charge": 1519.69, "npi": [1861530990]}]}, {"allowed_amount": 1537.96, "billing_code_modifier": ["RH"], "providers": [{"billed_charge": 1537.96, "npi": [1861530990]}]}, {"allowed_amount": 1489.87, "billing_code_modifier": ["SH"], "providers": [{"billed_charge": 1489.87, "npi": [1861530990]}]}, {"allowed_amount": 1473.0, "billing_code_modifier": ["ETRH"], "providers": [{"billed_charge": 1473.0, "npi": [1861530990]}]}, {"allowed_amount": 1492.29, "billing_code_modifier": ["RH"], "providers": [{"billed_charge": 1492.29, "npi": [1861530990]}]}, {"allowed_amount": 1537.35, "billing_code_modifier": ["RH"], "providers": [{"billed_charge": 1537.35, "npi": [1861530990]}]}, {"allowed_amount": 1518.94, "billing_code_modifier": ["PH"], "providers": [{"billed_charge": 1518.94, "npi": [1861530990]}]}, {"allowed_amount": 1526.09, "billing_code_modifier": ["EH"], "providers": [{"billed_charge": 1526.09, "npi": [1861530990]}]}, {"allowed_amount": 1475.42, "billing_code_modifier": ["SH"], "providers": [{"billed_charge": 1475.42, "npi": [1861530990]}]}, {"allowed_amount": 1474.54, "billing_code_modifier": ["JH"], "providers": [{"billed_charge": 1474.54, "npi": [1861530990]}]}, {"allowed_amount": 1473.0, "billing_code_modifier": ["SH"], "providers": [{"billed_charge": 1473.0, "npi": [1861530990]}]}, {"allowed_amount": 1787.27, "billing_code_modifier": ["PH"], "providers": [{"billed_charge": 1901.37, "npi": [1861530990]}, {"billed_charge": 1913.94, "npi": [1861530990]}]}, {"allowed_amount": 1475.25, "billing_code_modifier": ["RH"], "providers": [{"billed_charge": 1475.25, "npi": [1861530990]}]}, {"allowed_amount": 1787.27, "billing_code_modifier": ["RH"], "providers": [{"billed_charge": 1913.94, "npi": [1861530990]}, {"billed_charge": 1870.25, "npi": [1861530990]}, {"billed_charge": 1868.0, "npi": [1861530990]}, {"billed_charge": 1887.12, "npi": [1861530990]}]}, {"allowed_amount": 1535.81, "billing_code_modifier": ["RH"], "providers": [{"billed_charge": 1535.81, "npi": [1861530990]}]}, {"allowed_amount": 1493.66, "billing_code_modifier": ["SH"], "providers": [{"billed_charge": 1493.66, "npi": [1861530990]}]}, {"allowed_amount": 1492.12, "billing_code_modifier": ["RH"], "providers": [{"billed_charge": 1492.12, "npi": [1861530990]}]}, {"allowed_amount": 1516.69, "billing_code_modifier": ["SH"], "providers": [{"billed_charge": 1516.69, "npi": [1861530990]}]}, {"allowed_amount": 1787.27, "billing_code_modifier": ["SH"], "providers": [{"billed_charge": 1884.87, "npi": [1861530990]}, {"billed_charge": 1913.94, "npi": [1861530990]}, {"billed_charge": 1870.25, "npi": [1861530990]}, {"billed_charge": 1868.0, "npi": [1861530990]}, {"billed_charge": 1930.81, "npi": [1861530990]}, {"billed_charge": 1911.69, "npi": [1861530990]}]}, {"allowed_amount": 1475.42, "billing_code_modifier": ["RH"], "providers": [{"billed_charge": 1475.42, "npi": [1861530990]}]}, {"allowed_amount": 1475.25, "billing_code_modifier": ["SH"], "providers": [{"billed_charge": 1475.25, "npi": [1861530990]}]}, {"allowed_amount": 1492.12, "billing_code_modifier": ["SH"], "providers": [{"billed_charge": 1492.12, "npi": [1861530990]}]}, {"allowed_amount": 1473.0, "billing_code_modifier": ["RH"], "providers": [{"billed_charge": 1473.0, "npi": [1861530990]}]}, {"allowed_amount": 1533.56, "billing_code_modifier": ["RH"], "providers": [{"billed_charge": 1533.56, "npi": [1861530990]}]}, {"allowed_amount": 1535.81, "billing_code_modifier": ["SH"], "providers": [{"billed_charge": 1535.81, "npi": [1861530990]}]}, {"allowed_amount": 1489.87, "billing_code_modifier": ["RH"], "providers": [{"billed_charge": 1489.87, "npi": [1861530990]}]}, {"allowed_amount": 1519.69, "billing_code_modifier": ["SH"], "providers": [{"billed_charge": 1519.69, "npi": [1861530990]}]}, {"allowed_amount": 1493.66, "billing_code_modifier": ["PH"], "providers": [{"billed_charge": 1493.66, "npi": [1861530990]}]}, {"allowed_amount": 1526.09, "billing_code_modifier": ["SH"], "providers": [{"billed_charge": 1526.09, "npi": [1861530990]}]}, {"allowed_amount": 1518.94, "billing_code_modifier": ["RH"], "providers": [{"billed_charge": 1518.94, "npi": [1861530990]}]}, {"allowed_amount": 1560.06, "billing_code_modifier": ["SH"], "providers": [{"billed_charge": 1560.06, "npi": [1861530990]}]}, {"allowed_amount": 1509.22, "billing_code_modifier": ["RH"], "providers": [{"billed_charge": 1509.22, "npi": [1861530990]}]}, {"allowed_amount": 1516.69, "billing_code_modifier": ["RH"], "providers": [{"billed_charge": 1516.69, "npi": [1861530990]}]}, {"allowed_amount": 1518.94, "billing_code_modifier": ["SH"], "providers": [{"billed_charge": 1518.94, "npi": [1861530990]}]}]}]}, {"name": "Pharmacy - Extension of 25X - Drug Requiring Detailed Coding", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0636", "description": "Pharmacy - Extension of 25x", "allowed_amounts": [{"tin": {"type": "ein", "value": "824052186"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.49, "billing_code_modifier": [""], "providers": [{"billed_charge": 1.47, "npi": [1801826839]}]}, {"allowed_amount": 457.07, "billing_code_modifier": ["JZ"], "providers": [{"billed_charge": 1868.6, "npi": [1801826839]}]}, {"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 0.576, "npi": [1801826839]}, {"billed_charge": 0.1464, "npi": [1801826839]}, {"billed_charge": 73.83, "npi": [1801826839]}, {"billed_charge": 23.22, "npi": [1801826839]}, {"billed_charge": 103.0, "npi": [1801826839]}, {"billed_charge": 17.82, "npi": [1801826839]}, {"billed_charge": 3.756, "npi": [1801826839]}, {"billed_charge": 8.8956, "npi": [1801826839]}, {"billed_charge": 42.0, "npi": [1801826839]}, {"billed_charge": 11.41, "npi": [1801826839]}, {"billed_charge": 20.1, "npi": [1801826839]}, {"billed_charge": 0.505, "npi": [1801826839]}, {"billed_charge": 15.24, "npi": [1801826839]}, {"billed_charge": 6.4658, "npi": [1801826839]}, {"billed_charge": 276.85, "npi": [1801826839]}, {"billed_charge": 15.9, "npi": [1801826839]}, {"billed_charge": 20.76, "npi": [1801826839]}]}, {"allowed_amount": 0.49, "billing_code_modifier": ["JW"], "providers": [{"billed_charge": 2.73, "npi": [1801826839]}]}, {"allowed_amount": 0.48, "billing_code_modifier": [""], "providers": [{"billed_charge": 2.76, "npi": [1801826839]}, {"billed_charge": 1.47, "npi": [1801826839]}, {"billed_charge": 2.1, "npi": [1801826839]}]}, {"allowed_amount": 351.157, "billing_code_modifier": ["JZ"], "providers": [{"billed_charge": 1021.572, "npi": [1801826839]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["JZ"], "providers": [{"billed_charge": 1.925, "npi": [1801826839]}, {"billed_charge": 11.55, "npi": [1801826839]}, {"billed_charge": 2.5004, "npi": [1801826839]}, {"billed_charge": 1.02, "npi": [1801826839]}, {"billed_charge": 0.4586, "npi": [1801826839]}, {"billed_charge": 0.0675, "npi": [1801826839]}, {"billed_charge": 8.53, "npi": [1801826839]}]}, {"allowed_amount": 0.48, "billing_code_modifier": ["JW"], "providers": [{"billed_charge": 2.73, "npi": [1801826839]}, {"billed_charge": 2.76, "npi": [1801826839]}, {"billed_charge": 2.1, "npi": [1801826839]}]}]}]}, {"name": "Laboratory - General", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0300", "description": "Laboratory", "allowed_amounts": [{"tin": {"type": "ein", "value": "452694620"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 57.76, "npi": [1033120423]}, {"billed_charge": 257.37, "npi": [1033120423]}, {"billed_charge": 183.02, "npi": [1033120423]}, {"billed_charge": 40.24, "npi": [1033120423]}, {"billed_charge": 253.0, "npi": [1033120423]}]}, {"allowed_amount": 13.54, "billing_code_modifier": [""], "providers": [{"billed_charge": 57.76, "npi": [1033120423]}]}]}]}, {"name": "Laboratory - General", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0300", "description": "Laboratory", "allowed_amounts": [{"tin": {"type": "ein", "value": "751777119"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 392.86, "npi": [1073511762]}, {"billed_charge": 211.0, "npi": [1073511762]}, {"billed_charge": 91.63, "npi": [1073511762]}, {"billed_charge": 47.75, "npi": [1073511762]}, {"billed_charge": 71.9883, "npi": [1073511762]}, {"billed_charge": 40.0, "npi": [1073511762]}, {"billed_charge": 95.5, "npi": [1073511762]}, {"billed_charge": 201.1322, "npi": [1073511762]}, {"billed_charge": 212.5, "npi": [1073511762]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["XU"], "providers": [{"billed_charge": 212.5, "npi": [1073511762]}]}]}]}, {"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": "753175630"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 502.0, "npi": [1285798918]}]}, {"allowed_amount": 126.14, "billing_code_modifier": [""], "providers": [{"billed_charge": 502.0, "npi": [1285798918]}, {"billed_charge": 667.0, "npi": [1285798918]}]}]}]}, {"name": "Laboratory - Chemistry", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0301", "description": "Laboratory", "allowed_amounts": [{"tin": {"type": "ein", "value": "820551704"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 217.883, "npi": [1649273434]}, {"billed_charge": 249.74, "npi": [1649273434]}, {"billed_charge": 229.02, "npi": [1649273434]}, {"billed_charge": 407.22, "npi": [1649273434]}, {"billed_charge": 306.86, "npi": [1649273434]}, {"billed_charge": 104.78, "npi": [1649273434]}, {"billed_charge": 459.04, "npi": [1649273434]}, {"billed_charge": 240.75, "npi": [1649273434]}, {"billed_charge": 304.35, "npi": [1649273434]}, {"billed_charge": 239.5, "npi": [1649273434]}, {"billed_charge": 56.6, "npi": [1649273434]}, {"billed_charge": 150.94, "npi": [1649273434]}, {"billed_charge": 285.79, "npi": [1649273434]}, {"billed_charge": 217.7, "npi": [1649273434]}, {"billed_charge": 153.91, "npi": [1649273434]}, {"billed_charge": 302.19, "npi": [1649273434]}, {"billed_charge": 141.3541, "npi": [1649273434]}, {"billed_charge": 241.8353, "npi": [1649273434]}, {"billed_charge": 259.4729, "npi": [1649273434]}]}]}]}, {"name": "SCREENING MAMMOGRAPHY BI 2-VIEW BREAST INC CAD", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "77067", "description": "SCREENING MAMMOGRAPHY BI 2-VIEW BREAST INC CAD", "allowed_amounts": [{"tin": {"type": "ein", "value": "203324726"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 42.08, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 130.0, "npi": [1831199546]}]}]}]}, {"name": "BLOOD COUNT COMPLETE AUTO AND AUTO DIFRNTL WBC", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "85025", "description": "BLOOD COUNT COMPLETE AUTO AND AUTO DIFRNTL WBC", "allowed_amounts": [{"tin": {"type": "ein", "value": "853503076"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": ["QW91"], "providers": [{"billed_charge": 319.06, "npi": [1124623889]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["QW"], "providers": [{"billed_charge": 319.06, "npi": [1124623889]}]}]}]}, {"name": "Laboratory - Hematology", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0305", "description": "Laboratory", "allowed_amounts": [{"tin": {"type": "ein", "value": "820551704"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 150.89, "npi": [1649273434]}, {"billed_charge": 183.63, "npi": [1649273434]}, {"billed_charge": 105.5481, "npi": [1649273434]}, {"billed_charge": 175.8323, "npi": [1649273434]}, {"billed_charge": 169.39, "npi": [1649273434]}]}]}]}, {"name": "Medical/Surgical Supplies and Devices - General", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0270", "description": "Med/Surg Supplies &Devices (also see 062x, extension of 027x", "allowed_amounts": [{"tin": {"type": "ein", "value": "751837454"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 804.5792, "npi": [1447250253]}, {"billed_charge": 274.5, "npi": [1447250253]}]}]}]}, {"name": "Laboratory - Immunology", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0302", "description": "Laboratory", "allowed_amounts": [{"tin": {"type": "ein", "value": "752586857"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 171.97, "npi": [1992700983]}, {"billed_charge": 223.29, "npi": [1992700983]}, {"billed_charge": 187.94, "npi": [1992700983]}, {"billed_charge": 319.85, "npi": [1992700983]}, {"billed_charge": 251.24, "npi": [1992700983]}, {"billed_charge": 200.23, "npi": [1992700983]}, {"billed_charge": 197.09, "npi": [1992700983]}, {"billed_charge": 180.88, "npi": [1992700983]}, {"billed_charge": 162.81, "npi": [1992700983]}, {"billed_charge": 169.31, "npi": [1992700983]}, {"billed_charge": 228.91, "npi": [1992700983]}, {"billed_charge": 127.41, "npi": [1992700983]}, {"billed_charge": 144.74, "npi": [1992700983]}]}]}]}, {"name": "Laboratory - General", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0300", "description": "Laboratory", "allowed_amounts": [{"tin": {"type": "ein", "value": "364755936"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 102.74, "npi": [1679903967]}, {"billed_charge": 97.16, "npi": [1679903967]}, {"billed_charge": 376.7, "npi": [1679903967]}, {"billed_charge": 214.23, "npi": [1679903967]}, {"billed_charge": 70.2, "npi": [1679903967]}, {"billed_charge": 106.72, "npi": [1679903967]}, {"billed_charge": 140.17, "npi": [1679903967]}, {"billed_charge": 194.11, "npi": [1679903967]}, {"billed_charge": 238.12, "npi": [1679903967]}, {"billed_charge": 309.0, "npi": [1679903967]}, {"billed_charge": 185.56, "npi": [1679903967]}, {"billed_charge": 211.05, "npi": [1679903967]}, {"billed_charge": 170.43, "npi": [1679903967]}, {"billed_charge": 363.01, "npi": [1679903967]}, {"billed_charge": 100.35, "npi": [1679903967]}, {"billed_charge": 129.42, "npi": [1679903967]}, {"billed_charge": 105.92, "npi": [1679903967]}, {"billed_charge": 244.89, "npi": [1679903967]}]}, {"allowed_amount": 5.7, "billing_code_modifier": ["59"], "providers": [{"billed_charge": 79.64, "npi": [1679903967]}]}, {"allowed_amount": 5.7, "billing_code_modifier": [""], "providers": [{"billed_charge": 281.93, "npi": [1679903967]}]}, {"allowed_amount": 101.92, "billing_code_modifier": [""], "providers": [{"billed_charge": 137.78, "npi": [1679903967]}]}]}]}, {"name": "Pharmacy - Extension of 25X - Drug Requiring Detailed Coding", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0636", "description": "Pharmacy - Extension of 25x", "allowed_amounts": [{"tin": {"type": "ein", "value": "753175630"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 46.3492, "billing_code_modifier": ["JZ"], "providers": [{"billed_charge": 138.8483, "npi": [1285798918]}]}, {"allowed_amount": 0.49, "billing_code_modifier": ["JZ"], "providers": [{"billed_charge": 10.0, "npi": [1285798918]}]}, {"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 17.43, "npi": [1285798918]}, {"billed_charge": 10.0, "npi": [1285798918]}, {"billed_charge": 13.4, "npi": [1285798918]}, {"billed_charge": 1.3113, "npi": [1285798918]}, {"billed_charge": 26.4067, "npi": [1285798918]}, {"billed_charge": 19.5475, "npi": [1285798918]}, {"billed_charge": 2.5, "npi": [1285798918]}, {"billed_charge": 1.3115, "npi": [1285798918]}, {"billed_charge": 7.3833, "npi": [1285798918]}, {"billed_charge": 1203.04, "npi": [1285798918]}, {"billed_charge": 98.365, "npi": [1285798918]}, {"billed_charge": 25.5, "npi": [1285798918]}, {"billed_charge": 0.7291, "npi": [1285798918]}, {"billed_charge": 0.5, "npi": [1285798918]}, {"billed_charge": 2.806, "npi": [1285798918]}, {"billed_charge": 2.0, "npi": [1285798918]}, {"billed_charge": 0.2988, "npi": [1285798918]}, {"billed_charge": 12.9, "npi": [1285798918]}, {"billed_charge": 0.5828, "npi": [1285798918]}, {"billed_charge": 1.1775, "npi": [1285798918]}, {"billed_charge": 6.1246, "npi": [1285798918]}, {"billed_charge": 0.2, "npi": [1285798918]}, {"billed_charge": 0.4, "npi": [1285798918]}, {"billed_charge": 30.35, "npi": [1285798918]}, {"billed_charge": 32.97, "npi": [1285798918]}, {"billed_charge": 6.1247, "npi": [1285798918]}, {"billed_charge": 0.3035, "npi": [1285798918]}, {"billed_charge": 61.97, "npi": [1285798918]}, {"billed_charge": 0.125, "npi": [1285798918]}, {"billed_charge": 14.95, "npi": [1285798918]}, {"billed_charge": 13.395, "npi": [1285798918]}, {"billed_charge": 12.63, "npi": [1285798918]}, {"billed_charge": 2.705, "npi": [1285798918]}, {"billed_charge": 1.275, "npi": [1285798918]}, {"billed_charge": 60.7, "npi": [1285798918]}, {"billed_charge": 604.02, "npi": [1285798918]}, {"billed_charge": 6.1248, "npi": [1285798918]}, {"billed_charge": 5.0, "npi": [1285798918]}, {"billed_charge": 5.633, "npi": [1285798918]}, {"billed_charge": 3.035, "npi": [1285798918]}]}, {"allowed_amount": 0.485, "billing_code_modifier": ["JZ"], "providers": [{"billed_charge": 10.0, "npi": [1285798918]}]}, {"allowed_amount": 0.48, "billing_code_modifier": [""], "providers": [{"billed_charge": 10.0, "npi": [1285798918]}]}, {"allowed_amount": 0.48, "billing_code_modifier": ["JZ"], "providers": [{"billed_charge": 10.0, "npi": [1285798918]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["JZ"], "providers": [{"billed_charge": 4.245, "npi": [1285798918]}]}, {"allowed_amount": 0.48, "billing_code_modifier": ["JW"], "providers": [{"billed_charge": 10.0, "npi": [1285798918]}]}]}]}, {"name": "Anesthesia - General", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0370", "description": "Anesthesia", "allowed_amounts": [{"tin": {"type": "ein", "value": "751837454"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 283.2, "npi": [1447250253]}, {"billed_charge": 839.275, "npi": [1447250253]}, {"billed_charge": 413.1811, "npi": [1447250253]}, {"billed_charge": 397.7006, "npi": [1447250253]}, {"billed_charge": 179.03, "npi": [1447250253]}, {"billed_charge": 565.3575, "npi": [1447250253]}, {"billed_charge": 1387.11, "npi": [1447250253]}, {"billed_charge": 474.0517, "npi": [1447250253]}, {"billed_charge": 428.3988, "npi": [1447250253]}, {"billed_charge": 1500.0, "npi": [1447250253]}, {"billed_charge": 590.2591, "npi": [1447250253]}, {"billed_charge": 510.574, "npi": [1447250253]}, {"billed_charge": 387.37, "npi": [1447250253]}, {"billed_charge": 401.007, "npi": [1447250253]}, {"billed_charge": 519.0179, "npi": [1447250253]}]}]}]}, {"name": "Pharmacy - Extension of 25X - Drug Requiring Detailed Coding", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0636", "description": "Pharmacy - Extension of 25x", "allowed_amounts": [{"tin": {"type": "ein", "value": "751977850"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 0.5, "npi": [1396778064]}, {"billed_charge": 0.25, "npi": [1396778064]}, {"billed_charge": 0.125, "npi": [1396778064]}, {"billed_charge": 22.08, "npi": [1396778064]}, {"billed_charge": 11.04, "npi": [1396778064]}, {"billed_charge": 1.368, "npi": [1396778064]}, {"billed_charge": 13.73, "npi": [1396778064]}, {"billed_charge": 12.8, "npi": [1396778064]}, {"billed_charge": 18.7165, "npi": [1396778064]}, {"billed_charge": 10.0, "npi": [1396778064]}, {"billed_charge": 50.0, "npi": [1396778064]}, {"billed_charge": 15.0, "npi": [1396778064]}, {"billed_charge": 6.25, "npi": [1396778064]}, {"billed_charge": 0.7692, "npi": [1396778064]}, {"billed_charge": 3.75, "npi": [1396778064]}, {"billed_charge": 1.0, "npi": [1396778064]}, {"billed_charge": 0.2, "npi": [1396778064]}, {"billed_charge": 2.5, "npi": [1396778064]}, {"billed_charge": 15.96, "npi": [1396778064]}, {"billed_charge": 0.9045, "npi": [1396778064]}, {"billed_charge": 12.5, "npi": [1396778064]}]}, {"allowed_amount": 0.505, "billing_code_modifier": ["JZ"], "providers": [{"billed_charge": 14.89, "npi": [1396778064]}]}, {"allowed_amount": 0.5, "billing_code_modifier": ["JZ"], "providers": [{"billed_charge": 17.1, "npi": [1396778064]}, {"billed_charge": 10.0, "npi": [1396778064]}]}, {"allowed_amount": 0.51, "billing_code_modifier": ["JZ"], "providers": [{"billed_charge": 17.1, "npi": [1396778064]}, {"billed_charge": 10.0, "npi": [1396778064]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["JZ"], "providers": [{"billed_charge": 0.5, "npi": [1396778064]}, {"billed_charge": 16.33, "npi": [1396778064]}, {"billed_charge": 1.846, "npi": [1396778064]}, {"billed_charge": 13.68, "npi": [1396778064]}, {"billed_charge": 7.5, "npi": [1396778064]}, {"billed_charge": 6.0, "npi": [1396778064]}, {"billed_charge": 1.97, "npi": [1396778064]}, {"billed_charge": 1.4844, "npi": [1396778064]}, {"billed_charge": 0.2603, "npi": [1396778064]}, {"billed_charge": 9.0, "npi": [1396778064]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["JW"], "providers": [{"billed_charge": 1.4286, "npi": [1396778064]}]}]}]}, {"name": "Laboratory - General", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0300", "description": "Laboratory", "allowed_amounts": [{"tin": {"type": "ein", "value": "752770738"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 207.625, "npi": [1770514077]}, {"billed_charge": 41.5, "npi": [1770514077]}, {"billed_charge": 103.3333, "npi": [1770514077]}, {"billed_charge": 286.75, "npi": [1770514077]}, {"billed_charge": 267.1, "npi": [1770514077]}, {"billed_charge": 125.875, "npi": [1770514077]}, {"billed_charge": 120.875, "npi": [1770514077]}, {"billed_charge": 384.75, "npi": [1770514077]}, {"billed_charge": 1034.1667, "npi": [1770514077]}, {"billed_charge": 258.65, "npi": [1770514077]}]}]}]}, {"name": "Emergency Room - General", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0450", "description": "Emergency Room", "allowed_amounts": [{"tin": {"type": "ein", "value": "750800628"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 266.4, "billing_code_modifier": ["RT"], "providers": [{"billed_charge": 444.0, "npi": [1194743013]}]}, {"allowed_amount": 432.6, "billing_code_modifier": ["F2"], "providers": [{"billed_charge": 721.0, "npi": [1194743013]}]}, {"allowed_amount": 266.4, "billing_code_modifier": ["LT"], "providers": [{"billed_charge": 444.0, "npi": [1194743013]}]}, {"allowed_amount": 1060.8, "billing_code_modifier": ["RT"], "providers": [{"billed_charge": 1768.0, "npi": [1720480627]}]}, {"allowed_amount": 148.2, "billing_code_modifier": ["XU"], "providers": [{"billed_charge": 380.0, "npi": [1194743013]}]}, {"allowed_amount": 136.89, "billing_code_modifier": ["XU"], "providers": [{"billed_charge": 351.0, "npi": [1194743013]}]}, {"allowed_amount": 546.6, "billing_code_modifier": [""], "providers": [{"billed_charge": 911.0, "npi": [1194743013]}, {"billed_charge": 911.0, "npi": [1720480627]}]}, {"allowed_amount": 228.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 380.0, "npi": [1194743013]}]}, {"allowed_amount": 123.24, "billing_code_modifier": ["XU"], "providers": [{"billed_charge": 316.0, "npi": [1194743013]}]}, {"allowed_amount": 210.6, "billing_code_modifier": [""], "providers": [{"billed_charge": 351.0, "npi": [1720480627]}, {"billed_charge": 351.0, "npi": [1194743013]}]}, {"allowed_amount": 460.8, "billing_code_modifier": [""], "providers": [{"billed_charge": 768.0, "npi": [1194743013]}]}, {"allowed_amount": 311.4, "billing_code_modifier": [""], "providers": [{"billed_charge": 519.0, "npi": [1720480627]}]}, {"allowed_amount": 532.2, "billing_code_modifier": [""], "providers": [{"billed_charge": 887.0, "npi": [1720480627]}]}, {"allowed_amount": 432.6, "billing_code_modifier": [""], "providers": [{"billed_charge": 721.0, "npi": [1720480627]}]}, {"allowed_amount": 2344.8, "billing_code_modifier": [""], "providers": [{"billed_charge": 3908.0, "npi": [1194743013]}, {"billed_charge": 3908.0, "npi": [1720480627]}]}, {"allowed_amount": 189.6, "billing_code_modifier": [""], "providers": [{"billed_charge": 316.0, "npi": [1194743013]}]}, {"allowed_amount": 291.0, "billing_code_modifier": ["LT"], "providers": [{"billed_charge": 485.0, "npi": [1194743013]}]}, {"allowed_amount": 291.0, "billing_code_modifier": ["RT"], "providers": [{"billed_charge": 485.0, "npi": [1194743013]}]}, {"allowed_amount": 210.6, "billing_code_modifier": ["XU"], "providers": [{"billed_charge": 351.0, "npi": [1720480627]}, {"billed_charge": 351.0, "npi": [1194743013]}]}, {"allowed_amount": 189.6, "billing_code_modifier": ["XU"], "providers": [{"billed_charge": 316.0, "npi": [1720480627]}, {"billed_charge": 316.0, "npi": [1194743013]}]}, {"allowed_amount": 228.0, "billing_code_modifier": ["XU"], "providers": [{"billed_charge": 380.0, "npi": [1194743013]}]}, {"allowed_amount": 981.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 1635.0, "npi": [1194743013]}, {"billed_charge": 1635.0, "npi": [1720480627]}]}, {"allowed_amount": 460.8, "billing_code_modifier": ["XU"], "providers": [{"billed_charge": 768.0, "npi": [1194743013]}, {"billed_charge": 768.0, "npi": [1720480627]}]}, {"allowed_amount": 311.4, "billing_code_modifier": ["XU"], "providers": [{"billed_charge": 519.0, "npi": [1720480627]}]}, {"allowed_amount": 1993.08, "billing_code_modifier": [""], "providers": [{"billed_charge": 3908.0, "npi": [1720480627]}]}, {"allowed_amount": 1021.02, "billing_code_modifier": [""], "providers": [{"billed_charge": 2618.0, "npi": [1194743013]}]}, {"allowed_amount": 1570.8, "billing_code_modifier": [""], "providers": [{"billed_charge": 2618.0, "npi": [1194743013]}, {"billed_charge": 2618.0, "npi": [1720480627]}]}, {"allowed_amount": 1570.8, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 2618.0, "npi": [1720480627]}]}, {"allowed_amount": 445.8, "billing_code_modifier": [""], "providers": [{"billed_charge": 743.0, "npi": [1194743013]}]}, {"allowed_amount": 391.68, "billing_code_modifier": [""], "providers": [{"billed_charge": 768.0, "npi": [1194743013]}]}, {"allowed_amount": 981.0, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 1635.0, "npi": [1194743013]}]}]}]}, {"name": "Pharmacy - Extension of 25X - Drug Requiring Detailed Coding", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0636", "description": "Pharmacy - Extension of 25x", "allowed_amounts": [{"tin": {"type": "ein", "value": "751047527"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.49, "billing_code_modifier": [""], "providers": [{"billed_charge": 10.0, "npi": [1396779948]}]}, {"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 22.6883, "npi": [1396779948]}, {"billed_charge": 12.0625, "npi": [1396779948]}, {"billed_charge": 3.3608, "npi": [1396779948]}, {"billed_charge": 3.1373, "npi": [1396779948]}, {"billed_charge": 125.64, "npi": [1396779948]}, {"billed_charge": 2.775, "npi": [1396779948]}, {"billed_charge": 163.8, "npi": [1396779948]}, {"billed_charge": 2.1573, "npi": [1396779948]}, {"billed_charge": 10.0, "npi": [1396779948]}, {"billed_charge": 11.2945, "npi": [1396779948]}, {"billed_charge": 6.25, "npi": [1396779948]}, {"billed_charge": 0.5153, "npi": [1396779948]}, {"billed_charge": 19.07, "npi": [1396779948]}, {"billed_charge": 50.0, "npi": [1396779948]}, {"billed_charge": 3.75, "npi": [1396779948]}, {"billed_charge": 0.05, "npi": [1396779948]}, {"billed_charge": 25.0, "npi": [1396779948]}, {"billed_charge": 2.9827, "npi": [1396779948]}, {"billed_charge": 50.16, "npi": [1396779948]}, {"billed_charge": 1.596, "npi": [1396779948]}, {"billed_charge": 0.3584, "npi": [1396779948]}, {"billed_charge": 3.9804, "npi": [1396779948]}, {"billed_charge": 1.7007, "npi": [1396779948]}, {"billed_charge": 0.984, "npi": [1396779948]}, {"billed_charge": 3.6203, "npi": [1396779948]}, {"billed_charge": 10.945, "npi": [1396779948]}, {"billed_charge": 15.0, "npi": [1396779948]}, {"billed_charge": 31.01, "npi": [1396779948]}, {"billed_charge": 5.0, "npi": [1396779948]}, {"billed_charge": 7.5, "npi": [1396779948]}, {"billed_charge": 6.0, "npi": [1396779948]}, {"billed_charge": 41.04, "npi": [1396779948]}, {"billed_charge": 0.2, "npi": [1396779948]}, {"billed_charge": 1.5892, "npi": [1396779948]}, {"billed_charge": 2.5843, "npi": [1396779948]}, {"billed_charge": 37.2046, "npi": [1396779948]}, {"billed_charge": 14.345, "npi": [1396779948]}, {"billed_charge": 12.5, "npi": [1396779948]}, {"billed_charge": 21.09, "npi": [1396779948]}, {"billed_charge": 0.1277, "npi": [1396779948]}, {"billed_charge": 0.2792, "npi": [1396779948]}, {"billed_charge": 2.5, "npi": [1396779948]}, {"billed_charge": 3.8703, "npi": [1396779948]}, {"billed_charge": 0.5, "npi": [1396779948]}, {"billed_charge": 514.58, "npi": [1396779948]}, {"billed_charge": 9.0, "npi": [1396779948]}, {"billed_charge": 4.7753, "npi": [1396779948]}, {"billed_charge": 0.684, "npi": [1396779948]}, {"billed_charge": 1.0, "npi": [1396779948]}, {"billed_charge": 1.875, "npi": [1396779948]}]}, {"allowed_amount": 0.485, "billing_code_modifier": ["JZ"], "providers": [{"billed_charge": 5.0, "npi": [1396779948]}]}, {"allowed_amount": 0.49, "billing_code_modifier": ["JW"], "providers": [{"billed_charge": 10.0, "npi": [1396779948]}]}, {"allowed_amount": 0.48, "billing_code_modifier": [""], "providers": [{"billed_charge": 10.0, "npi": [1396779948]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["59"], "providers": [{"billed_charge": 186.78, "npi": [1396779948]}]}, {"allowed_amount": 2.043, "billing_code_modifier": ["JZ"], "providers": [{"billed_charge": 5.1934, "npi": [1396779948]}]}, {"allowed_amount": 0.485, "billing_code_modifier": ["JW"], "providers": [{"billed_charge": 10.0, "npi": [1396779948]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["JZ"], "providers": [{"billed_charge": 2.0, "npi": [1396779948]}, {"billed_charge": 1.9004, "npi": [1396779948]}, {"billed_charge": 16.11, "npi": [1396779948]}, {"billed_charge": 7.5, "npi": [1396779948]}, {"billed_charge": 6.0, "npi": [1396779948]}, {"billed_charge": 0.5, "npi": [1396779948]}, {"billed_charge": 9.0, "npi": [1396779948]}, {"billed_charge": 0.5472, "npi": [1396779948]}, {"billed_charge": 19.8233, "npi": [1396779948]}, {"billed_charge": 0.644, "npi": [1396779948]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["JW"], "providers": [{"billed_charge": 6.0, "npi": [1396779948]}, {"billed_charge": 9.0, "npi": [1396779948]}]}, {"allowed_amount": 0.48, "billing_code_modifier": ["JW"], "providers": [{"billed_charge": 10.0, "npi": [1396779948]}]}, {"allowed_amount": 0.485, "billing_code_modifier": [""], "providers": [{"billed_charge": 10.0, "npi": [1396779948]}]}]}]}, {"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": "751037591"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 151.54, "billing_code_modifier": [""], "providers": [{"billed_charge": 3424.65, "npi": [1124305065]}]}, {"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 3424.65, "npi": [1124305065]}, {"billed_charge": 9294.97, "npi": [1124305065]}, {"billed_charge": 6484.35, "npi": [1124305065]}, {"billed_charge": 3150.74, "npi": [1124305065]}, {"billed_charge": 3339.84, "npi": [1124305065]}, {"billed_charge": 6290.97, "npi": [1124305065]}, {"billed_charge": 4912.095, "npi": [1124305065]}, {"billed_charge": 6387.66, "npi": [1124305065]}]}, {"allowed_amount": 254.23, "billing_code_modifier": [""], "providers": [{"billed_charge": 3339.84, "npi": [1124305065]}, {"billed_charge": 6290.97, "npi": [1124305065]}]}, {"allowed_amount": 505.67, "billing_code_modifier": ["XU"], "providers": [{"billed_charge": 6484.35, "npi": [1124305065]}]}, {"allowed_amount": 505.67, "billing_code_modifier": [""], "providers": [{"billed_charge": 9294.97, "npi": [1124305065]}, {"billed_charge": 6484.35, "npi": [1124305065]}]}]}]}, {"name": "Laboratory - Hematology", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0305", "description": "Laboratory", "allowed_amounts": [{"tin": {"type": "ein", "value": "752586857"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 149.84, "npi": [1992700983]}, {"billed_charge": 196.5106, "npi": [1992700983]}, {"billed_charge": 177.5271, "npi": [1992700983]}, {"billed_charge": 111.76, "npi": [1992700983]}, {"billed_charge": 152.665, "npi": [1992700983]}, {"billed_charge": 93.56, "npi": [1992700983]}, {"billed_charge": 248.29, "npi": [1992700983]}, {"billed_charge": 183.63, "npi": [1992700983]}, {"billed_charge": 140.91, "npi": [1992700983]}, {"billed_charge": 166.1, "npi": [1992700983]}, {"billed_charge": 194.4067, "npi": [1992700983]}, {"billed_charge": 158.5838, "npi": [1992700983]}, {"billed_charge": 169.256, "npi": [1992700983]}, {"billed_charge": 146.11, "npi": [1992700983]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["91"], "providers": [{"billed_charge": 183.63, "npi": [1992700983]}]}]}]}, {"name": "Pharmacy - Extension of 25X - Drug Requiring Detailed Coding", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0636", "description": "Pharmacy - Extension of 25x", "allowed_amounts": [{"tin": {"type": "ein", "value": "831869297"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.49, "billing_code_modifier": [""], "providers": [{"billed_charge": 24.45, "npi": [1356960132]}]}, {"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 10.765, "npi": [1356960132]}, {"billed_charge": 48.0, "npi": [1356960132]}, {"billed_charge": 61.29, "npi": [1356960132]}, {"billed_charge": 15.8794, "npi": [1356960132]}, {"billed_charge": 5.9725, "npi": [1356960132]}, {"billed_charge": 67.53, "npi": [1356960132]}, {"billed_charge": 52.42, "npi": [1356960132]}, {"billed_charge": 250.64, "npi": [1356960132]}, {"billed_charge": 156.84, "npi": [1356960132]}, {"billed_charge": 0.3907, "npi": [1356960132]}, {"billed_charge": 0.5338, "npi": [1356960132]}, {"billed_charge": 45.95, "npi": [1356960132]}, {"billed_charge": 52.03, "npi": [1356960132]}, {"billed_charge": 46.64, "npi": [1356960132]}, {"billed_charge": 8.6025, "npi": [1356960132]}, {"billed_charge": 0.7367, "npi": [1356960132]}, {"billed_charge": 36.76, "npi": [1356960132]}, {"billed_charge": 21.1225, "npi": [1356960132]}]}, {"allowed_amount": 0.48, "billing_code_modifier": ["JZ"], "providers": [{"billed_charge": 26.63, "npi": [1356960132]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["JZ"], "providers": [{"billed_charge": 4.18, "npi": [1356960132]}, {"billed_charge": 0.751, "npi": [1356960132]}, {"billed_charge": 29.76, "npi": [1356960132]}, {"billed_charge": 16.0, "npi": [1356960132]}, {"billed_charge": 5.9725, "npi": [1356960132]}, {"billed_charge": 52.03, "npi": [1356960132]}, {"billed_charge": 45.33, "npi": [1356960132]}, {"billed_charge": 76.39, "npi": [1356960132]}, {"billed_charge": 41.59, "npi": [1356960132]}]}]}]}, {"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": "461415202"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 297.83, "billing_code_modifier": [""], "providers": [{"billed_charge": 1673.0, "npi": [1154595056]}]}, {"allowed_amount": 710.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 1673.0, "npi": [1154595056]}]}, {"allowed_amount": 581.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 1673.0, "npi": [1154595056]}]}]}]}, {"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": "731662763"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 10.0, "npi": [1659352987]}, {"billed_charge": 12.5, "npi": [1659352987]}, {"billed_charge": 3.05, "npi": [1659352987]}, {"billed_charge": 22.8, "npi": [1659352987]}, {"billed_charge": 2.85, "npi": [1659352987]}, {"billed_charge": 1.5544, "npi": [1659352987]}, {"billed_charge": 2.5, "npi": [1659352987]}, {"billed_charge": 3.75, "npi": [1659352987]}, {"billed_charge": 37.1, "npi": [1659352987]}, {"billed_charge": 50.0, "npi": [1659352987]}, {"billed_charge": 44.3, "npi": [1659352987]}, {"billed_charge": 16.95, "npi": [1659352987]}, {"billed_charge": 15.85, "npi": [1659352987]}]}, {"allowed_amount": 0.495, "billing_code_modifier": [""], "providers": [{"billed_charge": 11.4, "npi": [1659352987]}]}, {"allowed_amount": 0.485, "billing_code_modifier": [""], "providers": [{"billed_charge": 11.4, "npi": [1659352987]}]}]}]}, {"name": "SCREENING MAMMOGRAPHY BI 2-VIEW BREAST INC CAD", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "77067", "description": "SCREENING MAMMOGRAPHY BI 2-VIEW BREAST INC CAD", "allowed_amounts": [{"tin": {"type": "ein", "value": "741680498"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 42.08, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 316.0, "npi": [1447391487]}, {"billed_charge": 316.0, "npi": [1750404380]}]}, {"allowed_amount": 41.99, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 316.0, "npi": [1750404380]}]}, {"allowed_amount": 41.38, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 316.0, "npi": [1457542631]}, {"billed_charge": 316.0, "npi": [1821047374]}]}]}]}, {"name": "Laboratory - Chemistry", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0301", "description": "Laboratory", "allowed_amounts": [{"tin": {"type": "ein", "value": "751008430"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 306.86, "npi": [1669472387]}, {"billed_charge": 249.48, "npi": [1669472387]}, {"billed_charge": 302.19, "npi": [1669472387]}, {"billed_charge": 243.23, "npi": [1669472387]}, {"billed_charge": 285.79, "npi": [1669472387]}, {"billed_charge": 56.6, "npi": [1669472387]}, {"billed_charge": 131.3775, "npi": [1669472387]}, {"billed_charge": 432.76, "npi": [1669472387]}, {"billed_charge": 231.16, "npi": [1669472387]}, {"billed_charge": 163.41, "npi": [1669472387]}, {"billed_charge": 182.55, "npi": [1669472387]}, {"billed_charge": 264.44, "npi": [1669472387]}, {"billed_charge": 459.04, "npi": [1669472387]}, {"billed_charge": 185.85, "npi": [1669472387]}, {"billed_charge": 253.96, "npi": [1669472387]}, {"billed_charge": 217.7, "npi": [1669472387]}, {"billed_charge": 352.0225, "npi": [1669472387]}, {"billed_charge": 150.94, "npi": [1669472387]}, {"billed_charge": 246.474, "npi": [1669472387]}, {"billed_charge": 148.33, "npi": [1669472387]}, {"billed_charge": 153.91, "npi": [1669472387]}]}]}]}, {"name": "Physical Therapy - General", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0420", "description": "Physical Therapy", "allowed_amounts": [{"tin": {"type": "ein", "value": "741152597"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 37.635, "billing_code_modifier": ["GP"], "providers": [{"billed_charge": 371.75, "npi": [1982666111]}]}, {"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 295.1071, "npi": [1982666111]}]}, {"allowed_amount": 45.295, "billing_code_modifier": ["GP"], "providers": [{"billed_charge": 307.0, "npi": [1982666111]}]}, {"allowed_amount": 33.615, "billing_code_modifier": ["GP"], "providers": [{"billed_charge": 374.5, "npi": [1982666111]}]}, {"allowed_amount": 33.62, "billing_code_modifier": ["GP"], "providers": [{"billed_charge": 374.5, "npi": [1982666111]}]}, {"allowed_amount": 32.1, "billing_code_modifier": ["GP"], "providers": [{"billed_charge": 410.5, "npi": [1982666111]}]}, {"allowed_amount": 52.76, "billing_code_modifier": ["GP"], "providers": [{"billed_charge": 307.0, "npi": [1982666111]}]}, {"allowed_amount": 43.48, "billing_code_modifier": ["GP"], "providers": [{"billed_charge": 371.75, "npi": [1982666111]}]}]}]}, {"name": "EKG/ECG (Electrocardiogram) - General", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0730", "description": "EKG/ECG (Electrocardiogram)", "allowed_amounts": [{"tin": {"type": "ein", "value": "753175630"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 85.51, "billing_code_modifier": [""], "providers": [{"billed_charge": 471.0, "npi": [1285798918]}]}, {"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 471.0, "npi": [1285798918]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["XU"], "providers": [{"billed_charge": 471.0, "npi": [1285798918]}]}]}]}, {"name": "Laboratory - Chemistry", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0301", "description": "Laboratory", "allowed_amounts": [{"tin": {"type": "ein", "value": "751748586"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 335.75, "npi": [1508899204]}, {"billed_charge": 340.0, "npi": [1508899204]}, {"billed_charge": 493.5, "npi": [1508899204]}, {"billed_charge": 315.3958, "npi": [1508899204]}, {"billed_charge": 410.0, "npi": [1508899204]}, {"billed_charge": 679.25, "npi": [1508899204]}, {"billed_charge": 565.0, "npi": [1508899204]}, {"billed_charge": 49.25, "npi": [1508899204]}, {"billed_charge": 120.75, "npi": [1508899204]}, {"billed_charge": 278.25, "npi": [1508899204]}, {"billed_charge": 334.25, "npi": [1508899204]}, {"billed_charge": 324.5, "npi": [1508899204]}, {"billed_charge": 226.5, "npi": [1508899204]}, {"billed_charge": 153.5, "npi": [1508899204]}, {"billed_charge": 179.5, "npi": [1508899204]}, {"billed_charge": 123.25, "npi": [1508899204]}, {"billed_charge": 225.75, "npi": [1508899204]}, {"billed_charge": 442.5, "npi": [1508899204]}, {"billed_charge": 671.0, "npi": [1508899204]}, {"billed_charge": 463.25, "npi": [1508899204]}, {"billed_charge": 229.25, "npi": [1508899204]}, {"billed_charge": 1474.5, "npi": [1508899204]}]}, {"allowed_amount": 19.42, "billing_code_modifier": [""], "providers": [{"billed_charge": 679.25, "npi": [1508899204]}]}]}]}, {"name": "Laboratory - Chemistry", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0301", "description": "Laboratory", "allowed_amounts": [{"tin": {"type": "ein", "value": "260194016"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 459.04, "npi": [1205018439]}, {"billed_charge": 249.74, "npi": [1205018439]}, {"billed_charge": 148.33, "npi": [1205018439]}, {"billed_charge": 188.9664, "npi": [1205018439]}, {"billed_charge": 138.8435, "npi": [1205018439]}, {"billed_charge": 198.45, "npi": [1205018439]}, {"billed_charge": 198.34, "npi": [1205018439]}, {"billed_charge": 219.9939, "npi": [1205018439]}, {"billed_charge": 101.57, "npi": [1205018439]}, {"billed_charge": 87.97, "npi": [1205018439]}, {"billed_charge": 153.91, "npi": [1205018439]}, {"billed_charge": 56.6, "npi": [1205018439]}, {"billed_charge": 111.02, "npi": [1205018439]}, {"billed_charge": 302.19, "npi": [1205018439]}, {"billed_charge": 159.62, "npi": [1205018439]}, {"billed_charge": 229.02, "npi": [1205018439]}, {"billed_charge": 96.1, "npi": [1205018439]}, {"billed_charge": 372.39, "npi": [1205018439]}, {"billed_charge": 324.88, "npi": [1205018439]}, {"billed_charge": 103.54, "npi": [1205018439]}, {"billed_charge": 105.46, "npi": [1205018439]}, {"billed_charge": 217.7, "npi": [1205018439]}, {"billed_charge": 295.62, "npi": [1205018439]}, {"billed_charge": 108.35, "npi": [1205018439]}, {"billed_charge": 93.56, "npi": [1205018439]}, {"billed_charge": 137.21, "npi": [1205018439]}, {"billed_charge": 103.83, "npi": [1205018439]}, {"billed_charge": 285.79, "npi": [1205018439]}, {"billed_charge": 239.5, "npi": [1205018439]}, {"billed_charge": 104.78, "npi": [1205018439]}, {"billed_charge": 407.22, "npi": [1205018439]}, {"billed_charge": 88.72, "npi": [1205018439]}, {"billed_charge": 253.96, "npi": [1205018439]}, {"billed_charge": 306.86, "npi": [1205018439]}, {"billed_charge": 240.75, "npi": [1205018439]}, {"billed_charge": 243.23, "npi": [1205018439]}, {"billed_charge": 122.1106, "npi": [1205018439]}, {"billed_charge": 249.48, "npi": [1205018439]}, {"billed_charge": 185.85, "npi": [1205018439]}, {"billed_charge": 80.13, "npi": [1205018439]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["GZ"], "providers": [{"billed_charge": 459.04, "npi": [1205018439]}]}, {"allowed_amount": 19.42, "billing_code_modifier": [""], "providers": [{"billed_charge": 328.07, "npi": [1205018439]}]}, {"allowed_amount": 5.7, "billing_code_modifier": [""], "providers": [{"billed_charge": 99.79, "npi": [1205018439]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["91"], "providers": [{"billed_charge": 56.6, "npi": [1205018439]}, {"billed_charge": 306.86, "npi": [1205018439]}]}]}]}, {"name": "Laboratory - Immunology", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0302", "description": "Laboratory", "allowed_amounts": [{"tin": {"type": "ein", "value": "751837454"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 176.0967, "npi": [1447250253]}, {"billed_charge": 127.41, "npi": [1447250253]}, {"billed_charge": 235.56, "npi": [1447250253]}, {"billed_charge": 227.1794, "npi": [1447250253]}, {"billed_charge": 198.3083, "npi": [1447250253]}, {"billed_charge": 201.6012, "npi": [1447250253]}, {"billed_charge": 171.97, "npi": [1447250253]}, {"billed_charge": 313.7, "npi": [1447250253]}, {"billed_charge": 235.3537, "npi": [1447250253]}, {"billed_charge": 186.8867, "npi": [1447250253]}, {"billed_charge": 182.6561, "npi": [1447250253]}, {"billed_charge": 166.7, "npi": [1447250253]}, {"billed_charge": 169.31, "npi": [1447250253]}, {"billed_charge": 187.64, "npi": [1447250253]}, {"billed_charge": 226.6663, "npi": [1447250253]}, {"billed_charge": 238.0, "npi": [1447250253]}, {"billed_charge": 254.96, "npi": [1447250253]}, {"billed_charge": 142.026, "npi": [1447250253]}, {"billed_charge": 282.54, "npi": [1447250253]}, {"billed_charge": 244.11, "npi": [1447250253]}, {"billed_charge": 228.91, "npi": [1447250253]}, {"billed_charge": 197.09, "npi": [1447250253]}, {"billed_charge": 180.88, "npi": [1447250253]}, {"billed_charge": 202.792, "npi": [1447250253]}, {"billed_charge": 144.74, "npi": [1447250253]}, {"billed_charge": 171.76, "npi": [1447250253]}]}, {"allowed_amount": 6.19, "billing_code_modifier": [""], "providers": [{"billed_charge": 106.6, "npi": [1447250253]}]}, {"allowed_amount": 6.38, "billing_code_modifier": [""], "providers": [{"billed_charge": 116.31, "npi": [1447250253]}]}, {"allowed_amount": 19.2, "billing_code_modifier": [""], "providers": [{"billed_charge": 163.81, "npi": [1447250253]}]}]}]}, {"name": "Cardiology - Echocardiology", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0483", "description": "Cardiology", "allowed_amounts": [{"tin": {"type": "ein", "value": "751837454"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 1397.4, "npi": [1447250253]}, {"billed_charge": 2856.665, "npi": [1447250253]}, {"billed_charge": 4315.93, "npi": [1447250253]}, {"billed_charge": 2628.365, "npi": [1447250253]}, {"billed_charge": 2466.5867, "npi": [1447250253]}, {"billed_charge": 1174.0667, "npi": [1447250253]}, {"billed_charge": 2430.812, "npi": [1447250253]}]}]}]}, {"name": "SBSQ HOSPITAL IP/OBS CARE HIGH MDM 50 MINUTES", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "99233", "description": "SBSQ HOSPITAL IP/OBS CARE HIGH MDM 50 MINUTES", "allowed_amounts": [{"tin": {"type": "ein", "value": "270794018"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 128.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 150.0, "npi": [1932300779]}]}]}]}, {"name": "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": "753129210"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 84.4, "billing_code_modifier": [""], "providers": [{"billed_charge": 200.0, "npi": [1184041436]}]}, {"allowed_amount": 84.3, "billing_code_modifier": [""], "providers": [{"billed_charge": 200.0, "npi": [1184041436]}]}, {"allowed_amount": 83.29, "billing_code_modifier": [""], "providers": [{"billed_charge": 200.0, "npi": [1184041436]}]}]}]}, {"name": "Pharmacy - General", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0250", "description": "Pharmacy (also see 063x, an extension of 025x)", "allowed_amounts": [{"tin": {"type": "ein", "value": "751037591"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 1.8325, "npi": [1124305065]}, {"billed_charge": 3.4117, "npi": [1124305065]}, {"billed_charge": 11.58, "npi": [1124305065]}, {"billed_charge": 6.632, "npi": [1124305065]}, {"billed_charge": 3.47, "npi": [1124305065]}, {"billed_charge": 20.3, "npi": [1124305065]}, {"billed_charge": 27.3, "npi": [1124305065]}, {"billed_charge": 19.4933, "npi": [1124305065]}, {"billed_charge": 11.6, "npi": [1124305065]}, {"billed_charge": 84.12, "npi": [1124305065]}, {"billed_charge": 2.0, "npi": [1124305065]}, {"billed_charge": 5.3667, "npi": [1124305065]}, {"billed_charge": 23.44, "npi": [1124305065]}, {"billed_charge": 17.9325, "npi": [1124305065]}, {"billed_charge": 3.185, "npi": [1124305065]}, {"billed_charge": 6.2689, "npi": [1124305065]}, {"billed_charge": 4.6565, "npi": [1124305065]}, {"billed_charge": 5.1499, "npi": [1124305065]}, {"billed_charge": 3.95, "npi": [1124305065]}, {"billed_charge": 13.43, "npi": [1124305065]}, {"billed_charge": 3.3484, "npi": [1124305065]}, {"billed_charge": 10.0836, "npi": [1124305065]}, {"billed_charge": 1.944, "npi": [1124305065]}, {"billed_charge": 11.9533, "npi": [1124305065]}, {"billed_charge": 3.87, "npi": [1124305065]}, {"billed_charge": 18.03, "npi": [1124305065]}, {"billed_charge": 11.22, "npi": [1124305065]}, {"billed_charge": 1.8285, "npi": [1124305065]}, {"billed_charge": 16.3717, "npi": [1124305065]}, {"billed_charge": 7.992, "npi": [1124305065]}, {"billed_charge": 0.285, "npi": [1124305065]}, {"billed_charge": 0.8267, "npi": [1124305065]}, {"billed_charge": 1.6255, "npi": [1124305065]}, {"billed_charge": 12.0443, "npi": [1124305065]}, {"billed_charge": 1.9087, "npi": [1124305065]}, {"billed_charge": 0.1267, "npi": [1124305065]}, {"billed_charge": 1.09, "npi": [1124305065]}, {"billed_charge": 23.74, "npi": [1124305065]}, {"billed_charge": 3.5657, "npi": [1124305065]}, {"billed_charge": 0.17, "npi": [1124305065]}, {"billed_charge": 1.2317, "npi": [1124305065]}, {"billed_charge": 3.99, "npi": [1124305065]}]}]}]}, {"name": "Laboratory - Hematology", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0305", "description": "Laboratory", "allowed_amounts": [{"tin": {"type": "ein", "value": "751047527"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 225.25, "npi": [1396779948]}, {"billed_charge": 225.1071, "npi": [1396779948]}, {"billed_charge": 145.75, "npi": [1396779948]}, {"billed_charge": 221.125, "npi": [1396779948]}, {"billed_charge": 233.5, "npi": [1396779948]}, {"billed_charge": 213.0714, "npi": [1396779948]}, {"billed_charge": 206.5, "npi": [1396779948]}, {"billed_charge": 706.5, "npi": [1396779948]}, {"billed_charge": 226.5, "npi": [1396779948]}, {"billed_charge": 208.75, "npi": [1396779948]}, {"billed_charge": 235.375, "npi": [1396779948]}, {"billed_charge": 201.0, "npi": [1396779948]}, {"billed_charge": 312.3333, "npi": [1396779948]}, {"billed_charge": 226.7, "npi": [1396779948]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["91"], "providers": [{"billed_charge": 208.75, "npi": [1396779948]}]}]}]}, {"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": "270535750"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 3100.0, "npi": [1083753677]}]}, {"allowed_amount": 84.3, "billing_code_modifier": [""], "providers": [{"billed_charge": 3100.0, "npi": [1083753677]}]}, {"allowed_amount": 682.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 3100.0, "npi": [1083753677]}]}]}]}, {"name": "CT Scan - General", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0350", "description": "CT Scan", "allowed_amounts": [{"tin": {"type": "ein", "value": "751837454"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 320.73, "billing_code_modifier": [""], "providers": [{"billed_charge": 3403.77, "npi": [1447250253]}]}, {"allowed_amount": 622.69, "billing_code_modifier": [""], "providers": [{"billed_charge": 3403.77, "npi": [1447250253]}]}, {"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 2462.46, "npi": [1447250253]}, {"billed_charge": 3403.77, "npi": [1447250253]}]}]}]}, {"name": "Laboratory - General", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0300", "description": "Laboratory", "allowed_amounts": [{"tin": {"type": "ein", "value": "262978009"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 101.92, "billing_code_modifier": ["QW"], "providers": [{"billed_charge": 137.78, "npi": [1619308319]}]}, {"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 244.89, "npi": [1619308319]}, {"billed_charge": 170.43, "npi": [1407010622]}, {"billed_charge": 129.42, "npi": [1407010622]}, {"billed_charge": 106.72, "npi": [1619308319]}, {"billed_charge": 305.82, "npi": [1407344880]}, {"billed_charge": 170.43, "npi": [1407344880]}, {"billed_charge": 238.12, "npi": [1619308319]}, {"billed_charge": 70.2, "npi": [1407344880]}, {"billed_charge": 100.35, "npi": [1619308319]}, {"billed_charge": 376.7, "npi": [1619308319]}, {"billed_charge": 105.92, "npi": [1407344880]}, {"billed_charge": 376.7, "npi": [1407344880]}, {"billed_charge": 376.7, "npi": [1407010622]}, {"billed_charge": 100.35, "npi": [1407344880]}, {"billed_charge": 140.17, "npi": [1619308319]}, {"billed_charge": 101.36, "npi": [1407010622]}, {"billed_charge": 185.56, "npi": [1407344880]}, {"billed_charge": 139.37, "npi": [1619308319]}, {"billed_charge": 129.42, "npi": [1407344880]}, {"billed_charge": 185.56, "npi": [1619308319]}, {"billed_charge": 102.74, "npi": [1407344880]}, {"billed_charge": 97.16, "npi": [1407010622]}, {"billed_charge": 214.23, "npi": [1619308319]}, {"billed_charge": 100.35, "npi": [1407010622]}, {"billed_charge": 173.76, "npi": [1619308319]}, {"billed_charge": 214.23, "npi": [1407010622]}, {"billed_charge": 105.92, "npi": [1619308319]}, {"billed_charge": 106.72, "npi": [1407010622]}, {"billed_charge": 211.05, "npi": [1619308319]}, {"billed_charge": 140.17, "npi": [1407344880]}, {"billed_charge": 309.0, "npi": [1619308319]}, {"billed_charge": 70.2, "npi": [1619308319]}, {"billed_charge": 363.01, "npi": [1407010622]}, {"billed_charge": 230.96, "npi": [1619308319]}, {"billed_charge": 106.72, "npi": [1407344880]}, {"billed_charge": 17.2, "npi": [1619308319]}, {"billed_charge": 185.56, "npi": [1407010622]}, {"billed_charge": 170.43, "npi": [1619308319]}, {"billed_charge": 305.82, "npi": [1619308319]}, {"billed_charge": 305.82, "npi": [1407010622]}, {"billed_charge": 180.1, "npi": [1619308319]}, {"billed_charge": 102.74, "npi": [1619308319]}, {"billed_charge": 244.89, "npi": [1407010622]}, {"billed_charge": 363.01, "npi": [1619308319]}, {"billed_charge": 211.05, "npi": [1407344880]}, {"billed_charge": 214.23, "npi": [1407344880]}, {"billed_charge": 238.12, "npi": [1407344880]}, {"billed_charge": 105.92, "npi": [1407010622]}, {"billed_charge": 70.2, "npi": [1407010622]}, {"billed_charge": 194.11, "npi": [1619308319]}, {"billed_charge": 238.12, "npi": [1407010622]}, {"billed_charge": 97.16, "npi": [1407344880]}, {"billed_charge": 244.89, "npi": [1407344880]}, {"billed_charge": 140.17, "npi": [1407010622]}, {"billed_charge": 309.0, "npi": [1407010622]}, {"billed_charge": 102.74, "npi": [1407010622]}, {"billed_charge": 129.42, "npi": [1619308319]}, {"billed_charge": 97.16, "npi": [1619308319]}, {"billed_charge": 211.05, "npi": [1407010622]}]}, {"allowed_amount": 5.7, "billing_code_modifier": ["59"], "providers": [{"billed_charge": 79.64, "npi": [1407010622]}]}, {"allowed_amount": 5.7, "billing_code_modifier": ["5991"], "providers": [{"billed_charge": 79.64, "npi": [1407010622]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["QW"], "providers": [{"billed_charge": 137.78, "npi": [1407010622]}]}, {"allowed_amount": 5.7, "billing_code_modifier": [""], "providers": [{"billed_charge": 281.93, "npi": [1407344880]}, {"billed_charge": 281.93, "npi": [1619308319]}, {"billed_charge": 281.93, "npi": [1407010622]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["91"], "providers": [{"billed_charge": 244.89, "npi": [1407010622]}]}, {"allowed_amount": 101.92, "billing_code_modifier": [""], "providers": [{"billed_charge": 137.78, "npi": [1407010622]}, {"billed_charge": 137.78, "npi": [1407344880]}]}]}]}, {"name": "Emergency Room - General", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0450", "description": "Emergency Room", "allowed_amounts": [{"tin": {"type": "ein", "value": "752771437"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 308.31, "billing_code_modifier": [""], "providers": [{"billed_charge": 333.25, "npi": [1457382798]}]}, {"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 103.5, "npi": [1457382798]}, {"billed_charge": 333.25, "npi": [1457382798]}, {"billed_charge": 254.75, "npi": [1457382798]}]}, {"allowed_amount": 67.875, "billing_code_modifier": [""], "providers": [{"billed_charge": 333.25, "npi": [1457382798]}]}, {"allowed_amount": 67.875, "billing_code_modifier": ["59"], "providers": [{"billed_charge": 333.25, "npi": [1457382798]}]}, {"allowed_amount": 3791.1, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 2758.25, "npi": [1457382798]}]}, {"allowed_amount": 67.87, "billing_code_modifier": [""], "providers": [{"billed_charge": 103.5, "npi": [1457382798]}, {"billed_charge": 333.25, "npi": [1457382798]}]}, {"allowed_amount": 67.8733, "billing_code_modifier": [""], "providers": [{"billed_charge": 333.25, "npi": [1457382798]}]}, {"allowed_amount": 395.66, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 1042.5, "npi": [1457382798]}]}, {"allowed_amount": 395.66, "billing_code_modifier": [""], "providers": [{"billed_charge": 1042.5, "npi": [1457382798]}]}, {"allowed_amount": 863.2, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 2758.25, "npi": [1457382798]}]}, {"allowed_amount": 308.31, "billing_code_modifier": ["59"], "providers": [{"billed_charge": 333.25, "npi": [1457382798]}, {"billed_charge": 779.25, "npi": [1457382798]}]}, {"allowed_amount": 67.87, "billing_code_modifier": ["59"], "providers": [{"billed_charge": 103.5, "npi": [1457382798]}]}, {"allowed_amount": 604.81, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 1521.25, "npi": [1457382798]}]}]}]}, {"name": "Medical/Surgical Supplies and Devices - Sterile Supply", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0272", "description": "Med/Surg Supplies &Devices (also see 062x, extension of 027x", "allowed_amounts": [{"tin": {"type": "ein", "value": "751047527"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 14.2353, "npi": [1396779948]}, {"billed_charge": 21.7297, "npi": [1396779948]}, {"billed_charge": 10.0, "npi": [1396779948]}, {"billed_charge": 83.875, "npi": [1396779948]}, {"billed_charge": 56.5, "npi": [1396779948]}, {"billed_charge": 47.1111, "npi": [1396779948]}, {"billed_charge": 163.0, "npi": [1396779948]}, {"billed_charge": 23.0, "npi": [1396779948]}, {"billed_charge": 8.2, "npi": [1396779948]}, {"billed_charge": 182.5, "npi": [1396779948]}, {"billed_charge": 31.5833, "npi": [1396779948]}]}]}]}, {"name": "SCREENING DIGITAL BREAST TOMOSYNTHESIS BI", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "77063", "description": "SCREENING DIGITAL BREAST TOMOSYNTHESIS BI", "allowed_amounts": [{"tin": {"type": "ein", "value": "741680498"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 33.28, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 213.0, "npi": [1447391487]}, {"billed_charge": 213.0, "npi": [1750404380]}]}, {"allowed_amount": 32.72, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 213.0, "npi": [1457542631]}, {"billed_charge": 213.0, "npi": [1821047374]}]}, {"allowed_amount": 33.2, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 213.0, "npi": [1750404380]}]}]}]}, {"name": "Pharmacy - General", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0250", "description": "Pharmacy (also see 063x, an extension of 025x)", "allowed_amounts": [{"tin": {"type": "ein", "value": "741152597"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 0.875, "npi": [1982666111]}, {"billed_charge": 1.8333, "npi": [1982666111]}, {"billed_charge": 0.5833, "npi": [1982666111]}, {"billed_charge": 2.1667, "npi": [1982666111]}, {"billed_charge": 1.5, "npi": [1982666111]}, {"billed_charge": 93.25, "npi": [1982666111]}, {"billed_charge": 6.5, "npi": [1982666111]}, {"billed_charge": 2.5, "npi": [1982666111]}, {"billed_charge": 2.1543, "npi": [1982666111]}, {"billed_charge": 12.4722, "npi": [1982666111]}, {"billed_charge": 1.8502, "npi": [1982666111]}, {"billed_charge": 3.4167, "npi": [1982666111]}, {"billed_charge": 2.8125, "npi": [1982666111]}, {"billed_charge": 6.2015, "npi": [1982666111]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["U8JZ"], "providers": [{"billed_charge": 0.3594, "npi": [1982666111]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["U8"], "providers": [{"billed_charge": 0.875, "npi": [1982666111]}, {"billed_charge": 3.875, "npi": [1982666111]}, {"billed_charge": 4.125, "npi": [1982666111]}, {"billed_charge": 0.1125, "npi": [1982666111]}, {"billed_charge": 83.0, "npi": [1982666111]}, {"billed_charge": 2.25, "npi": [1982666111]}]}]}]}, {"name": "Laboratory - Hematology", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0305", "description": "Laboratory", "allowed_amounts": [{"tin": {"type": "ein", "value": "451502252"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 426.5, "npi": [1215296884]}, {"billed_charge": 706.5, "npi": [1215296884]}, {"billed_charge": 206.5, "npi": [1215296884]}, {"billed_charge": 208.75, "npi": [1215296884]}, {"billed_charge": 226.5, "npi": [1215296884]}, {"billed_charge": 150.8333, "npi": [1215296884]}, {"billed_charge": 151.6765, "npi": [1215296884]}, {"billed_charge": 233.5, "npi": [1215296884]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["91"], "providers": [{"billed_charge": 109.5, "npi": [1215296884]}]}]}]}, {"name": "GROUND MILEAGE PER STATUTE MILE", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "A0425", "description": "GROUND MILEAGE PER STATUTE MILE", "allowed_amounts": [{"tin": {"type": "ein", "value": "756000508"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 10.0, "billing_code_modifier": ["PH"], "providers": [{"billed_charge": 10.0, "npi": [1861530990]}]}, {"allowed_amount": 5.5, "billing_code_modifier": ["SH"], "providers": [{"billed_charge": 10.0, "npi": [1861530990]}]}, {"allowed_amount": 5.5, "billing_code_modifier": ["RH"], "providers": [{"billed_charge": 10.0, "npi": [1861530990]}]}, {"allowed_amount": 10.0, "billing_code_modifier": ["RH"], "providers": [{"billed_charge": 10.0, "npi": [1861530990]}]}, {"allowed_amount": 10.0, "billing_code_modifier": ["JH"], "providers": [{"billed_charge": 10.0, "npi": [1861530990]}]}, {"allowed_amount": 10.0, "billing_code_modifier": ["EH"], "providers": [{"billed_charge": 10.0, "npi": [1861530990]}]}, {"allowed_amount": 10.0, "billing_code_modifier": ["SH"], "providers": [{"billed_charge": 10.0, "npi": [1861530990]}]}, {"allowed_amount": 10.0, "billing_code_modifier": ["ETRH"], "providers": [{"billed_charge": 10.0, "npi": [1861530990]}]}]}]}, {"name": "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": "751752253"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 2.5, "npi": [1922031541]}, {"billed_charge": 12.5, "npi": [1922031541]}, {"billed_charge": 10.0, "npi": [1922031541]}, {"billed_charge": 50.0, "npi": [1922031541]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["U8JZ"], "providers": [{"billed_charge": 13.68, "npi": [1922031541]}, {"billed_charge": 8.733, "npi": [1922031541]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["U8"], "providers": [{"billed_charge": 2.5, "npi": [1922031541]}, {"billed_charge": 10.0, "npi": [1922031541]}, {"billed_charge": 6.25, "npi": [1922031541]}, {"billed_charge": 50.0, "npi": [1922031541]}, {"billed_charge": 24.81, "npi": [1922031541]}, {"billed_charge": 3.42, "npi": [1922031541]}, {"billed_charge": 15.29, "npi": [1922031541]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["JZ"], "providers": [{"billed_charge": 0.985, "npi": [1922031541]}, {"billed_charge": 9.0, "npi": [1922031541]}]}]}]}, {"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": "752770738"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 151.54, "billing_code_modifier": [""], "providers": [{"billed_charge": 3566.75, "npi": [1770514077]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["U6"], "providers": [{"billed_charge": 2889.5, "npi": [1770514077]}]}, {"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 5579.75, "npi": [1770514077]}, {"billed_charge": 6094.4167, "npi": [1770514077]}, {"billed_charge": 6586.25, "npi": [1770514077]}, {"billed_charge": 7358.25, "npi": [1770514077]}, {"billed_charge": 3566.75, "npi": [1770514077]}]}, {"allowed_amount": 622.69, "billing_code_modifier": ["U6"], "providers": [{"billed_charge": 9811.0, "npi": [1770514077]}]}, {"allowed_amount": 320.73, "billing_code_modifier": ["U6"], "providers": [{"billed_charge": 3566.75, "npi": [1770514077]}]}, {"allowed_amount": 505.67, "billing_code_modifier": [""], "providers": [{"billed_charge": 9811.0, "npi": [1770514077]}]}, {"allowed_amount": 151.54, "billing_code_modifier": ["U6"], "providers": [{"billed_charge": 3566.75, "npi": [1770514077]}]}]}]}, {"name": "Laboratory - Other Laboratory", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0309", "description": "Laboratory", "allowed_amounts": [{"tin": {"type": "ein", "value": "752770738"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 246.95, "billing_code_modifier": [""], "providers": [{"billed_charge": 178.5, "npi": [1770514077]}]}, {"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 145.75, "npi": [1770514077]}, {"billed_charge": 357.5, "npi": [1770514077]}, {"billed_charge": 172.25, "npi": [1770514077]}, {"billed_charge": 230.0, "npi": [1770514077]}, {"billed_charge": 114.5, "npi": [1770514077]}]}]}]}, {"name": "Laboratory - Hematology", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0305", "description": "Laboratory", "allowed_amounts": [{"tin": {"type": "ein", "value": "432008974"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 213.75, "npi": [1003883158]}, {"billed_charge": 180.5, "npi": [1003883158]}, {"billed_charge": 706.5, "npi": [1003883158]}, {"billed_charge": 207.8883, "npi": [1003883158]}, {"billed_charge": 233.5, "npi": [1003883158]}, {"billed_charge": 206.5, "npi": [1003883158]}, {"billed_charge": 226.5, "npi": [1003883158]}, {"billed_charge": 229.0, "npi": [1003883158]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["91"], "providers": [{"billed_charge": 109.5, "npi": [1003883158]}]}]}]}, {"name": "Laboratory - General", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0300", "description": "Laboratory", "allowed_amounts": [{"tin": {"type": "ein", "value": "751844139"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 143.25, "npi": [1265430177]}, {"billed_charge": 78.4191, "npi": [1265430177]}, {"billed_charge": 40.0, "npi": [1265430177]}, {"billed_charge": 392.86, "npi": [1265430177]}, {"billed_charge": 211.0, "npi": [1265430177]}, {"billed_charge": 164.8265, "npi": [1265430177]}, {"billed_charge": 149.3455, "npi": [1265430177]}, {"billed_charge": 160.2033, "npi": [1265430177]}, {"billed_charge": 47.75, "npi": [1265430177]}, {"billed_charge": 101.3933, "npi": [1265430177]}, {"billed_charge": 72.6342, "npi": [1265430177]}, {"billed_charge": 159.33, "npi": [1265430177]}]}, {"allowed_amount": 13.54, "billing_code_modifier": [""], "providers": [{"billed_charge": 47.75, "npi": [1265430177]}]}]}]}, {"name": "Laboratory - Chemistry", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0301", "description": "Laboratory", "allowed_amounts": [{"tin": {"type": "ein", "value": "751844139"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 21.82, "billing_code_modifier": [""], "providers": [{"billed_charge": 302.19, "npi": [1265430177]}]}, {"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 56.6, "npi": [1265430177]}, {"billed_charge": 243.0661, "npi": [1265430177]}, {"billed_charge": 306.86, "npi": [1265430177]}, {"billed_charge": 302.19, "npi": [1265430177]}, {"billed_charge": 99.79, "npi": [1265430177]}, {"billed_charge": 249.74, "npi": [1265430177]}, {"billed_charge": 153.91, "npi": [1265430177]}, {"billed_charge": 71.91, "npi": [1265430177]}, {"billed_charge": 214.55, "npi": [1265430177]}, {"billed_charge": 243.23, "npi": [1265430177]}, {"billed_charge": 109.891, "npi": [1265430177]}, {"billed_charge": 401.2, "npi": [1265430177]}, {"billed_charge": 229.02, "npi": [1265430177]}, {"billed_charge": 253.96, "npi": [1265430177]}, {"billed_charge": 120.2331, "npi": [1265430177]}, {"billed_charge": 148.4728, "npi": [1265430177]}, {"billed_charge": 407.22, "npi": [1265430177]}, {"billed_charge": 285.79, "npi": [1265430177]}, {"billed_charge": 190.6131, "npi": [1265430177]}, {"billed_charge": 459.04, "npi": [1265430177]}, {"billed_charge": 432.76, "npi": [1265430177]}, {"billed_charge": 135.1184, "npi": [1265430177]}, {"billed_charge": 217.7, "npi": [1265430177]}, {"billed_charge": 104.78, "npi": [1265430177]}, {"billed_charge": 159.62, "npi": [1265430177]}, {"billed_charge": 240.75, "npi": [1265430177]}, {"billed_charge": 137.2443, "npi": [1265430177]}, {"billed_charge": 273.89, "npi": [1265430177]}]}, {"allowed_amount": 5.7, "billing_code_modifier": ["91"], "providers": [{"billed_charge": 99.79, "npi": [1265430177]}]}, {"allowed_amount": 4.76, "billing_code_modifier": [""], "providers": [{"billed_charge": 56.6, "npi": [1265430177]}]}]}]}, {"name": "Pharmacy - General", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0250", "description": "Pharmacy (also see 063x, an extension of 025x)", "allowed_amounts": [{"tin": {"type": "ein", "value": "752586857"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 176.94, "npi": [1992700983]}, {"billed_charge": 15.5167, "npi": [1992700983]}, {"billed_charge": 0.6967, "npi": [1992700983]}, {"billed_charge": 3.288, "npi": [1992700983]}, {"billed_charge": 11.22, "npi": [1992700983]}, {"billed_charge": 0.9525, "npi": [1992700983]}, {"billed_charge": 50.0, "npi": [1992700983]}, {"billed_charge": 11.48, "npi": [1992700983]}, {"billed_charge": 0.252, "npi": [1992700983]}, {"billed_charge": 0.075, "npi": [1992700983]}, {"billed_charge": 4.8111, "npi": [1992700983]}, {"billed_charge": 0.92, "npi": [1992700983]}, {"billed_charge": 1.56, "npi": [1992700983]}, {"billed_charge": 3.535, "npi": [1992700983]}, {"billed_charge": 1.492, "npi": [1992700983]}, {"billed_charge": 0.8125, "npi": [1992700983]}, {"billed_charge": 6.4923, "npi": [1992700983]}, {"billed_charge": 0.222, "npi": [1992700983]}, {"billed_charge": 0.9111, "npi": [1992700983]}, {"billed_charge": 0.1367, "npi": [1992700983]}, {"billed_charge": 1.27, "npi": [1992700983]}, {"billed_charge": 56.3367, "npi": [1992700983]}, {"billed_charge": 4.1755, "npi": [1992700983]}, {"billed_charge": 6.8, "npi": [1992700983]}, {"billed_charge": 0.68, "npi": [1992700983]}, {"billed_charge": 3.3, "npi": [1992700983]}, {"billed_charge": 0.9609, "npi": [1992700983]}, {"billed_charge": 1.6889, "npi": [1992700983]}, {"billed_charge": 0.878, "npi": [1992700983]}, {"billed_charge": 4.328, "npi": [1992700983]}, {"billed_charge": 0.44, "npi": [1992700983]}, {"billed_charge": 8.864, "npi": [1992700983]}, {"billed_charge": 16.632, "npi": [1992700983]}, {"billed_charge": 8.33, "npi": [1992700983]}, {"billed_charge": 2.515, "npi": [1992700983]}, {"billed_charge": 0.3567, "npi": [1992700983]}, {"billed_charge": 0.11, "npi": [1992700983]}, {"billed_charge": 6.804, "npi": [1992700983]}, {"billed_charge": 2.1667, "npi": [1992700983]}, {"billed_charge": 0.56, "npi": [1992700983]}, {"billed_charge": 5.29, "npi": [1992700983]}, {"billed_charge": 1.282, "npi": [1992700983]}, {"billed_charge": 330.48, "npi": [1992700983]}, {"billed_charge": 1.22, "npi": [1992700983]}, {"billed_charge": 0.25, "npi": [1992700983]}, {"billed_charge": 5.153, "npi": [1992700983]}, {"billed_charge": 11.384, "npi": [1992700983]}, {"billed_charge": 4.075, "npi": [1992700983]}, {"billed_charge": 6.63, "npi": [1992700983]}, {"billed_charge": 14.9075, "npi": [1992700983]}, {"billed_charge": 1.8791, "npi": [1992700983]}, {"billed_charge": 0.0767, "npi": [1992700983]}, {"billed_charge": 4.945, "npi": [1992700983]}, {"billed_charge": 1.497, "npi": [1992700983]}, {"billed_charge": 1.3142, "npi": [1992700983]}, {"billed_charge": 7.754, "npi": [1992700983]}, {"billed_charge": 9.0725, "npi": [1992700983]}, {"billed_charge": 19.51, "npi": [1992700983]}, {"billed_charge": 3.88, "npi": [1992700983]}, {"billed_charge": 5.4421, "npi": [1992700983]}, {"billed_charge": 14.5575, "npi": [1992700983]}, {"billed_charge": 0.61, "npi": [1992700983]}, {"billed_charge": 0.13, "npi": [1992700983]}, {"billed_charge": 124.3588, "npi": [1992700983]}, {"billed_charge": 5.7629, "npi": [1992700983]}, {"billed_charge": 5.2256, "npi": [1992700983]}, {"billed_charge": 1.587, "npi": [1992700983]}, {"billed_charge": 10.4675, "npi": [1992700983]}, {"billed_charge": 2.5232, "npi": [1992700983]}, {"billed_charge": 2.2025, "npi": [1992700983]}, {"billed_charge": 3.82, "npi": [1992700983]}, {"billed_charge": 21.0, "npi": [1992700983]}, {"billed_charge": 14.7, "npi": [1992700983]}, {"billed_charge": 2.3211, "npi": [1992700983]}, {"billed_charge": 1.7417, "npi": [1992700983]}, {"billed_charge": 2.25, "npi": [1992700983]}, {"billed_charge": 7.505, "npi": [1992700983]}, {"billed_charge": 6.135, "npi": [1992700983]}, {"billed_charge": 0.53, "npi": [1992700983]}, {"billed_charge": 26.44, "npi": [1992700983]}, {"billed_charge": 1.8775, "npi": [1992700983]}, {"billed_charge": 20.265, "npi": [1992700983]}, {"billed_charge": 2.95, "npi": [1992700983]}, {"billed_charge": 1.659, "npi": [1992700983]}, {"billed_charge": 8.76, "npi": [1992700983]}, {"billed_charge": 7.5, "npi": [1992700983]}, {"billed_charge": 4.9162, "npi": [1992700983]}, {"billed_charge": 1.9, "npi": [1992700983]}, {"billed_charge": 0.16, "npi": [1992700983]}, {"billed_charge": 10.9625, "npi": [1992700983]}, {"billed_charge": 1.808, "npi": [1992700983]}, {"billed_charge": 4.3933, "npi": [1992700983]}, {"billed_charge": 12.315, "npi": [1992700983]}, {"billed_charge": 2.39, "npi": [1992700983]}, {"billed_charge": 1.795, "npi": [1992700983]}, {"billed_charge": 0.7767, "npi": [1992700983]}, {"billed_charge": 1.9017, "npi": [1992700983]}, {"billed_charge": 0.38, "npi": [1992700983]}, {"billed_charge": 0.7338, "npi": [1992700983]}, {"billed_charge": 0.165, "npi": [1992700983]}, {"billed_charge": 1.53, "npi": [1992700983]}, {"billed_charge": 19.68, "npi": [1992700983]}, {"billed_charge": 0.6167, "npi": [1992700983]}, {"billed_charge": 1.315, "npi": [1992700983]}, {"billed_charge": 4.95, "npi": [1992700983]}, {"billed_charge": 1.7683, "npi": [1992700983]}]}]}]}, {"name": "Other Therapeutic Services - General", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0940", "description": "Other Therapeutic Services", "allowed_amounts": [{"tin": {"type": "ein", "value": "752586857"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 321.2, "npi": [1992700983]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["XU"], "providers": [{"billed_charge": 321.2, "npi": [1992700983]}]}]}]}, {"name": "Pharmacy - Extension of 25X - Drug Requiring Detailed Coding", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0636", "description": "Pharmacy - Extension of 25x", "allowed_amounts": [{"tin": {"type": "ein", "value": "752890358"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.49, "billing_code_modifier": [""], "providers": [{"billed_charge": 10.0, "npi": [1548291883]}]}, {"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 9.0, "npi": [1548291883]}, {"billed_charge": 1.875, "npi": [1548291883]}, {"billed_charge": 1.0, "npi": [1548291883]}, {"billed_charge": 12.41, "npi": [1548291883]}, {"billed_charge": 50.0, "npi": [1548291883]}, {"billed_charge": 0.25, "npi": [1548291883]}, {"billed_charge": 12.5, "npi": [1548291883]}, {"billed_charge": 2.5, "npi": [1548291883]}, {"billed_charge": 2.5823, "npi": [1548291883]}]}, {"allowed_amount": 0.49, "billing_code_modifier": ["JW"], "providers": [{"billed_charge": 10.0, "npi": [1548291883]}]}, {"allowed_amount": 0.48, "billing_code_modifier": [""], "providers": [{"billed_charge": 10.0, "npi": [1548291883]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["JZ"], "providers": [{"billed_charge": 16.33, "npi": [1548291883]}, {"billed_charge": 0.5, "npi": [1548291883]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["JW"], "providers": [{"billed_charge": 9.0, "npi": [1548291883]}, {"billed_charge": 7.5, "npi": [1548291883]}]}, {"allowed_amount": 0.48, "billing_code_modifier": ["JW"], "providers": [{"billed_charge": 10.0, "npi": [1548291883]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["JA"], "providers": [{"billed_charge": 7.5, "npi": [1548291883]}]}]}]}, {"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": "472177648"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 647.98, "npi": [1790174860]}]}, {"allowed_amount": 90.81, "billing_code_modifier": [""], "providers": [{"billed_charge": 647.98, "npi": [1790174860]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["76"], "providers": [{"billed_charge": 647.98, "npi": [1790174860]}]}]}]}, {"name": "CT Scan - Head Scan", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0351", "description": "CT Scan", "allowed_amounts": [{"tin": {"type": "ein", "value": "751837454"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 151.54, "billing_code_modifier": [""], "providers": [{"billed_charge": 3178.59, "npi": [1447250253]}]}, {"allowed_amount": 622.69, "billing_code_modifier": [""], "providers": [{"billed_charge": 3178.59, "npi": [1447250253]}, {"billed_charge": 5907.07, "npi": [1447250253]}]}, {"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 7464.89, "npi": [1447250253]}, {"billed_charge": 2840.9, "npi": [1447250253]}, {"billed_charge": 4511.355, "npi": [1447250253]}, {"billed_charge": 11751.19, "npi": [1447250253]}, {"billed_charge": 6036.1233, "npi": [1447250253]}, {"billed_charge": 5844.12, "npi": [1447250253]}, {"billed_charge": 3178.59, "npi": [1447250253]}, {"billed_charge": 3306.97, "npi": [1447250253]}, {"billed_charge": 5907.07, "npi": [1447250253]}]}, {"allowed_amount": 254.23, "billing_code_modifier": [""], "providers": [{"billed_charge": 3340.68, "npi": [1447250253]}]}, {"allowed_amount": 151.54, "billing_code_modifier": ["U6"], "providers": [{"billed_charge": 3178.59, "npi": [1447250253]}]}]}]}, {"name": "Pharmacy - General", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0250", "description": "Pharmacy (also see 063x, an extension of 025x)", "allowed_amounts": [{"tin": {"type": "ein", "value": "824052186"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 1.005, "npi": [1801826839]}, {"billed_charge": 6.779, "npi": [1801826839]}, {"billed_charge": 1.37, "npi": [1801826839]}, {"billed_charge": 9.4017, "npi": [1801826839]}, {"billed_charge": 11.4175, "npi": [1801826839]}, {"billed_charge": 11.32, "npi": [1801826839]}, {"billed_charge": 8.9551, "npi": [1801826839]}, {"billed_charge": 1.5, "npi": [1801826839]}, {"billed_charge": 27.3, "npi": [1801826839]}, {"billed_charge": 0.09, "npi": [1801826839]}, {"billed_charge": 2.18, "npi": [1801826839]}, {"billed_charge": 15.72, "npi": [1801826839]}, {"billed_charge": 3.27, "npi": [1801826839]}, {"billed_charge": 18.5333, "npi": [1801826839]}, {"billed_charge": 18.9267, "npi": [1801826839]}, {"billed_charge": 3.88, "npi": [1801826839]}, {"billed_charge": 1.21, "npi": [1801826839]}, {"billed_charge": 0.1, "npi": [1801826839]}, {"billed_charge": 15.6, "npi": [1801826839]}, {"billed_charge": 1.024, "npi": [1801826839]}, {"billed_charge": 16.135, "npi": [1801826839]}]}]}]}, {"name": "EKG/ECG (Electrocardiogram) - General", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0730", "description": "EKG/ECG (Electrocardiogram)", "allowed_amounts": [{"tin": {"type": "ein", "value": "752586857"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 453.2, "npi": [1992700983]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["XU"], "providers": [{"billed_charge": 453.2, "npi": [1992700983]}]}]}]}, {"name": "Emergency Room - General", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0450", "description": "Emergency Room", "allowed_amounts": [{"tin": {"type": "ein", "value": "752770738"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 308.31, "billing_code_modifier": [""], "providers": [{"billed_charge": 333.25, "npi": [1770514077]}, {"billed_charge": 779.25, "npi": [1770514077]}]}, {"allowed_amount": 222.56, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 537.75, "npi": [1770514077]}]}, {"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 254.75, "npi": [1770514077]}, {"billed_charge": 809.375, "npi": [1770514077]}, {"billed_charge": 652.6667, "npi": [1770514077]}, {"billed_charge": 1342.4167, "npi": [1770514077]}, {"billed_charge": 333.25, "npi": [1770514077]}, {"billed_charge": 592.4722, "npi": [1770514077]}, {"billed_charge": 2758.25, "npi": [1770514077]}, {"billed_charge": 1521.25, "npi": [1770514077]}, {"billed_charge": 3045.5, "npi": [1770514077]}, {"billed_charge": 751.0313, "npi": [1770514077]}, {"billed_charge": 542.5, "npi": [1770514077]}, {"billed_charge": 103.5, "npi": [1770514077]}, {"billed_charge": 1051.0, "npi": [1770514077]}, {"billed_charge": 811.75, "npi": [1770514077]}]}, {"allowed_amount": 67.875, "billing_code_modifier": [""], "providers": [{"billed_charge": 333.25, "npi": [1770514077]}, {"billed_charge": 103.5, "npi": [1770514077]}]}, {"allowed_amount": 604.81, "billing_code_modifier": [""], "providers": [{"billed_charge": 1521.25, "npi": [1770514077]}]}, {"allowed_amount": 222.56, "billing_code_modifier": [""], "providers": [{"billed_charge": 537.75, "npi": [1770514077]}]}, {"allowed_amount": 122.22, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 332.25, "npi": [1770514077]}]}, {"allowed_amount": 67.8733, "billing_code_modifier": ["59"], "providers": [{"billed_charge": 333.25, "npi": [1770514077]}]}, {"allowed_amount": 3791.1, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 2758.25, "npi": [1770514077]}]}, {"allowed_amount": 67.87, "billing_code_modifier": [""], "providers": [{"billed_charge": 333.25, "npi": [1770514077]}, {"billed_charge": 103.5, "npi": [1770514077]}]}, {"allowed_amount": 290.83, "billing_code_modifier": [""], "providers": [{"billed_charge": 811.0, "npi": [1770514077]}]}, {"allowed_amount": 863.2, "billing_code_modifier": [""], "providers": [{"billed_charge": 2758.25, "npi": [1770514077]}]}, {"allowed_amount": 67.8733, "billing_code_modifier": [""], "providers": [{"billed_charge": 333.25, "npi": [1770514077]}]}, {"allowed_amount": 395.66, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 1042.5, "npi": [1770514077]}]}, {"allowed_amount": 395.66, "billing_code_modifier": [""], "providers": [{"billed_charge": 1042.5, "npi": [1770514077]}]}, {"allowed_amount": 863.2, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 2758.25, "npi": [1770514077]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["59"], "providers": [{"billed_charge": 254.75, "npi": [1770514077]}, {"billed_charge": 333.25, "npi": [1770514077]}, {"billed_charge": 103.5, "npi": [1770514077]}, {"billed_charge": 779.25, "npi": [1770514077]}]}, {"allowed_amount": 308.31, "billing_code_modifier": ["59"], "providers": [{"billed_charge": 333.25, "npi": [1770514077]}, {"billed_charge": 779.25, "npi": [1770514077]}]}, {"allowed_amount": 122.22, "billing_code_modifier": [""], "providers": [{"billed_charge": 332.25, "npi": [1770514077]}]}, {"allowed_amount": 67.87, "billing_code_modifier": ["59"], "providers": [{"billed_charge": 333.25, "npi": [1770514077]}, {"billed_charge": 103.5, "npi": [1770514077]}]}, {"allowed_amount": 604.81, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 1521.25, "npi": [1770514077]}]}]}]}, {"name": "Laboratory - Hematology", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0305", "description": "Laboratory", "allowed_amounts": [{"tin": {"type": "ein", "value": "751037591"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 140.91, "npi": [1124305065]}, {"billed_charge": 111.76, "npi": [1124305065]}, {"billed_charge": 173.6, "npi": [1124305065]}, {"billed_charge": 149.84, "npi": [1124305065]}, {"billed_charge": 121.7, "npi": [1124305065]}, {"billed_charge": 172.3667, "npi": [1124305065]}, {"billed_charge": 146.11, "npi": [1124305065]}, {"billed_charge": 183.63, "npi": [1124305065]}, {"billed_charge": 93.56, "npi": [1124305065]}]}]}]}, {"name": "Radiology - Diagnostic - Chest X-Ray", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0324", "description": "Radiology - Diagnostic", "allowed_amounts": [{"tin": {"type": "ein", "value": "751844139"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 366.74, "npi": [1265430177]}]}, {"allowed_amount": 126.14, "billing_code_modifier": [""], "providers": [{"billed_charge": 656.37, "npi": [1265430177]}, {"billed_charge": 366.74, "npi": [1265430177]}]}]}]}, {"name": "Pharmacy - Extension of 25X - Drug Requiring Detailed Coding", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0636", "description": "Pharmacy - Extension of 25x", "allowed_amounts": [{"tin": {"type": "ein", "value": "752771437"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.49, "billing_code_modifier": [""], "providers": [{"billed_charge": 10.0, "npi": [1457382798]}]}, {"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 51.69, "npi": [1457382798]}, {"billed_charge": 2.5, "npi": [1457382798]}, {"billed_charge": 9.0, "npi": [1457382798]}, {"billed_charge": 3.75, "npi": [1457382798]}, {"billed_charge": 12.5, "npi": [1457382798]}, {"billed_charge": 0.3747, "npi": [1457382798]}, {"billed_charge": 50.0, "npi": [1457382798]}, {"billed_charge": 6.25, "npi": [1457382798]}, {"billed_charge": 10.0, "npi": [1457382798]}]}, {"allowed_amount": 0.485, "billing_code_modifier": ["JZ"], "providers": [{"billed_charge": 14.89, "npi": [1457382798]}]}, {"allowed_amount": 0.49, "billing_code_modifier": ["JW"], "providers": [{"billed_charge": 10.0, "npi": [1457382798]}]}, {"allowed_amount": 0.48, "billing_code_modifier": [""], "providers": [{"billed_charge": 10.0, "npi": [1457382798]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["JZ"], "providers": [{"billed_charge": 0.5, "npi": [1457382798]}, {"billed_charge": 13.09, "npi": [1457382798]}, {"billed_charge": 32.65, "npi": [1457382798]}]}, {"allowed_amount": 0.48, "billing_code_modifier": ["JW"], "providers": [{"billed_charge": 10.0, "npi": [1457382798]}]}]}]}, {"name": "Laboratory - Hematology", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0305", "description": "Laboratory", "allowed_amounts": [{"tin": {"type": "ein", "value": "621789402"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 290.1, "npi": [1700805678]}, {"billed_charge": 282.32, "npi": [1700805678]}]}]}]}, {"name": "FETAL BIOPHYSICAL PROFILE NON-STRESS TESTING", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "76818", "description": "FETAL BIOPHYSICAL PROFILE NON-STRESS TESTING", "allowed_amounts": [{"tin": {"type": "ein", "value": "270393689"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 60.13, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 172.0, "npi": [1083969299]}]}, {"allowed_amount": 60.13, "billing_code_modifier": ["5926"], "providers": [{"billed_charge": 172.0, "npi": [1083969299]}]}]}]}, {"name": "Pharmacy - Extension of 25X - Drug Requiring Detailed Coding", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0636", "description": "Pharmacy - Extension of 25x", "allowed_amounts": [{"tin": {"type": "ein", "value": "202848116"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 12.59, "npi": [1629138029]}, {"billed_charge": 8.3778, "npi": [1629138029]}, {"billed_charge": 12.0625, "npi": [1629138029]}, {"billed_charge": 1.0, "npi": [1629138029]}, {"billed_charge": 4.56, "npi": [1629138029]}, {"billed_charge": 50.0, "npi": [1629138029]}, {"billed_charge": 9.0, "npi": [1629138029]}, {"billed_charge": 0.125, "npi": [1629138029]}, {"billed_charge": 2.7118, "npi": [1629138029]}, {"billed_charge": 0.3584, "npi": [1629138029]}, {"billed_charge": 3.42, "npi": [1629138029]}, {"billed_charge": 2.9255, "npi": [1629138029]}, {"billed_charge": 7.5, "npi": [1629138029]}, {"billed_charge": 3.75, "npi": [1629138029]}, {"billed_charge": 0.25, "npi": [1629138029]}, {"billed_charge": 2.5, "npi": [1629138029]}, {"billed_charge": 0.2, "npi": [1629138029]}, {"billed_charge": 22.4, "npi": [1629138029]}, {"billed_charge": 0.5, "npi": [1629138029]}, {"billed_charge": 3.8722, "npi": [1629138029]}]}, {"allowed_amount": 0.48, "billing_code_modifier": ["JZ"], "providers": [{"billed_charge": 17.1, "npi": [1629138029]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["JZ"], "providers": [{"billed_charge": 1.4844, "npi": [1629138029]}, {"billed_charge": 16.33, "npi": [1629138029]}, {"billed_charge": 9.0, "npi": [1629138029]}, {"billed_charge": 13.09, "npi": [1629138029]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["JW"], "providers": [{"billed_charge": 9.0, "npi": [1629138029]}]}]}]}, {"name": "Laboratory - Chemistry", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0301", "description": "Laboratory", "allowed_amounts": [{"tin": {"type": "ein", "value": "831869297"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 161.97, "npi": [1356960132]}, {"billed_charge": 715.04, "npi": [1356960132]}, {"billed_charge": 303.5, "npi": [1356960132]}, {"billed_charge": 272.4, "npi": [1356960132]}, {"billed_charge": 426.5, "npi": [1356960132]}, {"billed_charge": 86.45, "npi": [1356960132]}, {"billed_charge": 536.89, "npi": [1356960132]}, {"billed_charge": 140.15, "npi": [1356960132]}, {"billed_charge": 453.13, "npi": [1356960132]}, {"billed_charge": 183.38, "npi": [1356960132]}, {"billed_charge": 336.2268, "npi": [1356960132]}, {"billed_charge": 423.32, "npi": [1356960132]}, {"billed_charge": 831.08, "npi": [1356960132]}, {"billed_charge": 170.57, "npi": [1356960132]}]}, {"allowed_amount": 5.7, "billing_code_modifier": ["91"], "providers": [{"billed_charge": 70.38, "npi": [1356960132]}]}, {"allowed_amount": 5.7, "billing_code_modifier": ["QW91"], "providers": [{"billed_charge": 70.38, "npi": [1356960132]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["QW"], "providers": [{"billed_charge": 715.04, "npi": [1356960132]}, {"billed_charge": 426.5, "npi": [1356960132]}, {"billed_charge": 536.89, "npi": [1356960132]}, {"billed_charge": 91.04, "npi": [1356960132]}, {"billed_charge": 183.38, "npi": [1356960132]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["91"], "providers": [{"billed_charge": 272.4, "npi": [1356960132]}]}]}]}, {"name": "Laboratory - General", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0300", "description": "Laboratory", "allowed_amounts": [{"tin": {"type": "ein", "value": "260194016"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 59.0483, "npi": [1205018439]}, {"billed_charge": 91.63, "npi": [1205018439]}, {"billed_charge": 220.305, "npi": [1205018439]}, {"billed_charge": 40.0, "npi": [1205018439]}, {"billed_charge": 211.0, "npi": [1205018439]}, {"billed_charge": 47.75, "npi": [1205018439]}, {"billed_charge": 102.685, "npi": [1205018439]}, {"billed_charge": 392.86, "npi": [1205018439]}, {"billed_charge": 134.0275, "npi": [1205018439]}, {"billed_charge": 95.5, "npi": [1205018439]}, {"billed_charge": 160.2033, "npi": [1205018439]}]}]}]}, {"name": "Pharmacy - Extension of 25X - Drug Requiring Detailed Coding", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0636", "description": "Pharmacy - Extension of 25x", "allowed_amounts": [{"tin": {"type": "ein", "value": "750800628"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 11.25, "billing_code_modifier": [""], "providers": [{"billed_charge": 18.75, "npi": [1194743013]}]}, {"allowed_amount": 6.062, "billing_code_modifier": [""], "providers": [{"billed_charge": 10.1034, "npi": [1194743013]}]}, {"allowed_amount": 9.7476, "billing_code_modifier": [""], "providers": [{"billed_charge": 16.246, "npi": [1194743013]}]}, {"allowed_amount": 15.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 25.0, "npi": [1194743013]}]}, {"allowed_amount": 6.8614, "billing_code_modifier": [""], "providers": [{"billed_charge": 11.4356, "npi": [1194743013]}]}, {"allowed_amount": 14.625, "billing_code_modifier": [""], "providers": [{"billed_charge": 37.5, "npi": [1194743013]}]}, {"allowed_amount": 45.12, "billing_code_modifier": [""], "providers": [{"billed_charge": 75.2, "npi": [1194743013]}]}, {"allowed_amount": 52.65, "billing_code_modifier": [""], "providers": [{"billed_charge": 87.75, "npi": [1194743013]}]}, {"allowed_amount": 0.5885, "billing_code_modifier": [""], "providers": [{"billed_charge": 0.9808, "npi": [1194743013]}]}, {"allowed_amount": 33.75, "billing_code_modifier": [""], "providers": [{"billed_charge": 56.25, "npi": [1194743013]}]}, {"allowed_amount": 25.2, "billing_code_modifier": [""], "providers": [{"billed_charge": 42.0, "npi": [1194743013]}]}, {"allowed_amount": 30.285, "billing_code_modifier": [""], "providers": [{"billed_charge": 50.475, "npi": [1194743013]}]}, {"allowed_amount": 22.5, "billing_code_modifier": [""], "providers": [{"billed_charge": 37.5, "npi": [1194743013]}]}, {"allowed_amount": 25.875, "billing_code_modifier": [""], "providers": [{"billed_charge": 43.125, "npi": [1194743013]}]}, {"allowed_amount": 9.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 15.0, "npi": [1194743013]}]}, {"allowed_amount": 21.995, "billing_code_modifier": [""], "providers": [{"billed_charge": 43.125, "npi": [1194743013]}]}, {"allowed_amount": 52.44, "billing_code_modifier": [""], "providers": [{"billed_charge": 87.4, "npi": [1194743013]}]}, {"allowed_amount": 22.685, "billing_code_modifier": [""], "providers": [{"billed_charge": 37.8083, "npi": [1194743013]}]}, {"allowed_amount": 6.5693, "billing_code_modifier": [""], "providers": [{"billed_charge": 10.9488, "npi": [1194743013]}]}, {"allowed_amount": 7.2, "billing_code_modifier": [""], "providers": [{"billed_charge": 12.0, "npi": [1194743013]}]}, {"allowed_amount": 9.6672, "billing_code_modifier": [""], "providers": [{"billed_charge": 16.112, "npi": [1194743013]}]}, {"allowed_amount": 1081.65, "billing_code_modifier": [""], "providers": [{"billed_charge": 1802.75, "npi": [1194743013]}]}, {"allowed_amount": 45.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 75.0, "npi": [1194743013]}]}, {"allowed_amount": 66.12, "billing_code_modifier": [""], "providers": [{"billed_charge": 110.2, "npi": [1194743013]}]}, {"allowed_amount": 12.75, "billing_code_modifier": [""], "providers": [{"billed_charge": 25.0, "npi": [1194743013]}]}, {"allowed_amount": 7.3125, "billing_code_modifier": [""], "providers": [{"billed_charge": 18.75, "npi": [1194743013]}]}, {"allowed_amount": 7.7151, "billing_code_modifier": [""], "providers": [{"billed_charge": 12.8585, "npi": [1194743013]}]}]}]}, {"name": "IV Therapy -General", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0260", "description": "IV Therapy", "allowed_amounts": [{"tin": {"type": "ein", "value": "753175630"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 308.31, "billing_code_modifier": [""], "providers": [{"billed_charge": 426.0, "npi": [1285798918]}]}, {"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 348.75, "npi": [1285798918]}, {"billed_charge": 323.0, "npi": [1285798918]}, {"billed_charge": 392.0, "npi": [1285798918]}, {"billed_charge": 418.0, "npi": [1285798918]}, {"billed_charge": 426.0, "npi": [1285798918]}, {"billed_charge": 443.3333, "npi": [1285798918]}]}, {"allowed_amount": 67.875, "billing_code_modifier": [""], "providers": [{"billed_charge": 323.0, "npi": [1285798918]}]}, {"allowed_amount": 67.87, "billing_code_modifier": [""], "providers": [{"billed_charge": 323.0, "npi": [1285798918]}]}, {"allowed_amount": 308.31, "billing_code_modifier": ["XU"], "providers": [{"billed_charge": 426.0, "npi": [1285798918]}]}, {"allowed_amount": 308.31, "billing_code_modifier": ["59"], "providers": [{"billed_charge": 426.0, "npi": [1285798918]}]}, {"allowed_amount": 67.87, "billing_code_modifier": ["59"], "providers": [{"billed_charge": 323.0, "npi": [1285798918]}]}]}]}, {"name": "Laboratory - Chemistry", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0301", "description": "Laboratory", "allowed_amounts": [{"tin": {"type": "ein", "value": "752682017"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 12.69, "billing_code_modifier": [""], "providers": [{"billed_charge": 1021.0, "npi": [1114998911]}]}, {"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 2077.0, "npi": [1114998911]}, {"billed_charge": 145.0, "npi": [1114998911]}, {"billed_charge": 423.0, "npi": [1114998911]}, {"billed_charge": 670.0, "npi": [1114998911]}, {"billed_charge": 1447.0, "npi": [1114998911]}, {"billed_charge": 1039.5, "npi": [1114998911]}, {"billed_charge": 1585.0, "npi": [1114998911]}, {"billed_charge": 549.0, "npi": [1114998911]}, {"billed_charge": 1021.0, "npi": [1114998911]}, {"billed_charge": 541.0, "npi": [1114998911]}, {"billed_charge": 398.0, "npi": [1114998911]}, {"billed_charge": 213.0, "npi": [1114998911]}, {"billed_charge": 1939.0, "npi": [1114998911]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["59"], "providers": [{"billed_charge": 549.0, "npi": [1114998911]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["91"], "providers": [{"billed_charge": 1447.0, "npi": [1114998911]}, {"billed_charge": 541.0, "npi": [1114998911]}]}]}]}, {"name": "INFUSION NORMAL SALINE SOLUTION 1000 CC", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "J7030", "description": "INFUSION NORMAL SALINE SOLUTION 1000 CC", "allowed_amounts": [{"tin": {"type": "ein", "value": "853503076"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 59.03, "npi": [1124623889]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["76"], "providers": [{"billed_charge": 59.03, "npi": [1124623889]}]}]}]}, {"name": "Laboratory - Bacteriology & Microbiology", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0306", "description": "Laboratory", "allowed_amounts": [{"tin": {"type": "ein", "value": "750800628"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 302.94, "billing_code_modifier": [""], "providers": [{"billed_charge": 594.0, "npi": [1194743013]}]}, {"allowed_amount": 238.2, "billing_code_modifier": [""], "providers": [{"billed_charge": 397.0, "npi": [1194743013]}]}, {"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 295.0, "npi": [1194743013]}, {"billed_charge": 421.0, "npi": [1194743013]}]}, {"allowed_amount": 157.8, "billing_code_modifier": [""], "providers": [{"billed_charge": 263.0, "npi": [1194743013]}]}, {"allowed_amount": 177.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 295.0, "npi": [1194743013]}]}, {"allowed_amount": 163.2, "billing_code_modifier": [""], "providers": [{"billed_charge": 272.0, "npi": [1194743013]}]}, {"allowed_amount": 209.4, "billing_code_modifier": [""], "providers": [{"billed_charge": 349.0, "npi": [1194743013]}]}, {"allowed_amount": 115.05, "billing_code_modifier": [""], "providers": [{"billed_charge": 336.0, "npi": [1194743013]}]}, {"allowed_amount": 126.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 210.0, "npi": [1194743013]}]}, {"allowed_amount": 252.6, "billing_code_modifier": [""], "providers": [{"billed_charge": 421.0, "npi": [1194743013]}]}, {"allowed_amount": 356.4, "billing_code_modifier": [""], "providers": [{"billed_charge": 594.0, "npi": [1194743013]}]}, {"allowed_amount": 69.6, "billing_code_modifier": [""], "providers": [{"billed_charge": 116.0, "npi": [1194743013]}]}, {"allowed_amount": 201.6, "billing_code_modifier": [""], "providers": [{"billed_charge": 336.0, "npi": [1194743013]}]}, {"allowed_amount": 908.4, "billing_code_modifier": [""], "providers": [{"billed_charge": 1514.0, "npi": [1194743013]}]}, {"allowed_amount": 335.85, "billing_code_modifier": [""], "providers": [{"billed_charge": 559.75, "npi": [1194743013]}]}]}]}, {"name": "Laboratory - Chemistry", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0301", "description": "Laboratory", "allowed_amounts": [{"tin": {"type": "ein", "value": "752771437"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 679.25, "npi": [1457382798]}, {"billed_charge": 153.5, "npi": [1457382798]}, {"billed_charge": 334.25, "npi": [1457382798]}, {"billed_charge": 231.0, "npi": [1457382798]}, {"billed_charge": 278.25, "npi": [1457382798]}, {"billed_charge": 335.75, "npi": [1457382798]}, {"billed_charge": 324.5, "npi": [1457382798]}, {"billed_charge": 49.25, "npi": [1457382798]}, {"billed_charge": 668.5, "npi": [1457382798]}]}, {"allowed_amount": 19.42, "billing_code_modifier": [""], "providers": [{"billed_charge": 679.25, "npi": [1457382798]}]}]}]}, {"name": "CT Scan - Body Scan", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0352", "description": "CT Scan", "allowed_amounts": [{"tin": {"type": "ein", "value": "260194016"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 151.54, "billing_code_modifier": [""], "providers": [{"billed_charge": 3424.65, "npi": [1205018439]}]}, {"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 6484.35, "npi": [1205018439]}, {"billed_charge": 3339.84, "npi": [1205018439]}, {"billed_charge": 6070.7325, "npi": [1205018439]}, {"billed_charge": 6290.97, "npi": [1205018439]}, {"billed_charge": 9294.97, "npi": [1205018439]}, {"billed_charge": 6093.885, "npi": [1205018439]}]}, {"allowed_amount": 254.23, "billing_code_modifier": [""], "providers": [{"billed_charge": 6290.97, "npi": [1205018439]}]}, {"allowed_amount": 345.85, "billing_code_modifier": [""], "providers": [{"billed_charge": 5896.8, "npi": [1205018439]}]}, {"allowed_amount": 505.67, "billing_code_modifier": [""], "providers": [{"billed_charge": 6484.35, "npi": [1205018439]}]}]}]}, {"name": "Laboratory - Chemistry", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0301", "description": "Laboratory", "allowed_amounts": [{"tin": {"type": "ein", "value": "752586857"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 148.33, "npi": [1992700983]}, {"billed_charge": 150.893, "npi": [1992700983]}, {"billed_charge": 198.5171, "npi": [1992700983]}, {"billed_charge": 217.7, "npi": [1992700983]}, {"billed_charge": 105.46, "npi": [1992700983]}, {"billed_charge": 302.19, "npi": [1992700983]}, {"billed_charge": 306.86, "npi": [1992700983]}, {"billed_charge": 249.48, "npi": [1992700983]}, {"billed_charge": 88.72, "npi": [1992700983]}, {"billed_charge": 295.62, "npi": [1992700983]}, {"billed_charge": 87.97, "npi": [1992700983]}, {"billed_charge": 104.78, "npi": [1992700983]}, {"billed_charge": 185.85, "npi": [1992700983]}, {"billed_charge": 96.1, "npi": [1992700983]}, {"billed_charge": 407.22, "npi": [1992700983]}, {"billed_charge": 229.02, "npi": [1992700983]}, {"billed_charge": 134.0181, "npi": [1992700983]}, {"billed_charge": 56.6, "npi": [1992700983]}, {"billed_charge": 128.49, "npi": [1992700983]}, {"billed_charge": 243.23, "npi": [1992700983]}, {"billed_charge": 103.54, "npi": [1992700983]}, {"billed_charge": 93.56, "npi": [1992700983]}, {"billed_charge": 163.41, "npi": [1992700983]}, {"billed_charge": 144.4764, "npi": [1992700983]}, {"billed_charge": 99.79, "npi": [1992700983]}, {"billed_charge": 182.55, "npi": [1992700983]}, {"billed_charge": 108.6617, "npi": [1992700983]}, {"billed_charge": 80.13, "npi": [1992700983]}, {"billed_charge": 153.91, "npi": [1992700983]}, {"billed_charge": 459.04, "npi": [1992700983]}, {"billed_charge": 215.37, "npi": [1992700983]}, {"billed_charge": 117.24, "npi": [1992700983]}, {"billed_charge": 214.55, "npi": [1992700983]}, {"billed_charge": 126.1527, "npi": [1992700983]}, {"billed_charge": 167.2347, "npi": [1992700983]}, {"billed_charge": 150.94, "npi": [1992700983]}, {"billed_charge": 88.6224, "npi": [1992700983]}, {"billed_charge": 111.02, "npi": [1992700983]}, {"billed_charge": 239.5, "npi": [1992700983]}, {"billed_charge": 285.79, "npi": [1992700983]}, {"billed_charge": 432.76, "npi": [1992700983]}, {"billed_charge": 324.88, "npi": [1992700983]}, {"billed_charge": 124.74, "npi": [1992700983]}, {"billed_charge": 103.83, "npi": [1992700983]}, {"billed_charge": 240.75, "npi": [1992700983]}, {"billed_charge": 249.74, "npi": [1992700983]}, {"billed_charge": 101.57, "npi": [1992700983]}, {"billed_charge": 159.62, "npi": [1992700983]}, {"billed_charge": 108.35, "npi": [1992700983]}]}, {"allowed_amount": 19.42, "billing_code_modifier": [""], "providers": [{"billed_charge": 328.07, "npi": [1992700983]}]}, {"allowed_amount": 5.7, "billing_code_modifier": ["XU91"], "providers": [{"billed_charge": 99.79, "npi": [1992700983]}]}, {"allowed_amount": 5.7, "billing_code_modifier": [""], "providers": [{"billed_charge": 99.79, "npi": [1992700983]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["91"], "providers": [{"billed_charge": 217.7, "npi": [1992700983]}, {"billed_charge": 56.6, "npi": [1992700983]}, {"billed_charge": 111.02, "npi": [1992700983]}]}]}]}, {"name": "Emergency Room - General", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0450", "description": "Emergency Room", "allowed_amounts": [{"tin": {"type": "ein", "value": "750972805"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 67.99, "billing_code_modifier": ["59"], "providers": [{"billed_charge": 333.25, "npi": [1174533343]}]}, {"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 729.25, "npi": [1174533343]}, {"billed_charge": 254.75, "npi": [1174533343]}, {"billed_charge": 1545.75, "npi": [1174533343]}]}, {"allowed_amount": 308.82, "billing_code_modifier": ["59"], "providers": [{"billed_charge": 333.25, "npi": [1174533343]}]}, {"allowed_amount": 396.31, "billing_code_modifier": [""], "providers": [{"billed_charge": 1042.5, "npi": [1174533343]}]}, {"allowed_amount": 291.31, "billing_code_modifier": [""], "providers": [{"billed_charge": 811.0, "npi": [1174533343]}]}, {"allowed_amount": 222.92, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 537.75, "npi": [1174533343]}]}, {"allowed_amount": 122.42, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 332.25, "npi": [1174533343]}]}, {"allowed_amount": 3797.35, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 2758.25, "npi": [1174533343]}]}, {"allowed_amount": 864.64, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 2758.25, "npi": [1174533343]}]}, {"allowed_amount": 605.81, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 1521.25, "npi": [1174533343]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["59"], "providers": [{"billed_charge": 333.25, "npi": [1174533343]}]}, {"allowed_amount": 222.92, "billing_code_modifier": [""], "providers": [{"billed_charge": 537.75, "npi": [1174533343]}]}, {"allowed_amount": 67.99, "billing_code_modifier": [""], "providers": [{"billed_charge": 103.5, "npi": [1174533343]}, {"billed_charge": 333.25, "npi": [1174533343]}]}, {"allowed_amount": 308.82, "billing_code_modifier": [""], "providers": [{"billed_charge": 779.25, "npi": [1174533343]}, {"billed_charge": 333.25, "npi": [1174533343]}]}]}]}, {"name": "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": "824052186"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 50.0, "npi": [1801826839]}, {"billed_charge": 46.0, "npi": [1801826839]}, {"billed_charge": 49.1429, "npi": [1801826839]}]}]}]}, {"name": "Pharmacy - Extension of 25X - Drug Requiring Detailed Coding", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0636", "description": "Pharmacy - Extension of 25x", "allowed_amounts": [{"tin": {"type": "ein", "value": "752682017"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 120.0, "npi": [1114998911]}, {"billed_charge": 12.0, "npi": [1114998911]}, {"billed_charge": 32.0, "npi": [1114998911]}, {"billed_charge": 30.0, "npi": [1114998911]}, {"billed_charge": 40.0, "npi": [1114998911]}, {"billed_charge": 4.2, "npi": [1114998911]}, {"billed_charge": 27.0, "npi": [1114998911]}, {"billed_charge": 33.0, "npi": [1114998911]}, {"billed_charge": 11.0, "npi": [1114998911]}, {"billed_charge": 26.0, "npi": [1114998911]}, {"billed_charge": 5.3, "npi": [1114998911]}, {"billed_charge": 1026.0, "npi": [1114998911]}, {"billed_charge": 349.0, "npi": [1114998911]}, {"billed_charge": 71.0, "npi": [1114998911]}, {"billed_charge": 19.0, "npi": [1114998911]}, {"billed_charge": 17.0, "npi": [1114998911]}, {"billed_charge": 58.0, "npi": [1114998911]}, {"billed_charge": 0.1, "npi": [1114998911]}, {"billed_charge": 15.0, "npi": [1114998911]}, {"billed_charge": 4.4, "npi": [1114998911]}, {"billed_charge": 15.84, "npi": [1114998911]}, {"billed_charge": 138.0, "npi": [1114998911]}]}, {"allowed_amount": 0.505, "billing_code_modifier": ["JZ"], "providers": [{"billed_charge": 115.0, "npi": [1114998911]}]}, {"allowed_amount": 0.5, "billing_code_modifier": ["JZ"], "providers": [{"billed_charge": 205.0, "npi": [1114998911]}, {"billed_charge": 115.0, "npi": [1114998911]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["JZ"], "providers": [{"billed_charge": 0.9, "npi": [1114998911]}, {"billed_charge": 233.0, "npi": [1114998911]}, {"billed_charge": 5.9, "npi": [1114998911]}]}, {"allowed_amount": 2.1135, "billing_code_modifier": ["JZ"], "providers": [{"billed_charge": 18.0, "npi": [1114998911]}]}]}]}, {"name": "Pharmacy - General", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0250", "description": "Pharmacy (also see 063x, an extension of 025x)", "allowed_amounts": [{"tin": {"type": "ein", "value": "751977850"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 0.5, "npi": [1396778064]}, {"billed_charge": 0.25, "npi": [1396778064]}, {"billed_charge": 38.9323, "npi": [1396778064]}, {"billed_charge": 24.645, "npi": [1396778064]}, {"billed_charge": 2.3975, "npi": [1396778064]}, {"billed_charge": 1.3333, "npi": [1396778064]}, {"billed_charge": 2.265, "npi": [1396778064]}, {"billed_charge": 2.0, "npi": [1396778064]}, {"billed_charge": 50.0, "npi": [1396778064]}, {"billed_charge": 30.325, "npi": [1396778064]}, {"billed_charge": 1.5, "npi": [1396778064]}, {"billed_charge": 1.0, "npi": [1396778064]}, {"billed_charge": 3.18, "npi": [1396778064]}, {"billed_charge": 15.075, "npi": [1396778064]}, {"billed_charge": 32.99, "npi": [1396778064]}]}]}]}, {"name": "Pharmacy - Extension of 25X - Drug Requiring Detailed Coding", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0636", "description": "Pharmacy - Extension of 25x", "allowed_amounts": [{"tin": {"type": "ein", "value": "751438726"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 4.5004, "npi": [1104845015]}, {"billed_charge": 3.99, "npi": [1104845015]}, {"billed_charge": 2.5, "npi": [1104845015]}, {"billed_charge": 10.0, "npi": [1104845015]}, {"billed_charge": 38.86, "npi": [1104845015]}, {"billed_charge": 50.0, "npi": [1104845015]}, {"billed_charge": 24.81, "npi": [1104845015]}, {"billed_charge": 0.125, "npi": [1104845015]}, {"billed_charge": 3.42, "npi": [1104845015]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["U8JZ"], "providers": [{"billed_charge": 16.11, "npi": [1104845015]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["U8JW"], "providers": [{"billed_charge": 9.0, "npi": [1104845015]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["U8"], "providers": [{"billed_charge": 9.0, "npi": [1104845015]}, {"billed_charge": 27.25, "npi": [1104845015]}, {"billed_charge": 11.3125, "npi": [1104845015]}, {"billed_charge": 3.25, "npi": [1104845015]}, {"billed_charge": 2.3905, "npi": [1104845015]}, {"billed_charge": 50.0, "npi": [1104845015]}, {"billed_charge": 0.05, "npi": [1104845015]}]}, {"allowed_amount": 0.495, "billing_code_modifier": ["TBU8JZ"], "providers": [{"billed_charge": 5.0, "npi": [1104845015]}]}, {"allowed_amount": 0.48, "billing_code_modifier": ["U8JZ"], "providers": [{"billed_charge": 17.1, "npi": [1104845015]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["JZ"], "providers": [{"billed_charge": 9.0, "npi": [1104845015]}, {"billed_charge": 0.5472, "npi": [1104845015]}]}]}]}, {"name": "ANESTHESIA LOWER INTST ENDOSCOPIC PX SCR COLSC", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "00812", "description": "ANESTHESIA LOWER INTST ENDOSCOPIC PX SCR COLSC", "allowed_amounts": [{"tin": {"type": "ein", "value": "453710597"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 54.5625, "billing_code_modifier": ["AAP1"], "providers": [{"billed_charge": 648.0, "npi": [1265438311]}]}, {"allowed_amount": 53.352, "billing_code_modifier": ["AAP2"], "providers": [{"billed_charge": 660.0, "npi": [1265438311]}]}, {"allowed_amount": 49.3379, "billing_code_modifier": ["AAP2"], "providers": [{"billed_charge": 708.0, "npi": [1265438311]}]}, {"allowed_amount": 58.8952, "billing_code_modifier": ["AAP2"], "providers": [{"billed_charge": 612.0, "npi": [1265438311]}]}, {"allowed_amount": 76.2143, "billing_code_modifier": ["AAP1"], "providers": [{"billed_charge": 528.0, "npi": [1265438311]}]}, {"allowed_amount": 47.7194, "billing_code_modifier": ["AAP3"], "providers": [{"billed_charge": 852.0, "npi": [1265438311]}]}, {"allowed_amount": 62.5421, "billing_code_modifier": ["AAP1"], "providers": [{"billed_charge": 588.0, "npi": [1265438311]}]}, {"allowed_amount": 64.6667, "billing_code_modifier": ["AAP3"], "providers": [{"billed_charge": 696.0, "npi": [1265438311]}]}, {"allowed_amount": 46.297, "billing_code_modifier": ["AAP1"], "providers": [{"billed_charge": 756.0, "npi": [1265438311]}]}, {"allowed_amount": 69.7188, "billing_code_modifier": ["AAP1"], "providers": [{"billed_charge": 552.0, "npi": [1265438311]}]}, {"allowed_amount": 55.8826, "billing_code_modifier": ["AAP1"], "providers": [{"billed_charge": 636.0, "npi": [1265438311]}]}, {"allowed_amount": 55.8826, "billing_code_modifier": ["AAP2"], "providers": [{"billed_charge": 636.0, "npi": [1265438311]}]}, {"allowed_amount": 46.297, "billing_code_modifier": ["AAP2"], "providers": [{"billed_charge": 756.0, "npi": [1265438311]}]}, {"allowed_amount": 60.625, "billing_code_modifier": ["AAP1"], "providers": [{"billed_charge": 600.0, "npi": [1265438311]}]}, {"allowed_amount": 51.1963, "billing_code_modifier": ["AAP3"], "providers": [{"billed_charge": 804.0, "npi": [1265438311]}]}, {"allowed_amount": 60.625, "billing_code_modifier": ["AAP2"], "providers": [{"billed_charge": 600.0, "npi": [1265438311]}]}, {"allowed_amount": 58.8952, "billing_code_modifier": ["AAP1"], "providers": [{"billed_charge": 612.0, "npi": [1265438311]}]}, {"allowed_amount": 57.3182, "billing_code_modifier": ["AAP2"], "providers": [{"billed_charge": 624.0, "npi": [1265438311]}]}, {"allowed_amount": 62.5421, "billing_code_modifier": ["AAP2"], "providers": [{"billed_charge": 588.0, "npi": [1265438311]}]}, {"allowed_amount": 76.2143, "billing_code_modifier": ["AAP2"], "providers": [{"billed_charge": 528.0, "npi": [1265438311]}]}, {"allowed_amount": 67.0471, "billing_code_modifier": ["AAP2"], "providers": [{"billed_charge": 564.0, "npi": [1265438311]}]}, {"allowed_amount": 48.5, "billing_code_modifier": ["AAP3"], "providers": [{"billed_charge": 840.0, "npi": [1265438311]}]}, {"allowed_amount": 67.0471, "billing_code_modifier": ["AAP1"], "providers": [{"billed_charge": 564.0, "npi": [1265438311]}]}, {"allowed_amount": 76.2143, "billing_code_modifier": ["AAP3"], "providers": [{"billed_charge": 648.0, "npi": [1265438311]}]}, {"allowed_amount": 72.7533, "billing_code_modifier": ["AAP1"], "providers": [{"billed_charge": 540.0, "npi": [1265438311]}]}]}]}, {"name": "Laboratory - Hematology", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0305", "description": "Laboratory", "allowed_amounts": [{"tin": {"type": "ein", "value": "751844139"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 248.29, "npi": [1265430177]}, {"billed_charge": 166.735, "npi": [1265430177]}, {"billed_charge": 175.086, "npi": [1265430177]}, {"billed_charge": 148.0054, "npi": [1265430177]}, {"billed_charge": 149.84, "npi": [1265430177]}, {"billed_charge": 146.11, "npi": [1265430177]}, {"billed_charge": 183.63, "npi": [1265430177]}, {"billed_charge": 140.91, "npi": [1265430177]}, {"billed_charge": 158.1267, "npi": [1265430177]}, {"billed_charge": 161.398, "npi": [1265430177]}, {"billed_charge": 159.615, "npi": [1265430177]}, {"billed_charge": 93.56, "npi": [1265430177]}, {"billed_charge": 233.6836, "npi": [1265430177]}]}, {"allowed_amount": 11.27, "billing_code_modifier": [""], "providers": [{"billed_charge": 183.63, "npi": [1265430177]}]}]}]}, {"name": "EKG/ECG (Electrocardiogram) - General", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0730", "description": "EKG/ECG (Electrocardiogram)", "allowed_amounts": [{"tin": {"type": "ein", "value": "751837454"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 453.2, "npi": [1447250253]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["XU"], "providers": [{"billed_charge": 453.2, "npi": [1447250253]}]}]}]}, {"name": "Emergency Room - General", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0450", "description": "Emergency Room", "allowed_amounts": [{"tin": {"type": "ein", "value": "621789402"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 308.31, "billing_code_modifier": [""], "providers": [{"billed_charge": 742.9, "npi": [1700805678]}, {"billed_charge": 749.06, "npi": [1700805678]}]}, {"allowed_amount": 222.56, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 1065.68, "npi": [1700805678]}]}, {"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 309.23, "npi": [1700805678]}]}, {"allowed_amount": 3791.1, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 4860.24, "npi": [1700805678]}]}, {"allowed_amount": 290.83, "billing_code_modifier": [""], "providers": [{"billed_charge": 1894.82, "npi": [1700805678]}]}, {"allowed_amount": 395.66, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 1724.8, "npi": [1700805678]}]}, {"allowed_amount": 863.2, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 4860.24, "npi": [1700805678]}]}, {"allowed_amount": 604.81, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 2981.44, "npi": [1700805678]}]}]}]}, {"name": "Laboratory - Chemistry", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0301", "description": "Laboratory", "allowed_amounts": [{"tin": {"type": "ein", "value": "831683025"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 40.0, "npi": [1942778824]}, {"billed_charge": 48.0, "npi": [1942778824]}, {"billed_charge": 236.0, "npi": [1942778824]}, {"billed_charge": 107.0, "npi": [1942778824]}, {"billed_charge": 31.0, "npi": [1942778824]}, {"billed_charge": 134.0, "npi": [1942778824]}, {"billed_charge": 51.0, "npi": [1942778824]}, {"billed_charge": 55.0, "npi": [1942778824]}, {"billed_charge": 84.0, "npi": [1942778824]}, {"billed_charge": 92.0, "npi": [1942778824]}, {"billed_charge": 99.0, "npi": [1942778824]}, {"billed_charge": 77.0, "npi": [1942778824]}, {"billed_charge": 296.0, "npi": [1942778824]}, {"billed_charge": 115.0, "npi": [1942778824]}]}]}]}, {"name": "Pharmacy - General", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0250", "description": "Pharmacy (also see 063x, an extension of 025x)", "allowed_amounts": [{"tin": {"type": "ein", "value": "750800628"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 2.81, "billing_code_modifier": [""], "providers": [{"billed_charge": 4.6833, "npi": [1720480627]}]}, {"allowed_amount": 12.054, "billing_code_modifier": [""], "providers": [{"billed_charge": 20.09, "npi": [1194743013]}]}, {"allowed_amount": 7.475, "billing_code_modifier": [""], "providers": [{"billed_charge": 12.4583, "npi": [1720480627]}]}, {"allowed_amount": 3.51, "billing_code_modifier": [""], "providers": [{"billed_charge": 5.85, "npi": [1194743013]}]}, {"allowed_amount": 15.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 25.0, "npi": [1194743013]}]}, {"allowed_amount": 3.72, "billing_code_modifier": [""], "providers": [{"billed_charge": 6.2, "npi": [1720480627]}]}, {"allowed_amount": 5.736, "billing_code_modifier": [""], "providers": [{"billed_charge": 9.56, "npi": [1194743013]}]}, {"allowed_amount": 35.9817, "billing_code_modifier": [""], "providers": [{"billed_charge": 59.9694, "npi": [1194743013]}]}, {"allowed_amount": 58.5283, "billing_code_modifier": [""], "providers": [{"billed_charge": 97.5472, "npi": [1194743013]}]}, {"allowed_amount": 4.14, "billing_code_modifier": [""], "providers": [{"billed_charge": 6.9, "npi": [1720480627]}, {"billed_charge": 6.9, "npi": [1194743013]}]}, {"allowed_amount": 17.3673, "billing_code_modifier": [""], "providers": [{"billed_charge": 28.9455, "npi": [1720480627]}]}, {"allowed_amount": 55.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 91.6667, "npi": [1194743013]}]}, {"allowed_amount": 3.8325, "billing_code_modifier": [""], "providers": [{"billed_charge": 6.3875, "npi": [1194743013]}]}, {"allowed_amount": 32.7, "billing_code_modifier": [""], "providers": [{"billed_charge": 54.5, "npi": [1720480627]}]}, {"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 75.0, "npi": [1194743013]}, {"billed_charge": 12.4583, "npi": [1720480627]}, {"billed_charge": 28.3929, "npi": [1194743013]}]}, {"allowed_amount": 24.48, "billing_code_modifier": [""], "providers": [{"billed_charge": 40.8, "npi": [1194743013]}]}, {"allowed_amount": 22.306, "billing_code_modifier": [""], "providers": [{"billed_charge": 37.1767, "npi": [1720480627]}]}, {"allowed_amount": 21.8365, "billing_code_modifier": [""], "providers": [{"billed_charge": 36.3941, "npi": [1194743013]}]}, {"allowed_amount": 2.785, "billing_code_modifier": [""], "providers": [{"billed_charge": 4.6417, "npi": [1194743013]}]}, {"allowed_amount": 22.7411, "billing_code_modifier": [""], "providers": [{"billed_charge": 37.9019, "npi": [1194743013]}]}, {"allowed_amount": 2.325, "billing_code_modifier": [""], "providers": [{"billed_charge": 3.875, "npi": [1720480627]}]}, {"allowed_amount": 50.4, "billing_code_modifier": [""], "providers": [{"billed_charge": 84.0, "npi": [1720480627]}]}, {"allowed_amount": 17.0357, "billing_code_modifier": [""], "providers": [{"billed_charge": 28.3929, "npi": [1194743013]}]}, {"allowed_amount": 2.2275, "billing_code_modifier": [""], "providers": [{"billed_charge": 3.7125, "npi": [1720480627]}]}, {"allowed_amount": 3.42, "billing_code_modifier": [""], "providers": [{"billed_charge": 5.7, "npi": [1720480627]}]}, {"allowed_amount": 32.43, "billing_code_modifier": [""], "providers": [{"billed_charge": 54.05, "npi": [1720480627]}]}, {"allowed_amount": 29.3775, "billing_code_modifier": [""], "providers": [{"billed_charge": 48.9625, "npi": [1194743013]}]}, {"allowed_amount": 26.3933, "billing_code_modifier": [""], "providers": [{"billed_charge": 43.9889, "npi": [1720480627]}]}, {"allowed_amount": 19.29, "billing_code_modifier": [""], "providers": [{"billed_charge": 32.15, "npi": [1194743013]}]}, {"allowed_amount": 52.12, "billing_code_modifier": [""], "providers": [{"billed_charge": 86.8667, "npi": [1194743013]}]}, {"allowed_amount": 4.11, "billing_code_modifier": [""], "providers": [{"billed_charge": 6.85, "npi": [1720480627]}]}, {"allowed_amount": 20.82, "billing_code_modifier": [""], "providers": [{"billed_charge": 34.7, "npi": [1720480627]}]}, {"allowed_amount": 3.81, "billing_code_modifier": [""], "providers": [{"billed_charge": 6.35, "npi": [1194743013]}]}, {"allowed_amount": 1.2, "billing_code_modifier": [""], "providers": [{"billed_charge": 2.0, "npi": [1720480627]}, {"billed_charge": 2.0, "npi": [1194743013]}]}, {"allowed_amount": 21.7988, "billing_code_modifier": [""], "providers": [{"billed_charge": 36.3313, "npi": [1720480627]}]}, {"allowed_amount": 4.876, "billing_code_modifier": [""], "providers": [{"billed_charge": 9.56, "npi": [1194743013]}]}, {"allowed_amount": 16.98, "billing_code_modifier": [""], "providers": [{"billed_charge": 28.3, "npi": [1720480627]}]}, {"allowed_amount": 31.32, "billing_code_modifier": [""], "providers": [{"billed_charge": 52.2, "npi": [1720480627]}]}, {"allowed_amount": 3.45, "billing_code_modifier": [""], "providers": [{"billed_charge": 5.75, "npi": [1720480627]}]}, {"allowed_amount": 22.28, "billing_code_modifier": [""], "providers": [{"billed_charge": 37.1333, "npi": [1194743013]}]}, {"allowed_amount": 13.215, "billing_code_modifier": [""], "providers": [{"billed_charge": 22.025, "npi": [1720480627]}]}, {"allowed_amount": 15.21, "billing_code_modifier": [""], "providers": [{"billed_charge": 25.35, "npi": [1720480627]}]}, {"allowed_amount": 53.9186, "billing_code_modifier": [""], "providers": [{"billed_charge": 89.8643, "npi": [1194743013]}]}, {"allowed_amount": 18.99, "billing_code_modifier": [""], "providers": [{"billed_charge": 31.65, "npi": [1194743013]}]}, {"allowed_amount": 60.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 100.0, "npi": [1194743013]}, {"billed_charge": 100.0, "npi": [1720480627]}]}, {"allowed_amount": 29.97, "billing_code_modifier": [""], "providers": [{"billed_charge": 49.95, "npi": [1720480627]}]}, {"allowed_amount": 6.6338, "billing_code_modifier": [""], "providers": [{"billed_charge": 11.0563, "npi": [1720480627]}]}, {"allowed_amount": 55.608, "billing_code_modifier": [""], "providers": [{"billed_charge": 92.68, "npi": [1194743013]}]}, {"allowed_amount": 15.72, "billing_code_modifier": [""], "providers": [{"billed_charge": 26.2, "npi": [1194743013]}]}, {"allowed_amount": 57.0825, "billing_code_modifier": [""], "providers": [{"billed_charge": 95.1375, "npi": [1194743013]}]}, {"allowed_amount": 2.5586, "billing_code_modifier": [""], "providers": [{"billed_charge": 4.2643, "npi": [1720480627]}]}, {"allowed_amount": 22.66, "billing_code_modifier": [""], "providers": [{"billed_charge": 37.7667, "npi": [1720480627]}]}, {"allowed_amount": 3.765, "billing_code_modifier": [""], "providers": [{"billed_charge": 6.275, "npi": [1720480627]}]}, {"allowed_amount": 53.8473, "billing_code_modifier": [""], "providers": [{"billed_charge": 89.7455, "npi": [1194743013]}]}, {"allowed_amount": 35.64, "billing_code_modifier": [""], "providers": [{"billed_charge": 59.4, "npi": [1720480627]}]}, {"allowed_amount": 44.0775, "billing_code_modifier": [""], "providers": [{"billed_charge": 73.4625, "npi": [1720480627]}]}, {"allowed_amount": 113.91, "billing_code_modifier": [""], "providers": [{"billed_charge": 189.85, "npi": [1720480627]}, {"billed_charge": 189.85, "npi": [1194743013]}]}, {"allowed_amount": 22.9371, "billing_code_modifier": [""], "providers": [{"billed_charge": 38.2286, "npi": [1194743013]}]}, {"allowed_amount": 83.1043, "billing_code_modifier": [""], "providers": [{"billed_charge": 138.5071, "npi": [1194743013]}]}, {"allowed_amount": 37.4175, "billing_code_modifier": [""], "providers": [{"billed_charge": 62.3625, "npi": [1720480627]}]}, {"allowed_amount": 34.6286, "billing_code_modifier": [""], "providers": [{"billed_charge": 57.7143, "npi": [1194743013]}]}, {"allowed_amount": 45.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 75.0, "npi": [1194743013]}]}, {"allowed_amount": 18.9367, "billing_code_modifier": [""], "providers": [{"billed_charge": 37.1333, "npi": [1194743013]}]}, {"allowed_amount": 48.6263, "billing_code_modifier": [""], "providers": [{"billed_charge": 81.0438, "npi": [1194743013]}]}, {"allowed_amount": 30.8365, "billing_code_modifier": [""], "providers": [{"billed_charge": 51.3941, "npi": [1194743013]}]}, {"allowed_amount": 40.18, "billing_code_modifier": [""], "providers": [{"billed_charge": 66.9667, "npi": [1194743013]}]}, {"allowed_amount": 12.75, "billing_code_modifier": [""], "providers": [{"billed_charge": 25.0, "npi": [1194743013]}]}, {"allowed_amount": 4.98, "billing_code_modifier": [""], "providers": [{"billed_charge": 8.3, "npi": [1194743013]}]}, {"allowed_amount": 37.5, "billing_code_modifier": [""], "providers": [{"billed_charge": 62.5, "npi": [1720480627]}]}, {"allowed_amount": 41.75, "billing_code_modifier": [""], "providers": [{"billed_charge": 69.5833, "npi": [1720480627]}]}, {"allowed_amount": 16.89, "billing_code_modifier": [""], "providers": [{"billed_charge": 28.15, "npi": [1720480627]}]}]}]}, {"name": "Emergency Room - General", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0450", "description": "Emergency Room", "allowed_amounts": [{"tin": {"type": "ein", "value": "824052186"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 308.31, "billing_code_modifier": [""], "providers": [{"billed_charge": 814.34, "npi": [1801826839]}, {"billed_charge": 524.33, "npi": [1801826839]}]}, {"allowed_amount": 222.56, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 782.31, "npi": [1801826839]}]}, {"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 321.2, "npi": [1801826839]}, {"billed_charge": 3879.67, "npi": [1801826839]}, {"billed_charge": 1366.97, "npi": [1801826839]}, {"billed_charge": 317.78, "npi": [1801826839]}, {"billed_charge": 361.12, "npi": [1801826839]}, {"billed_charge": 2122.8, "npi": [1801826839]}, {"billed_charge": 782.31, "npi": [1801826839]}, {"billed_charge": 392.06, "npi": [1801826839]}, {"billed_charge": 801.4, "npi": [1801826839]}]}, {"allowed_amount": 67.875, "billing_code_modifier": [""], "providers": [{"billed_charge": 317.78, "npi": [1801826839]}, {"billed_charge": 392.06, "npi": [1801826839]}]}, {"allowed_amount": 67.875, "billing_code_modifier": ["XU"], "providers": [{"billed_charge": 392.06, "npi": [1801826839]}]}, {"allowed_amount": 222.56, "billing_code_modifier": ["2527"], "providers": [{"billed_charge": 782.31, "npi": [1801826839]}]}, {"allowed_amount": 67.87, "billing_code_modifier": ["XU"], "providers": [{"billed_charge": 392.06, "npi": [1801826839]}]}, {"allowed_amount": 222.56, "billing_code_modifier": [""], "providers": [{"billed_charge": 782.31, "npi": [1801826839]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["XU"], "providers": [{"billed_charge": 392.06, "npi": [1801826839]}, {"billed_charge": 524.33, "npi": [1801826839]}]}, {"allowed_amount": 3791.1, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 3879.67, "npi": [1801826839]}]}, {"allowed_amount": 67.87, "billing_code_modifier": [""], "providers": [{"billed_charge": 317.78, "npi": [1801826839]}, {"billed_charge": 392.06, "npi": [1801826839]}]}, {"allowed_amount": 395.66, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 1283.4, "npi": [1801826839]}]}, {"allowed_amount": 308.31, "billing_code_modifier": ["XU"], "providers": [{"billed_charge": 902.11, "npi": [1801826839]}, {"billed_charge": 524.33, "npi": [1801826839]}]}, {"allowed_amount": 863.2, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 3879.67, "npi": [1801826839]}]}, {"allowed_amount": 604.81, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 2122.8, "npi": [1801826839]}]}, {"allowed_amount": 1197.29, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 4233.71, "npi": [1801826839]}]}]}]}, {"name": "Laboratory - Chemistry", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0301", "description": "Laboratory", "allowed_amounts": [{"tin": {"type": "ein", "value": "621789402"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 609.66, "npi": [1700805678]}, {"billed_charge": 752.4, "npi": [1700805678]}, {"billed_charge": 614.32, "npi": [1700805678]}, {"billed_charge": 636.05, "npi": [1700805678]}, {"billed_charge": 620.53, "npi": [1700805678]}, {"billed_charge": 406.4525, "npi": [1700805678]}, {"billed_charge": 90.0, "npi": [1700805678]}, {"billed_charge": 814.45, "npi": [1700805678]}, {"billed_charge": 44.1, "npi": [1700805678]}, {"billed_charge": 136.52, "npi": [1700805678]}, {"billed_charge": 328.89, "npi": [1700805678]}, {"billed_charge": 335.09, "npi": [1700805678]}, {"billed_charge": 429.71, "npi": [1700805678]}, {"billed_charge": 235.81, "npi": [1700805678]}, {"billed_charge": 248.21, "npi": [1700805678]}, {"billed_charge": 302.52, "npi": [1700805678]}, {"billed_charge": 1061.11, "npi": [1700805678]}, {"billed_charge": 376.99, "npi": [1700805678]}]}]}]}, {"name": "Laboratory - Hematology", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0305", "description": "Laboratory", "allowed_amounts": [{"tin": {"type": "ein", "value": "750800628"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 141.6, "billing_code_modifier": [""], "providers": [{"billed_charge": 236.0, "npi": [1720480627]}, {"billed_charge": 236.0, "npi": [1194743013]}]}, {"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 236.0, "npi": [1194743013]}, {"billed_charge": 223.0, "npi": [1194743013]}]}, {"allowed_amount": 171.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 285.0, "npi": [1720480627]}]}, {"allowed_amount": 157.8, "billing_code_modifier": [""], "providers": [{"billed_charge": 263.0, "npi": [1720480627]}]}, {"allowed_amount": 165.6, "billing_code_modifier": [""], "providers": [{"billed_charge": 276.0, "npi": [1194743013]}, {"billed_charge": 276.0, "npi": [1720480627]}]}, {"allowed_amount": 43.86, "billing_code_modifier": [""], "providers": [{"billed_charge": 86.0, "npi": [1194743013]}]}, {"allowed_amount": 140.7, "billing_code_modifier": [""], "providers": [{"billed_charge": 234.5, "npi": [1194743013]}]}, {"allowed_amount": 126.39, "billing_code_modifier": [""], "providers": [{"billed_charge": 383.0, "npi": [1194743013]}]}, {"allowed_amount": 120.36, "billing_code_modifier": [""], "providers": [{"billed_charge": 236.0, "npi": [1720480627]}]}, {"allowed_amount": 158.6809, "billing_code_modifier": [""], "providers": [{"billed_charge": 264.4681, "npi": [1194743013]}]}, {"allowed_amount": 133.8, "billing_code_modifier": [""], "providers": [{"billed_charge": 223.0, "npi": [1720480627]}, {"billed_charge": 223.0, "npi": [1194743013]}]}, {"allowed_amount": 73.2, "billing_code_modifier": [""], "providers": [{"billed_charge": 122.0, "npi": [1194743013]}]}, {"allowed_amount": 70.8, "billing_code_modifier": [""], "providers": [{"billed_charge": 118.0, "npi": [1720480627]}]}, {"allowed_amount": 40.26, "billing_code_modifier": [""], "providers": [{"billed_charge": 122.0, "npi": [1194743013]}]}, {"allowed_amount": 51.6, "billing_code_modifier": [""], "providers": [{"billed_charge": 86.0, "npi": [1194743013]}, {"billed_charge": 86.0, "npi": [1720480627]}]}, {"allowed_amount": 229.8, "billing_code_modifier": [""], "providers": [{"billed_charge": 383.0, "npi": [1194743013]}, {"billed_charge": 383.0, "npi": [1720480627]}]}, {"allowed_amount": 126.4667, "billing_code_modifier": [""], "providers": [{"billed_charge": 210.7778, "npi": [1194743013]}]}, {"allowed_amount": 195.33, "billing_code_modifier": [""], "providers": [{"billed_charge": 383.0, "npi": [1194743013]}]}]}]}, {"name": "Other Therapeutic Services - General", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0940", "description": "Other Therapeutic Services", "allowed_amounts": [{"tin": {"type": "ein", "value": "751837454"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 321.2, "npi": [1447250253]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["XU"], "providers": [{"billed_charge": 321.2, "npi": [1447250253]}]}]}]}, {"name": "CT Scan - Body Scan", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0352", "description": "CT Scan", "allowed_amounts": [{"tin": {"type": "ein", "value": "751837454"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 622.69, "billing_code_modifier": [""], "providers": [{"billed_charge": 6290.97, "npi": [1447250253]}]}, {"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 4912.095, "npi": [1447250253]}, {"billed_charge": 6417.572, "npi": [1447250253]}, {"billed_charge": 6290.97, "npi": [1447250253]}, {"billed_charge": 9294.97, "npi": [1447250253]}, {"billed_charge": 2858.93, "npi": [1447250253]}, {"billed_charge": 5896.8, "npi": [1447250253]}, {"billed_charge": 3150.74, "npi": [1447250253]}, {"billed_charge": 6090.5783, "npi": [1447250253]}, {"billed_charge": 3991.35, "npi": [1447250253]}, {"billed_charge": 3424.65, "npi": [1447250253]}, {"billed_charge": 6387.66, "npi": [1447250253]}, {"billed_charge": 5436.18, "npi": [1447250253]}, {"billed_charge": 6484.35, "npi": [1447250253]}, {"billed_charge": 2800.19, "npi": [1447250253]}, {"billed_charge": 3339.84, "npi": [1447250253]}]}, {"allowed_amount": 254.23, "billing_code_modifier": [""], "providers": [{"billed_charge": 6290.97, "npi": [1447250253]}, {"billed_charge": 3339.84, "npi": [1447250253]}]}, {"allowed_amount": 345.85, "billing_code_modifier": [""], "providers": [{"billed_charge": 5896.8, "npi": [1447250253]}]}, {"allowed_amount": 505.67, "billing_code_modifier": [""], "providers": [{"billed_charge": 9294.97, "npi": [1447250253]}, {"billed_charge": 6484.35, "npi": [1447250253]}]}]}]}, {"name": "Laboratory - Bacteriology & Microbiology", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0306", "description": "Laboratory", "allowed_amounts": [{"tin": {"type": "ein", "value": "472177648"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 1013.0, "npi": [1790174860]}, {"billed_charge": 298.73, "npi": [1790174860]}, {"billed_charge": 465.0, "npi": [1790174860]}, {"billed_charge": 181.0, "npi": [1790174860]}, {"billed_charge": 642.9125, "npi": [1790174860]}, {"billed_charge": 707.2633, "npi": [1790174860]}, {"billed_charge": 420.0127, "npi": [1790174860]}, {"billed_charge": 728.4033, "npi": [1790174860]}, {"billed_charge": 1929.0, "npi": [1790174860]}, {"billed_charge": 587.0, "npi": [1790174860]}, {"billed_charge": 514.0, "npi": [1790174860]}, {"billed_charge": 375.0, "npi": [1790174860]}, {"billed_charge": 434.0, "npi": [1790174860]}, {"billed_charge": 429.5667, "npi": [1790174860]}, {"billed_charge": 641.57, "npi": [1790174860]}, {"billed_charge": 470.98, "npi": [1790174860]}, {"billed_charge": 553.85, "npi": [1790174860]}, {"billed_charge": 200.0, "npi": [1790174860]}]}, {"allowed_amount": 108.25, "billing_code_modifier": [""], "providers": [{"billed_charge": 298.73, "npi": [1790174860]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["59"], "providers": [{"billed_charge": 641.57, "npi": [1790174860]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["91"], "providers": [{"billed_charge": 514.0, "npi": [1790174860]}]}, {"allowed_amount": 101.92, "billing_code_modifier": [""], "providers": [{"billed_charge": 298.73, "npi": [1790174860]}]}]}]}, {"name": "BLS ROUTINE DISPOSABLE SUPPLIES", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "A0382", "description": "BLS ROUTINE DISPOSABLE SUPPLIES", "allowed_amounts": [{"tin": {"type": "ein", "value": "300688582"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": ["HE"], "providers": [{"billed_charge": 182.0, "npi": [1750676870]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["HH"], "providers": [{"billed_charge": 182.0, "npi": [1750676870]}, {"billed_charge": 50.0, "npi": [1750676870]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["HD"], "providers": [{"billed_charge": 182.0, "npi": [1750676870]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["PE"], "providers": [{"billed_charge": 182.0, "npi": [1750676870]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["EP"], "providers": [{"billed_charge": 182.0, "npi": [1750676870]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["HR"], "providers": [{"billed_charge": 182.0, "npi": [1750676870]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["EH"], "providers": [{"billed_charge": 182.0, "npi": [1750676870]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["HRGY"], "providers": [{"billed_charge": 182.0, "npi": [1750676870]}]}]}]}, {"name": "ALCOHL  AND OR RX SRVC; METHADONE ADMIN  AND OR SERVICE", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "H0020", "description": "ALCOHL  AND OR RX SRVC; METHADONE ADMIN  AND OR SERVICE", "allowed_amounts": [{"tin": {"type": "ein", "value": "204680462"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 9.84, "billing_code_modifier": ["U1"], "providers": [{"billed_charge": 9.84, "npi": [1992966584]}]}, {"allowed_amount": 18.84, "billing_code_modifier": ["UA"], "providers": [{"billed_charge": 18.84, "npi": [1992966584]}]}]}]}, {"name": "Laboratory - Bacteriology & Microbiology", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0306", "description": "Laboratory", "allowed_amounts": [{"tin": {"type": "ein", "value": "751844139"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 206.81, "billing_code_modifier": [""], "providers": [{"billed_charge": 174.88, "npi": [1265430177]}]}, {"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 125.99, "npi": [1265430177]}, {"billed_charge": 102.41, "npi": [1265430177]}, {"billed_charge": 215.5, "npi": [1265430177]}, {"billed_charge": 17.0, "npi": [1265430177]}, {"billed_charge": 358.64, "npi": [1265430177]}, {"billed_charge": 272.5425, "npi": [1265430177]}, {"billed_charge": 546.59, "npi": [1265430177]}, {"billed_charge": 173.2582, "npi": [1265430177]}, {"billed_charge": 340.52, "npi": [1265430177]}]}, {"allowed_amount": 148.49, "billing_code_modifier": [""], "providers": [{"billed_charge": 102.41, "npi": [1265430177]}]}]}]}, {"name": "Laboratory - General", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0300", "description": "Laboratory", "allowed_amounts": [{"tin": {"type": "ein", "value": "820551704"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 115.997, "npi": [1649273434]}, {"billed_charge": 82.8806, "npi": [1649273434]}, {"billed_charge": 147.7567, "npi": [1649273434]}, {"billed_charge": 51.86, "npi": [1649273434]}, {"billed_charge": 211.0, "npi": [1649273434]}, {"billed_charge": 392.86, "npi": [1649273434]}, {"billed_charge": 162.7867, "npi": [1649273434]}, {"billed_charge": 47.75, "npi": [1649273434]}, {"billed_charge": 40.0, "npi": [1649273434]}]}]}]}, {"name": "Emergency Room - General", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0450", "description": "Emergency Room", "allowed_amounts": [{"tin": {"type": "ein", "value": "751748586"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 67.99, "billing_code_modifier": ["59"], "providers": [{"billed_charge": 333.25, "npi": [1508899204]}]}, {"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 254.75, "npi": [1508899204]}, {"billed_charge": 577.1667, "npi": [1508899204]}, {"billed_charge": 333.25, "npi": [1508899204]}]}, {"allowed_amount": 308.82, "billing_code_modifier": ["59"], "providers": [{"billed_charge": 333.25, "npi": [1508899204]}]}, {"allowed_amount": 396.31, "billing_code_modifier": [""], "providers": [{"billed_charge": 1042.5, "npi": [1508899204]}]}, {"allowed_amount": 864.64, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 2758.25, "npi": [1508899204]}]}, {"allowed_amount": 864.64, "billing_code_modifier": ["2527"], "providers": [{"billed_charge": 2758.25, "npi": [1508899204]}]}, {"allowed_amount": 605.81, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 1521.25, "npi": [1508899204]}]}, {"allowed_amount": 396.31, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 1042.5, "npi": [1508899204]}]}, {"allowed_amount": 222.92, "billing_code_modifier": [""], "providers": [{"billed_charge": 537.75, "npi": [1508899204]}]}, {"allowed_amount": 67.99, "billing_code_modifier": [""], "providers": [{"billed_charge": 103.5, "npi": [1508899204]}, {"billed_charge": 333.25, "npi": [1508899204]}]}, {"allowed_amount": 308.82, "billing_code_modifier": [""], "providers": [{"billed_charge": 779.25, "npi": [1508899204]}, {"billed_charge": 333.25, "npi": [1508899204]}]}]}]}, {"name": "Laboratory - Urology", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0307", "description": "Laboratory", "allowed_amounts": [{"tin": {"type": "ein", "value": "751037591"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 83.58, "npi": [1124305065]}, {"billed_charge": 129.78, "npi": [1124305065]}, {"billed_charge": 162.16, "npi": [1124305065]}]}]}]}, {"name": "Laboratory - General", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0300", "description": "Laboratory", "allowed_amounts": [{"tin": {"type": "ein", "value": "751047527"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 91.2188, "npi": [1396779948]}, {"billed_charge": 275.3333, "npi": [1396779948]}, {"billed_charge": 68.0, "npi": [1396779948]}, {"billed_charge": 286.75, "npi": [1396779948]}, {"billed_charge": 384.75, "npi": [1396779948]}, {"billed_charge": 307.65, "npi": [1396779948]}, {"billed_charge": 141.5833, "npi": [1396779948]}, {"billed_charge": 127.5625, "npi": [1396779948]}, {"billed_charge": 41.5, "npi": [1396779948]}, {"billed_charge": 341.75, "npi": [1396779948]}, {"billed_charge": 512.1667, "npi": [1396779948]}]}]}]}, {"name": "ALCOHL  AND OR RX SRVC; METHADONE ADMIN  AND OR SERVICE", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "H0020", "description": "ALCOHL  AND OR RX SRVC; METHADONE ADMIN  AND OR SERVICE", "allowed_amounts": [{"tin": {"type": "ein", "value": "274250532"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 9.84, "billing_code_modifier": ["U1"], "providers": [{"billed_charge": 9.84, "npi": [1770781106]}]}]}]}, {"name": "Pharmacy - Extension of 25X - Drug Requiring Detailed Coding", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0636", "description": "Pharmacy - Extension of 25x", "allowed_amounts": [{"tin": {"type": "ein", "value": "756001743"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 10.0, "npi": [1336172105]}, {"billed_charge": 1.284, "npi": [1336172105]}, {"billed_charge": 9.375, "npi": [1336172105]}, {"billed_charge": 25.0, "npi": [1336172105]}, {"billed_charge": 3.5164, "npi": [1336172105]}, {"billed_charge": 0.8572, "npi": [1336172105]}, {"billed_charge": 163.8, "npi": [1336172105]}, {"billed_charge": 24.24, "npi": [1336172105]}, {"billed_charge": 2.7452, "npi": [1336172105]}, {"billed_charge": 24.81, "npi": [1336172105]}, {"billed_charge": 4.4672, "npi": [1336172105]}, {"billed_charge": 50.0, "npi": [1336172105]}, {"billed_charge": 3.9175, "npi": [1336172105]}, {"billed_charge": 0.125, "npi": [1336172105]}, {"billed_charge": 12.5, "npi": [1336172105]}, {"billed_charge": 2.5, "npi": [1336172105]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["U8JZ"], "providers": [{"billed_charge": 0.5, "npi": [1336172105]}, {"billed_charge": 1.7867, "npi": [1336172105]}, {"billed_charge": 0.0407, "npi": [1336172105]}, {"billed_charge": 3.2451, "npi": [1336172105]}, {"billed_charge": 5.0, "npi": [1336172105]}, {"billed_charge": 9.0, "npi": [1336172105]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["U8JW"], "providers": [{"billed_charge": 9.0, "npi": [1336172105]}]}, {"allowed_amount": 0.48, "billing_code_modifier": ["TBU8JZ"], "providers": [{"billed_charge": 13.73, "npi": [1336172105]}, {"billed_charge": 17.1, "npi": [1336172105]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["U8"], "providers": [{"billed_charge": 10.0, "npi": [1336172105]}, {"billed_charge": 0.3584, "npi": [1336172105]}, {"billed_charge": 11.3125, "npi": [1336172105]}, {"billed_charge": 12.89, "npi": [1336172105]}, {"billed_charge": 0.1319, "npi": [1336172105]}, {"billed_charge": 6.25, "npi": [1336172105]}, {"billed_charge": 1.575, "npi": [1336172105]}, {"billed_charge": 5.1933, "npi": [1336172105]}, {"billed_charge": 0.146, "npi": [1336172105]}, {"billed_charge": 181.34, "npi": [1336172105]}, {"billed_charge": 2.025, "npi": [1336172105]}, {"billed_charge": 163.8, "npi": [1336172105]}, {"billed_charge": 37.62, "npi": [1336172105]}, {"billed_charge": 1.368, "npi": [1336172105]}, {"billed_charge": 0.21, "npi": [1336172105]}, {"billed_charge": 3.42, "npi": [1336172105]}, {"billed_charge": 50.0, "npi": [1336172105]}, {"billed_charge": 0.125, "npi": [1336172105]}, {"billed_charge": 12.5, "npi": [1336172105]}, {"billed_charge": 718.13, "npi": [1336172105]}, {"billed_charge": 9.0, "npi": [1336172105]}, {"billed_charge": 3.99, "npi": [1336172105]}, {"billed_charge": 0.1, "npi": [1336172105]}, {"billed_charge": 2.5, "npi": [1336172105]}, {"billed_charge": 9.9538, "npi": [1336172105]}, {"billed_charge": 12.8, "npi": [1336172105]}]}, {"allowed_amount": 0.49, "billing_code_modifier": ["U8JZ"], "providers": [{"billed_charge": 17.1, "npi": [1336172105]}]}, {"allowed_amount": 0.48, "billing_code_modifier": ["U8JZ"], "providers": [{"billed_charge": 17.1, "npi": [1336172105]}, {"billed_charge": 13.72, "npi": [1336172105]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["JZ"], "providers": [{"billed_charge": 0.5, "npi": [1336172105]}, {"billed_charge": 1.9004, "npi": [1336172105]}, {"billed_charge": 9.0, "npi": [1336172105]}]}, {"allowed_amount": 0.49, "billing_code_modifier": ["TBU8JZ"], "providers": [{"billed_charge": 17.1, "npi": [1336172105]}]}]}]}, {"name": "DOPPLER VELOCIMETRY FETAL UMBILICAL ARTERY", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "76820", "description": "DOPPLER VELOCIMETRY FETAL UMBILICAL ARTERY", "allowed_amounts": [{"tin": {"type": "ein", "value": "270393689"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 28.88, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 82.0, "npi": [1083969299]}]}, {"allowed_amount": 28.88, "billing_code_modifier": ["5926"], "providers": [{"billed_charge": 82.0, "npi": [1083969299]}]}]}]}, {"name": "Laboratory - Chemistry", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0301", "description": "Laboratory", "allowed_amounts": [{"tin": {"type": "ein", "value": "451502252"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 442.5, "npi": [1215296884]}, {"billed_charge": 231.0, "npi": [1215296884]}, {"billed_charge": 229.25, "npi": [1215296884]}, {"billed_charge": 153.5, "npi": [1215296884]}, {"billed_charge": 421.25, "npi": [1215296884]}, {"billed_charge": 133.0, "npi": [1215296884]}, {"billed_charge": 335.75, "npi": [1215296884]}, {"billed_charge": 225.75, "npi": [1215296884]}, {"billed_charge": 679.25, "npi": [1215296884]}, {"billed_charge": 138.0577, "npi": [1215296884]}, {"billed_charge": 671.0, "npi": [1215296884]}, {"billed_charge": 278.25, "npi": [1215296884]}, {"billed_charge": 377.75, "npi": [1215296884]}, {"billed_charge": 324.5, "npi": [1215296884]}, {"billed_charge": 340.0, "npi": [1215296884]}, {"billed_charge": 348.5, "npi": [1215296884]}, {"billed_charge": 129.5, "npi": [1215296884]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["91"], "providers": [{"billed_charge": 335.75, "npi": [1215296884]}]}]}]}, {"name": "AMBULANCE SERVICE BLS EMERGENCY TRANSPORT", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "A0429", "description": "AMBULANCE SERVICE BLS EMERGENCY TRANSPORT", "allowed_amounts": [{"tin": {"type": "ein", "value": "756000508"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 1473.0, "billing_code_modifier": ["ETRH"], "providers": [{"billed_charge": 1473.0, "npi": [1861530990]}]}, {"allowed_amount": 1473.0, "billing_code_modifier": ["SH"], "providers": [{"billed_charge": 1473.0, "npi": [1861530990]}]}, {"allowed_amount": 1475.25, "billing_code_modifier": ["RH"], "providers": [{"billed_charge": 1475.25, "npi": [1861530990]}]}, {"allowed_amount": 1480.0, "billing_code_modifier": ["SH"], "providers": [{"billed_charge": 1480.0, "npi": [1861530990]}]}, {"allowed_amount": 1475.25, "billing_code_modifier": ["EH"], "providers": [{"billed_charge": 1475.25, "npi": [1861530990]}]}, {"allowed_amount": 1505.08, "billing_code_modifier": ["RH"], "providers": [{"billed_charge": 1531.2, "npi": [1861530990]}, {"billed_charge": 1870.25, "npi": [1861530990]}, {"billed_charge": 1516.69, "npi": [1861530990]}, {"billed_charge": 1868.0, "npi": [1861530990]}]}, {"allowed_amount": 1455.42, "billing_code_modifier": ["SH"], "providers": [{"billed_charge": 1868.0, "npi": [1861530990]}]}, {"allowed_amount": 1475.25, "billing_code_modifier": ["SH"], "providers": [{"billed_charge": 1475.25, "npi": [1861530990]}]}, {"allowed_amount": 1473.0, "billing_code_modifier": ["RH"], "providers": [{"billed_charge": 1473.0, "npi": [1861530990]}]}, {"allowed_amount": 1505.08, "billing_code_modifier": ["PH"], "providers": [{"billed_charge": 1870.25, "npi": [1861530990]}]}, {"allowed_amount": 125.0, "billing_code_modifier": ["ETRW"], "providers": [{"billed_charge": 125.0, "npi": [1861530990]}]}, {"allowed_amount": 1505.08, "billing_code_modifier": ["SH"], "providers": [{"billed_charge": 1509.22, "npi": [1861530990]}, {"billed_charge": 1870.25, "npi": [1861530990]}, {"billed_charge": 1516.69, "npi": [1861530990]}, {"billed_charge": 1868.0, "npi": [1861530990]}, {"billed_charge": 1911.69, "npi": [1861530990]}]}, {"allowed_amount": 1473.0, "billing_code_modifier": ["JH"], "providers": [{"billed_charge": 1473.0, "npi": [1861530990]}]}]}]}, {"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": "752770738"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 35.446, "npi": [1770514077]}, {"billed_charge": 22.3953, "npi": [1770514077]}, {"billed_charge": 40.4114, "npi": [1770514077]}, {"billed_charge": 15.55, "npi": [1770514077]}, {"billed_charge": 48.3077, "npi": [1770514077]}, {"billed_charge": 17.4286, "npi": [1770514077]}, {"billed_charge": 12.0, "npi": [1770514077]}, {"billed_charge": 10.0, "npi": [1770514077]}]}]}]}, {"name": "Pharmacy - General", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0250", "description": "Pharmacy (also see 063x, an extension of 025x)", "allowed_amounts": [{"tin": {"type": "ein", "value": "750972805"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 2.276, "npi": [1174533343]}, {"billed_charge": 6.62, "npi": [1174533343]}, {"billed_charge": 3.1741, "npi": [1174533343]}, {"billed_charge": 4.7402, "npi": [1174533343]}, {"billed_charge": 0.5833, "npi": [1174533343]}, {"billed_charge": 1.0, "npi": [1174533343]}, {"billed_charge": 3.795, "npi": [1174533343]}, {"billed_charge": 1.3225, "npi": [1174533343]}, {"billed_charge": 1.6672, "npi": [1174533343]}, {"billed_charge": 4.145, "npi": [1174533343]}, {"billed_charge": 0.25, "npi": [1174533343]}, {"billed_charge": 1.36, "npi": [1174533343]}, {"billed_charge": 7.35, "npi": [1174533343]}, {"billed_charge": 1.6274, "npi": [1174533343]}, {"billed_charge": 2.0, "npi": [1174533343]}, {"billed_charge": 0.55, "npi": [1174533343]}, {"billed_charge": 1.6667, "npi": [1174533343]}, {"billed_charge": 1.7362, "npi": [1174533343]}, {"billed_charge": 1.4736, "npi": [1174533343]}]}]}]}, {"name": "Radiology - Diagnostic - General", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0320", "description": "Radiology - Diagnostic", "allowed_amounts": [{"tin": {"type": "ein", "value": "752586857"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 151.54, "billing_code_modifier": [""], "providers": [{"billed_charge": 909.4, "npi": [1992700983]}]}, {"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 464.28, "npi": [1992700983]}, {"billed_charge": 562.56, "npi": [1992700983]}, {"billed_charge": 697.72, "npi": [1992700983]}, {"billed_charge": 412.73, "npi": [1992700983]}, {"billed_charge": 542.99, "npi": [1992700983]}, {"billed_charge": 726.93, "npi": [1992700983]}, {"billed_charge": 271.22, "npi": [1992700983]}, {"billed_charge": 521.34, "npi": [1992700983]}, {"billed_charge": 451.4, "npi": [1992700983]}, {"billed_charge": 1007.06, "npi": [1992700983]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["RT"], "providers": [{"billed_charge": 511.46, "npi": [1992700983]}, {"billed_charge": 529.64, "npi": [1992700983]}, {"billed_charge": 455.33, "npi": [1992700983]}, {"billed_charge": 608.85, "npi": [1992700983]}, {"billed_charge": 363.38, "npi": [1992700983]}, {"billed_charge": 515.76, "npi": [1992700983]}, {"billed_charge": 532.06, "npi": [1992700983]}, {"billed_charge": 529.37, "npi": [1992700983]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["50"], "providers": [{"billed_charge": 766.19, "npi": [1992700983]}, {"billed_charge": 767.19, "npi": [1992700983]}, {"billed_charge": 683.0, "npi": [1992700983]}, {"billed_charge": 794.06, "npi": [1992700983]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["LT"], "providers": [{"billed_charge": 511.46, "npi": [1992700983]}, {"billed_charge": 484.07, "npi": [1992700983]}, {"billed_charge": 515.52, "npi": [1992700983]}, {"billed_charge": 493.74, "npi": [1992700983]}, {"billed_charge": 455.33, "npi": [1992700983]}, {"billed_charge": 493.42, "npi": [1992700983]}, {"billed_charge": 529.37, "npi": [1992700983]}]}]}]}, {"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": "751664109"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 42.12, "billing_code_modifier": ["2659"], "providers": [{"billed_charge": 210.0, "npi": [1508346370]}]}, {"allowed_amount": 42.12, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 210.0, "npi": [1508346370]}]}]}]}, {"name": "INFUS SPL EXT RX INFUS PUMP CASSETTE/BAG", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "A4222", "description": "INFUS SPL EXT RX INFUS PUMP CASSETTE/BAG", "allowed_amounts": [{"tin": {"type": "ein", "value": "853503076"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 368.99, "npi": [1124623889]}]}]}]}, {"name": "EKG/ECG (Electrocardiogram) - General", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0730", "description": "EKG/ECG (Electrocardiogram)", "allowed_amounts": [{"tin": {"type": "ein", "value": "756001743"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 356.0, "npi": [1336172105]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["59"], "providers": [{"billed_charge": 356.0, "npi": [1336172105]}]}]}]}, {"name": "Pharmacy - Extension of 25X - Drug Requiring Detailed Coding", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0636", "description": "Pharmacy - Extension of 25x", "allowed_amounts": [{"tin": {"type": "ein", "value": "752586857"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.49, "billing_code_modifier": [""], "providers": [{"billed_charge": 4.56, "npi": [1992700983]}, {"billed_charge": 2.76, "npi": [1992700983]}, {"billed_charge": 3.68, "npi": [1992700983]}, {"billed_charge": 1.93, "npi": [1992700983]}, {"billed_charge": 5.25, "npi": [1992700983]}]}, {"allowed_amount": 0.49, "billing_code_modifier": ["JZ"], "providers": [{"billed_charge": 5.25, "npi": [1992700983]}]}, {"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 18.565, "npi": [1992700983]}, {"billed_charge": 21.35, "npi": [1992700983]}, {"billed_charge": 9.75, "npi": [1992700983]}, {"billed_charge": 31.55, "npi": [1992700983]}, {"billed_charge": 5.762, "npi": [1992700983]}, {"billed_charge": 18.77, "npi": [1992700983]}, {"billed_charge": 10.592, "npi": [1992700983]}, {"billed_charge": 0.42, "npi": [1992700983]}, {"billed_charge": 0.73, "npi": [1992700983]}, {"billed_charge": 20.98, "npi": [1992700983]}, {"billed_charge": 3.535, "npi": [1992700983]}, {"billed_charge": 42.0, "npi": [1992700983]}, {"billed_charge": 0.708, "npi": [1992700983]}, {"billed_charge": 23.22, "npi": [1992700983]}, {"billed_charge": 17.49, "npi": [1992700983]}, {"billed_charge": 19.275, "npi": [1992700983]}, {"billed_charge": 0.5503, "npi": [1992700983]}, {"billed_charge": 3.54, "npi": [1992700983]}, {"billed_charge": 1.8, "npi": [1992700983]}, {"billed_charge": 276.85, "npi": [1992700983]}, {"billed_charge": 31.8, "npi": [1992700983]}, {"billed_charge": 0.1326, "npi": [1992700983]}, {"billed_charge": 0.1488, "npi": [1992700983]}, {"billed_charge": 29.85, "npi": [1992700983]}, {"billed_charge": 7.162, "npi": [1992700983]}, {"billed_charge": 19.26, "npi": [1992700983]}, {"billed_charge": 5.395, "npi": [1992700983]}, {"billed_charge": 4.32, "npi": [1992700983]}, {"billed_charge": 11.9667, "npi": [1992700983]}, {"billed_charge": 73.83, "npi": [1992700983]}, {"billed_charge": 0.4716, "npi": [1992700983]}, {"billed_charge": 1.08, "npi": [1992700983]}, {"billed_charge": 6.36, "npi": [1992700983]}, {"billed_charge": 23.03, "npi": [1992700983]}, {"billed_charge": 1.296, "npi": [1992700983]}, {"billed_charge": 1.35, "npi": [1992700983]}, {"billed_charge": 15.24, "npi": [1992700983]}, {"billed_charge": 7.2191, "npi": [1992700983]}, {"billed_charge": 2.5361, "npi": [1992700983]}, {"billed_charge": 3.8938, "npi": [1992700983]}, {"billed_charge": 5.28, "npi": [1992700983]}, {"billed_charge": 17.82, "npi": [1992700983]}, {"billed_charge": 11.41, "npi": [1992700983]}, {"billed_charge": 0.5004, "npi": [1992700983]}, {"billed_charge": 6.0, "npi": [1992700983]}, {"billed_charge": 10.2, "npi": [1992700983]}, {"billed_charge": 16.44, "npi": [1992700983]}, {"billed_charge": 21.36, "npi": [1992700983]}, {"billed_charge": 173.53, "npi": [1992700983]}, {"billed_charge": 13.49, "npi": [1992700983]}, {"billed_charge": 1.6891, "npi": [1992700983]}, {"billed_charge": 7.688, "npi": [1992700983]}, {"billed_charge": 0.3375, "npi": [1992700983]}, {"billed_charge": 1.6471, "npi": [1992700983]}, {"billed_charge": 3.215, "npi": [1992700983]}, {"billed_charge": 0.0173, "npi": [1992700983]}, {"billed_charge": 10.3335, "npi": [1992700983]}, {"billed_charge": 18.06, "npi": [1992700983]}, {"billed_charge": 2.68, "npi": [1992700983]}, {"billed_charge": 10.49, "npi": [1992700983]}, {"billed_charge": 0.0756, "npi": [1992700983]}, {"billed_charge": 2.12, "npi": [1992700983]}, {"billed_charge": 17.925, "npi": [1992700983]}, {"billed_charge": 3.74, "npi": [1992700983]}, {"billed_charge": 20.11, "npi": [1992700983]}, {"billed_charge": 1.305, "npi": [1992700983]}, {"billed_charge": 0.2952, "npi": [1992700983]}, {"billed_charge": 0.0198, "npi": [1992700983]}, {"billed_charge": 12.52, "npi": [1992700983]}, {"billed_charge": 8.1438, "npi": [1992700983]}, {"billed_charge": 40.96, "npi": [1992700983]}, {"billed_charge": 6.33, "npi": [1992700983]}, {"billed_charge": 2.54, "npi": [1992700983]}]}, {"allowed_amount": 0.485, "billing_code_modifier": ["JZ"], "providers": [{"billed_charge": 4.56, "npi": [1992700983]}, {"billed_charge": 2.76, "npi": [1992700983]}, {"billed_charge": 5.25, "npi": [1992700983]}]}, {"allowed_amount": 0.49, "billing_code_modifier": ["JW"], "providers": [{"billed_charge": 4.56, "npi": [1992700983]}, {"billed_charge": 6.83, "npi": [1992700983]}, {"billed_charge": 2.76, "npi": [1992700983]}, {"billed_charge": 3.59, "npi": [1992700983]}, {"billed_charge": 5.25, "npi": [1992700983]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["JZU8"], "providers": [{"billed_charge": 1.8545, "npi": [1992700983]}]}, {"allowed_amount": 0.495, "billing_code_modifier": ["JZ"], "providers": [{"billed_charge": 5.25, "npi": [1992700983]}, {"billed_charge": 14.97, "npi": [1992700983]}]}, {"allowed_amount": 0.48, "billing_code_modifier": [""], "providers": [{"billed_charge": 17.1, "npi": [1992700983]}, {"billed_charge": 4.56, "npi": [1992700983]}, {"billed_charge": 3.19, "npi": [1992700983]}, {"billed_charge": 2.76, "npi": [1992700983]}, {"billed_charge": 1.93, "npi": [1992700983]}, {"billed_charge": 4.69, "npi": [1992700983]}]}, {"allowed_amount": 0.48, "billing_code_modifier": ["JZ"], "providers": [{"billed_charge": 3.68, "npi": [1992700983]}, {"billed_charge": 5.25, "npi": [1992700983]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["JZ"], "providers": [{"billed_charge": 4.8, "npi": [1992700983]}, {"billed_charge": 43.3825, "npi": [1992700983]}, {"billed_charge": 24.176, "npi": [1992700983]}, {"billed_charge": 4.32, "npi": [1992700983]}, {"billed_charge": 0.0675, "npi": [1992700983]}, {"billed_charge": 0.75, "npi": [1992700983]}, {"billed_charge": 272.375, "npi": [1992700983]}, {"billed_charge": 0.4594, "npi": [1992700983]}, {"billed_charge": 0.3068, "npi": [1992700983]}, {"billed_charge": 11.41, "npi": [1992700983]}, {"billed_charge": 1.772, "npi": [1992700983]}, {"billed_charge": 5.7, "npi": [1992700983]}, {"billed_charge": 1.925, "npi": [1992700983]}, {"billed_charge": 1.165, "npi": [1992700983]}, {"billed_charge": 9.03, "npi": [1992700983]}, {"billed_charge": 14.52, "npi": [1992700983]}, {"billed_charge": 29.04, "npi": [1992700983]}, {"billed_charge": 11.55, "npi": [1992700983]}, {"billed_charge": 1.1638, "npi": [1992700983]}, {"billed_charge": 1.02, "npi": [1992700983]}, {"billed_charge": 3.52, "npi": [1992700983]}, {"billed_charge": 0.0714, "npi": [1992700983]}, {"billed_charge": 54.0, "npi": [1992700983]}, {"billed_charge": 2.5004, "npi": [1992700983]}, {"billed_charge": 0.5098, "npi": [1992700983]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["JW"], "providers": [{"billed_charge": 1.8, "npi": [1992700983]}, {"billed_charge": 4.32, "npi": [1992700983]}, {"billed_charge": 1.08, "npi": [1992700983]}, {"billed_charge": 0.3505, "npi": [1992700983]}]}, {"allowed_amount": 0.48, "billing_code_modifier": ["JW"], "providers": [{"billed_charge": 17.1, "npi": [1992700983]}, {"billed_charge": 4.56, "npi": [1992700983]}, {"billed_charge": 2.76, "npi": [1992700983]}, {"billed_charge": 3.59, "npi": [1992700983]}, {"billed_charge": 5.93, "npi": [1992700983]}, {"billed_charge": 4.69, "npi": [1992700983]}]}]}]}, {"name": "Laboratory - Chemistry", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0301", "description": "Laboratory", "allowed_amounts": [{"tin": {"type": "ein", "value": "751037591"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 302.19, "npi": [1851108765]}, {"billed_charge": 249.74, "npi": [1851108765]}, {"billed_charge": 249.74, "npi": [1124305065]}, {"billed_charge": 196.68, "npi": [1851108765]}, {"billed_charge": 459.04, "npi": [1124305065]}, {"billed_charge": 407.22, "npi": [1851108765]}, {"billed_charge": 243.23, "npi": [1124305065]}, {"billed_charge": 229.02, "npi": [1124305065]}, {"billed_charge": 56.6, "npi": [1124305065]}, {"billed_charge": 217.7, "npi": [1124305065]}, {"billed_charge": 159.62, "npi": [1124305065]}, {"billed_charge": 96.466, "npi": [1124305065]}, {"billed_charge": 324.88, "npi": [1124305065]}, {"billed_charge": 217.7, "npi": [1851108765]}, {"billed_charge": 229.02, "npi": [1851108765]}, {"billed_charge": 306.86, "npi": [1124305065]}, {"billed_charge": 153.91, "npi": [1124305065]}, {"billed_charge": 375.8309, "npi": [1851108765]}, {"billed_charge": 67.975, "npi": [1124305065]}, {"billed_charge": 306.86, "npi": [1851108765]}, {"billed_charge": 121.9275, "npi": [1124305065]}, {"billed_charge": 304.35, "npi": [1124305065]}, {"billed_charge": 285.79, "npi": [1851108765]}, {"billed_charge": 185.85, "npi": [1124305065]}, {"billed_charge": 143.701, "npi": [1124305065]}, {"billed_charge": 153.91, "npi": [1851108765]}, {"billed_charge": 285.79, "npi": [1124305065]}, {"billed_charge": 56.6, "npi": [1851108765]}, {"billed_charge": 257.747, "npi": [1124305065]}, {"billed_charge": 407.22, "npi": [1124305065]}]}, {"allowed_amount": 19.42, "billing_code_modifier": [""], "providers": [{"billed_charge": 328.07, "npi": [1124305065]}]}]}]}, {"name": "IV Therapy -General", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0260", "description": "IV Therapy", "allowed_amounts": [{"tin": {"type": "ein", "value": "452694620"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 422.516, "npi": [1033120423]}, {"billed_charge": 385.5, "npi": [1033120423]}, {"billed_charge": 431.77, "npi": [1033120423]}, {"billed_charge": 367.6933, "npi": [1033120423]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["XU"], "providers": [{"billed_charge": 945.65, "npi": [1033120423]}, {"billed_charge": 431.77, "npi": [1033120423]}, {"billed_charge": 319.34, "npi": [1033120423]}]}, {"allowed_amount": 67.99, "billing_code_modifier": ["XU"], "providers": [{"billed_charge": 285.81, "npi": [1033120423]}, {"billed_charge": 431.77, "npi": [1033120423]}]}, {"allowed_amount": 308.82, "billing_code_modifier": ["XU"], "providers": [{"billed_charge": 385.5, "npi": [1033120423]}]}, {"allowed_amount": 67.99, "billing_code_modifier": [""], "providers": [{"billed_charge": 285.81, "npi": [1033120423]}, {"billed_charge": 431.77, "npi": [1033120423]}]}, {"allowed_amount": 308.82, "billing_code_modifier": [""], "providers": [{"billed_charge": 862.59, "npi": [1033120423]}, {"billed_charge": 385.5, "npi": [1033120423]}]}]}]}, {"name": "Pharmacy - General", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0250", "description": "Pharmacy (also see 063x, an extension of 025x)", "allowed_amounts": [{"tin": {"type": "ein", "value": "472177648"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 0.8, "npi": [1790174860]}, {"billed_charge": 7.8098, "npi": [1790174860]}, {"billed_charge": 9.2469, "npi": [1790174860]}, {"billed_charge": 7.2126, "npi": [1790174860]}, {"billed_charge": 5.1833, "npi": [1790174860]}, {"billed_charge": 22.1, "npi": [1790174860]}, {"billed_charge": 2.0847, "npi": [1790174860]}, {"billed_charge": 7.3, "npi": [1790174860]}, {"billed_charge": 8.0067, "npi": [1790174860]}, {"billed_charge": 11.6, "npi": [1790174860]}, {"billed_charge": 5.123, "npi": [1790174860]}, {"billed_charge": 30.0, "npi": [1790174860]}, {"billed_charge": 2.4805, "npi": [1790174860]}, {"billed_charge": 12.84, "npi": [1790174860]}, {"billed_charge": 587.5, "npi": [1790174860]}, {"billed_charge": 104.3, "npi": [1790174860]}, {"billed_charge": 0.4, "npi": [1790174860]}, {"billed_charge": 28.95, "npi": [1790174860]}, {"billed_charge": 220.4, "npi": [1790174860]}, {"billed_charge": 4.6389, "npi": [1790174860]}, {"billed_charge": 34.0, "npi": [1790174860]}, {"billed_charge": 25.7, "npi": [1790174860]}, {"billed_charge": 2.1248, "npi": [1790174860]}, {"billed_charge": 0.3, "npi": [1790174860]}, {"billed_charge": 6.5596, "npi": [1790174860]}, {"billed_charge": 10.8977, "npi": [1790174860]}, {"billed_charge": 17.4194, "npi": [1790174860]}, {"billed_charge": 311.4, "npi": [1790174860]}, {"billed_charge": 34.9667, "npi": [1790174860]}, {"billed_charge": 285.6667, "npi": [1790174860]}, {"billed_charge": 14.6379, "npi": [1790174860]}, {"billed_charge": 19.25, "npi": [1790174860]}, {"billed_charge": 7.0, "npi": [1790174860]}]}]}]}, {"name": "Laboratory - Urology", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0307", "description": "Laboratory", "allowed_amounts": [{"tin": {"type": "ein", "value": "753175630"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 51.0, "npi": [1285798918]}, {"billed_charge": 82.5, "npi": [1285798918]}, {"billed_charge": 32.0, "npi": [1285798918]}, {"billed_charge": 114.0, "npi": [1285798918]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["59"], "providers": [{"billed_charge": 51.0, "npi": [1285798918]}]}]}]}, {"name": "Pharmacy - General", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0250", "description": "Pharmacy (also see 063x, an extension of 025x)", "allowed_amounts": [{"tin": {"type": "ein", "value": "262978009"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 37.94, "npi": [1619308319]}, {"billed_charge": 6.49, "npi": [1619308319]}, {"billed_charge": 87.39, "npi": [1619308319]}, {"billed_charge": 106.12, "npi": [1619308319]}, {"billed_charge": 1.85, "npi": [1407010622]}, {"billed_charge": 5.2, "npi": [1407010622]}, {"billed_charge": 2.08, "npi": [1407010622]}, {"billed_charge": 0.52, "npi": [1407010622]}, {"billed_charge": 0.15, "npi": [1407010622]}, {"billed_charge": 1.04, "npi": [1407010622]}, {"billed_charge": 0.55, "npi": [1407010622]}, {"billed_charge": 34.33, "npi": [1619308319]}, {"billed_charge": 0.05, "npi": [1619308319]}, {"billed_charge": 7.28, "npi": [1619308319]}, {"billed_charge": 0.06, "npi": [1407010622]}, {"billed_charge": 14.57, "npi": [1619308319]}, {"billed_charge": 1.86, "npi": [1407010622]}, {"billed_charge": 1.85, "npi": [1619308319]}, {"billed_charge": 5.2, "npi": [1619308319]}, {"billed_charge": 26.01, "npi": [1407010622]}, {"billed_charge": 0.39, "npi": [1407010622]}, {"billed_charge": 19.77, "npi": [1407010622]}, {"billed_charge": 0.24, "npi": [1619308319]}, {"billed_charge": 1.04, "npi": [1619308319]}, {"billed_charge": 10.4, "npi": [1619308319]}, {"billed_charge": 2.08, "npi": [1619308319]}, {"billed_charge": 3.12, "npi": [1619308319]}, {"billed_charge": 4.16, "npi": [1619308319]}, {"billed_charge": 176.87, "npi": [1407010622]}, {"billed_charge": 7.28, "npi": [1407010622]}]}]}]}, {"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": "900433939"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 128.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 190.0, "npi": [1518067602]}]}]}]}, {"name": "Pharmacy - General", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0250", "description": "Pharmacy (also see 063x, an extension of 025x)", "allowed_amounts": [{"tin": {"type": "ein", "value": "452694620"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 28.0513, "npi": [1033120423]}, {"billed_charge": 48.85, "npi": [1033120423]}, {"billed_charge": 45.2, "npi": [1033120423]}, {"billed_charge": 36.0758, "npi": [1033120423]}, {"billed_charge": 46.476, "npi": [1033120423]}, {"billed_charge": 42.0933, "npi": [1033120423]}, {"billed_charge": 35.1475, "npi": [1033120423]}, {"billed_charge": 49.0, "npi": [1033120423]}, {"billed_charge": 28.2275, "npi": [1033120423]}, {"billed_charge": 33.9894, "npi": [1033120423]}, {"billed_charge": 54.3092, "npi": [1033120423]}, {"billed_charge": 54.95, "npi": [1033120423]}, {"billed_charge": 43.218, "npi": [1033120423]}, {"billed_charge": 54.98, "npi": [1033120423]}, {"billed_charge": 39.3733, "npi": [1033120423]}, {"billed_charge": 26.13, "npi": [1033120423]}]}]}]}, {"name": "EKG/ECG (Electrocardiogram) - General", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0730", "description": "EKG/ECG (Electrocardiogram)", "allowed_amounts": [{"tin": {"type": "ein", "value": "751037591"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 453.2, "npi": [1124305065]}]}]}]}, {"name": "CRITICAL CARE ILL/INJURED PATIENT INIT 30-74 MIN", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "99291", "description": "CRITICAL CARE ILL/INJURED PATIENT INIT 30-74 MIN", "allowed_amounts": [{"tin": {"type": "ein", "value": "271072321"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 235.06, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 903.0, "npi": [1538521323]}]}, {"allowed_amount": 235.06, "billing_code_modifier": [""], "providers": [{"billed_charge": 903.0, "npi": [1538521323]}]}]}]}, {"name": "Laboratory - Bacteriology & Microbiology", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0306", "description": "Laboratory", "allowed_amounts": [{"tin": {"type": "ein", "value": "831869297"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 380.3, "npi": [1356960132]}, {"billed_charge": 359.52, "npi": [1356960132]}, {"billed_charge": 146.64, "npi": [1356960132]}, {"billed_charge": 2588.875, "npi": [1356960132]}, {"billed_charge": 311.53, "npi": [1356960132]}, {"billed_charge": 485.11, "npi": [1356960132]}, {"billed_charge": 1322.87, "npi": [1356960132]}]}, {"allowed_amount": 50.88, "billing_code_modifier": [""], "providers": [{"billed_charge": 435.99, "npi": [1356960132]}, {"billed_charge": 485.11, "npi": [1356960132]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["QW"], "providers": [{"billed_charge": 3854.88, "npi": [1356960132]}, {"billed_charge": 359.52, "npi": [1356960132]}, {"billed_charge": 1322.87, "npi": [1356960132]}]}, {"allowed_amount": 11.72, "billing_code_modifier": [""], "providers": [{"billed_charge": 359.52, "npi": [1356960132]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["91QW"], "providers": [{"billed_charge": 359.52, "npi": [1356960132]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["91"], "providers": [{"billed_charge": 380.3, "npi": [1356960132]}]}]}]}, {"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": "831683025"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 0.21, "npi": [1942778824]}, {"billed_charge": 19.75, "npi": [1942778824]}, {"billed_charge": 180.0, "npi": [1942778824]}, {"billed_charge": 5.25, "npi": [1942778824]}, {"billed_charge": 0.13, "npi": [1942778824]}, {"billed_charge": 2.63, "npi": [1942778824]}, {"billed_charge": 13.75, "npi": [1942778824]}, {"billed_charge": 2.1, "npi": [1942778824]}, {"billed_charge": 2.78, "npi": [1942778824]}, {"billed_charge": 0.79, "npi": [1942778824]}, {"billed_charge": 1.9, "npi": [1942778824]}, {"billed_charge": 10.5, "npi": [1942778824]}, {"billed_charge": 3.16, "npi": [1942778824]}, {"billed_charge": 0.53, "npi": [1942778824]}, {"billed_charge": 1.85, "npi": [1942778824]}, {"billed_charge": 2.35, "npi": [1942778824]}, {"billed_charge": 9.67, "npi": [1942778824]}, {"billed_charge": 25.25, "npi": [1942778824]}, {"billed_charge": 0.2, "npi": [1942778824]}, {"billed_charge": 0.11, "npi": [1942778824]}]}, {"allowed_amount": 0.51, "billing_code_modifier": ["JZ"], "providers": [{"billed_charge": 2.63, "npi": [1942778824]}, {"billed_charge": 8.25, "npi": [1942778824]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["JZ"], "providers": [{"billed_charge": 5.25, "npi": [1942778824]}, {"billed_charge": 8.25, "npi": [1942778824]}]}]}]}, {"name": "Laboratory - General", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0300", "description": "Laboratory", "allowed_amounts": [{"tin": {"type": "ein", "value": "432008974"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 230.3125, "npi": [1003883158]}, {"billed_charge": 296.5, "npi": [1003883158]}, {"billed_charge": 268.075, "npi": [1003883158]}, {"billed_charge": 286.75, "npi": [1003883158]}, {"billed_charge": 41.5, "npi": [1003883158]}]}]}]}, {"name": "Occupational Therapy - Evaluation or Reevaluation", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0434", "description": "Occupational Therapy", "allowed_amounts": [{"tin": {"type": "ein", "value": "751837454"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 623.53, "npi": [1447250253]}, {"billed_charge": 447.07, "npi": [1447250253]}, {"billed_charge": 586.75, "npi": [1447250253]}]}, {"allowed_amount": 146.1, "billing_code_modifier": ["GO"], "providers": [{"billed_charge": 447.07, "npi": [1447250253]}, {"billed_charge": 586.75, "npi": [1447250253]}]}]}]}, {"name": "AMBULANCE RESPONSE AND TREATMENT NO TRANSPORT", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "A0998", "description": "AMBULANCE RESPONSE AND TREATMENT NO TRANSPORT", "allowed_amounts": [{"tin": {"type": "ein", "value": "756000508"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 172.48, "npi": [1861530990]}, {"billed_charge": 127.25, "npi": [1861530990]}, {"billed_charge": 168.69, "npi": [1861530990]}, {"billed_charge": 170.94, "npi": [1861530990]}]}]}]}, {"name": "Laboratory - Urology", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0307", "description": "Laboratory", "allowed_amounts": [{"tin": {"type": "ein", "value": "752770738"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 187.0, "npi": [1770514077]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["59"], "providers": [{"billed_charge": 187.0, "npi": [1770514077]}]}]}]}, {"name": "Laboratory - Bacteriology & Microbiology", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0306", "description": "Laboratory", "allowed_amounts": [{"tin": {"type": "ein", "value": "752770738"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 206.81, "billing_code_modifier": [""], "providers": [{"billed_charge": 494.0, "npi": [1770514077]}]}, {"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 423.05, "npi": [1770514077]}, {"billed_charge": 399.5, "npi": [1770514077]}, {"billed_charge": 237.75, "npi": [1770514077]}, {"billed_charge": 414.5, "npi": [1770514077]}, {"billed_charge": 391.4375, "npi": [1770514077]}, {"billed_charge": 303.2375, "npi": [1770514077]}, {"billed_charge": 536.25, "npi": [1770514077]}, {"billed_charge": 582.75, "npi": [1770514077]}, {"billed_charge": 317.75, "npi": [1770514077]}, {"billed_charge": 229.25, "npi": [1770514077]}, {"billed_charge": 271.6736, "npi": [1770514077]}, {"billed_charge": 364.0, "npi": [1770514077]}, {"billed_charge": 266.0625, "npi": [1770514077]}, {"billed_charge": 342.3333, "npi": [1770514077]}, {"billed_charge": 230.0, "npi": [1770514077]}, {"billed_charge": 252.75, "npi": [1770514077]}, {"billed_charge": 366.0556, "npi": [1770514077]}, {"billed_charge": 158.5, "npi": [1770514077]}]}, {"allowed_amount": 13.32, "billing_code_modifier": [""], "providers": [{"billed_charge": 230.0, "npi": [1770514077]}]}, {"allowed_amount": 74.4, "billing_code_modifier": [""], "providers": [{"billed_charge": 225.25, "npi": [1770514077]}]}, {"allowed_amount": 6.58, "billing_code_modifier": [""], "providers": [{"billed_charge": 158.5, "npi": [1770514077]}]}, {"allowed_amount": 13.27, "billing_code_modifier": [""], "providers": [{"billed_charge": 364.0, "npi": [1770514077]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["91"], "providers": [{"billed_charge": 414.5, "npi": [1770514077]}]}]}]}, {"name": "Radiology - Diagnostic - General", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0320", "description": "Radiology - Diagnostic", "allowed_amounts": [{"tin": {"type": "ein", "value": "756001743"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 909.0, "npi": [1336172105]}, {"billed_charge": 631.5, "npi": [1336172105]}, {"billed_charge": 679.0313, "npi": [1336172105]}, {"billed_charge": 664.25, "npi": [1336172105]}, {"billed_charge": 618.1667, "npi": [1336172105]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["LT77"], "providers": [{"billed_charge": 870.25, "npi": [1336172105]}]}, {"allowed_amount": 126.14, "billing_code_modifier": [""], "providers": [{"billed_charge": 792.25, "npi": [1336172105]}, {"billed_charge": 664.25, "npi": [1336172105]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["RT"], "providers": [{"billed_charge": 644.75, "npi": [1336172105]}, {"billed_charge": 489.25, "npi": [1336172105]}, {"billed_charge": 701.0, "npi": [1336172105]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["LT"], "providers": [{"billed_charge": 644.75, "npi": [1336172105]}, {"billed_charge": 870.25, "npi": [1336172105]}, {"billed_charge": 664.25, "npi": [1336172105]}, {"billed_charge": 489.25, "npi": [1336172105]}, {"billed_charge": 701.0, "npi": [1336172105]}, {"billed_charge": 608.5, "npi": [1336172105]}]}]}]}, {"name": "Physical Therapy - General", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0420", "description": "Physical Therapy", "allowed_amounts": [{"tin": {"type": "ein", "value": "751837454"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 206.3208, "npi": [1447250253]}, {"billed_charge": 200.8579, "npi": [1447250253]}, {"billed_charge": 198.995, "npi": [1447250253]}, {"billed_charge": 200.8633, "npi": [1447250253]}, {"billed_charge": 204.1083, "npi": [1447250253]}, {"billed_charge": 204.6, "npi": [1447250253]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["GP"], "providers": [{"billed_charge": 193.39, "npi": [1447250253]}, {"billed_charge": 204.6, "npi": [1447250253]}]}, {"allowed_amount": 36.4, "billing_code_modifier": ["GP"], "providers": [{"billed_charge": 204.6, "npi": [1447250253]}]}]}]}, {"name": "Laboratory - Hematology", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0305", "description": "Laboratory", "allowed_amounts": [{"tin": {"type": "ein", "value": "831869297"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 473.9, "npi": [1356960132]}, {"billed_charge": 229.48, "npi": [1356960132]}, {"billed_charge": 231.878, "npi": [1356960132]}, {"billed_charge": 215.56, "npi": [1356960132]}, {"billed_charge": 75.99, "npi": [1356960132]}, {"billed_charge": 223.56, "npi": [1356960132]}, {"billed_charge": 265.15, "npi": [1356960132]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["QW"], "providers": [{"billed_charge": 265.15, "npi": [1356960132]}]}]}]}, {"name": "Laboratory - Bacteriology & Microbiology", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0306", "description": "Laboratory", "allowed_amounts": [{"tin": {"type": "ein", "value": "260194016"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 206.81, "billing_code_modifier": [""], "providers": [{"billed_charge": 174.88, "npi": [1205018439]}]}, {"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 357.84, "npi": [1205018439]}, {"billed_charge": 465.18, "npi": [1205018439]}, {"billed_charge": 204.565, "npi": [1205018439]}, {"billed_charge": 231.8013, "npi": [1205018439]}, {"billed_charge": 282.44, "npi": [1205018439]}, {"billed_charge": 316.95, "npi": [1205018439]}, {"billed_charge": 125.99, "npi": [1205018439]}, {"billed_charge": 448.72, "npi": [1205018439]}, {"billed_charge": 218.1367, "npi": [1205018439]}, {"billed_charge": 215.5, "npi": [1205018439]}, {"billed_charge": 142.75, "npi": [1205018439]}, {"billed_charge": 199.29, "npi": [1205018439]}, {"billed_charge": 349.4643, "npi": [1205018439]}, {"billed_charge": 146.91, "npi": [1205018439]}, {"billed_charge": 340.52, "npi": [1205018439]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["XU"], "providers": [{"billed_charge": 161.69, "npi": [1205018439]}]}, {"allowed_amount": 148.49, "billing_code_modifier": [""], "providers": [{"billed_charge": 102.41, "npi": [1205018439]}]}]}]}, {"name": "Laboratory - Urology", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0307", "description": "Laboratory", "allowed_amounts": [{"tin": {"type": "ein", "value": "472177648"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 189.6, "npi": [1790174860]}, {"billed_charge": 213.26, "npi": [1790174860]}, {"billed_charge": 236.92, "npi": [1790174860]}, {"billed_charge": 188.0, "npi": [1790174860]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["59"], "providers": [{"billed_charge": 236.92, "npi": [1790174860]}, {"billed_charge": 188.0, "npi": [1790174860]}]}]}]}, {"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": "264304912"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 1745.25, "billing_code_modifier": ["SH"], "providers": [{"billed_charge": 2100.0, "npi": [1871724864]}]}, {"allowed_amount": 1728.32, "billing_code_modifier": ["SH"], "providers": [{"billed_charge": 2100.0, "npi": [1871724864]}]}, {"allowed_amount": 1745.25, "billing_code_modifier": ["RH"], "providers": [{"billed_charge": 2100.0, "npi": [1871724864]}]}, {"allowed_amount": 1728.32, "billing_code_modifier": ["RH"], "providers": [{"billed_charge": 2100.0, "npi": [1871724864]}]}, {"allowed_amount": 1745.25, "billing_code_modifier": ["RI"], "providers": [{"billed_charge": 2100.0, "npi": [1871724864]}]}, {"allowed_amount": 1728.32, "billing_code_modifier": ["NH"], "providers": [{"billed_charge": 2100.0, "npi": [1871724864]}]}]}]}, {"name": "GROUND MILEAGE PER STATUTE MILE", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "A0425", "description": "GROUND MILEAGE PER STATUTE MILE", "allowed_amounts": [{"tin": {"type": "ein", "value": "264304912"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 30.3223, "billing_code_modifier": ["RH"], "providers": [{"billed_charge": 35.0, "npi": [1871724864]}]}, {"allowed_amount": 30.3229, "billing_code_modifier": ["RH"], "providers": [{"billed_charge": 35.0, "npi": [1871724864]}]}, {"allowed_amount": 35.0, "billing_code_modifier": ["RH"], "providers": [{"billed_charge": 35.0, "npi": [1871724864]}]}, {"allowed_amount": 30.325, "billing_code_modifier": ["SH"], "providers": [{"billed_charge": 35.0, "npi": [1871724864]}]}, {"allowed_amount": 35.0, "billing_code_modifier": ["SH"], "providers": [{"billed_charge": 35.0, "npi": [1871724864]}]}, {"allowed_amount": 30.3223, "billing_code_modifier": ["HH"], "providers": [{"billed_charge": 35.0, "npi": [1871724864]}]}, {"allowed_amount": 30.3225, "billing_code_modifier": ["SH"], "providers": [{"billed_charge": 35.0, "npi": [1871724864]}]}, {"allowed_amount": 30.3229, "billing_code_modifier": ["HH"], "providers": [{"billed_charge": 35.0, "npi": [1871724864]}]}, {"allowed_amount": 35.0, "billing_code_modifier": ["RI"], "providers": [{"billed_charge": 35.0, "npi": [1871724864]}]}, {"allowed_amount": 30.3226, "billing_code_modifier": ["RH"], "providers": [{"billed_charge": 35.0, "npi": [1871724864]}]}, {"allowed_amount": 30.3225, "billing_code_modifier": ["RH"], "providers": [{"billed_charge": 35.0, "npi": [1871724864]}]}, {"allowed_amount": 30.3224, "billing_code_modifier": ["RH"], "providers": [{"billed_charge": 35.0, "npi": [1871724864]}]}, {"allowed_amount": 30.3226, "billing_code_modifier": ["SH"], "providers": [{"billed_charge": 35.0, "npi": [1871724864]}]}, {"allowed_amount": 23.34, "billing_code_modifier": ["JH"], "providers": [{"billed_charge": 35.0, "npi": [1871724864]}]}, {"allowed_amount": 30.3224, "billing_code_modifier": ["NH"], "providers": [{"billed_charge": 35.0, "npi": [1871724864]}]}, {"allowed_amount": 30.3229, "billing_code_modifier": ["SH"], "providers": [{"billed_charge": 35.0, "npi": [1871724864]}]}, {"allowed_amount": 30.3225, "billing_code_modifier": ["HH"], "providers": [{"billed_charge": 35.0, "npi": [1871724864]}]}]}]}, {"name": "SCREENING DIGITAL BREAST TOMOSYNTHESIS BI", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "77063", "description": "SCREENING DIGITAL BREAST TOMOSYNTHESIS BI", "allowed_amounts": [{"tin": {"type": "ein", "value": "203324726"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 33.28, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 75.0, "npi": [1831199546]}]}]}]}, {"name": "Laboratory - General", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0300", "description": "Laboratory", "allowed_amounts": [{"tin": {"type": "ein", "value": "472177648"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 98.02, "npi": [1790174860]}, {"billed_charge": 149.962, "npi": [1790174860]}]}]}]}, {"name": "Laboratory - General", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0300", "description": "Laboratory", "allowed_amounts": [{"tin": {"type": "ein", "value": "751837454"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 59.0483, "npi": [1447250253]}, {"billed_charge": 105.2683, "npi": [1447250253]}, {"billed_charge": 40.0, "npi": [1447250253]}, {"billed_charge": 220.305, "npi": [1447250253]}, {"billed_charge": 95.5, "npi": [1447250253]}, {"billed_charge": 49.7809, "npi": [1447250253]}, {"billed_charge": 132.09, "npi": [1447250253]}, {"billed_charge": 143.25, "npi": [1447250253]}, {"billed_charge": 178.0269, "npi": [1447250253]}, {"billed_charge": 90.8888, "npi": [1447250253]}, {"billed_charge": 91.5126, "npi": [1447250253]}, {"billed_charge": 147.1108, "npi": [1447250253]}, {"billed_charge": 206.4354, "npi": [1447250253]}, {"billed_charge": 89.525, "npi": [1447250253]}, {"billed_charge": 272.12, "npi": [1447250253]}, {"billed_charge": 203.9136, "npi": [1447250253]}, {"billed_charge": 93.0276, "npi": [1447250253]}, {"billed_charge": 89.1741, "npi": [1447250253]}, {"billed_charge": 100.38, "npi": [1447250253]}, {"billed_charge": 160.2033, "npi": [1447250253]}, {"billed_charge": 175.2288, "npi": [1447250253]}, {"billed_charge": 85.3757, "npi": [1447250253]}, {"billed_charge": 220.4319, "npi": [1447250253]}, {"billed_charge": 1021.68, "npi": [1447250253]}, {"billed_charge": 162.7867, "npi": [1447250253]}, {"billed_charge": 58.2708, "npi": [1447250253]}, {"billed_charge": 148.0793, "npi": [1447250253]}, {"billed_charge": 149.5547, "npi": [1447250253]}, {"billed_charge": 80.4063, "npi": [1447250253]}, {"billed_charge": 176.5291, "npi": [1447250253]}, {"billed_charge": 191.5458, "npi": [1447250253]}, {"billed_charge": 137.575, "npi": [1447250253]}, {"billed_charge": 66.4922, "npi": [1447250253]}, {"billed_charge": 113.672, "npi": [1447250253]}, {"billed_charge": 102.0056, "npi": [1447250253]}, {"billed_charge": 170.45, "npi": [1447250253]}, {"billed_charge": 97.0514, "npi": [1447250253]}, {"billed_charge": 216.2671, "npi": [1447250253]}, {"billed_charge": 211.0, "npi": [1447250253]}, {"billed_charge": 45.1667, "npi": [1447250253]}, {"billed_charge": 87.5267, "npi": [1447250253]}, {"billed_charge": 392.86, "npi": [1447250253]}, {"billed_charge": 185.794, "npi": [1447250253]}, {"billed_charge": 75.6009, "npi": [1447250253]}, {"billed_charge": 131.1213, "npi": [1447250253]}, {"billed_charge": 191.0, "npi": [1447250253]}, {"billed_charge": 125.548, "npi": [1447250253]}, {"billed_charge": 144.9975, "npi": [1447250253]}, {"billed_charge": 47.75, "npi": [1447250253]}, {"billed_charge": 91.63, "npi": [1447250253]}, {"billed_charge": 128.0545, "npi": [1447250253]}, {"billed_charge": 235.9918, "npi": [1447250253]}, {"billed_charge": 305.6138, "npi": [1447250253]}]}, {"allowed_amount": 13.54, "billing_code_modifier": [""], "providers": [{"billed_charge": 47.75, "npi": [1447250253]}]}]}]}, {"name": "Emergency Room - General", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0450", "description": "Emergency Room", "allowed_amounts": [{"tin": {"type": "ein", "value": "751777119"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 500.62, "npi": [1073511762]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["XU"], "providers": [{"billed_charge": 500.62, "npi": [1073511762]}]}, {"allowed_amount": 864.64, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 3879.67, "npi": [1073511762]}]}, {"allowed_amount": 308.82, "billing_code_modifier": ["XU"], "providers": [{"billed_charge": 524.33, "npi": [1073511762]}, {"billed_charge": 902.11, "npi": [1073511762]}]}, {"allowed_amount": 605.81, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 2122.8, "npi": [1073511762]}]}, {"allowed_amount": 396.31, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 1283.4, "npi": [1073511762]}]}, {"allowed_amount": 67.99, "billing_code_modifier": [""], "providers": [{"billed_charge": 317.78, "npi": [1073511762]}, {"billed_charge": 392.06, "npi": [1073511762]}]}, {"allowed_amount": 308.82, "billing_code_modifier": [""], "providers": [{"billed_charge": 814.34, "npi": [1073511762]}, {"billed_charge": 524.33, "npi": [1073511762]}]}, {"allowed_amount": 1199.27, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 4233.71, "npi": [1073511762]}]}]}]}, {"name": "Behavioral Health Treatments/Services - Partial Hospitalizat", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0912", "description": "Behavioral Health Treatments/Services - Extension of 090x", "allowed_amounts": [{"tin": {"type": "ein", "value": "834188451"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 765.0, "npi": [1922642040]}]}]}]}, {"name": "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": "812792506"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 126.29, "billing_code_modifier": [""], "providers": [{"billed_charge": 227.0, "npi": [1770762262]}]}]}]}, {"name": "Radiology - Diagnostic - Chest X-Ray", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0324", "description": "Radiology - Diagnostic", "allowed_amounts": [{"tin": {"type": "ein", "value": "752586857"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 366.74, "npi": [1992700983]}, {"billed_charge": 656.37, "npi": [1992700983]}]}, {"allowed_amount": 126.14, "billing_code_modifier": [""], "providers": [{"billed_charge": 366.74, "npi": [1992700983]}, {"billed_charge": 656.37, "npi": [1992700983]}]}]}]}, {"name": "Laboratory - Hematology", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0305", "description": "Laboratory", "allowed_amounts": [{"tin": {"type": "ein", "value": "752770738"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 145.75, "npi": [1770514077]}, {"billed_charge": 208.75, "npi": [1770514077]}, {"billed_charge": 233.5, "npi": [1770514077]}, {"billed_charge": 209.9352, "npi": [1770514077]}, {"billed_charge": 226.5, "npi": [1770514077]}, {"billed_charge": 706.5, "npi": [1770514077]}, {"billed_charge": 206.5, "npi": [1770514077]}, {"billed_charge": 192.1705, "npi": [1770514077]}, {"billed_charge": 218.0357, "npi": [1770514077]}, {"billed_charge": 223.7083, "npi": [1770514077]}, {"billed_charge": 230.8, "npi": [1770514077]}, {"billed_charge": 231.1429, "npi": [1770514077]}, {"billed_charge": 199.1071, "npi": [1770514077]}]}]}]}, {"name": "Laboratory Pathological - General", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0310", "description": "Laboratory Pathology", "allowed_amounts": [{"tin": {"type": "ein", "value": "750800628"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 262.68, "billing_code_modifier": [""], "providers": [{"billed_charge": 796.0, "npi": [1720480627]}]}, {"allowed_amount": 477.6, "billing_code_modifier": [""], "providers": [{"billed_charge": 796.0, "npi": [1720480627]}]}]}]}, {"name": "CT Scan - Body Scan", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0352", "description": "CT Scan", "allowed_amounts": [{"tin": {"type": "ein", "value": "751844139"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": ["U6"], "providers": [{"billed_charge": 6484.35, "npi": [1265430177]}, {"billed_charge": 3424.65, "npi": [1265430177]}, {"billed_charge": 3150.74, "npi": [1265430177]}, {"billed_charge": 3339.84, "npi": [1265430177]}]}, {"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 6484.35, "npi": [1265430177]}, {"billed_charge": 2800.19, "npi": [1265430177]}, {"billed_charge": 5896.8, "npi": [1265430177]}, {"billed_charge": 6290.97, "npi": [1265430177]}, {"billed_charge": 7792.97, "npi": [1265430177]}]}, {"allowed_amount": 254.23, "billing_code_modifier": [""], "providers": [{"billed_charge": 6290.97, "npi": [1265430177]}]}, {"allowed_amount": 505.67, "billing_code_modifier": [""], "providers": [{"billed_charge": 6484.35, "npi": [1265430177]}]}]}]}, {"name": "Laboratory - General", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0300", "description": "Laboratory", "allowed_amounts": [{"tin": {"type": "ein", "value": "751008430"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 220.305, "npi": [1669472387]}, {"billed_charge": 40.0, "npi": [1669472387]}, {"billed_charge": 392.86, "npi": [1669472387]}, {"billed_charge": 47.75, "npi": [1669472387]}, {"billed_charge": 229.67, "npi": [1669472387]}, {"billed_charge": 172.7694, "npi": [1669472387]}]}]}]}, {"name": "Laboratory - Urology", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0307", "description": "Laboratory", "allowed_amounts": [{"tin": {"type": "ein", "value": "751844139"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 129.78, "npi": [1265430177]}, {"billed_charge": 162.16, "npi": [1265430177]}, {"billed_charge": 83.58, "npi": [1265430177]}]}, {"allowed_amount": 12.48, "billing_code_modifier": [""], "providers": [{"billed_charge": 162.16, "npi": [1265430177]}]}, {"allowed_amount": 4.6, "billing_code_modifier": [""], "providers": [{"billed_charge": 129.78, "npi": [1265430177]}]}]}]}, {"name": "Pulmonary Function - General", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0460", "description": "Pulmonary Function", "allowed_amounts": [{"tin": {"type": "ein", "value": "752586857"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 304.29, "npi": [1992700983]}, {"billed_charge": 323.88, "npi": [1992700983]}, {"billed_charge": 278.17, "npi": [1992700983]}, {"billed_charge": 232.46, "npi": [1992700983]}, {"billed_charge": 186.75, "npi": [1992700983]}]}]}]}, {"name": "Laboratory - Hematology", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0305", "description": "Laboratory", "allowed_amounts": [{"tin": {"type": "ein", "value": "452694620"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 240.62, "npi": [1033120423]}, {"billed_charge": 224.93, "npi": [1033120423]}, {"billed_charge": 191.56, "npi": [1033120423]}, {"billed_charge": 265.15, "npi": [1033120423]}, {"billed_charge": 279.1467, "npi": [1033120423]}, {"billed_charge": 223.56, "npi": [1033120423]}, {"billed_charge": 229.48, "npi": [1033120423]}, {"billed_charge": 215.56, "npi": [1033120423]}, {"billed_charge": 75.99, "npi": [1033120423]}, {"billed_charge": 233.796, "npi": [1033120423]}, {"billed_charge": 226.4033, "npi": [1033120423]}, {"billed_charge": 473.9, "npi": [1033120423]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["QW"], "providers": [{"billed_charge": 265.15, "npi": [1033120423]}]}]}]}, {"name": "EKG/ECG (Electrocardiogram) - General", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0730", "description": "EKG/ECG (Electrocardiogram)", "allowed_amounts": [{"tin": {"type": "ein", "value": "751844139"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 85.51, "billing_code_modifier": [""], "providers": [{"billed_charge": 453.2, "npi": [1265430177]}]}, {"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 453.2, "npi": [1265430177]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["XU"], "providers": [{"billed_charge": 453.2, "npi": [1265430177]}]}]}]}, {"name": "GROUND MILEAGE PER STATUTE MILE", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "A0425", "description": "GROUND MILEAGE PER STATUTE MILE", "allowed_amounts": [{"tin": {"type": "ein", "value": "752474011"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 20.01, "billing_code_modifier": ["RH"], "providers": [{"billed_charge": 22.03, "npi": [1881628014]}]}, {"allowed_amount": 19.62, "billing_code_modifier": ["RH"], "providers": [{"billed_charge": 22.03, "npi": [1881628014]}]}, {"allowed_amount": 20.01, "billing_code_modifier": ["HH"], "providers": [{"billed_charge": 22.03, "npi": [1881628014]}]}, {"allowed_amount": 19.6201, "billing_code_modifier": ["ETHH"], "providers": [{"billed_charge": 22.1604, "npi": [1881628014]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["RH"], "providers": [{"billed_charge": 22.03, "npi": [1881628014]}]}, {"allowed_amount": 19.62, "billing_code_modifier": ["SH"], "providers": [{"billed_charge": 22.03, "npi": [1881628014]}]}, {"allowed_amount": 19.6204, "billing_code_modifier": ["ETRH"], "providers": [{"billed_charge": 22.4796, "npi": [1881628014]}]}, {"allowed_amount": 19.62, "billing_code_modifier": ["NH"], "providers": [{"billed_charge": 22.03, "npi": [1881628014]}]}, {"allowed_amount": 20.01, "billing_code_modifier": ["SH"], "providers": [{"billed_charge": 22.03, "npi": [1881628014]}]}, {"allowed_amount": 19.62, "billing_code_modifier": ["HH"], "providers": [{"billed_charge": 22.2619, "npi": [1881628014]}, {"billed_charge": 22.03, "npi": [1881628014]}]}, {"allowed_amount": 19.6185, "billing_code_modifier": ["ETRH"], "providers": [{"billed_charge": 24.4778, "npi": [1881628014]}]}, {"allowed_amount": 19.6199, "billing_code_modifier": ["ETHH"], "providers": [{"billed_charge": 22.5608, "npi": [1881628014]}]}, {"allowed_amount": 19.62, "billing_code_modifier": ["ETSH"], "providers": [{"billed_charge": 22.03, "npi": [1881628014]}]}]}]}, {"name": "Radiology - Diagnostic - General", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0320", "description": "Radiology - Diagnostic", "allowed_amounts": [{"tin": {"type": "ein", "value": "751837454"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 151.54, "billing_code_modifier": [""], "providers": [{"billed_charge": 909.4, "npi": [1447250253]}]}, {"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 773.0, "npi": [1447250253]}, {"billed_charge": 525.82, "npi": [1447250253]}, {"billed_charge": 463.7343, "npi": [1447250253]}, {"billed_charge": 511.46, "npi": [1447250253]}, {"billed_charge": 483.22, "npi": [1447250253]}, {"billed_charge": 532.06, "npi": [1447250253]}, {"billed_charge": 647.915, "npi": [1447250253]}, {"billed_charge": 608.85, "npi": [1447250253]}, {"billed_charge": 502.44, "npi": [1447250253]}, {"billed_charge": 412.73, "npi": [1447250253]}, {"billed_charge": 464.28, "npi": [1447250253]}, {"billed_charge": 709.895, "npi": [1447250253]}, {"billed_charge": 444.0105, "npi": [1447250253]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["RT"], "providers": [{"billed_charge": 529.64, "npi": [1447250253]}, {"billed_charge": 511.46, "npi": [1447250253]}, {"billed_charge": 532.06, "npi": [1447250253]}, {"billed_charge": 493.74, "npi": [1447250253]}, {"billed_charge": 484.07, "npi": [1447250253]}, {"billed_charge": 608.85, "npi": [1447250253]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["50"], "providers": [{"billed_charge": 773.28, "npi": [1447250253]}, {"billed_charge": 766.19, "npi": [1447250253]}, {"billed_charge": 726.11, "npi": [1447250253]}, {"billed_charge": 683.0, "npi": [1447250253]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["LT"], "providers": [{"billed_charge": 515.76, "npi": [1447250253]}, {"billed_charge": 529.64, "npi": [1447250253]}, {"billed_charge": 447.67, "npi": [1447250253]}, {"billed_charge": 511.46, "npi": [1447250253]}, {"billed_charge": 486.95, "npi": [1447250253]}, {"billed_charge": 532.06, "npi": [1447250253]}, {"billed_charge": 493.42, "npi": [1447250253]}, {"billed_charge": 529.37, "npi": [1447250253]}, {"billed_charge": 486.57, "npi": [1447250253]}, {"billed_charge": 493.74, "npi": [1447250253]}, {"billed_charge": 608.85, "npi": [1447250253]}, {"billed_charge": 510.79, "npi": [1447250253]}, {"billed_charge": 455.33, "npi": [1447250253]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["LT52"], "providers": [{"billed_charge": 511.46, "npi": [1447250253]}]}]}]}, {"name": "GROUND MILEAGE PER STATUTE MILE", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "A0425", "description": "GROUND MILEAGE PER STATUTE MILE", "allowed_amounts": [{"tin": {"type": "ein", "value": "756000599"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 15.0, "billing_code_modifier": ["ETRH"], "providers": [{"billed_charge": 15.0, "npi": [1558460329]}]}, {"allowed_amount": 15.0, "billing_code_modifier": ["EH"], "providers": [{"billed_charge": 15.0, "npi": [1558460329]}]}, {"allowed_amount": 15.0, "billing_code_modifier": ["SH"], "providers": [{"billed_charge": 15.0, "npi": [1558460329]}]}, {"allowed_amount": 15.0, "billing_code_modifier": ["ETSH"], "providers": [{"billed_charge": 15.0, "npi": [1558460329]}]}, {"allowed_amount": 15.0, "billing_code_modifier": ["ETEH"], "providers": [{"billed_charge": 15.0, "npi": [1558460329]}]}, {"allowed_amount": 15.0, "billing_code_modifier": ["RH"], "providers": [{"billed_charge": 15.0, "npi": [1558460329]}]}]}]}, {"name": "Laboratory - Chemistry", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0301", "description": "Laboratory", "allowed_amounts": [{"tin": {"type": "ein", "value": "751438726"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 335.75, "npi": [1104845015]}, {"billed_charge": 324.5, "npi": [1104845015]}, {"billed_charge": 225.75, "npi": [1104845015]}, {"billed_charge": 565.0, "npi": [1104845015]}, {"billed_charge": 49.25, "npi": [1104845015]}, {"billed_charge": 561.75, "npi": [1104845015]}, {"billed_charge": 269.5, "npi": [1104845015]}, {"billed_charge": 287.75, "npi": [1104845015]}, {"billed_charge": 231.0, "npi": [1104845015]}, {"billed_charge": 671.0, "npi": [1104845015]}, {"billed_charge": 442.5, "npi": [1104845015]}, {"billed_charge": 229.25, "npi": [1104845015]}, {"billed_charge": 278.25, "npi": [1104845015]}, {"billed_charge": 404.8125, "npi": [1104845015]}, {"billed_charge": 153.5, "npi": [1104845015]}, {"billed_charge": 679.25, "npi": [1104845015]}, {"billed_charge": 1474.5, "npi": [1104845015]}]}, {"allowed_amount": 19.42, "billing_code_modifier": [""], "providers": [{"billed_charge": 679.25, "npi": [1104845015]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["91"], "providers": [{"billed_charge": 49.25, "npi": [1104845015]}]}]}]}, {"name": "Laboratory - Bacteriology & Microbiology", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0306", "description": "Laboratory", "allowed_amounts": [{"tin": {"type": "ein", "value": "751047527"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 333.625, "npi": [1396779948]}, {"billed_charge": 303.25, "npi": [1396779948]}, {"billed_charge": 225.25, "npi": [1396779948]}, {"billed_charge": 582.75, "npi": [1396779948]}, {"billed_charge": 410.6667, "npi": [1396779948]}, {"billed_charge": 229.25, "npi": [1396779948]}, {"billed_charge": 399.5, "npi": [1396779948]}, {"billed_charge": 333.1667, "npi": [1396779948]}, {"billed_charge": 244.5, "npi": [1396779948]}, {"billed_charge": 310.3333, "npi": [1396779948]}, {"billed_charge": 536.25, "npi": [1396779948]}, {"billed_charge": 429.9167, "npi": [1396779948]}, {"billed_charge": 352.1667, "npi": [1396779948]}, {"billed_charge": 377.4167, "npi": [1396779948]}, {"billed_charge": 317.75, "npi": [1396779948]}, {"billed_charge": 310.1143, "npi": [1396779948]}, {"billed_charge": 297.875, "npi": [1396779948]}, {"billed_charge": 637.75, "npi": [1396779948]}, {"billed_charge": 364.0, "npi": [1396779948]}, {"billed_charge": 414.5, "npi": [1396779948]}]}, {"allowed_amount": 74.4, "billing_code_modifier": [""], "providers": [{"billed_charge": 225.25, "npi": [1396779948]}, {"billed_charge": 242.75, "npi": [1396779948]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["91"], "providers": [{"billed_charge": 414.5, "npi": [1396779948]}]}]}]}, {"name": "Laboratory - Chemistry", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0301", "description": "Laboratory", "allowed_amounts": [{"tin": {"type": "ein", "value": "202848116"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 410.0, "npi": [1629138029]}, {"billed_charge": 349.3095, "npi": [1629138029]}, {"billed_charge": 561.75, "npi": [1629138029]}, {"billed_charge": 49.25, "npi": [1629138029]}, {"billed_charge": 348.5, "npi": [1629138029]}, {"billed_charge": 225.75, "npi": [1629138029]}, {"billed_charge": 287.75, "npi": [1629138029]}, {"billed_charge": 328.75, "npi": [1629138029]}, {"billed_charge": 406.5, "npi": [1629138029]}, {"billed_charge": 153.5, "npi": [1629138029]}, {"billed_charge": 679.25, "npi": [1629138029]}, {"billed_charge": 257.75, "npi": [1629138029]}, {"billed_charge": 324.5, "npi": [1629138029]}, {"billed_charge": 274.25, "npi": [1629138029]}, {"billed_charge": 442.5, "npi": [1629138029]}, {"billed_charge": 278.25, "npi": [1629138029]}, {"billed_charge": 335.75, "npi": [1629138029]}, {"billed_charge": 161.0, "npi": [1629138029]}, {"billed_charge": 231.0, "npi": [1629138029]}, {"billed_charge": 210.75, "npi": [1629138029]}]}, {"allowed_amount": 4.76, "billing_code_modifier": [""], "providers": [{"billed_charge": 49.25, "npi": [1629138029]}]}]}]}, {"name": "Laboratory - Bacteriology & Microbiology", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0306", "description": "Laboratory", "allowed_amounts": [{"tin": {"type": "ein", "value": "752586857"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 206.81, "billing_code_modifier": [""], "providers": [{"billed_charge": 174.88, "npi": [1992700983]}]}, {"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 285.48, "npi": [1992700983]}, {"billed_charge": 448.72, "npi": [1992700983]}, {"billed_charge": 241.82, "npi": [1992700983]}, {"billed_charge": 125.99, "npi": [1992700983]}, {"billed_charge": 361.38, "npi": [1992700983]}, {"billed_charge": 123.65, "npi": [1992700983]}, {"billed_charge": 298.8467, "npi": [1992700983]}, {"billed_charge": 197.09, "npi": [1992700983]}, {"billed_charge": 423.9133, "npi": [1992700983]}, {"billed_charge": 403.065, "npi": [1992700983]}, {"billed_charge": 321.7543, "npi": [1992700983]}, {"billed_charge": 636.53, "npi": [1992700983]}, {"billed_charge": 465.18, "npi": [1992700983]}, {"billed_charge": 357.84, "npi": [1992700983]}, {"billed_charge": 340.52, "npi": [1992700983]}, {"billed_charge": 215.5, "npi": [1992700983]}]}, {"allowed_amount": 148.49, "billing_code_modifier": [""], "providers": [{"billed_charge": 102.41, "npi": [1992700983]}]}]}]}, {"name": "Laboratory - Chemistry", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0301", "description": "Laboratory", "allowed_amounts": [{"tin": {"type": "ein", "value": "472177648"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 701.0, "npi": [1790174860]}, {"billed_charge": 486.33, "npi": [1790174860]}, {"billed_charge": 325.68, "npi": [1790174860]}, {"billed_charge": 281.5, "npi": [1790174860]}, {"billed_charge": 762.48, "npi": [1790174860]}, {"billed_charge": 450.7753, "npi": [1790174860]}, {"billed_charge": 277.03, "npi": [1790174860]}, {"billed_charge": 256.3545, "npi": [1790174860]}, {"billed_charge": 351.0, "npi": [1790174860]}, {"billed_charge": 917.1, "npi": [1790174860]}, {"billed_charge": 760.0, "npi": [1790174860]}, {"billed_charge": 397.0, "npi": [1790174860]}, {"billed_charge": 148.0, "npi": [1790174860]}, {"billed_charge": 278.5579, "npi": [1790174860]}, {"billed_charge": 464.2643, "npi": [1790174860]}, {"billed_charge": 467.47, "npi": [1790174860]}, {"billed_charge": 344.8689, "npi": [1790174860]}, {"billed_charge": 878.04, "npi": [1790174860]}, {"billed_charge": 271.0, "npi": [1790174860]}, {"billed_charge": 205.0, "npi": [1790174860]}, {"billed_charge": 443.8219, "npi": [1790174860]}, {"billed_charge": 310.4494, "npi": [1790174860]}, {"billed_charge": 202.654, "npi": [1790174860]}, {"billed_charge": 706.47, "npi": [1790174860]}, {"billed_charge": 712.49, "npi": [1790174860]}, {"billed_charge": 346.957, "npi": [1790174860]}, {"billed_charge": 874.24, "npi": [1790174860]}, {"billed_charge": 275.0662, "npi": [1790174860]}, {"billed_charge": 330.0, "npi": [1790174860]}]}, {"allowed_amount": 19.42, "billing_code_modifier": [""], "providers": [{"billed_charge": 590.33, "npi": [1790174860]}]}, {"allowed_amount": 5.7, "billing_code_modifier": [""], "providers": [{"billed_charge": 86.62, "npi": [1790174860]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["91"], "providers": [{"billed_charge": 397.0, "npi": [1790174860]}, {"billed_charge": 148.0, "npi": [1790174860]}, {"billed_charge": 205.0, "npi": [1790174860]}]}]}]}, {"name": "IV Therapy -General", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0260", "description": "IV Therapy", "allowed_amounts": [{"tin": {"type": "ein", "value": "752586857"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 902.11, "npi": [1992700983]}, {"billed_charge": 468.18, "npi": [1992700983]}, {"billed_charge": 392.06, "npi": [1992700983]}, {"billed_charge": 524.33, "npi": [1992700983]}, {"billed_charge": 317.78, "npi": [1992700983]}, {"billed_charge": 361.12, "npi": [1992700983]}, {"billed_charge": 330.56, "npi": [1992700983]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["XS"], "providers": [{"billed_charge": 524.33, "npi": [1992700983]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["XU"], "providers": [{"billed_charge": 902.11, "npi": [1992700983]}, {"billed_charge": 392.06, "npi": [1992700983]}, {"billed_charge": 361.12, "npi": [1992700983]}, {"billed_charge": 330.56, "npi": [1992700983]}]}, {"allowed_amount": 308.31, "billing_code_modifier": ["XU"], "providers": [{"billed_charge": 902.11, "npi": [1992700983]}]}]}]}, {"name": "Laboratory - Immunology", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0302", "description": "Laboratory", "allowed_amounts": [{"tin": {"type": "ein", "value": "260194016"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 127.41, "npi": [1205018439]}, {"billed_charge": 169.31, "npi": [1205018439]}, {"billed_charge": 171.97, "npi": [1205018439]}, {"billed_charge": 228.91, "npi": [1205018439]}, {"billed_charge": 205.4117, "npi": [1205018439]}, {"billed_charge": 185.6267, "npi": [1205018439]}]}, {"allowed_amount": 19.2, "billing_code_modifier": [""], "providers": [{"billed_charge": 163.81, "npi": [1205018439]}]}]}]}, {"name": "Pharmacy - Extension of 25X - Drug Requiring Detailed Coding", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0636", "description": "Pharmacy - Extension of 25x", "allowed_amounts": [{"tin": {"type": "ein", "value": "432008974"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.49, "billing_code_modifier": ["JZ"], "providers": [{"billed_charge": 10.0, "npi": [1003883158]}]}, {"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 1.0, "npi": [1003883158]}, {"billed_charge": 4.8125, "npi": [1003883158]}, {"billed_charge": 10.0, "npi": [1003883158]}, {"billed_charge": 7.7774, "npi": [1003883158]}, {"billed_charge": 0.1277, "npi": [1003883158]}, {"billed_charge": 106.14, "npi": [1003883158]}, {"billed_charge": 3.99, "npi": [1003883158]}, {"billed_charge": 22.69, "npi": [1003883158]}, {"billed_charge": 5.985, "npi": [1003883158]}, {"billed_charge": 0.125, "npi": [1003883158]}, {"billed_charge": 1.8629, "npi": [1003883158]}, {"billed_charge": 3.5342, "npi": [1003883158]}, {"billed_charge": 2.5, "npi": [1003883158]}, {"billed_charge": 12.5, "npi": [1003883158]}, {"billed_charge": 3.4035, "npi": [1003883158]}, {"billed_charge": 3.42, "npi": [1003883158]}, {"billed_charge": 50.0, "npi": [1003883158]}, {"billed_charge": 6.6575, "npi": [1003883158]}]}, {"allowed_amount": 0.48, "billing_code_modifier": ["JZ"], "providers": [{"billed_charge": 17.1, "npi": [1003883158]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["JZ"], "providers": [{"billed_charge": 9.0, "npi": [1003883158]}, {"billed_charge": 0.5, "npi": [1003883158]}]}]}]}, {"name": "Pharmacy - Extension of 25X - Drug Requiring Detailed Coding", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0636", "description": "Pharmacy - Extension of 25x", "allowed_amounts": [{"tin": {"type": "ein", "value": "260194016"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 8.87, "billing_code_modifier": ["JZ"], "providers": [{"billed_charge": 45.0, "npi": [1205018439]}]}, {"allowed_amount": 0.49, "billing_code_modifier": ["JZ"], "providers": [{"billed_charge": 6.06, "npi": [1205018439]}]}, {"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 14.3084, "npi": [1205018439]}, {"billed_charge": 17.7, "npi": [1205018439]}, {"billed_charge": 3.6375, "npi": [1205018439]}, {"billed_charge": 8.28, "npi": [1205018439]}, {"billed_charge": 0.1488, "npi": [1205018439]}, {"billed_charge": 1.482, "npi": [1205018439]}, {"billed_charge": 0.1596, "npi": [1205018439]}, {"billed_charge": 15.9, "npi": [1205018439]}, {"billed_charge": 0.576, "npi": [1205018439]}, {"billed_charge": 1.8, "npi": [1205018439]}, {"billed_charge": 2.2635, "npi": [1205018439]}, {"billed_charge": 0.0295, "npi": [1205018439]}, {"billed_charge": 42.0, "npi": [1205018439]}, {"billed_charge": 3.535, "npi": [1205018439]}, {"billed_charge": 19.26, "npi": [1205018439]}, {"billed_charge": 31.55, "npi": [1205018439]}, {"billed_charge": 3.74, "npi": [1205018439]}, {"billed_charge": 7.688, "npi": [1205018439]}, {"billed_charge": 7.45, "npi": [1205018439]}, {"billed_charge": 6.36, "npi": [1205018439]}, {"billed_charge": 0.901, "npi": [1205018439]}, {"billed_charge": 36.0, "npi": [1205018439]}, {"billed_charge": 20.76, "npi": [1205018439]}, {"billed_charge": 4.1191, "npi": [1205018439]}, {"billed_charge": 2.7209, "npi": [1205018439]}, {"billed_charge": 0.2748, "npi": [1205018439]}, {"billed_charge": 4.8517, "npi": [1205018439]}, {"billed_charge": 18.06, "npi": [1205018439]}, {"billed_charge": 0.857, "npi": [1205018439]}, {"billed_charge": 3.3, "npi": [1205018439]}, {"billed_charge": 1.655, "npi": [1205018439]}, {"billed_charge": 31.8, "npi": [1205018439]}, {"billed_charge": 103.0, "npi": [1205018439]}, {"billed_charge": 18.77, "npi": [1205018439]}, {"billed_charge": 17.82, "npi": [1205018439]}, {"billed_charge": 0.708, "npi": [1205018439]}, {"billed_charge": 6.25, "npi": [1205018439]}]}, {"allowed_amount": 0.485, "billing_code_modifier": ["JZ"], "providers": [{"billed_charge": 2.1, "npi": [1205018439]}, {"billed_charge": 5.25, "npi": [1205018439]}]}, {"allowed_amount": 0.48, "billing_code_modifier": [""], "providers": [{"billed_charge": 2.76, "npi": [1205018439]}, {"billed_charge": 2.1, "npi": [1205018439]}, {"billed_charge": 5.25, "npi": [1205018439]}]}, {"allowed_amount": 0.48, "billing_code_modifier": ["JZ"], "providers": [{"billed_charge": 22.5, "npi": [1205018439]}, {"billed_charge": 4.74, "npi": [1205018439]}, {"billed_charge": 15.0, "npi": [1205018439]}, {"billed_charge": 3.16, "npi": [1205018439]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["JZ"], "providers": [{"billed_charge": 10.5, "npi": [1205018439]}, {"billed_charge": 0.468, "npi": [1205018439]}, {"billed_charge": 0.0675, "npi": [1205018439]}, {"billed_charge": 1.004, "npi": [1205018439]}, {"billed_charge": 10.0, "npi": [1205018439]}, {"billed_charge": 6.18, "npi": [1205018439]}, {"billed_charge": 1.2, "npi": [1205018439]}, {"billed_charge": 1.02, "npi": [1205018439]}, {"billed_charge": 1.35, "npi": [1205018439]}, {"billed_charge": 3.35, "npi": [1205018439]}, {"billed_charge": 4.405, "npi": [1205018439]}, {"billed_charge": 14.52, "npi": [1205018439]}, {"billed_charge": 8.75, "npi": [1205018439]}, {"billed_charge": 1.925, "npi": [1205018439]}, {"billed_charge": 0.5028, "npi": [1205018439]}, {"billed_charge": 1.0794, "npi": [1205018439]}, {"billed_charge": 1.45, "npi": [1205018439]}, {"billed_charge": 0.4788, "npi": [1205018439]}, {"billed_charge": 20.77, "npi": [1205018439]}, {"billed_charge": 4.23, "npi": [1205018439]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["JW"], "providers": [{"billed_charge": 1.6714, "npi": [1205018439]}, {"billed_charge": 4.8525, "npi": [1205018439]}]}, {"allowed_amount": 0.48, "billing_code_modifier": ["JW"], "providers": [{"billed_charge": 2.76, "npi": [1205018439]}, {"billed_charge": 2.1, "npi": [1205018439]}, {"billed_charge": 5.25, "npi": [1205018439]}]}]}]}, {"name": "CT Scan - General", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0350", "description": "CT Scan", "allowed_amounts": [{"tin": {"type": "ein", "value": "756001743"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 320.73, "billing_code_modifier": [""], "providers": [{"billed_charge": 4150.0, "npi": [1336172105]}]}, {"allowed_amount": 622.69, "billing_code_modifier": [""], "providers": [{"billed_charge": 6795.5, "npi": [1336172105]}, {"billed_charge": 4150.0, "npi": [1336172105]}]}, {"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 6795.5, "npi": [1336172105]}, {"billed_charge": 10189.0, "npi": [1336172105]}, {"billed_charge": 5817.25, "npi": [1336172105]}, {"billed_charge": 1849.75, "npi": [1336172105]}, {"billed_charge": 5266.25, "npi": [1336172105]}, {"billed_charge": 4150.0, "npi": [1336172105]}]}, {"allowed_amount": 345.85, "billing_code_modifier": [""], "providers": [{"billed_charge": 5817.25, "npi": [1336172105]}]}, {"allowed_amount": 505.67, "billing_code_modifier": ["U6"], "providers": [{"billed_charge": 6795.5, "npi": [1336172105]}]}, {"allowed_amount": 505.67, "billing_code_modifier": [""], "providers": [{"billed_charge": 6795.5, "npi": [1336172105]}]}]}]}, {"name": "CHIROPRACTIC MANIPULATIVE TX SPINAL 3-4 REGIONS", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "98941", "description": "CHIROPRACTIC MANIPULATIVE TX SPINAL 3-4 REGIONS", "allowed_amounts": [{"tin": {"type": "ein", "value": "830673541"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 46.21, "billing_code_modifier": [""], "providers": [{"billed_charge": 92.0, "npi": [1164122420]}]}, {"allowed_amount": 46.21, "billing_code_modifier": ["AT"], "providers": [{"billed_charge": 92.0, "npi": [1164122420]}]}]}]}, {"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": "451502252"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 9.0, "npi": [1215296884]}, {"billed_charge": 2.5, "npi": [1215296884]}, {"billed_charge": 0.125, "npi": [1215296884]}, {"billed_charge": 1.0, "npi": [1215296884]}, {"billed_charge": 1.5994, "npi": [1215296884]}, {"billed_charge": 6.2218, "npi": [1215296884]}, {"billed_charge": 15.0, "npi": [1215296884]}, {"billed_charge": 0.7813, "npi": [1215296884]}, {"billed_charge": 50.0, "npi": [1215296884]}, {"billed_charge": 12.5, "npi": [1215296884]}, {"billed_charge": 3.99, "npi": [1215296884]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["JZ"], "providers": [{"billed_charge": 5.9975, "npi": [1215296884]}, {"billed_charge": 10.41, "npi": [1215296884]}, {"billed_charge": 13.09, "npi": [1215296884]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["JW"], "providers": [{"billed_charge": 1.3889, "npi": [1215296884]}]}]}]}, {"name": "IAADIADOO INFLUENZA", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "87804", "description": "IAADIADOO INFLUENZA", "allowed_amounts": [{"tin": {"type": "ein", "value": "853503076"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": ["QW59"], "providers": [{"billed_charge": 342.53, "npi": [1124623889]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["QW"], "providers": [{"billed_charge": 342.53, "npi": [1124623889]}]}]}]}, {"name": "Laboratory - Hematology", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0305", "description": "Laboratory", "allowed_amounts": [{"tin": {"type": "ein", "value": "752890358"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 233.5, "npi": [1548291883]}, {"billed_charge": 706.5, "npi": [1548291883]}, {"billed_charge": 230.75, "npi": [1548291883]}]}]}]}, {"name": "Laboratory - Hematology", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0305", "description": "Laboratory", "allowed_amounts": [{"tin": {"type": "ein", "value": "753175630"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 71.0, "npi": [1285798918]}, {"billed_charge": 119.0, "npi": [1285798918]}, {"billed_charge": 175.0, "npi": [1285798918]}, {"billed_charge": 108.0, "npi": [1285798918]}, {"billed_charge": 42.0, "npi": [1285798918]}, {"billed_charge": 176.0, "npi": [1285798918]}, {"billed_charge": 121.3, "npi": [1285798918]}, {"billed_charge": 113.6, "npi": [1285798918]}, {"billed_charge": 110.0, "npi": [1285798918]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["91"], "providers": [{"billed_charge": 42.0, "npi": [1285798918]}]}, {"allowed_amount": 11.27, "billing_code_modifier": [""], "providers": [{"billed_charge": 119.0, "npi": [1285798918]}]}]}]}, {"name": "Radiology - Diagnostic - Chest X-Ray", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0324", "description": "Radiology - Diagnostic", "allowed_amounts": [{"tin": {"type": "ein", "value": "751837454"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 366.74, "npi": [1447250253]}]}, {"allowed_amount": 126.14, "billing_code_modifier": [""], "providers": [{"billed_charge": 656.37, "npi": [1447250253]}, {"billed_charge": 366.74, "npi": [1447250253]}]}, {"allowed_amount": 94.61, "billing_code_modifier": [""], "providers": [{"billed_charge": 366.74, "npi": [1447250253]}]}, {"allowed_amount": 126.135, "billing_code_modifier": [""], "providers": [{"billed_charge": 366.74, "npi": [1447250253]}]}]}]}, {"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": "472177648"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 151.54, "billing_code_modifier": [""], "providers": [{"billed_charge": 5511.2, "npi": [1790174860]}, {"billed_charge": 3140.0, "npi": [1790174860]}]}, {"allowed_amount": 622.69, "billing_code_modifier": [""], "providers": [{"billed_charge": 11591.64, "npi": [1790174860]}]}, {"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 4823.1067, "npi": [1790174860]}, {"billed_charge": 5511.2, "npi": [1790174860]}, {"billed_charge": 1167.6, "npi": [1790174860]}, {"billed_charge": 12735.76, "npi": [1790174860]}, {"billed_charge": 4580.0, "npi": [1790174860]}, {"billed_charge": 9506.115, "npi": [1790174860]}, {"billed_charge": 3140.0, "npi": [1790174860]}, {"billed_charge": 6959.97, "npi": [1790174860]}]}, {"allowed_amount": 345.85, "billing_code_modifier": [""], "providers": [{"billed_charge": 1167.6, "npi": [1790174860]}]}, {"allowed_amount": 505.67, "billing_code_modifier": [""], "providers": [{"billed_charge": 12735.76, "npi": [1790174860]}]}]}]}, {"name": "Laboratory - Hematology", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0305", "description": "Laboratory", "allowed_amounts": [{"tin": {"type": "ein", "value": "752682017"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 417.0, "npi": [1114998911]}, {"billed_charge": 290.0, "npi": [1114998911]}, {"billed_charge": 327.0, "npi": [1114998911]}, {"billed_charge": 252.0, "npi": [1114998911]}, {"billed_charge": 416.6667, "npi": [1114998911]}]}, {"allowed_amount": 11.66, "billing_code_modifier": [""], "providers": [{"billed_charge": 417.0, "npi": [1114998911]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["91"], "providers": [{"billed_charge": 327.0, "npi": [1114998911]}]}]}]}, {"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": "621789402"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 5.0, "npi": [1700805678]}, {"billed_charge": 12.78, "npi": [1700805678]}, {"billed_charge": 2.14, "npi": [1700805678]}, {"billed_charge": 183.5, "npi": [1700805678]}, {"billed_charge": 29.53, "npi": [1700805678]}, {"billed_charge": 0.62, "npi": [1700805678]}, {"billed_charge": 13.0, "npi": [1700805678]}, {"billed_charge": 35.1, "npi": [1700805678]}, {"billed_charge": 1.23, "npi": [1700805678]}, {"billed_charge": 8.24, "npi": [1700805678]}, {"billed_charge": 212.7, "npi": [1700805678]}, {"billed_charge": 4.28, "npi": [1700805678]}, {"billed_charge": 23.18, "npi": [1700805678]}]}, {"allowed_amount": 0.485, "billing_code_modifier": ["JZ"], "providers": [{"billed_charge": 42.23, "npi": [1700805678]}]}, {"allowed_amount": 0.4833, "billing_code_modifier": ["JZ"], "providers": [{"billed_charge": 42.23, "npi": [1700805678]}]}, {"allowed_amount": 0.4825, "billing_code_modifier": ["JZ"], "providers": [{"billed_charge": 42.23, "npi": [1700805678]}]}]}]}, {"name": "Emergency Room - General", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0450", "description": "Emergency Room", "allowed_amounts": [{"tin": {"type": "ein", "value": "452694620"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 3886.45, "npi": [1033120423]}, {"billed_charge": 8264.08, "npi": [1033120423]}, {"billed_charge": 586.58, "npi": [1033120423]}]}, {"allowed_amount": 396.31, "billing_code_modifier": [""], "providers": [{"billed_charge": 1551.97, "npi": [1033120423]}]}, {"allowed_amount": 3797.35, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 3886.45, "npi": [1033120423]}]}, {"allowed_amount": 864.64, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 3886.45, "npi": [1033120423]}, {"billed_charge": 8264.08, "npi": [1033120423]}, {"billed_charge": 3015.17, "npi": [1033120423]}]}, {"allowed_amount": 605.81, "billing_code_modifier": [""], "providers": [{"billed_charge": 2804.94, "npi": [1033120423]}]}, {"allowed_amount": 605.81, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 2804.94, "npi": [1033120423]}]}, {"allowed_amount": 358.14, "billing_code_modifier": ["RT"], "providers": [{"billed_charge": 2143.89, "npi": [1033120423]}, {"billed_charge": 3015.17, "npi": [1033120423]}]}]}]}, {"name": "SERVICES PROVIDED BTW 10 PM AND 8 AM AT 24-HR FACI", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "99053", "description": "SERVICES PROVIDED BTW 10 PM AND 8 AM AT 24-HR FACI", "allowed_amounts": [{"tin": {"type": "ein", "value": "751286819"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 45.0, "npi": [1811307259]}, {"billed_charge": 45.0, "npi": [1780902593]}]}]}]}, {"name": "Laboratory - Urology", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0307", "description": "Laboratory", "allowed_amounts": [{"tin": {"type": "ein", "value": "752586857"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 145.97, "npi": [1992700983]}, {"billed_charge": 83.58, "npi": [1992700983]}, {"billed_charge": 162.16, "npi": [1992700983]}, {"billed_charge": 129.78, "npi": [1992700983]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["XU"], "providers": [{"billed_charge": 129.78, "npi": [1992700983]}]}]}]}, {"name": "Respiratory Services - General", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0410", "description": "Respiratory Services", "allowed_amounts": [{"tin": {"type": "ein", "value": "751837454"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 466.1879, "npi": [1447250253]}, {"billed_charge": 459.836, "npi": [1447250253]}, {"billed_charge": 2978.89, "npi": [1447250253]}, {"billed_charge": 369.3215, "npi": [1447250253]}, {"billed_charge": 442.6921, "npi": [1447250253]}, {"billed_charge": 344.6371, "npi": [1447250253]}, {"billed_charge": 584.868, "npi": [1447250253]}, {"billed_charge": 339.15, "npi": [1447250253]}, {"billed_charge": 3140.09, "npi": [1447250253]}, {"billed_charge": 309.8821, "npi": [1447250253]}, {"billed_charge": 2258.73, "npi": [1447250253]}, {"billed_charge": 1546.01, "npi": [1447250253]}, {"billed_charge": 307.1686, "npi": [1447250253]}]}]}]}, {"name": "Laboratory - Hematology", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0305", "description": "Laboratory", "allowed_amounts": [{"tin": {"type": "ein", "value": "751977850"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 206.5, "npi": [1396778064]}, {"billed_charge": 233.5, "npi": [1396778064]}, {"billed_charge": 706.5, "npi": [1396778064]}]}]}]}, {"name": "Radiology - Diagnostic - General", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0320", "description": "Radiology - Diagnostic", "allowed_amounts": [{"tin": {"type": "ein", "value": "750800628"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 503.4, "billing_code_modifier": ["RT"], "providers": [{"billed_charge": 839.0, "npi": [1194743013]}, {"billed_charge": 839.0, "npi": [1720480627]}]}, {"allowed_amount": 334.8, "billing_code_modifier": ["LT"], "providers": [{"billed_charge": 558.0, "npi": [1194743013]}]}, {"allowed_amount": 373.2, "billing_code_modifier": ["RT"], "providers": [{"billed_charge": 622.0, "npi": [1720480627]}, {"billed_charge": 622.0, "npi": [1194743013]}]}, {"allowed_amount": 227.37, "billing_code_modifier": [""], "providers": [{"billed_charge": 689.0, "npi": [1720480627]}]}, {"allowed_amount": 412.2, "billing_code_modifier": ["RT"], "providers": [{"billed_charge": 687.0, "npi": [1720480627]}, {"billed_charge": 687.0, "npi": [1194743013]}]}, {"allowed_amount": 373.2, "billing_code_modifier": ["LT"], "providers": [{"billed_charge": 622.0, "npi": [1194743013]}]}, {"allowed_amount": 396.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 660.0, "npi": [1194743013]}, {"billed_charge": 660.0, "npi": [1720480627]}]}, {"allowed_amount": 411.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 685.0, "npi": [1194743013]}]}, {"allowed_amount": 454.8, "billing_code_modifier": ["RT"], "providers": [{"billed_charge": 758.0, "npi": [1194743013]}]}, {"allowed_amount": 589.4, "billing_code_modifier": [""], "providers": [{"billed_charge": 982.3333, "npi": [1194743013]}]}, {"allowed_amount": 385.8, "billing_code_modifier": ["RT"], "providers": [{"billed_charge": 643.0, "npi": [1720480627]}]}, {"allowed_amount": 413.4, "billing_code_modifier": [""], "providers": [{"billed_charge": 689.0, "npi": [1720480627]}, {"billed_charge": 689.0, "npi": [1194743013]}]}, {"allowed_amount": 268.71, "billing_code_modifier": [""], "providers": [{"billed_charge": 689.0, "npi": [1194743013]}]}, {"allowed_amount": 403.8, "billing_code_modifier": ["RT"], "providers": [{"billed_charge": 673.0, "npi": [1720480627]}]}, {"allowed_amount": 319.8, "billing_code_modifier": ["LT"], "providers": [{"billed_charge": 533.0, "npi": [1194743013]}]}, {"allowed_amount": 412.2, "billing_code_modifier": ["LT"], "providers": [{"billed_charge": 687.0, "npi": [1720480627]}]}, {"allowed_amount": 516.2, "billing_code_modifier": [""], "providers": [{"billed_charge": 860.3333, "npi": [1194743013]}]}, {"allowed_amount": 403.8, "billing_code_modifier": ["LT"], "providers": [{"billed_charge": 673.0, "npi": [1194743013]}]}, {"allowed_amount": 503.4, "billing_code_modifier": ["LT"], "providers": [{"billed_charge": 839.0, "npi": [1194743013]}]}]}]}, {"name": "BHVAL HEALTH; SHORT-TERM RES W/O ROOM and BOARD-DIEM", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "H0018", "description": "BHVAL HEALTH; SHORT-TERM RES W/O ROOM and BOARD-DIEM", "allowed_amounts": [{"tin": {"type": "ein", "value": "452974402"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 1275.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 4250.0, "npi": [1063786069]}]}]}]}, {"name": "Pharmacy - Extension of 25X - Drug Requiring Detailed Coding", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0636", "description": "Pharmacy - Extension of 25x", "allowed_amounts": [{"tin": {"type": "ein", "value": "751748586"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.49, "billing_code_modifier": [""], "providers": [{"billed_charge": 10.0, "npi": [1508899204]}]}, {"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 7.5, "npi": [1508899204]}, {"billed_charge": 12.5, "npi": [1508899204]}, {"billed_charge": 0.5385, "npi": [1508899204]}, {"billed_charge": 13.66, "npi": [1508899204]}, {"billed_charge": 10.55, "npi": [1508899204]}, {"billed_charge": 22.6875, "npi": [1508899204]}, {"billed_charge": 51.69, "npi": [1508899204]}, {"billed_charge": 4.7192, "npi": [1508899204]}, {"billed_charge": 1.0, "npi": [1508899204]}, {"billed_charge": 15.0, "npi": [1508899204]}, {"billed_charge": 10.0, "npi": [1508899204]}, {"billed_charge": 50.0, "npi": [1508899204]}, {"billed_charge": 13.73, "npi": [1508899204]}, {"billed_charge": 24.24, "npi": [1508899204]}, {"billed_charge": 0.125, "npi": [1508899204]}, {"billed_charge": 0.25, "npi": [1508899204]}, {"billed_charge": 12.12, "npi": [1508899204]}, {"billed_charge": 2.5, "npi": [1508899204]}, {"billed_charge": 3.42, "npi": [1508899204]}, {"billed_charge": 22.69, "npi": [1508899204]}]}, {"allowed_amount": 0.49, "billing_code_modifier": ["JW"], "providers": [{"billed_charge": 10.0, "npi": [1508899204]}]}, {"allowed_amount": 0.48, "billing_code_modifier": [""], "providers": [{"billed_charge": 10.0, "npi": [1508899204]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["JZ"], "providers": [{"billed_charge": 0.5, "npi": [1508899204]}, {"billed_charge": 2.0, "npi": [1508899204]}, {"billed_charge": 9.0, "npi": [1508899204]}, {"billed_charge": 1.4844, "npi": [1508899204]}]}, {"allowed_amount": 0.48, "billing_code_modifier": ["JW"], "providers": [{"billed_charge": 10.0, "npi": [1508899204]}]}]}]}, {"name": "Laboratory - Hematology", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0305", "description": "Laboratory", "allowed_amounts": [{"tin": {"type": "ein", "value": "202848116"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 233.5, "npi": [1629138029]}, {"billed_charge": 145.75, "npi": [1629138029]}, {"billed_charge": 206.5, "npi": [1629138029]}, {"billed_charge": 208.75, "npi": [1629138029]}, {"billed_charge": 225.0, "npi": [1629138029]}, {"billed_charge": 182.2188, "npi": [1629138029]}, {"billed_charge": 150.8333, "npi": [1629138029]}, {"billed_charge": 226.5, "npi": [1629138029]}]}]}]}, {"name": "Pharmacy - Drugs Incident to Radiology", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0255", "description": "Pharmacy (also see 063x, an extension of 025x)", "allowed_amounts": [{"tin": {"type": "ein", "value": "751837454"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 4.6283, "npi": [1447250253]}, {"billed_charge": 4.059, "npi": [1447250253]}, {"billed_charge": 4.2549, "npi": [1447250253]}, {"billed_charge": 14.312, "npi": [1447250253]}, {"billed_charge": 11.077, "npi": [1447250253]}, {"billed_charge": 6.773, "npi": [1447250253]}, {"billed_charge": 783.285, "npi": [1447250253]}, {"billed_charge": 9.6977, "npi": [1447250253]}, {"billed_charge": 4.1606, "npi": [1447250253]}, {"billed_charge": 4.0163, "npi": [1447250253]}, {"billed_charge": 4.5315, "npi": [1447250253]}, {"billed_charge": 4.5405, "npi": [1447250253]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["JZ"], "providers": [{"billed_charge": 4.059, "npi": [1447250253]}, {"billed_charge": 4.5406, "npi": [1447250253]}, {"billed_charge": 783.285, "npi": [1447250253]}, {"billed_charge": 4.5405, "npi": [1447250253]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["JW"], "providers": [{"billed_charge": 4.5405, "npi": [1447250253]}]}]}]}, {"name": "Pharmacy - Extension of 25X - Drug Requiring Detailed Coding", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0636", "description": "Pharmacy - Extension of 25x", "allowed_amounts": [{"tin": {"type": "ein", "value": "472177648"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.49, "billing_code_modifier": [""], "providers": [{"billed_charge": 34.2, "npi": [1790174860]}]}, {"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 65.875, "npi": [1790174860]}, {"billed_charge": 21.9, "npi": [1790174860]}, {"billed_charge": 34.4, "npi": [1790174860]}, {"billed_charge": 4.575, "npi": [1790174860]}, {"billed_charge": 18.0, "npi": [1790174860]}, {"billed_charge": 2.59, "npi": [1790174860]}, {"billed_charge": 8.45, "npi": [1790174860]}, {"billed_charge": 4.35, "npi": [1790174860]}, {"billed_charge": 7.1, "npi": [1790174860]}, {"billed_charge": 16.0, "npi": [1790174860]}, {"billed_charge": 8.65, "npi": [1790174860]}, {"billed_charge": 0.6, "npi": [1790174860]}, {"billed_charge": 2.575, "npi": [1790174860]}, {"billed_charge": 52.5, "npi": [1790174860]}, {"billed_charge": 36.1, "npi": [1790174860]}, {"billed_charge": 548.0, "npi": [1790174860]}, {"billed_charge": 30.0, "npi": [1790174860]}, {"billed_charge": 1.8, "npi": [1790174860]}, {"billed_charge": 12.11, "npi": [1790174860]}, {"billed_charge": 10.89, "npi": [1790174860]}, {"billed_charge": 0.1431, "npi": [1790174860]}, {"billed_charge": 71.9, "npi": [1790174860]}, {"billed_charge": 14.4, "npi": [1790174860]}, {"billed_charge": 102.3, "npi": [1790174860]}, {"billed_charge": 1.925, "npi": [1790174860]}, {"billed_charge": 597.2, "npi": [1790174860]}, {"billed_charge": 34.1333, "npi": [1790174860]}, {"billed_charge": 70.0, "npi": [1790174860]}, {"billed_charge": 40.0, "npi": [1790174860]}, {"billed_charge": 33.0, "npi": [1790174860]}, {"billed_charge": 43.0, "npi": [1790174860]}, {"billed_charge": 0.2414, "npi": [1790174860]}, {"billed_charge": 67.2, "npi": [1790174860]}, {"billed_charge": 8.64, "npi": [1790174860]}, {"billed_charge": 18.1, "npi": [1790174860]}, {"billed_charge": 57.8, "npi": [1790174860]}, {"billed_charge": 3.6, "npi": [1790174860]}, {"billed_charge": 41.8333, "npi": [1790174860]}, {"billed_charge": 3.5, "npi": [1790174860]}, {"billed_charge": 7.0, "npi": [1790174860]}]}, {"allowed_amount": 0.485, "billing_code_modifier": ["JZ"], "providers": [{"billed_charge": 34.2, "npi": [1790174860]}]}, {"allowed_amount": 0.49, "billing_code_modifier": ["JW"], "providers": [{"billed_charge": 34.2, "npi": [1790174860]}]}, {"allowed_amount": 0.495, "billing_code_modifier": ["JZ"], "providers": [{"billed_charge": 34.2, "npi": [1790174860]}]}, {"allowed_amount": 0.48, "billing_code_modifier": [""], "providers": [{"billed_charge": 34.2, "npi": [1790174860]}]}, {"allowed_amount": 0.4925, "billing_code_modifier": ["JZ"], "providers": [{"billed_charge": 34.2, "npi": [1790174860]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["JW"], "providers": [{"billed_charge": 18.0, "npi": [1790174860]}, {"billed_charge": 2.59, "npi": [1790174860]}, {"billed_charge": 8.65, "npi": [1790174860]}, {"billed_charge": 21.85, "npi": [1790174860]}]}, {"allowed_amount": 0.48, "billing_code_modifier": ["JW"], "providers": [{"billed_charge": 34.2, "npi": [1790174860]}]}]}]}, {"name": "Room & Board - Private - General", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0110", "description": "Room & Board - Private (One Bed)", "allowed_amounts": [{"tin": {"type": "ein", "value": "751837454"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 5779.5367, "billing_code_modifier": [""], "providers": [{"billed_charge": 1308.15, "npi": [1447250253]}]}, {"allowed_amount": 8835.76, "billing_code_modifier": [""], "providers": [{"billed_charge": 1308.15, "npi": [1447250253]}]}, {"allowed_amount": 1594.264, "billing_code_modifier": [""], "providers": [{"billed_charge": 1308.15, "npi": [1447250253]}]}, {"allowed_amount": 1474.8567, "billing_code_modifier": [""], "providers": [{"billed_charge": 1308.15, "npi": [1447250253]}]}, {"allowed_amount": 2330.9675, "billing_code_modifier": [""], "providers": [{"billed_charge": 1308.15, "npi": [1447250253]}]}, {"allowed_amount": 4469.675, "billing_code_modifier": [""], "providers": [{"billed_charge": 1308.15, "npi": [1447250253]}]}, {"allowed_amount": 4595.76, "billing_code_modifier": [""], "providers": [{"billed_charge": 1308.15, "npi": [1447250253]}]}, {"allowed_amount": 3551.68, "billing_code_modifier": [""], "providers": [{"billed_charge": 1308.15, "npi": [1447250253]}]}, {"allowed_amount": 1422.966, "billing_code_modifier": [""], "providers": [{"billed_charge": 1308.15, "npi": [1447250253]}]}, {"allowed_amount": 25570.46, "billing_code_modifier": [""], "providers": [{"billed_charge": 1308.15, "npi": [1447250253]}]}, {"allowed_amount": 3539.842, "billing_code_modifier": [""], "providers": [{"billed_charge": 1308.15, "npi": [1447250253]}]}, {"allowed_amount": 11244.3, "billing_code_modifier": [""], "providers": [{"billed_charge": 1308.15, "npi": [1447250253]}]}, {"allowed_amount": 2083.4, "billing_code_modifier": [""], "providers": [{"billed_charge": 1308.15, "npi": [1447250253]}]}, {"allowed_amount": 8031.54, "billing_code_modifier": [""], "providers": [{"billed_charge": 1308.15, "npi": [1447250253]}]}, {"allowed_amount": 961.327, "billing_code_modifier": [""], "providers": [{"billed_charge": 1308.15, "npi": [1447250253]}]}, {"allowed_amount": 3826.3775, "billing_code_modifier": [""], "providers": [{"billed_charge": 1308.15, "npi": [1447250253]}]}, {"allowed_amount": 8043.69, "billing_code_modifier": [""], "providers": [{"billed_charge": 1308.15, "npi": [1447250253]}]}, {"allowed_amount": 4829.69, "billing_code_modifier": [""], "providers": [{"billed_charge": 1308.15, "npi": [1447250253]}]}, {"allowed_amount": 4867.78, "billing_code_modifier": [""], "providers": [{"billed_charge": 1308.15, "npi": [1447250253]}]}, {"allowed_amount": 1632.053, "billing_code_modifier": [""], "providers": [{"billed_charge": 1308.15, "npi": [1447250253]}]}, {"allowed_amount": 13090.58, "billing_code_modifier": [""], "providers": [{"billed_charge": 1308.15, "npi": [1447250253]}]}, {"allowed_amount": 2251.286, "billing_code_modifier": [""], "providers": [{"billed_charge": 1308.15, "npi": [1447250253]}]}, {"allowed_amount": 2439.05, "billing_code_modifier": [""], "providers": [{"billed_charge": 1308.15, "npi": [1447250253]}]}, {"allowed_amount": 44998.37, "billing_code_modifier": [""], "providers": [{"billed_charge": 1308.15, "npi": [1447250253]}]}, {"allowed_amount": 7809.54, "billing_code_modifier": [""], "providers": [{"billed_charge": 1308.15, "npi": [1447250253]}]}, {"allowed_amount": 2919.6467, "billing_code_modifier": [""], "providers": [{"billed_charge": 1308.15, "npi": [1447250253]}]}, {"allowed_amount": 8165.79, "billing_code_modifier": [""], "providers": [{"billed_charge": 1308.15, "npi": [1447250253]}]}, {"allowed_amount": 4691.04, "billing_code_modifier": [""], "providers": [{"billed_charge": 1308.15, "npi": [1447250253]}]}, {"allowed_amount": 5624.7963, "billing_code_modifier": [""], "providers": [{"billed_charge": 1308.15, "npi": [1447250253]}]}, {"allowed_amount": 3286.9938, "billing_code_modifier": [""], "providers": [{"billed_charge": 1308.15, "npi": [1447250253]}]}, {"allowed_amount": 1192.3143, "billing_code_modifier": [""], "providers": [{"billed_charge": 1308.15, "npi": [1447250253]}]}, {"allowed_amount": 2435.365, "billing_code_modifier": [""], "providers": [{"billed_charge": 1308.15, "npi": [1447250253]}]}, {"allowed_amount": 7669.44, "billing_code_modifier": [""], "providers": [{"billed_charge": 1308.15, "npi": [1447250253]}]}, {"allowed_amount": 1632.763, "billing_code_modifier": [""], "providers": [{"billed_charge": 1308.15, "npi": [1447250253]}]}, {"allowed_amount": 10317.91, "billing_code_modifier": [""], "providers": [{"billed_charge": 1308.15, "npi": [1447250253]}]}, {"allowed_amount": 4654.9, "billing_code_modifier": [""], "providers": [{"billed_charge": 1308.15, "npi": [1447250253]}]}, {"allowed_amount": 841.9119, "billing_code_modifier": [""], "providers": [{"billed_charge": 1308.15, "npi": [1447250253]}]}, {"allowed_amount": 2010.9225, "billing_code_modifier": [""], "providers": [{"billed_charge": 1308.15, "npi": [1447250253]}]}, {"allowed_amount": 1633.158, "billing_code_modifier": [""], "providers": [{"billed_charge": 1308.15, "npi": [1447250253]}]}]}]}, {"name": "Laboratory - General", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0300", "description": "Laboratory", "allowed_amounts": [{"tin": {"type": "ein", "value": "824052186"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 40.0, "npi": [1801826839]}, {"billed_charge": 99.8045, "npi": [1801826839]}, {"billed_charge": 204.1485, "npi": [1801826839]}, {"billed_charge": 143.25, "npi": [1801826839]}, {"billed_charge": 392.86, "npi": [1801826839]}, {"billed_charge": 47.75, "npi": [1801826839]}]}]}]}, {"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": "472177648"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 151.54, "billing_code_modifier": [""], "providers": [{"billed_charge": 1612.0, "npi": [1790174860]}, {"billed_charge": 1910.85, "npi": [1790174860]}, {"billed_charge": 1960.61, "npi": [1790174860]}]}, {"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 1495.0, "npi": [1790174860]}, {"billed_charge": 1938.0, "npi": [1790174860]}, {"billed_charge": 2267.34, "npi": [1790174860]}, {"billed_charge": 2175.14, "npi": [1790174860]}, {"billed_charge": 3633.53, "npi": [1790174860]}]}, {"allowed_amount": 426.43, "billing_code_modifier": [""], "providers": [{"billed_charge": 1910.85, "npi": [1790174860]}]}]}]}, {"name": "Pharmacy - General", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0250", "description": "Pharmacy (also see 063x, an extension of 025x)", "allowed_amounts": [{"tin": {"type": "ein", "value": "621789402"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 282.3, "npi": [1700805678]}, {"billed_charge": 10.8, "npi": [1700805678]}, {"billed_charge": 60.0, "npi": [1700805678]}, {"billed_charge": 652.6, "npi": [1700805678]}, {"billed_charge": 9.275, "npi": [1700805678]}, {"billed_charge": 10.0875, "npi": [1700805678]}, {"billed_charge": 25.6, "npi": [1700805678]}, {"billed_charge": 13.0409, "npi": [1700805678]}, {"billed_charge": 3.3, "npi": [1700805678]}, {"billed_charge": 7.3, "npi": [1700805678]}, {"billed_charge": 20.632, "npi": [1700805678]}, {"billed_charge": 5.3667, "npi": [1700805678]}, {"billed_charge": 52.1333, "npi": [1700805678]}, {"billed_charge": 1.5, "npi": [1700805678]}, {"billed_charge": 5.2, "npi": [1700805678]}, {"billed_charge": 105.8, "npi": [1700805678]}, {"billed_charge": 5.5889, "npi": [1700805678]}, {"billed_charge": 15.9667, "npi": [1700805678]}, {"billed_charge": 38.6, "npi": [1700805678]}, {"billed_charge": 12.0609, "npi": [1700805678]}, {"billed_charge": 28.1231, "npi": [1700805678]}, {"billed_charge": 9.9571, "npi": [1700805678]}, {"billed_charge": 35.65, "npi": [1700805678]}, {"billed_charge": 11.9955, "npi": [1700805678]}, {"billed_charge": 40.5, "npi": [1700805678]}, {"billed_charge": 3.8, "npi": [1700805678]}, {"billed_charge": 6.7, "npi": [1700805678]}]}]}]}, {"name": "Laboratory - Chemistry", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0301", "description": "Laboratory", "allowed_amounts": [{"tin": {"type": "ein", "value": "742781812"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 695.0, "npi": [1679528889]}, {"billed_charge": 1160.0, "npi": [1679528889]}, {"billed_charge": 1602.0, "npi": [1679528889]}, {"billed_charge": 611.0, "npi": [1679528889]}, {"billed_charge": 614.0, "npi": [1679528889]}, {"billed_charge": 1057.0, "npi": [1679528889]}]}]}]}, {"name": "Laboratory - Chemistry", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0301", "description": "Laboratory", "allowed_amounts": [{"tin": {"type": "ein", "value": "751777119"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 108.35, "npi": [1073511762]}, {"billed_charge": 153.91, "npi": [1073511762]}, {"billed_charge": 87.97, "npi": [1073511762]}, {"billed_charge": 103.83, "npi": [1073511762]}, {"billed_charge": 407.22, "npi": [1073511762]}, {"billed_charge": 80.9495, "npi": [1073511762]}, {"billed_charge": 187.7192, "npi": [1073511762]}, {"billed_charge": 185.85, "npi": [1073511762]}, {"billed_charge": 96.1, "npi": [1073511762]}, {"billed_charge": 432.76, "npi": [1073511762]}, {"billed_charge": 103.54, "npi": [1073511762]}, {"billed_charge": 459.04, "npi": [1073511762]}, {"billed_charge": 285.79, "npi": [1073511762]}, {"billed_charge": 229.02, "npi": [1073511762]}, {"billed_charge": 306.86, "npi": [1073511762]}, {"billed_charge": 105.46, "npi": [1073511762]}, {"billed_charge": 88.72, "npi": [1073511762]}, {"billed_charge": 99.79, "npi": [1073511762]}, {"billed_charge": 243.23, "npi": [1073511762]}, {"billed_charge": 217.7, "npi": [1073511762]}, {"billed_charge": 249.74, "npi": [1073511762]}, {"billed_charge": 56.6, "npi": [1073511762]}, {"billed_charge": 101.57, "npi": [1073511762]}, {"billed_charge": 93.56, "npi": [1073511762]}, {"billed_charge": 80.13, "npi": [1073511762]}, {"billed_charge": 111.02, "npi": [1073511762]}]}, {"allowed_amount": 5.7, "billing_code_modifier": [""], "providers": [{"billed_charge": 99.79, "npi": [1073511762]}]}]}]}, {"name": "Laboratory - Chemistry", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0301", "description": "Laboratory", "allowed_amounts": [{"tin": {"type": "ein", "value": "750972805"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 679.25, "npi": [1174533343]}, {"billed_charge": 340.0, "npi": [1174533343]}, {"billed_charge": 222.25, "npi": [1174533343]}, {"billed_charge": 155.8259, "npi": [1174533343]}, {"billed_charge": 240.7083, "npi": [1174533343]}, {"billed_charge": 231.0, "npi": [1174533343]}, {"billed_charge": 310.4091, "npi": [1174533343]}, {"billed_charge": 671.0, "npi": [1174533343]}, {"billed_charge": 308.0, "npi": [1174533343]}, {"billed_charge": 576.25, "npi": [1174533343]}, {"billed_charge": 328.75, "npi": [1174533343]}, {"billed_charge": 348.5, "npi": [1174533343]}, {"billed_charge": 161.0, "npi": [1174533343]}, {"billed_charge": 153.5, "npi": [1174533343]}, {"billed_charge": 254.5, "npi": [1174533343]}, {"billed_charge": 210.75, "npi": [1174533343]}, {"billed_charge": 442.5, "npi": [1174533343]}, {"billed_charge": 561.75, "npi": [1174533343]}, {"billed_charge": 225.75, "npi": [1174533343]}, {"billed_charge": 278.25, "npi": [1174533343]}, {"billed_charge": 324.5, "npi": [1174533343]}, {"billed_charge": 378.4688, "npi": [1174533343]}, {"billed_charge": 257.75, "npi": [1174533343]}, {"billed_charge": 334.25, "npi": [1174533343]}, {"billed_charge": 463.25, "npi": [1174533343]}]}, {"allowed_amount": 5.7, "billing_code_modifier": ["91"], "providers": [{"billed_charge": 49.25, "npi": [1174533343]}]}, {"allowed_amount": 19.42, "billing_code_modifier": [""], "providers": [{"billed_charge": 679.25, "npi": [1174533343]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["91"], "providers": [{"billed_charge": 247.0, "npi": [1174533343]}]}]}]}, {"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": "742781812"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 13.0, "npi": [1679528889]}, {"billed_charge": 5.6, "npi": [1679528889]}, {"billed_charge": 2.73, "npi": [1679528889]}, {"billed_charge": 7.0, "npi": [1679528889]}, {"billed_charge": 2.2, "npi": [1679528889]}, {"billed_charge": 93.0, "npi": [1679528889]}, {"billed_charge": 28.0, "npi": [1679528889]}, {"billed_charge": 448.0, "npi": [1679528889]}, {"billed_charge": 33.0, "npi": [1679528889]}, {"billed_charge": 4.45, "npi": [1679528889]}, {"billed_charge": 24.0, "npi": [1679528889]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["JW"], "providers": [{"billed_charge": 2.2, "npi": [1679528889]}, {"billed_charge": 24.0, "npi": [1679528889]}]}]}]}, {"name": "ALS ROUTINE DISPOSABLE SUPPLIES", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "A0398", "description": "ALS ROUTINE DISPOSABLE SUPPLIES", "allowed_amounts": [{"tin": {"type": "ein", "value": "264304912"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": ["HH"], "providers": [{"billed_charge": 425.0, "npi": [1871724864]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["RI"], "providers": [{"billed_charge": 425.0, "npi": [1871724864]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["RH"], "providers": [{"billed_charge": 425.0, "npi": [1871724864]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["SH"], "providers": [{"billed_charge": 425.0, "npi": [1871724864]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["NH"], "providers": [{"billed_charge": 425.0, "npi": [1871724864]}]}]}]}, {"name": "Pharmacy - General", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0250", "description": "Pharmacy (also see 063x, an extension of 025x)", "allowed_amounts": [{"tin": {"type": "ein", "value": "751844139"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 1.3833, "npi": [1265430177]}, {"billed_charge": 2.29, "npi": [1265430177]}, {"billed_charge": 2.92, "npi": [1265430177]}, {"billed_charge": 2.268, "npi": [1265430177]}, {"billed_charge": 6.2751, "npi": [1265430177]}, {"billed_charge": 0.71, "npi": [1265430177]}, {"billed_charge": 8.82, "npi": [1265430177]}, {"billed_charge": 28.8486, "npi": [1265430177]}, {"billed_charge": 4.815, "npi": [1265430177]}, {"billed_charge": 8.86, "npi": [1265430177]}, {"billed_charge": 3.97, "npi": [1265430177]}, {"billed_charge": 9.91, "npi": [1265430177]}, {"billed_charge": 0.3425, "npi": [1265430177]}, {"billed_charge": 1.6, "npi": [1265430177]}, {"billed_charge": 0.578, "npi": [1265430177]}, {"billed_charge": 21.45, "npi": [1265430177]}, {"billed_charge": 2.0, "npi": [1265430177]}, {"billed_charge": 0.26, "npi": [1265430177]}, {"billed_charge": 1.4046, "npi": [1265430177]}, {"billed_charge": 0.68, "npi": [1265430177]}, {"billed_charge": 0.16, "npi": [1265430177]}, {"billed_charge": 15.69, "npi": [1265430177]}, {"billed_charge": 14.655, "npi": [1265430177]}, {"billed_charge": 6.9933, "npi": [1265430177]}, {"billed_charge": 0.075, "npi": [1265430177]}, {"billed_charge": 6.8867, "npi": [1265430177]}, {"billed_charge": 6.3944, "npi": [1265430177]}, {"billed_charge": 0.11, "npi": [1265430177]}, {"billed_charge": 2.4616, "npi": [1265430177]}, {"billed_charge": 82.5333, "npi": [1265430177]}, {"billed_charge": 5.29, "npi": [1265430177]}, {"billed_charge": 0.7875, "npi": [1265430177]}, {"billed_charge": 11.72, "npi": [1265430177]}, {"billed_charge": 6.1013, "npi": [1265430177]}, {"billed_charge": 0.09, "npi": [1265430177]}, {"billed_charge": 0.1625, "npi": [1265430177]}, {"billed_charge": 1.045, "npi": [1265430177]}, {"billed_charge": 1.005, "npi": [1265430177]}, {"billed_charge": 0.13, "npi": [1265430177]}, {"billed_charge": 8.689, "npi": [1265430177]}, {"billed_charge": 0.04, "npi": [1265430177]}, {"billed_charge": 3.11, "npi": [1265430177]}, {"billed_charge": 0.31, "npi": [1265430177]}, {"billed_charge": 28.2, "npi": [1265430177]}, {"billed_charge": 7.0525, "npi": [1265430177]}, {"billed_charge": 0.47, "npi": [1265430177]}, {"billed_charge": 2.056, "npi": [1265430177]}, {"billed_charge": 2.17, "npi": [1265430177]}, {"billed_charge": 8.7087, "npi": [1265430177]}, {"billed_charge": 0.605, "npi": [1265430177]}, {"billed_charge": 11.24, "npi": [1265430177]}, {"billed_charge": 2.16, "npi": [1265430177]}, {"billed_charge": 15.72, "npi": [1265430177]}]}]}]}, {"name": "Pharmacy - Extension of 25X - Drug Requiring Detailed Coding", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0636", "description": "Pharmacy - Extension of 25x", "allowed_amounts": [{"tin": {"type": "ein", "value": "751037591"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.49, "billing_code_modifier": [""], "providers": [{"billed_charge": 2.1, "npi": [1124305065]}, {"billed_charge": 2.76, "npi": [1124305065]}, {"billed_charge": 5.25, "npi": [1124305065]}]}, {"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 0.0198, "npi": [1851108765]}, {"billed_charge": 11.84, "npi": [1124305065]}, {"billed_charge": 31.55, "npi": [1124305065]}, {"billed_charge": 12.03, "npi": [1124305065]}, {"billed_charge": 4.32, "npi": [1124305065]}, {"billed_charge": 23.882, "npi": [1124305065]}, {"billed_charge": 1.5581, "npi": [1124305065]}, {"billed_charge": 18.77, "npi": [1124305065]}, {"billed_charge": 1.35, "npi": [1124305065]}, {"billed_charge": 3.535, "npi": [1124305065]}, {"billed_charge": 18.06, "npi": [1124305065]}, {"billed_charge": 20.98, "npi": [1124305065]}, {"billed_charge": 0.3886, "npi": [1124305065]}, {"billed_charge": 42.0, "npi": [1124305065]}, {"billed_charge": 17.82, "npi": [1124305065]}, {"billed_charge": 0.394, "npi": [1124305065]}, {"billed_charge": 13.49, "npi": [1124305065]}, {"billed_charge": 20.76, "npi": [1124305065]}, {"billed_charge": 12.52, "npi": [1124305065]}, {"billed_charge": 2.4444, "npi": [1124305065]}, {"billed_charge": 276.85, "npi": [1124305065]}, {"billed_charge": 2.795, "npi": [1124305065]}, {"billed_charge": 12.52, "npi": [1851108765]}, {"billed_charge": 2.04, "npi": [1124305065]}, {"billed_charge": 20.1, "npi": [1124305065]}, {"billed_charge": 7.1339, "npi": [1851108765]}, {"billed_charge": 0.857, "npi": [1124305065]}, {"billed_charge": 10.0367, "npi": [1124305065]}, {"billed_charge": 11.395, "npi": [1851108765]}, {"billed_charge": 10.05, "npi": [1124305065]}, {"billed_charge": 17.82, "npi": [1851108765]}, {"billed_charge": 1.4504, "npi": [1124305065]}, {"billed_charge": 31.8, "npi": [1124305065]}, {"billed_charge": 28.47, "npi": [1124305065]}, {"billed_charge": 4.23, "npi": [1124305065]}, {"billed_charge": 16.44, "npi": [1851108765]}, {"billed_charge": 172.03, "npi": [1124305065]}, {"billed_charge": 0.1306, "npi": [1124305065]}, {"billed_charge": 23.22, "npi": [1124305065]}, {"billed_charge": 6.9318, "npi": [1851108765]}, {"billed_charge": 17.7283, "npi": [1124305065]}, {"billed_charge": 157.105, "npi": [1124305065]}, {"billed_charge": 0.7327, "npi": [1124305065]}, {"billed_charge": 18.06, "npi": [1851108765]}]}, {"allowed_amount": 0.485, "billing_code_modifier": ["JZ"], "providers": [{"billed_charge": 5.25, "npi": [1124305065]}]}, {"allowed_amount": 0.49, "billing_code_modifier": ["JW"], "providers": [{"billed_charge": 2.1, "npi": [1124305065]}, {"billed_charge": 2.76, "npi": [1124305065]}, {"billed_charge": 5.25, "npi": [1124305065]}]}, {"allowed_amount": 0.48, "billing_code_modifier": [""], "providers": [{"billed_charge": 2.1, "npi": [1124305065]}, {"billed_charge": 2.76, "npi": [1124305065]}, {"billed_charge": 5.25, "npi": [1124305065]}, {"billed_charge": 2.1, "npi": [1851108765]}, {"billed_charge": 1.93, "npi": [1124305065]}]}, {"allowed_amount": 0.48, "billing_code_modifier": ["JZ"], "providers": [{"billed_charge": 5.46, "npi": [1124305065]}, {"billed_charge": 22.5, "npi": [1124305065]}, {"billed_charge": 2.1, "npi": [1124305065]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["JZ"], "providers": [{"billed_charge": 2.5004, "npi": [1124305065]}, {"billed_charge": 5.016, "npi": [1124305065]}, {"billed_charge": 14.52, "npi": [1124305065]}, {"billed_charge": 1.0124, "npi": [1124305065]}, {"billed_charge": 2.159, "npi": [1124305065]}, {"billed_charge": 8.53, "npi": [1851108765]}, {"billed_charge": 1.67, "npi": [1124305065]}, {"billed_charge": 0.0675, "npi": [1124305065]}, {"billed_charge": 1.925, "npi": [1124305065]}, {"billed_charge": 3.35, "npi": [1124305065]}, {"billed_charge": 0.4668, "npi": [1851108765]}, {"billed_charge": 10.0, "npi": [1124305065]}, {"billed_charge": 1.925, "npi": [1851108765]}, {"billed_charge": 15.8, "npi": [1124305065]}, {"billed_charge": 5.7, "npi": [1124305065]}, {"billed_charge": 1.02, "npi": [1124305065]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["JW"], "providers": [{"billed_charge": 4.32, "npi": [1124305065]}]}, {"allowed_amount": 0.48, "billing_code_modifier": ["JW"], "providers": [{"billed_charge": 2.1, "npi": [1124305065]}, {"billed_charge": 2.76, "npi": [1124305065]}, {"billed_charge": 5.25, "npi": [1124305065]}, {"billed_charge": 2.1, "npi": [1851108765]}, {"billed_charge": 3.59, "npi": [1124305065]}]}]}]}, {"name": "Medical/Surgical Supplies and Devices - Nonsterile Supply", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0271", "description": "Med/Surg Supplies &Devices (also see 062x, extension of 027x", "allowed_amounts": [{"tin": {"type": "ein", "value": "472177648"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 48.3333, "npi": [1790174860]}, {"billed_charge": 105.0, "npi": [1790174860]}, {"billed_charge": 53.7266, "npi": [1790174860]}, {"billed_charge": 24.3071, "npi": [1790174860]}, {"billed_charge": 120.0, "npi": [1790174860]}, {"billed_charge": 31.38, "npi": [1790174860]}, {"billed_charge": 56.0667, "npi": [1790174860]}, {"billed_charge": 7.56, "npi": [1790174860]}, {"billed_charge": 13.95, "npi": [1790174860]}, {"billed_charge": 80.0, "npi": [1790174860]}, {"billed_charge": 67.375, "npi": [1790174860]}, {"billed_charge": 135.0, "npi": [1790174860]}, {"billed_charge": 39.6381, "npi": [1790174860]}, {"billed_charge": 24.7571, "npi": [1790174860]}, {"billed_charge": 31.0, "npi": [1790174860]}, {"billed_charge": 37.5, "npi": [1790174860]}, {"billed_charge": 55.0, "npi": [1790174860]}]}]}]}, {"name": "Pharmacy - Drugs Incident to Radiology", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0255", "description": "Pharmacy (also see 063x, an extension of 025x)", "allowed_amounts": [{"tin": {"type": "ein", "value": "752586857"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 4.7466, "npi": [1992700983]}, {"billed_charge": 4.5405, "npi": [1992700983]}, {"billed_charge": 234.99, "npi": [1992700983]}, {"billed_charge": 6.8222, "npi": [1992700983]}, {"billed_charge": 4.5315, "npi": [1992700983]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["JZ"], "providers": [{"billed_charge": 4.5405, "npi": [1992700983]}, {"billed_charge": 234.99, "npi": [1992700983]}, {"billed_charge": 4.5315, "npi": [1992700983]}, {"billed_charge": 4.086, "npi": [1992700983]}]}]}]}, {"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": "824052186"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 453.2, "npi": [1801826839]}]}]}]}, {"name": "Emergency Room - General", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0450", "description": "Emergency Room", "allowed_amounts": [{"tin": {"type": "ein", "value": "752682017"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 636.96, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 5248.0, "npi": [1114998911]}]}, {"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 1029.0, "npi": [1114998911]}, {"billed_charge": 434.0, "npi": [1114998911]}]}, {"allowed_amount": 636.96, "billing_code_modifier": [""], "providers": [{"billed_charge": 5248.0, "npi": [1114998911]}]}, {"allowed_amount": 909.11, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 8746.0, "npi": [1114998911]}]}, {"allowed_amount": 128.73, "billing_code_modifier": [""], "providers": [{"billed_charge": 1118.0, "npi": [1114998911]}]}, {"allowed_amount": 416.7, "billing_code_modifier": [""], "providers": [{"billed_charge": 3024.0, "npi": [1114998911]}]}, {"allowed_amount": 416.7, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 3024.0, "npi": [1114998911]}]}, {"allowed_amount": 234.39, "billing_code_modifier": [""], "providers": [{"billed_charge": 2103.0, "npi": [1114998911]}]}]}]}, {"name": "Laboratory - Bacteriology & Microbiology", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0306", "description": "Laboratory", "allowed_amounts": [{"tin": {"type": "ein", "value": "751748586"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 69.25, "npi": [1508899204]}, {"billed_charge": 252.75, "npi": [1508899204]}, {"billed_charge": 317.75, "npi": [1508899204]}, {"billed_charge": 364.0, "npi": [1508899204]}, {"billed_charge": 380.75, "npi": [1508899204]}, {"billed_charge": 237.75, "npi": [1508899204]}, {"billed_charge": 230.0, "npi": [1508899204]}, {"billed_charge": 536.25, "npi": [1508899204]}, {"billed_charge": 399.5, "npi": [1508899204]}, {"billed_charge": 229.25, "npi": [1508899204]}]}, {"allowed_amount": 74.4, "billing_code_modifier": [""], "providers": [{"billed_charge": 225.25, "npi": [1508899204]}, {"billed_charge": 242.75, "npi": [1508899204]}]}]}]}, {"name": "Laboratory - Chemistry", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0301", "description": "Laboratory", "allowed_amounts": [{"tin": {"type": "ein", "value": "432008974"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 679.25, "npi": [1003883158]}, {"billed_charge": 335.75, "npi": [1003883158]}, {"billed_charge": 153.5, "npi": [1003883158]}, {"billed_charge": 334.25, "npi": [1003883158]}, {"billed_charge": 218.9518, "npi": [1003883158]}, {"billed_charge": 227.3017, "npi": [1003883158]}, {"billed_charge": 225.75, "npi": [1003883158]}, {"billed_charge": 191.6354, "npi": [1003883158]}, {"billed_charge": 402.6875, "npi": [1003883158]}, {"billed_charge": 1474.5, "npi": [1003883158]}, {"billed_charge": 457.0536, "npi": [1003883158]}, {"billed_charge": 278.25, "npi": [1003883158]}, {"billed_charge": 247.0, "npi": [1003883158]}, {"billed_charge": 324.5, "npi": [1003883158]}, {"billed_charge": 213.0247, "npi": [1003883158]}, {"billed_charge": 410.0, "npi": [1003883158]}]}]}]}, {"name": "Emergency Room - General", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0450", "description": "Emergency Room", "allowed_amounts": [{"tin": {"type": "ein", "value": "753175630"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 3758.0, "npi": [1285798918]}, {"billed_charge": 2443.0, "npi": [1285798918]}]}, {"allowed_amount": 122.22, "billing_code_modifier": ["2527"], "providers": [{"billed_charge": 452.0, "npi": [1285798918]}]}, {"allowed_amount": 604.81, "billing_code_modifier": [""], "providers": [{"billed_charge": 2443.0, "npi": [1285798918]}]}, {"allowed_amount": 222.56, "billing_code_modifier": [""], "providers": [{"billed_charge": 940.0, "npi": [1285798918]}]}, {"allowed_amount": 3791.1, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 3758.0, "npi": [1285798918]}]}, {"allowed_amount": 395.66, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 1541.0, "npi": [1285798918]}]}, {"allowed_amount": 395.66, "billing_code_modifier": [""], "providers": [{"billed_charge": 1541.0, "npi": [1285798918]}]}, {"allowed_amount": 863.2, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 3758.0, "npi": [1285798918]}]}, {"allowed_amount": 122.22, "billing_code_modifier": [""], "providers": [{"billed_charge": 452.0, "npi": [1285798918]}]}, {"allowed_amount": 604.81, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 2443.0, "npi": [1285798918]}]}, {"allowed_amount": 357.54, "billing_code_modifier": ["LT"], "providers": [{"billed_charge": 616.0, "npi": [1285798918]}]}]}]}, {"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": "260194016"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 151.54, "billing_code_modifier": [""], "providers": [{"billed_charge": 3178.59, "npi": [1205018439]}]}, {"allowed_amount": 622.69, "billing_code_modifier": [""], "providers": [{"billed_charge": 2798.1, "npi": [1205018439]}, {"billed_charge": 3178.59, "npi": [1205018439]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["U6"], "providers": [{"billed_charge": 3178.59, "npi": [1205018439]}]}, {"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 2840.9, "npi": [1205018439]}, {"billed_charge": 3178.59, "npi": [1205018439]}, {"billed_charge": 11751.19, "npi": [1205018439]}]}, {"allowed_amount": 254.23, "billing_code_modifier": [""], "providers": [{"billed_charge": 3340.68, "npi": [1205018439]}]}]}]}, {"name": "VISIT COMPLEXITY INHERENT TO HOS INPT/OBS CARE", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "G0545", "description": "VISIT COMPLEXITY INHERENT TO HOS INPT/OBS CARE", "allowed_amounts": [{"tin": {"type": "ein", "value": "752905110"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 45.0, "npi": [1144457649]}]}]}]}, {"name": "Laboratory - Hematology", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0305", "description": "Laboratory", "allowed_amounts": [{"tin": {"type": "ein", "value": "750972805"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 645.5, "npi": [1174533343]}, {"billed_charge": 206.5, "npi": [1174533343]}, {"billed_charge": 226.5, "npi": [1174533343]}, {"billed_charge": 302.5417, "npi": [1174533343]}, {"billed_charge": 209.2321, "npi": [1174533343]}, {"billed_charge": 297.5, "npi": [1174533343]}, {"billed_charge": 212.625, "npi": [1174533343]}, {"billed_charge": 233.5, "npi": [1174533343]}, {"billed_charge": 145.75, "npi": [1174533343]}, {"billed_charge": 208.75, "npi": [1174533343]}]}]}]}, {"name": "Room & Board - Private - Medical/Surgical/GYN", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0111", "description": "Room & Board - Private (One Bed)", "allowed_amounts": [{"tin": {"type": "ein", "value": "752770738"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 4745.0, "npi": [1770514077]}]}, {"allowed_amount": 4539.0229, "billing_code_modifier": [""], "providers": [{"billed_charge": 2210.0, "npi": [1770514077]}]}, {"allowed_amount": 3653.41, "billing_code_modifier": [""], "providers": [{"billed_charge": 2210.0, "npi": [1770514077]}]}, {"allowed_amount": 13797.27, "billing_code_modifier": [""], "providers": [{"billed_charge": 2210.0, "npi": [1770514077]}]}, {"allowed_amount": 2260.5692, "billing_code_modifier": [""], "providers": [{"billed_charge": 2210.0, "npi": [1770514077]}]}, {"allowed_amount": 24254.32, "billing_code_modifier": [""], "providers": [{"billed_charge": 4745.0, "npi": [1770514077]}]}, {"allowed_amount": 8544.125, "billing_code_modifier": [""], "providers": [{"billed_charge": 2210.0, "npi": [1770514077]}]}, {"allowed_amount": 2137.0563, "billing_code_modifier": [""], "providers": [{"billed_charge": 2210.0, "npi": [1770514077]}]}, {"allowed_amount": 2068.8129, "billing_code_modifier": [""], "providers": [{"billed_charge": 2210.0, "npi": [1770514077]}]}]}]}, {"name": "Laboratory - Chemistry", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0301", "description": "Laboratory", "allowed_amounts": [{"tin": {"type": "ein", "value": "752890358"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 324.5, "npi": [1548291883]}, {"billed_charge": 335.75, "npi": [1548291883]}, {"billed_charge": 225.75, "npi": [1548291883]}, {"billed_charge": 257.75, "npi": [1548291883]}, {"billed_charge": 328.75, "npi": [1548291883]}, {"billed_charge": 278.25, "npi": [1548291883]}, {"billed_charge": 49.25, "npi": [1548291883]}, {"billed_charge": 334.25, "npi": [1548291883]}, {"billed_charge": 679.25, "npi": [1548291883]}, {"billed_charge": 671.0, "npi": [1548291883]}, {"billed_charge": 161.0, "npi": [1548291883]}, {"billed_charge": 210.75, "npi": [1548291883]}, {"billed_charge": 340.0, "npi": [1548291883]}, {"billed_charge": 348.5, "npi": [1548291883]}, {"billed_charge": 246.8333, "npi": [1548291883]}, {"billed_charge": 442.5, "npi": [1548291883]}, {"billed_charge": 561.75, "npi": [1548291883]}, {"billed_charge": 153.5, "npi": [1548291883]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["59"], "providers": [{"billed_charge": 120.75, "npi": [1548291883]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["91"], "providers": [{"billed_charge": 335.75, "npi": [1548291883]}, {"billed_charge": 49.25, "npi": [1548291883]}]}]}]}, {"name": "EMERGENCY DEPARTMENT VISIT MODERATE MDM", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "99284", "description": "EMERGENCY DEPARTMENT VISIT MODERATE MDM", "allowed_amounts": [{"tin": {"type": "ein", "value": "853503076"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 5940.92, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 4957.82, "npi": [1124623889]}]}, {"allowed_amount": 2363.42, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 4957.82, "npi": [1124623889]}]}, {"allowed_amount": 2378.89, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 4957.82, "npi": [1124623889]}]}, {"allowed_amount": 1403.44, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 4957.82, "npi": [1124623889]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 4957.82, "npi": [1124623889]}]}, {"allowed_amount": 2037.44, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 4957.82, "npi": [1124623889]}]}, {"allowed_amount": 4925.24, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 4957.82, "npi": [1124623889]}]}, {"allowed_amount": 3197.56, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 4957.82, "npi": [1124623889]}]}]}]}, {"name": "Laboratory - Hematology", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0305", "description": "Laboratory", "allowed_amounts": [{"tin": {"type": "ein", "value": "756001743"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 212.875, "npi": [1336172105]}, {"billed_charge": 233.5, "npi": [1336172105]}, {"billed_charge": 145.75, "npi": [1336172105]}, {"billed_charge": 206.5, "npi": [1336172105]}, {"billed_charge": 208.75, "npi": [1336172105]}, {"billed_charge": 231.5714, "npi": [1336172105]}, {"billed_charge": 286.6071, "npi": [1336172105]}, {"billed_charge": 248.1429, "npi": [1336172105]}, {"billed_charge": 226.5, "npi": [1336172105]}]}]}]}, {"name": "Pharmacy - General", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0250", "description": "Pharmacy (also see 063x, an extension of 025x)", "allowed_amounts": [{"tin": {"type": "ein", "value": "752682017"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 98.0, "npi": [1114998911]}, {"billed_charge": 25.0, "npi": [1114998911]}, {"billed_charge": 12.0, "npi": [1114998911]}, {"billed_charge": 407.0, "npi": [1114998911]}, {"billed_charge": 32.0, "npi": [1114998911]}, {"billed_charge": 56.0, "npi": [1114998911]}, {"billed_charge": 277.0, "npi": [1114998911]}, {"billed_charge": 145.0, "npi": [1114998911]}, {"billed_charge": 1.4, "npi": [1114998911]}, {"billed_charge": 29.0, "npi": [1114998911]}, {"billed_charge": 11.0, "npi": [1114998911]}, {"billed_charge": 14.0, "npi": [1114998911]}, {"billed_charge": 275.0, "npi": [1114998911]}, {"billed_charge": 516.0, "npi": [1114998911]}, {"billed_charge": 23.0, "npi": [1114998911]}, {"billed_charge": 13.0, "npi": [1114998911]}, {"billed_charge": 47.0, "npi": [1114998911]}, {"billed_charge": 10.0, "npi": [1114998911]}, {"billed_charge": 62.0, "npi": [1114998911]}, {"billed_charge": 0.6, "npi": [1114998911]}, {"billed_charge": 19.0, "npi": [1114998911]}, {"billed_charge": 17.0, "npi": [1114998911]}, {"billed_charge": 6.7, "npi": [1114998911]}, {"billed_charge": 46.0, "npi": [1114998911]}, {"billed_charge": 2.7, "npi": [1114998911]}, {"billed_charge": 57.0, "npi": [1114998911]}, {"billed_charge": 6.6, "npi": [1114998911]}, {"billed_charge": 15.0, "npi": [1114998911]}, {"billed_charge": 257.0, "npi": [1114998911]}, {"billed_charge": 1036.0, "npi": [1114998911]}, {"billed_charge": 164.0, "npi": [1114998911]}, {"billed_charge": 1646.0, "npi": [1114998911]}]}]}]}, {"name": "Medical/Surgical Supplies and Devices - General", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0270", "description": "Med/Surg Supplies &Devices (also see 062x, extension of 027x", "allowed_amounts": [{"tin": {"type": "ein", "value": "472177648"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 5.0, "npi": [1790174860]}, {"billed_charge": 16.7125, "npi": [1790174860]}, {"billed_charge": 18.76, "npi": [1790174860]}, {"billed_charge": 7.4944, "npi": [1790174860]}, {"billed_charge": 30.825, "npi": [1790174860]}, {"billed_charge": 67.5, "npi": [1790174860]}, {"billed_charge": 14.975, "npi": [1790174860]}, {"billed_charge": 11.8375, "npi": [1790174860]}, {"billed_charge": 6.6267, "npi": [1790174860]}, {"billed_charge": 38.9033, "npi": [1790174860]}, {"billed_charge": 47.225, "npi": [1790174860]}, {"billed_charge": 65.574, "npi": [1790174860]}, {"billed_charge": 8.4857, "npi": [1790174860]}, {"billed_charge": 29.4, "npi": [1790174860]}, {"billed_charge": 16.225, "npi": [1790174860]}, {"billed_charge": 27.45, "npi": [1790174860]}, {"billed_charge": 34.2, "npi": [1790174860]}]}]}]}, {"name": "Emergency Room - General", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0450", "description": "Emergency Room", "allowed_amounts": [{"tin": {"type": "ein", "value": "751844139"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 308.31, "billing_code_modifier": [""], "providers": [{"billed_charge": 814.34, "npi": [1265430177]}, {"billed_charge": 524.33, "npi": [1265430177]}]}, {"allowed_amount": 222.56, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 782.31, "npi": [1265430177]}]}, {"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 1297.03, "npi": [1265430177]}, {"billed_charge": 862.0, "npi": [1265430177]}, {"billed_charge": 1897.8025, "npi": [1265430177]}, {"billed_charge": 321.2, "npi": [1265430177]}, {"billed_charge": 1366.97, "npi": [1265430177]}, {"billed_charge": 4233.71, "npi": [1265430177]}, {"billed_charge": 1118.22, "npi": [1265430177]}, {"billed_charge": 753.62, "npi": [1265430177]}, {"billed_charge": 524.33, "npi": [1265430177]}, {"billed_charge": 1385.54, "npi": [1265430177]}, {"billed_charge": 806.34, "npi": [1265430177]}]}, {"allowed_amount": 67.875, "billing_code_modifier": [""], "providers": [{"billed_charge": 392.06, "npi": [1265430177]}, {"billed_charge": 317.78, "npi": [1265430177]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["XS"], "providers": [{"billed_charge": 524.33, "npi": [1265430177]}]}, {"allowed_amount": 604.81, "billing_code_modifier": [""], "providers": [{"billed_charge": 2122.8, "npi": [1265430177]}]}, {"allowed_amount": 222.56, "billing_code_modifier": [""], "providers": [{"billed_charge": 782.31, "npi": [1265430177]}]}, {"allowed_amount": 122.22, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 478.23, "npi": [1265430177]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["XU"], "providers": [{"billed_charge": 392.06, "npi": [1265430177]}, {"billed_charge": 902.11, "npi": [1265430177]}, {"billed_charge": 524.33, "npi": [1265430177]}]}, {"allowed_amount": 3791.1, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 3879.67, "npi": [1265430177]}]}, {"allowed_amount": 67.87, "billing_code_modifier": [""], "providers": [{"billed_charge": 392.06, "npi": [1265430177]}, {"billed_charge": 317.78, "npi": [1265430177]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 3879.67, "npi": [1265430177]}]}, {"allowed_amount": 67.8733, "billing_code_modifier": [""], "providers": [{"billed_charge": 392.06, "npi": [1265430177]}]}, {"allowed_amount": 395.66, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 1283.4, "npi": [1265430177]}]}, {"allowed_amount": 395.66, "billing_code_modifier": [""], "providers": [{"billed_charge": 1283.4, "npi": [1265430177]}]}, {"allowed_amount": 308.31, "billing_code_modifier": ["XU"], "providers": [{"billed_charge": 524.33, "npi": [1265430177]}]}, {"allowed_amount": 863.2, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 3879.67, "npi": [1265430177]}]}, {"allowed_amount": 122.22, "billing_code_modifier": [""], "providers": [{"billed_charge": 478.23, "npi": [1265430177]}]}, {"allowed_amount": 604.81, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 2122.8, "npi": [1265430177]}]}]}]}, {"name": "Pharmacy - General", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0250", "description": "Pharmacy (also see 063x, an extension of 025x)", "allowed_amounts": [{"tin": {"type": "ein", "value": "820551704"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 8.025, "npi": [1649273434]}, {"billed_charge": 71.526, "npi": [1649273434]}, {"billed_charge": 15.72, "npi": [1649273434]}, {"billed_charge": 14.41, "npi": [1649273434]}, {"billed_charge": 1.0875, "npi": [1649273434]}, {"billed_charge": 0.4448, "npi": [1649273434]}, {"billed_charge": 1.7033, "npi": [1649273434]}, {"billed_charge": 1.3, "npi": [1649273434]}, {"billed_charge": 0.685, "npi": [1649273434]}, {"billed_charge": 0.38, "npi": [1649273434]}, {"billed_charge": 4.662, "npi": [1649273434]}, {"billed_charge": 7.0943, "npi": [1649273434]}, {"billed_charge": 0.545, "npi": [1649273434]}, {"billed_charge": 6.6457, "npi": [1649273434]}, {"billed_charge": 3.5122, "npi": [1649273434]}, {"billed_charge": 2.1733, "npi": [1649273434]}, {"billed_charge": 8.22, "npi": [1649273434]}, {"billed_charge": 1.9516, "npi": [1649273434]}, {"billed_charge": 2.5137, "npi": [1649273434]}, {"billed_charge": 1.39, "npi": [1649273434]}, {"billed_charge": 2.07, "npi": [1649273434]}, {"billed_charge": 1.76, "npi": [1649273434]}, {"billed_charge": 7.6, "npi": [1649273434]}, {"billed_charge": 2.9936, "npi": [1649273434]}]}]}]}, {"name": "Pharmacy - Extension of 25X - Drug Requiring Detailed Coding", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0636", "description": "Pharmacy - Extension of 25x", "allowed_amounts": [{"tin": {"type": "ein", "value": "752770738"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.49, "billing_code_modifier": [""], "providers": [{"billed_charge": 10.0, "npi": [1770514077]}]}, {"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 3.055, "npi": [1770514077]}, {"billed_charge": 15.0, "npi": [1770514077]}, {"billed_charge": 18.75, "npi": [1770514077]}, {"billed_charge": 0.984, "npi": [1770514077]}, {"billed_charge": 7.4299, "npi": [1770514077]}, {"billed_charge": 3.2825, "npi": [1770514077]}, {"billed_charge": 181.34, "npi": [1770514077]}, {"billed_charge": 0.0772, "npi": [1770514077]}, {"billed_charge": 9.0, "npi": [1770514077]}, {"billed_charge": 2.5, "npi": [1770514077]}, {"billed_charge": 1.2127, "npi": [1770514077]}, {"billed_charge": 1.0, "npi": [1770514077]}, {"billed_charge": 64.35, "npi": [1770514077]}, {"billed_charge": 3.8526, "npi": [1770514077]}, {"billed_charge": 51.685, "npi": [1770514077]}, {"billed_charge": 128.7, "npi": [1770514077]}, {"billed_charge": 19.07, "npi": [1770514077]}, {"billed_charge": 1.2675, "npi": [1770514077]}, {"billed_charge": 186.78, "npi": [1770514077]}, {"billed_charge": 31.2102, "npi": [1770514077]}, {"billed_charge": 45.4, "npi": [1770514077]}, {"billed_charge": 2.6191, "npi": [1770514077]}, {"billed_charge": 61.56, "npi": [1770514077]}, {"billed_charge": 10.0, "npi": [1770514077]}, {"billed_charge": 41.04, "npi": [1770514077]}, {"billed_charge": 385.94, "npi": [1770514077]}, {"billed_charge": 1.8584, "npi": [1770514077]}, {"billed_charge": 6.25, "npi": [1770514077]}, {"billed_charge": 1.8981, "npi": [1770514077]}, {"billed_charge": 0.2468, "npi": [1770514077]}, {"billed_charge": 53.07, "npi": [1770514077]}, {"billed_charge": 50.0, "npi": [1770514077]}, {"billed_charge": 1.875, "npi": [1770514077]}, {"billed_charge": 75.24, "npi": [1770514077]}, {"billed_charge": 9.735, "npi": [1770514077]}, {"billed_charge": 0.1248, "npi": [1770514077]}, {"billed_charge": 0.125, "npi": [1770514077]}, {"billed_charge": 25.0, "npi": [1770514077]}, {"billed_charge": 12.5, "npi": [1770514077]}]}, {"allowed_amount": 0.485, "billing_code_modifier": ["JZ"], "providers": [{"billed_charge": 5.0, "npi": [1770514077]}]}, {"allowed_amount": 0.49, "billing_code_modifier": ["JW"], "providers": [{"billed_charge": 10.0, "npi": [1770514077]}]}, {"allowed_amount": 0.4825, "billing_code_modifier": ["JZ"], "providers": [{"billed_charge": 2.5, "npi": [1770514077]}]}, {"allowed_amount": 0.4833, "billing_code_modifier": ["JW"], "providers": [{"billed_charge": 3.3333, "npi": [1770514077]}]}, {"allowed_amount": 0.495, "billing_code_modifier": ["JZ"], "providers": [{"billed_charge": 5.0, "npi": [1770514077]}]}, {"allowed_amount": 0.48, "billing_code_modifier": [""], "providers": [{"billed_charge": 10.0, "npi": [1770514077]}]}, {"allowed_amount": 0.485, "billing_code_modifier": ["JW"], "providers": [{"billed_charge": 5.0, "npi": [1770514077]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["JZ"], "providers": [{"billed_charge": 0.2603, "npi": [1770514077]}, {"billed_charge": 1.846, "npi": [1770514077]}, {"billed_charge": 5.9975, "npi": [1770514077]}, {"billed_charge": 0.1551, "npi": [1770514077]}, {"billed_charge": 7.5, "npi": [1770514077]}, {"billed_charge": 13.09, "npi": [1770514077]}, {"billed_charge": 9.0, "npi": [1770514077]}, {"billed_charge": 1.0, "npi": [1770514077]}, {"billed_charge": 1.4844, "npi": [1770514077]}, {"billed_charge": 0.5, "npi": [1770514077]}, {"billed_charge": 6.67, "npi": [1770514077]}, {"billed_charge": 1.3, "npi": [1770514077]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["JW"], "providers": [{"billed_charge": 9.0, "npi": [1770514077]}]}, {"allowed_amount": 0.48, "billing_code_modifier": ["JW"], "providers": [{"billed_charge": 10.0, "npi": [1770514077]}]}, {"allowed_amount": 0.485, "billing_code_modifier": [""], "providers": [{"billed_charge": 5.0, "npi": [1770514077]}]}]}]}, {"name": "Laboratory - General", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0300", "description": "Laboratory", "allowed_amounts": [{"tin": {"type": "ein", "value": "750800628"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 382.8, "billing_code_modifier": [""], "providers": [{"billed_charge": 638.0, "npi": [1194743013]}]}, {"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 32.0, "npi": [1194743013]}]}, {"allowed_amount": 16.32, "billing_code_modifier": [""], "providers": [{"billed_charge": 32.0, "npi": [1194743013]}]}, {"allowed_amount": 55.56, "billing_code_modifier": [""], "providers": [{"billed_charge": 92.6, "npi": [1194743013]}]}, {"allowed_amount": 10.56, "billing_code_modifier": [""], "providers": [{"billed_charge": 32.0, "npi": [1194743013]}]}, {"allowed_amount": 19.2, "billing_code_modifier": [""], "providers": [{"billed_charge": 32.0, "npi": [1194743013]}]}]}]}, {"name": "Laboratory - Chemistry", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0301", "description": "Laboratory", "allowed_amounts": [{"tin": {"type": "ein", "value": "751977850"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 565.0, "npi": [1396778064]}, {"billed_charge": 278.25, "npi": [1396778064]}, {"billed_charge": 324.5, "npi": [1396778064]}, {"billed_charge": 442.5, "npi": [1396778064]}, {"billed_charge": 414.575, "npi": [1396778064]}, {"billed_charge": 679.25, "npi": [1396778064]}, {"billed_charge": 153.5, "npi": [1396778064]}, {"billed_charge": 57.25, "npi": [1396778064]}]}]}]}, {"name": "GROUND MILEAGE PER STATUTE MILE", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "A0425", "description": "GROUND MILEAGE PER STATUTE MILE", "allowed_amounts": [{"tin": {"type": "ein", "value": "208424689"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 30.3214, "billing_code_modifier": ["ETHH"], "providers": [{"billed_charge": 85.0, "npi": [1952588329]}]}, {"allowed_amount": 30.3, "billing_code_modifier": ["ETHH"], "providers": [{"billed_charge": 85.0, "npi": [1952588329]}]}, {"allowed_amount": 30.3182, "billing_code_modifier": ["ETHH"], "providers": [{"billed_charge": 85.0, "npi": [1952588329]}]}, {"allowed_amount": 30.3231, "billing_code_modifier": ["ETHH"], "providers": [{"billed_charge": 85.0, "npi": [1952588329]}]}, {"allowed_amount": 30.3218, "billing_code_modifier": ["ETHH"], "providers": [{"billed_charge": 85.0, "npi": [1952588329]}]}, {"allowed_amount": 30.3206, "billing_code_modifier": ["ETHH"], "providers": [{"billed_charge": 85.0, "npi": [1952588329]}]}, {"allowed_amount": 30.3235, "billing_code_modifier": ["ETHH"], "providers": [{"billed_charge": 85.0, "npi": [1952588329]}]}, {"allowed_amount": 30.3233, "billing_code_modifier": ["ETHH"], "providers": [{"billed_charge": 85.0, "npi": [1952588329]}]}, {"allowed_amount": 30.3233, "billing_code_modifier": ["HR"], "providers": [{"billed_charge": 85.0, "npi": [1952588329]}]}, {"allowed_amount": 30.3236, "billing_code_modifier": ["ETHH"], "providers": [{"billed_charge": 85.0, "npi": [1952588329]}]}, {"allowed_amount": 30.3242, "billing_code_modifier": ["ETHH"], "providers": [{"billed_charge": 85.0, "npi": [1952588329]}]}, {"allowed_amount": 30.325, "billing_code_modifier": ["HH"], "providers": [{"billed_charge": 85.0, "npi": [1952588329]}]}, {"allowed_amount": 30.3222, "billing_code_modifier": ["ETHH"], "providers": [{"billed_charge": 85.0, "npi": [1952588329]}]}, {"allowed_amount": 30.3226, "billing_code_modifier": ["ETHH"], "providers": [{"billed_charge": 85.0, "npi": [1952588329]}]}, {"allowed_amount": 30.3221, "billing_code_modifier": ["HH"], "providers": [{"billed_charge": 85.0, "npi": [1952588329]}]}, {"allowed_amount": 30.3225, "billing_code_modifier": ["HH"], "providers": [{"billed_charge": 85.0, "npi": [1952588329]}]}, {"allowed_amount": 30.3216, "billing_code_modifier": ["HH"], "providers": [{"billed_charge": 85.0, "npi": [1952588329]}]}, {"allowed_amount": 30.3221, "billing_code_modifier": ["ETHH"], "providers": [{"billed_charge": 85.0, "npi": [1952588329]}]}, {"allowed_amount": 30.3225, "billing_code_modifier": ["ETHH"], "providers": [{"billed_charge": 85.0, "npi": [1952588329]}]}]}]}, {"name": "Laboratory - Urology", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0307", "description": "Laboratory", "allowed_amounts": [{"tin": {"type": "ein", "value": "751047527"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 187.0, "npi": [1396779948]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["59"], "providers": [{"billed_charge": 187.0, "npi": [1396779948]}]}]}]}, {"name": "Medical/Surgical Supplies and Devices - Sterile Supply", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0272", "description": "Med/Surg Supplies &Devices (also see 062x, extension of 027x", "allowed_amounts": [{"tin": {"type": "ein", "value": "751837454"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 409.31, "npi": [1447250253]}, {"billed_charge": 82.1733, "npi": [1447250253]}, {"billed_charge": 1449.4, "npi": [1447250253]}, {"billed_charge": 1416.846, "npi": [1447250253]}, {"billed_charge": 107.415, "npi": [1447250253]}, {"billed_charge": 1218.25, "npi": [1447250253]}, {"billed_charge": 403.52, "npi": [1447250253]}, {"billed_charge": 948.04, "npi": [1447250253]}, {"billed_charge": 3114.5725, "npi": [1447250253]}, {"billed_charge": 315.0967, "npi": [1447250253]}, {"billed_charge": 131.92, "npi": [1447250253]}, {"billed_charge": 69.21, "npi": [1447250253]}, {"billed_charge": 696.2445, "npi": [1447250253]}, {"billed_charge": 281.42, "npi": [1447250253]}, {"billed_charge": 132.94, "npi": [1447250253]}, {"billed_charge": 271.953, "npi": [1447250253]}, {"billed_charge": 263.84, "npi": [1447250253]}, {"billed_charge": 130.87, "npi": [1447250253]}]}]}]}, {"name": "Laboratory - Urology", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0307", "description": "Laboratory", "allowed_amounts": [{"tin": {"type": "ein", "value": "260194016"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 129.78, "npi": [1205018439]}, {"billed_charge": 83.58, "npi": [1205018439]}, {"billed_charge": 162.16, "npi": [1205018439]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["XU"], "providers": [{"billed_charge": 129.78, "npi": [1205018439]}]}]}]}, {"name": "Emergency Room - General", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0450", "description": "Emergency Room", "allowed_amounts": [{"tin": {"type": "ein", "value": "820551704"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 39.015, "billing_code_modifier": [""], "providers": [{"billed_charge": 317.78, "npi": [1649273434]}]}, {"allowed_amount": 308.31, "billing_code_modifier": [""], "providers": [{"billed_charge": 814.34, "npi": [1649273434]}, {"billed_charge": 524.33, "npi": [1649273434]}]}, {"allowed_amount": 222.56, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 782.31, "npi": [1649273434]}]}, {"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 1585.5975, "npi": [1649273434]}, {"billed_charge": 321.2, "npi": [1649273434]}, {"billed_charge": 1940.61, "npi": [1649273434]}, {"billed_charge": 361.12, "npi": [1649273434]}, {"billed_charge": 392.06, "npi": [1649273434]}, {"billed_charge": 1366.97, "npi": [1649273434]}]}, {"allowed_amount": 67.875, "billing_code_modifier": [""], "providers": [{"billed_charge": 317.78, "npi": [1649273434]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["XS"], "providers": [{"billed_charge": 524.33, "npi": [1649273434]}]}, {"allowed_amount": 222.56, "billing_code_modifier": [""], "providers": [{"billed_charge": 782.31, "npi": [1649273434]}]}, {"allowed_amount": 67.874, "billing_code_modifier": [""], "providers": [{"billed_charge": 392.06, "npi": [1649273434]}]}, {"allowed_amount": 3791.1, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 4233.71, "npi": [1649273434]}, {"billed_charge": 3879.67, "npi": [1649273434]}]}, {"allowed_amount": 67.87, "billing_code_modifier": [""], "providers": [{"billed_charge": 317.78, "npi": [1649273434]}, {"billed_charge": 392.06, "npi": [1649273434]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 1408.48, "npi": [1649273434]}]}, {"allowed_amount": 395.66, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 1283.4, "npi": [1649273434]}]}, {"allowed_amount": 395.66, "billing_code_modifier": [""], "providers": [{"billed_charge": 1283.4, "npi": [1649273434]}]}, {"allowed_amount": 308.31, "billing_code_modifier": ["XU"], "providers": [{"billed_charge": 814.34, "npi": [1649273434]}, {"billed_charge": 524.33, "npi": [1649273434]}]}, {"allowed_amount": 863.2, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 3879.67, "npi": [1649273434]}]}, {"allowed_amount": 200.4, "billing_code_modifier": [""], "providers": [{"billed_charge": 524.33, "npi": [1649273434]}]}, {"allowed_amount": 44.118, "billing_code_modifier": [""], "providers": [{"billed_charge": 392.06, "npi": [1649273434]}]}, {"allowed_amount": 604.81, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 2122.8, "npi": [1649273434]}]}, {"allowed_amount": 1197.29, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 4233.71, "npi": [1649273434]}]}]}]}, {"name": "Pharmacy - General", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0250", "description": "Pharmacy (also see 063x, an extension of 025x)", "allowed_amounts": [{"tin": {"type": "ein", "value": "756001743"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 6.07, "npi": [1336172105]}, {"billed_charge": 3.55, "npi": [1336172105]}, {"billed_charge": 1.572, "npi": [1336172105]}, {"billed_charge": 3.9845, "npi": [1336172105]}, {"billed_charge": 5.9339, "npi": [1336172105]}, {"billed_charge": 8.1306, "npi": [1336172105]}, {"billed_charge": 3.18, "npi": [1336172105]}, {"billed_charge": 4.5, "npi": [1336172105]}, {"billed_charge": 5.0, "npi": [1336172105]}, {"billed_charge": 8.63, "npi": [1336172105]}, {"billed_charge": 1.2708, "npi": [1336172105]}, {"billed_charge": 25.125, "npi": [1336172105]}, {"billed_charge": 8.6667, "npi": [1336172105]}, {"billed_charge": 2.0, "npi": [1336172105]}, {"billed_charge": 29.945, "npi": [1336172105]}, {"billed_charge": 50.0, "npi": [1336172105]}, {"billed_charge": 1.5, "npi": [1336172105]}, {"billed_charge": 1.598, "npi": [1336172105]}, {"billed_charge": 1.579, "npi": [1336172105]}, {"billed_charge": 0.9375, "npi": [1336172105]}, {"billed_charge": 4.8105, "npi": [1336172105]}, {"billed_charge": 18.0, "npi": [1336172105]}, {"billed_charge": 1.0, "npi": [1336172105]}, {"billed_charge": 26.0, "npi": [1336172105]}, {"billed_charge": 16.2825, "npi": [1336172105]}, {"billed_charge": 14.6127, "npi": [1336172105]}, {"billed_charge": 3.1552, "npi": [1336172105]}]}]}]}, {"name": "Pharmacy - General", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0250", "description": "Pharmacy (also see 063x, an extension of 025x)", "allowed_amounts": [{"tin": {"type": "ein", "value": "751748586"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 0.75, "npi": [1508899204]}, {"billed_charge": 0.5, "npi": [1508899204]}, {"billed_charge": 1.06, "npi": [1508899204]}, {"billed_charge": 1.635, "npi": [1508899204]}, {"billed_charge": 5.5384, "npi": [1508899204]}, {"billed_charge": 3.6338, "npi": [1508899204]}, {"billed_charge": 1.0, "npi": [1508899204]}, {"billed_charge": 2.775, "npi": [1508899204]}, {"billed_charge": 1.2, "npi": [1508899204]}, {"billed_charge": 8.2367, "npi": [1508899204]}, {"billed_charge": 0.625, "npi": [1508899204]}, {"billed_charge": 16.8333, "npi": [1508899204]}, {"billed_charge": 1.6667, "npi": [1508899204]}, {"billed_charge": 2.882, "npi": [1508899204]}, {"billed_charge": 26.81, "npi": [1508899204]}]}]}]}, {"name": "MENTAL HEALTH PARTIAL HOSP TX  LT  24 HOURS", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "H0035", "description": "MENTAL HEALTH PARTIAL HOSP TX  LT  24 HOURS", "allowed_amounts": [{"tin": {"type": "ein", "value": "853060929"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 1200.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 4000.0, "npi": [1548860406]}]}, {"allowed_amount": 808.5, "billing_code_modifier": [""], "providers": [{"billed_charge": 2695.0, "npi": [1548860406]}]}]}]}, {"name": "Emergency Room - General", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0450", "description": "Emergency Room", "allowed_amounts": [{"tin": {"type": "ein", "value": "751438726"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 103.5, "npi": [1104845015]}, {"billed_charge": 699.125, "npi": [1104845015]}, {"billed_charge": 254.75, "npi": [1104845015]}]}, {"allowed_amount": 308.82, "billing_code_modifier": ["59"], "providers": [{"billed_charge": 333.25, "npi": [1104845015]}]}, {"allowed_amount": 396.31, "billing_code_modifier": [""], "providers": [{"billed_charge": 1042.5, "npi": [1104845015]}]}, {"allowed_amount": 313.49, "billing_code_modifier": [""], "providers": [{"billed_charge": 945.5, "npi": [1104845015]}]}, {"allowed_amount": 3797.35, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 2758.25, "npi": [1104845015]}]}, {"allowed_amount": 864.64, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 2758.25, "npi": [1104845015]}]}, {"allowed_amount": 122.42, "billing_code_modifier": [""], "providers": [{"billed_charge": 332.25, "npi": [1104845015]}]}, {"allowed_amount": 605.81, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 1521.25, "npi": [1104845015]}]}, {"allowed_amount": 396.31, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 1042.5, "npi": [1104845015]}, {"billed_charge": 1410.0, "npi": [1104845015]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["59"], "providers": [{"billed_charge": 779.25, "npi": [1104845015]}]}, {"allowed_amount": 67.99, "billing_code_modifier": [""], "providers": [{"billed_charge": 333.25, "npi": [1104845015]}]}, {"allowed_amount": 308.82, "billing_code_modifier": [""], "providers": [{"billed_charge": 333.25, "npi": [1104845015]}]}]}]}, {"name": "Pharmacy - IV Solutions", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0258", "description": "Pharmacy (also see 063x, an extension of 025x)", "allowed_amounts": [{"tin": {"type": "ein", "value": "260194016"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 42.0, "npi": [1205018439]}, {"billed_charge": 50.0, "npi": [1205018439]}, {"billed_charge": 25.5, "npi": [1205018439]}, {"billed_charge": 48.9655, "npi": [1205018439]}, {"billed_charge": 47.8553, "npi": [1205018439]}]}]}]}, {"name": "EKG/ECG (Electrocardiogram) - General", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0730", "description": "EKG/ECG (Electrocardiogram)", "allowed_amounts": [{"tin": {"type": "ein", "value": "752770738"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 356.0, "npi": [1770514077]}]}]}]}, {"name": "Laboratory - Chemistry", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0301", "description": "Laboratory", "allowed_amounts": [{"tin": {"type": "ein", "value": "750800628"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 176.0914, "billing_code_modifier": [""], "providers": [{"billed_charge": 293.4857, "npi": [1194743013]}]}, {"allowed_amount": 180.54, "billing_code_modifier": [""], "providers": [{"billed_charge": 354.0, "npi": [1720480627]}]}, {"allowed_amount": 166.6, "billing_code_modifier": [""], "providers": [{"billed_charge": 277.6667, "npi": [1194743013]}]}, {"allowed_amount": 106.2, "billing_code_modifier": [""], "providers": [{"billed_charge": 177.0, "npi": [1194743013]}, {"billed_charge": 177.0, "npi": [1720480627]}]}, {"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 356.0, "npi": [1194743013]}]}, {"allowed_amount": 188.4, "billing_code_modifier": [""], "providers": [{"billed_charge": 314.0, "npi": [1194743013]}, {"billed_charge": 314.0, "npi": [1720480627]}]}, {"allowed_amount": 177.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 295.0, "npi": [1720480627]}]}, {"allowed_amount": 223.8, "billing_code_modifier": [""], "providers": [{"billed_charge": 373.0, "npi": [1194743013]}]}, {"allowed_amount": 212.4, "billing_code_modifier": [""], "providers": [{"billed_charge": 354.0, "npi": [1194743013]}, {"billed_charge": 354.0, "npi": [1720480627]}]}, {"allowed_amount": 144.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 240.0, "npi": [1720480627]}, {"billed_charge": 240.0, "npi": [1194743013]}]}, {"allowed_amount": 57.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 95.0, "npi": [1720480627]}]}, {"allowed_amount": 160.14, "billing_code_modifier": [""], "providers": [{"billed_charge": 314.0, "npi": [1720480627]}]}, {"allowed_amount": 95.4, "billing_code_modifier": [""], "providers": [{"billed_charge": 159.0, "npi": [1194743013]}]}, {"allowed_amount": 117.48, "billing_code_modifier": [""], "providers": [{"billed_charge": 356.0, "npi": [1194743013]}]}, {"allowed_amount": 253.8, "billing_code_modifier": [""], "providers": [{"billed_charge": 423.0, "npi": [1194743013]}]}, {"allowed_amount": 266.4, "billing_code_modifier": [""], "providers": [{"billed_charge": 444.0, "npi": [1720480627]}]}, {"allowed_amount": 114.762, "billing_code_modifier": [""], "providers": [{"billed_charge": 191.27, "npi": [1194743013]}]}, {"allowed_amount": 102.6, "billing_code_modifier": [""], "providers": [{"billed_charge": 171.0, "npi": [1720480627]}]}, {"allowed_amount": 225.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 375.0, "npi": [1720480627]}]}, {"allowed_amount": 106.92, "billing_code_modifier": [""], "providers": [{"billed_charge": 324.0, "npi": [1194743013]}]}, {"allowed_amount": 54.6, "billing_code_modifier": [""], "providers": [{"billed_charge": 91.0, "npi": [1194743013]}]}, {"allowed_amount": 213.6, "billing_code_modifier": [""], "providers": [{"billed_charge": 356.0, "npi": [1194743013]}]}, {"allowed_amount": 244.5, "billing_code_modifier": [""], "providers": [{"billed_charge": 407.5, "npi": [1194743013]}]}, {"allowed_amount": 130.2, "billing_code_modifier": [""], "providers": [{"billed_charge": 217.0, "npi": [1194743013]}, {"billed_charge": 217.0, "npi": [1720480627]}]}, {"allowed_amount": 215.8286, "billing_code_modifier": [""], "providers": [{"billed_charge": 359.7143, "npi": [1194743013]}]}, {"allowed_amount": 124.2, "billing_code_modifier": [""], "providers": [{"billed_charge": 207.0, "npi": [1720480627]}]}, {"allowed_amount": 288.6, "billing_code_modifier": [""], "providers": [{"billed_charge": 481.0, "npi": [1720480627]}]}, {"allowed_amount": 194.4, "billing_code_modifier": [""], "providers": [{"billed_charge": 324.0, "npi": [1194743013]}, {"billed_charge": 324.0, "npi": [1720480627]}]}, {"allowed_amount": 165.24, "billing_code_modifier": [""], "providers": [{"billed_charge": 324.0, "npi": [1720480627]}]}, {"allowed_amount": 345.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 575.0, "npi": [1720480627]}, {"billed_charge": 575.0, "npi": [1194743013]}]}, {"allowed_amount": 101.4, "billing_code_modifier": [""], "providers": [{"billed_charge": 169.0, "npi": [1194743013]}, {"billed_charge": 169.0, "npi": [1720480627]}]}, {"allowed_amount": 54.6, "billing_code_modifier": ["XU"], "providers": [{"billed_charge": 91.0, "npi": [1720480627]}]}]}]}, {"name": "IV Therapy -General", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0260", "description": "IV Therapy", "allowed_amounts": [{"tin": {"type": "ein", "value": "751837454"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 308.31, "billing_code_modifier": [""], "providers": [{"billed_charge": 814.34, "npi": [1447250253]}, {"billed_charge": 902.11, "npi": [1447250253]}]}, {"allowed_amount": 67.8743, "billing_code_modifier": [""], "providers": [{"billed_charge": 330.56, "npi": [1447250253]}]}, {"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 361.12, "npi": [1447250253]}, {"billed_charge": 392.06, "npi": [1447250253]}, {"billed_charge": 317.78, "npi": [1447250253]}, {"billed_charge": 330.56, "npi": [1447250253]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["XS"], "providers": [{"billed_charge": 902.11, "npi": [1447250253]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["XU"], "providers": [{"billed_charge": 361.12, "npi": [1447250253]}, {"billed_charge": 392.06, "npi": [1447250253]}, {"billed_charge": 902.11, "npi": [1447250253]}, {"billed_charge": 317.78, "npi": [1447250253]}, {"billed_charge": 524.33, "npi": [1447250253]}]}, {"allowed_amount": 67.87, "billing_code_modifier": [""], "providers": [{"billed_charge": 317.78, "npi": [1447250253]}]}]}]}, {"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": "751037591"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 4.5405, "npi": [1124305065]}, {"billed_charge": 4.908, "npi": [1124305065]}, {"billed_charge": 4.7466, "npi": [1124305065]}, {"billed_charge": 1.108, "npi": [1124305065]}, {"billed_charge": 4.5315, "npi": [1124305065]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["JZ"], "providers": [{"billed_charge": 4.5405, "npi": [1124305065]}]}]}]}, {"name": "Pharmacy - Extension of 25X - Drug Requiring Detailed Coding", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0636", "description": "Pharmacy - Extension of 25x", "allowed_amounts": [{"tin": {"type": "ein", "value": "751844139"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.49, "billing_code_modifier": ["JZ"], "providers": [{"billed_charge": 22.5, "npi": [1265430177]}]}, {"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 25.2425, "npi": [1265430177]}, {"billed_charge": 1.8, "npi": [1265430177]}, {"billed_charge": 0.1488, "npi": [1265430177]}, {"billed_charge": 0.3033, "npi": [1265430177]}, {"billed_charge": 0.2952, "npi": [1265430177]}, {"billed_charge": 3.2552, "npi": [1265430177]}, {"billed_charge": 0.1304, "npi": [1265430177]}, {"billed_charge": 0.0295, "npi": [1265430177]}, {"billed_charge": 2.0725, "npi": [1265430177]}, {"billed_charge": 1.7361, "npi": [1265430177]}, {"billed_charge": 0.031, "npi": [1265430177]}, {"billed_charge": 0.6398, "npi": [1265430177]}, {"billed_charge": 276.85, "npi": [1265430177]}, {"billed_charge": 20.98, "npi": [1265430177]}, {"billed_charge": 15.8875, "npi": [1265430177]}, {"billed_charge": 18.06, "npi": [1265430177]}, {"billed_charge": 2.795, "npi": [1265430177]}, {"billed_charge": 18.74, "npi": [1265430177]}, {"billed_charge": 8.28, "npi": [1265430177]}, {"billed_charge": 15.24, "npi": [1265430177]}, {"billed_charge": 15.9, "npi": [1265430177]}, {"billed_charge": 20.1, "npi": [1265430177]}, {"billed_charge": 16.44, "npi": [1265430177]}, {"billed_charge": 2.04, "npi": [1265430177]}, {"billed_charge": 2.8791, "npi": [1265430177]}, {"billed_charge": 0.654, "npi": [1265430177]}, {"billed_charge": 42.0, "npi": [1265430177]}, {"billed_charge": 0.3788, "npi": [1265430177]}, {"billed_charge": 10.05, "npi": [1265430177]}, {"billed_charge": 3.8434, "npi": [1265430177]}, {"billed_charge": 6.36, "npi": [1265430177]}, {"billed_charge": 17.82, "npi": [1265430177]}, {"billed_charge": 0.857, "npi": [1265430177]}, {"billed_charge": 6.33, "npi": [1265430177]}, {"billed_charge": 10.68, "npi": [1265430177]}, {"billed_charge": 26.2496, "npi": [1265430177]}, {"billed_charge": 11.8958, "npi": [1265430177]}, {"billed_charge": 2.2635, "npi": [1265430177]}, {"billed_charge": 20.8932, "npi": [1265430177]}]}, {"allowed_amount": 0.485, "billing_code_modifier": ["JZ"], "providers": [{"billed_charge": 3.36, "npi": [1265430177]}]}, {"allowed_amount": 5.5348, "billing_code_modifier": ["JZ"], "providers": [{"billed_charge": 14.5, "npi": [1265430177]}, {"billed_charge": 8.57, "npi": [1265430177]}]}, {"allowed_amount": 0.48, "billing_code_modifier": ["JZ"], "providers": [{"billed_charge": 22.5, "npi": [1265430177]}, {"billed_charge": 4.74, "npi": [1265430177]}, {"billed_charge": 3.64, "npi": [1265430177]}, {"billed_charge": 5.46, "npi": [1265430177]}, {"billed_charge": 15.0, "npi": [1265430177]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["JZ"], "providers": [{"billed_charge": 5.016, "npi": [1265430177]}, {"billed_charge": 3.52, "npi": [1265430177]}, {"billed_charge": 0.4668, "npi": [1265430177]}, {"billed_charge": 1.67, "npi": [1265430177]}, {"billed_charge": 7.0, "npi": [1265430177]}, {"billed_charge": 29.04, "npi": [1265430177]}, {"billed_charge": 14.52, "npi": [1265430177]}, {"billed_charge": 8.53, "npi": [1265430177]}, {"billed_charge": 0.376, "npi": [1265430177]}, {"billed_charge": 15.06, "npi": [1265430177]}, {"billed_charge": 1.02, "npi": [1265430177]}, {"billed_charge": 58.08, "npi": [1265430177]}, {"billed_charge": 1.925, "npi": [1265430177]}, {"billed_charge": 0.92, "npi": [1265430177]}, {"billed_charge": 3.542, "npi": [1265430177]}, {"billed_charge": 2.2635, "npi": [1265430177]}, {"billed_charge": 4.32, "npi": [1265430177]}, {"billed_charge": 0.69, "npi": [1265430177]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["JW"], "providers": [{"billed_charge": 0.179, "npi": [1265430177]}]}, {"allowed_amount": 91.9781, "billing_code_modifier": ["JZ"], "providers": [{"billed_charge": 173.7124, "npi": [1265430177]}]}]}]}, {"name": "Physical Therapy - Evaluation or Reevaluation", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0424", "description": "Physical Therapy", "allowed_amounts": [{"tin": {"type": "ein", "value": "751837454"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 475.16, "npi": [1447250253]}, {"billed_charge": 305.09, "npi": [1447250253]}, {"billed_charge": 508.79, "npi": [1447250253]}, {"billed_charge": 395.47, "npi": [1447250253]}, {"billed_charge": 344.935, "npi": [1447250253]}]}, {"allowed_amount": 142.25, "billing_code_modifier": ["GP"], "providers": [{"billed_charge": 475.16, "npi": [1447250253]}, {"billed_charge": 395.47, "npi": [1447250253]}]}, {"allowed_amount": 108.95, "billing_code_modifier": ["GP"], "providers": [{"billed_charge": 475.16, "npi": [1447250253]}, {"billed_charge": 395.47, "npi": [1447250253]}]}]}]}, {"name": "Pharmacy - Extension of 25X - Drug Requiring Detailed Coding", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0636", "description": "Pharmacy - Extension of 25x", "allowed_amounts": [{"tin": {"type": "ein", "value": "820551704"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.49, "billing_code_modifier": [""], "providers": [{"billed_charge": 5.25, "npi": [1649273434]}]}, {"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 0.9278, "npi": [1649273434]}, {"billed_charge": 3.888, "npi": [1649273434]}, {"billed_charge": 73.8, "npi": [1649273434]}, {"billed_charge": 1.668, "npi": [1649273434]}, {"billed_charge": 35.94, "npi": [1649273434]}, {"billed_charge": 31.83, "npi": [1649273434]}, {"billed_charge": 2.0, "npi": [1649273434]}, {"billed_charge": 3.74, "npi": [1649273434]}, {"billed_charge": 0.8766, "npi": [1649273434]}, {"billed_charge": 0.1488, "npi": [1649273434]}, {"billed_charge": 20.11, "npi": [1649273434]}, {"billed_charge": 73.83, "npi": [1649273434]}, {"billed_charge": 0.857, "npi": [1649273434]}, {"billed_charge": 0.5017, "npi": [1649273434]}, {"billed_charge": 0.2952, "npi": [1649273434]}, {"billed_charge": 12.52, "npi": [1649273434]}, {"billed_charge": 3.535, "npi": [1649273434]}, {"billed_charge": 0.2305, "npi": [1649273434]}, {"billed_charge": 6.06, "npi": [1649273434]}, {"billed_charge": 276.85, "npi": [1649273434]}]}, {"allowed_amount": 0.49, "billing_code_modifier": ["JW"], "providers": [{"billed_charge": 5.25, "npi": [1649273434]}]}, {"allowed_amount": 0.32, "billing_code_modifier": ["JW"], "providers": [{"billed_charge": 5.25, "npi": [1649273434]}]}, {"allowed_amount": 0.48, "billing_code_modifier": [""], "providers": [{"billed_charge": 1.47, "npi": [1649273434]}, {"billed_charge": 1.93, "npi": [1649273434]}]}, {"allowed_amount": 0.32, "billing_code_modifier": [""], "providers": [{"billed_charge": 5.25, "npi": [1649273434]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["JZ"], "providers": [{"billed_charge": 1.67, "npi": [1649273434]}, {"billed_charge": 3.35, "npi": [1649273434]}, {"billed_charge": 58.08, "npi": [1649273434]}, {"billed_charge": 0.9, "npi": [1649273434]}, {"billed_charge": 17.65, "npi": [1649273434]}]}, {"allowed_amount": 0.48, "billing_code_modifier": ["JW"], "providers": [{"billed_charge": 2.73, "npi": [1649273434]}, {"billed_charge": 3.59, "npi": [1649273434]}]}]}]}, {"name": "PSYCHOSOCIAL REHAB SERVICES PER 15 MINUTES", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "H2017", "description": "PSYCHOSOCIAL REHAB SERVICES PER 15 MINUTES", "allowed_amounts": [{"tin": {"type": "ein", "value": "851283674"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 26.93, "billing_code_modifier": [""], "providers": [{"billed_charge": 80.0, "npi": [1679029136]}]}, {"allowed_amount": 5.39, "billing_code_modifier": ["HQ"], "providers": [{"billed_charge": 10.0, "npi": [1679029136]}]}, {"allowed_amount": 26.93, "billing_code_modifier": ["TD"], "providers": [{"billed_charge": 38.75, "npi": [1679029136]}]}]}]}, {"name": "Laboratory - General", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0300", "description": "Laboratory", "allowed_amounts": [{"tin": {"type": "ein", "value": "752890358"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 286.75, "npi": [1548291883]}, {"billed_charge": 121.0, "npi": [1548291883]}, {"billed_charge": 41.5, "npi": [1548291883]}, {"billed_charge": 584.25, "npi": [1548291883]}]}]}]}, {"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": "260194016"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 366.74, "npi": [1205018439]}]}, {"allowed_amount": 126.14, "billing_code_modifier": [""], "providers": [{"billed_charge": 656.37, "npi": [1205018439]}, {"billed_charge": 366.74, "npi": [1205018439]}]}]}]}, {"name": "Laboratory - Chemistry", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0301", "description": "Laboratory", "allowed_amounts": [{"tin": {"type": "ein", "value": "756001743"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 375.3958, "npi": [1336172105]}, {"billed_charge": 671.0, "npi": [1336172105]}, {"billed_charge": 316.4531, "npi": [1336172105]}, {"billed_charge": 210.75, "npi": [1336172105]}, {"billed_charge": 179.5, "npi": [1336172105]}, {"billed_charge": 161.0, "npi": [1336172105]}, {"billed_charge": 225.75, "npi": [1336172105]}, {"billed_charge": 565.0, "npi": [1336172105]}, {"billed_charge": 679.25, "npi": [1336172105]}, {"billed_charge": 328.75, "npi": [1336172105]}, {"billed_charge": 143.1875, "npi": [1336172105]}, {"billed_charge": 1474.5, "npi": [1336172105]}, {"billed_charge": 324.5, "npi": [1336172105]}, {"billed_charge": 247.0, "npi": [1336172105]}, {"billed_charge": 396.1771, "npi": [1336172105]}, {"billed_charge": 493.5, "npi": [1336172105]}, {"billed_charge": 348.5, "npi": [1336172105]}, {"billed_charge": 49.25, "npi": [1336172105]}, {"billed_charge": 123.25, "npi": [1336172105]}, {"billed_charge": 120.75, "npi": [1336172105]}, {"billed_charge": 257.75, "npi": [1336172105]}, {"billed_charge": 284.0, "npi": [1336172105]}, {"billed_charge": 561.75, "npi": [1336172105]}, {"billed_charge": 129.5, "npi": [1336172105]}, {"billed_charge": 404.0625, "npi": [1336172105]}, {"billed_charge": 153.5, "npi": [1336172105]}, {"billed_charge": 335.75, "npi": [1336172105]}, {"billed_charge": 442.5, "npi": [1336172105]}, {"billed_charge": 470.4444, "npi": [1336172105]}, {"billed_charge": 229.25, "npi": [1336172105]}, {"billed_charge": 278.25, "npi": [1336172105]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["91"], "providers": [{"billed_charge": 49.25, "npi": [1336172105]}]}]}]}, {"name": "Laboratory - Bacteriology & Microbiology", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0306", "description": "Laboratory", "allowed_amounts": [{"tin": {"type": "ein", "value": "756001743"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 206.81, "billing_code_modifier": [""], "providers": [{"billed_charge": 494.0, "npi": [1336172105]}]}, {"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 536.25, "npi": [1336172105]}, {"billed_charge": 376.7, "npi": [1336172105]}, {"billed_charge": 42.5, "npi": [1336172105]}, {"billed_charge": 397.25, "npi": [1336172105]}, {"billed_charge": 321.4063, "npi": [1336172105]}, {"billed_charge": 252.75, "npi": [1336172105]}, {"billed_charge": 230.0, "npi": [1336172105]}, {"billed_charge": 331.0, "npi": [1336172105]}, {"billed_charge": 582.75, "npi": [1336172105]}, {"billed_charge": 364.0, "npi": [1336172105]}, {"billed_charge": 237.75, "npi": [1336172105]}, {"billed_charge": 309.5, "npi": [1336172105]}, {"billed_charge": 158.5, "npi": [1336172105]}]}, {"allowed_amount": 74.4, "billing_code_modifier": [""], "providers": [{"billed_charge": 225.25, "npi": [1336172105]}, {"billed_charge": 242.75, "npi": [1336172105]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["59"], "providers": [{"billed_charge": 601.75, "npi": [1336172105]}, {"billed_charge": 1550.0, "npi": [1336172105]}]}]}]}, {"name": "Pharmacy - Extension of 25X - Self Administrable Drugs", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0637", "description": "Pharmacy - Extension of 25x", "allowed_amounts": [{"tin": {"type": "ein", "value": "753175630"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 0.968, "npi": [1285798918]}, {"billed_charge": 1.475, "npi": [1285798918]}, {"billed_charge": 1.4357, "npi": [1285798918]}, {"billed_charge": 0.68, "npi": [1285798918]}, {"billed_charge": 0.0565, "npi": [1285798918]}, {"billed_charge": 4.32, "npi": [1285798918]}, {"billed_charge": 15.4017, "npi": [1285798918]}, {"billed_charge": 1.315, "npi": [1285798918]}, {"billed_charge": 1.9577, "npi": [1285798918]}, {"billed_charge": 0.5, "npi": [1285798918]}, {"billed_charge": 0.7767, "npi": [1285798918]}, {"billed_charge": 16.2033, "npi": [1285798918]}, {"billed_charge": 0.6667, "npi": [1285798918]}, {"billed_charge": 14.09, "npi": [1285798918]}, {"billed_charge": 0.8782, "npi": [1285798918]}, {"billed_charge": 2.032, "npi": [1285798918]}, {"billed_charge": 1.0, "npi": [1285798918]}, {"billed_charge": 0.25, "npi": [1285798918]}, {"billed_charge": 1.2, "npi": [1285798918]}, {"billed_charge": 3.38, "npi": [1285798918]}, {"billed_charge": 48.6375, "npi": [1285798918]}]}]}]}, {"name": "Emergency Room - General", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0450", "description": "Emergency Room", "allowed_amounts": [{"tin": {"type": "ein", "value": "461353294"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 370.79, "billing_code_modifier": [""], "providers": [{"billed_charge": 1301.0, "npi": [1760417646]}]}, {"allowed_amount": 174.39, "billing_code_modifier": [""], "providers": [{"billed_charge": 484.0, "npi": [1760417646]}]}, {"allowed_amount": 551.76, "billing_code_modifier": [""], "providers": [{"billed_charge": 1936.0, "npi": [1760417646]}]}, {"allowed_amount": 246.24, "billing_code_modifier": ["59"], "providers": [{"billed_charge": 864.0, "npi": [1760417646]}]}, {"allowed_amount": 826.79, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 2901.0, "npi": [1760417646]}]}, {"allowed_amount": 697.55, "billing_code_modifier": [""], "providers": [{"billed_charge": 1936.0, "npi": [1760417646]}]}, {"allowed_amount": 61.8467, "billing_code_modifier": [""], "providers": [{"billed_charge": 217.0, "npi": [1760417646]}]}, {"allowed_amount": 246.24, "billing_code_modifier": [""], "providers": [{"billed_charge": 864.0, "npi": [1760417646]}]}, {"allowed_amount": 68.97, "billing_code_modifier": [""], "providers": [{"billed_charge": 242.0, "npi": [1760417646]}]}, {"allowed_amount": 620.73, "billing_code_modifier": [""], "providers": [{"billed_charge": 2178.0, "npi": [1760417646]}]}, {"allowed_amount": 1140.86, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 4003.0, "npi": [1760417646]}]}, {"allowed_amount": 468.75, "billing_code_modifier": [""], "providers": [{"billed_charge": 1301.0, "npi": [1760417646]}]}, {"allowed_amount": 1132.43, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 3143.0, "npi": [1760417646]}]}, {"allowed_amount": 1060.49, "billing_code_modifier": [""], "providers": [{"billed_charge": 3721.0, "npi": [1760417646]}]}, {"allowed_amount": 87.195, "billing_code_modifier": [""], "providers": [{"billed_charge": 242.0, "npi": [1760417646]}]}, {"allowed_amount": 59.85, "billing_code_modifier": [""], "providers": [{"billed_charge": 210.0, "npi": [1760417646]}]}, {"allowed_amount": 551.76, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 1936.0, "npi": [1760417646]}]}]}]}, {"name": "EKG/ECG (Electrocardiogram) - General", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0730", "description": "EKG/ECG (Electrocardiogram)", "allowed_amounts": [{"tin": {"type": "ein", "value": "751047527"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 356.0, "npi": [1396779948]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["59"], "providers": [{"billed_charge": 356.0, "npi": [1396779948]}]}]}]}, {"name": "IV Therapy -General", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0260", "description": "IV Therapy", "allowed_amounts": [{"tin": {"type": "ein", "value": "831869297"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 68.21, "billing_code_modifier": ["XU"], "providers": [{"billed_charge": 431.77, "npi": [1356960132]}]}, {"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 424.0583, "npi": [1356960132]}]}, {"allowed_amount": 309.82, "billing_code_modifier": [""], "providers": [{"billed_charge": 862.59, "npi": [1356960132]}, {"billed_charge": 385.5, "npi": [1356960132]}, {"billed_charge": 945.65, "npi": [1356960132]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["XU"], "providers": [{"billed_charge": 431.77, "npi": [1356960132]}]}, {"allowed_amount": 309.82, "billing_code_modifier": ["XU"], "providers": [{"billed_charge": 385.5, "npi": [1356960132]}, {"billed_charge": 945.65, "npi": [1356960132]}]}, {"allowed_amount": 104.88, "billing_code_modifier": [""], "providers": [{"billed_charge": 822.21, "npi": [1356960132]}]}, {"allowed_amount": 68.21, "billing_code_modifier": [""], "providers": [{"billed_charge": 285.81, "npi": [1356960132]}, {"billed_charge": 431.77, "npi": [1356960132]}]}, {"allowed_amount": 68.2067, "billing_code_modifier": [""], "providers": [{"billed_charge": 431.77, "npi": [1356960132]}]}]}]}, {"name": "Pharmacy - IV Solutions", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0258", "description": "Pharmacy (also see 063x, an extension of 025x)", "allowed_amounts": [{"tin": {"type": "ein", "value": "752586857"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 40.0, "npi": [1992700983]}, {"billed_charge": 50.0, "npi": [1992700983]}, {"billed_charge": 46.0, "npi": [1992700983]}, {"billed_charge": 42.4, "npi": [1992700983]}, {"billed_charge": 28.75, "npi": [1992700983]}, {"billed_charge": 43.3333, "npi": [1992700983]}, {"billed_charge": 42.75, "npi": [1992700983]}]}]}]}, {"name": "Emergency Room - General", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0450", "description": "Emergency Room", "allowed_amounts": [{"tin": {"type": "ein", "value": "831869297"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 236.7, "billing_code_modifier": ["RT"], "providers": [{"billed_charge": 1898.66, "npi": [1356960132]}]}, {"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 3886.45, "npi": [1356960132]}]}, {"allowed_amount": 607.78, "billing_code_modifier": [""], "providers": [{"billed_charge": 2804.94, "npi": [1356960132]}]}, {"allowed_amount": 607.78, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 2804.94, "npi": [1356960132]}, {"billed_charge": 1898.65, "npi": [1356960132]}]}, {"allowed_amount": 397.62, "billing_code_modifier": [""], "providers": [{"billed_charge": 1551.97, "npi": [1356960132]}]}, {"allowed_amount": 867.45, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 3886.45, "npi": [1356960132]}]}]}]}, {"name": "Pharmacy - Extension of 25X - Drug Requiring Detailed Coding", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0636", "description": "Pharmacy - Extension of 25x", "allowed_amounts": [{"tin": {"type": "ein", "value": "751837454"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 13.861, "billing_code_modifier": ["JZ"], "providers": [{"billed_charge": 40.5, "npi": [1447250253]}]}, {"allowed_amount": 46.3492, "billing_code_modifier": ["JZ"], "providers": [{"billed_charge": 78.33, "npi": [1447250253]}]}, {"allowed_amount": 0.49, "billing_code_modifier": ["JZ"], "providers": [{"billed_charge": 15.0, "npi": [1447250253]}, {"billed_charge": 22.5, "npi": [1447250253]}, {"billed_charge": 3.64, "npi": [1447250253]}, {"billed_charge": 6.06, "npi": [1447250253]}]}, {"allowed_amount": 0.49, "billing_code_modifier": [""], "providers": [{"billed_charge": 17.1, "npi": [1447250253]}, {"billed_charge": 5.25, "npi": [1447250253]}]}, {"allowed_amount": 457.07, "billing_code_modifier": ["JZ"], "providers": [{"billed_charge": 1868.6, "npi": [1447250253]}]}, {"allowed_amount": 0.26, "billing_code_modifier": ["JZ"], "providers": [{"billed_charge": 22.5, "npi": [1447250253]}]}, {"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 1.6479, "npi": [1447250253]}, {"billed_charge": 9.2381, "npi": [1447250253]}, {"billed_charge": 0.75, "npi": [1447250253]}, {"billed_charge": 9.4913, "npi": [1447250253]}, {"billed_charge": 3.535, "npi": [1447250253]}, {"billed_charge": 3.74, "npi": [1447250253]}, {"billed_charge": 6.0, "npi": [1447250253]}, {"billed_charge": 15.24, "npi": [1447250253]}, {"billed_charge": 29.67, "npi": [1447250253]}, {"billed_charge": 17.7, "npi": [1447250253]}, {"billed_charge": 0.8313, "npi": [1447250253]}, {"billed_charge": 0.9912, "npi": [1447250253]}, {"billed_charge": 2.12, "npi": [1447250253]}, {"billed_charge": 0.6596, "npi": [1447250253]}, {"billed_charge": 1.8329, "npi": [1447250253]}, {"billed_charge": 1.7192, "npi": [1447250253]}, {"billed_charge": 9.02, "npi": [1447250253]}, {"billed_charge": 7.844, "npi": [1447250253]}, {"billed_charge": 0.2064, "npi": [1447250253]}, {"billed_charge": 0.0173, "npi": [1447250253]}, {"billed_charge": 29.85, "npi": [1447250253]}, {"billed_charge": 8.28, "npi": [1447250253]}, {"billed_charge": 31.8, "npi": [1447250253]}, {"billed_charge": 263.76, "npi": [1447250253]}, {"billed_charge": 0.41, "npi": [1447250253]}, {"billed_charge": 1.6913, "npi": [1447250253]}, {"billed_charge": 0.505, "npi": [1447250253]}, {"billed_charge": 4.9666, "npi": [1447250253]}, {"billed_charge": 2.795, "npi": [1447250253]}, {"billed_charge": 0.78, "npi": [1447250253]}, {"billed_charge": 9.6238, "npi": [1447250253]}, {"billed_charge": 16.8, "npi": [1447250253]}, {"billed_charge": 1.3925, "npi": [1447250253]}, {"billed_charge": 18.22, "npi": [1447250253]}, {"billed_charge": 7.688, "npi": [1447250253]}, {"billed_charge": 1.67, "npi": [1447250253]}, {"billed_charge": 1.9502, "npi": [1447250253]}, {"billed_charge": 29.28, "npi": [1447250253]}, {"billed_charge": 42.0, "npi": [1447250253]}, {"billed_charge": 13.7028, "npi": [1447250253]}, {"billed_charge": 1.35, "npi": [1447250253]}, {"billed_charge": 49.525, "npi": [1447250253]}, {"billed_charge": 3.7527, "npi": [1447250253]}, {"billed_charge": 12.7033, "npi": [1447250253]}, {"billed_charge": 0.7853, "npi": [1447250253]}, {"billed_charge": 0.0295, "npi": [1447250253]}, {"billed_charge": 2.9712, "npi": [1447250253]}, {"billed_charge": 0.1655, "npi": [1447250253]}, {"billed_charge": 4.32, "npi": [1447250253]}, {"billed_charge": 19.2, "npi": [1447250253]}, {"billed_charge": 6.0175, "npi": [1447250253]}, {"billed_charge": 19.26, "npi": [1447250253]}, {"billed_charge": 1.5625, "npi": [1447250253]}, {"billed_charge": 10.592, "npi": [1447250253]}, {"billed_charge": 19.4406, "npi": [1447250253]}, {"billed_charge": 0.709, "npi": [1447250253]}, {"billed_charge": 64.581, "npi": [1447250253]}, {"billed_charge": 1.0111, "npi": [1447250253]}, {"billed_charge": 0.1464, "npi": [1447250253]}, {"billed_charge": 7.4993, "npi": [1447250253]}, {"billed_charge": 12.52, "npi": [1447250253]}, {"billed_charge": 85.92, "npi": [1447250253]}, {"billed_charge": 1.4562, "npi": [1447250253]}, {"billed_charge": 4.8517, "npi": [1447250253]}, {"billed_charge": 0.962, "npi": [1447250253]}, {"billed_charge": 37.0811, "npi": [1447250253]}, {"billed_charge": 2.4899, "npi": [1447250253]}, {"billed_charge": 0.72, "npi": [1447250253]}, {"billed_charge": 2.0725, "npi": [1447250253]}, {"billed_charge": 22.2685, "npi": [1447250253]}, {"billed_charge": 11.3625, "npi": [1447250253]}, {"billed_charge": 8.9725, "npi": [1447250253]}, {"billed_charge": 276.85, "npi": [1447250253]}, {"billed_charge": 1.4264, "npi": [1447250253]}, {"billed_charge": 1.296, "npi": [1447250253]}, {"billed_charge": 0.9763, "npi": [1447250253]}, {"billed_charge": 5.5634, "npi": [1447250253]}, {"billed_charge": 14.94, "npi": [1447250253]}, {"billed_charge": 57.0, "npi": [1447250253]}, {"billed_charge": 0.0714, "npi": [1447250253]}, {"billed_charge": 13.49, "npi": [1447250253]}, {"billed_charge": 13.1133, "npi": [1447250253]}, {"billed_charge": 3.215, "npi": [1447250253]}, {"billed_charge": 9.6476, "npi": [1447250253]}, {"billed_charge": 0.102, "npi": [1447250253]}, {"billed_charge": 0.0715, "npi": [1447250253]}, {"billed_charge": 10.2971, "npi": [1447250253]}, {"billed_charge": 160.65, "npi": [1447250253]}, {"billed_charge": 18.06, "npi": [1447250253]}, {"billed_charge": 5.4928, "npi": [1447250253]}, {"billed_charge": 2.97, "npi": [1447250253]}, {"billed_charge": 27.01, "npi": [1447250253]}, {"billed_charge": 0.9845, "npi": [1447250253]}, {"billed_charge": 0.031, "npi": [1447250253]}, {"billed_charge": 1.1649, "npi": [1447250253]}, {"billed_charge": 12.5002, "npi": [1447250253]}, {"billed_charge": 0.648, "npi": [1447250253]}, {"billed_charge": 18.74, "npi": [1447250253]}, {"billed_charge": 66.0, "npi": [1447250253]}, {"billed_charge": 2.4232, "npi": [1447250253]}, {"billed_charge": 15.9, "npi": [1447250253]}, {"billed_charge": 23.22, "npi": [1447250253]}, {"billed_charge": 13.2121, "npi": [1447250253]}, {"billed_charge": 2.5317, "npi": [1447250253]}, {"billed_charge": 19.275, "npi": [1447250253]}, {"billed_charge": 45.7129, "npi": [1447250253]}, {"billed_charge": 16.44, "npi": [1447250253]}, {"billed_charge": 2.68, "npi": [1447250253]}, {"billed_charge": 0.1, "npi": [1447250253]}, {"billed_charge": 1.655, "npi": [1447250253]}, {"billed_charge": 5.395, "npi": [1447250253]}, {"billed_charge": 0.0297, "npi": [1447250253]}, {"billed_charge": 172.03, "npi": [1447250253]}, {"billed_charge": 20.11, "npi": [1447250253]}, {"billed_charge": 17.82, "npi": [1447250253]}, {"billed_charge": 11.395, "npi": [1447250253]}, {"billed_charge": 1.9859, "npi": [1447250253]}]}, {"allowed_amount": 13.89, "billing_code_modifier": ["JZ"], "providers": [{"billed_charge": 40.5, "npi": [1447250253]}]}, {"allowed_amount": 0.49, "billing_code_modifier": ["JW"], "providers": [{"billed_charge": 17.1, "npi": [1447250253]}, {"billed_charge": 5.25, "npi": [1447250253]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["JZU8"], "providers": [{"billed_charge": 1.29, "npi": [1447250253]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["U8"], "providers": [{"billed_charge": 0.78, "npi": [1447250253]}, {"billed_charge": 66.0, "npi": [1447250253]}, {"billed_charge": 5.395, "npi": [1447250253]}]}, {"allowed_amount": 0.495, "billing_code_modifier": ["JZ"], "providers": [{"billed_charge": 2.76, "npi": [1447250253]}, {"billed_charge": 5.25, "npi": [1447250253]}]}, {"allowed_amount": 0.48, "billing_code_modifier": ["JZ"], "providers": [{"billed_charge": 5.46, "npi": [1447250253]}, {"billed_charge": 15.0, "npi": [1447250253]}, {"billed_charge": 22.5, "npi": [1447250253]}, {"billed_charge": 6.3, "npi": [1447250253]}, {"billed_charge": 3.64, "npi": [1447250253]}]}, {"allowed_amount": 351.157, "billing_code_modifier": ["JZ"], "providers": [{"billed_charge": 1021.572, "npi": [1447250253]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["JZ"], "providers": [{"billed_charge": 6.562, "npi": [1447250253]}, {"billed_charge": 0.0668, "npi": [1447250253]}, {"billed_charge": 2.159, "npi": [1447250253]}, {"billed_charge": 1.29, "npi": [1447250253]}, {"billed_charge": 0.352, "npi": [1447250253]}, {"billed_charge": 2.4, "npi": [1447250253]}, {"billed_charge": 1.67, "npi": [1447250253]}, {"billed_charge": 7.26, "npi": [1447250253]}, {"billed_charge": 14.52, "npi": [1447250253]}, {"billed_charge": 0.162, "npi": [1447250253]}, {"billed_charge": 8.53, "npi": [1447250253]}, {"billed_charge": 4.32, "npi": [1447250253]}, {"billed_charge": 0.69, "npi": [1447250253]}, {"billed_charge": 6.18, "npi": [1447250253]}, {"billed_charge": 4.8513, "npi": [1447250253]}, {"billed_charge": 6.47, "npi": [1447250253]}, {"billed_charge": 2.282, "npi": [1447250253]}, {"billed_charge": 4.8517, "npi": [1447250253]}, {"billed_charge": 29.04, "npi": [1447250253]}, {"billed_charge": 0.468, "npi": [1447250253]}, {"billed_charge": 2.5004, "npi": [1447250253]}, {"billed_charge": 0.3288, "npi": [1447250253]}, {"billed_charge": 5.75, "npi": [1447250253]}, {"billed_charge": 0.0714, "npi": [1447250253]}, {"billed_charge": 0.4668, "npi": [1447250253]}, {"billed_charge": 1.02, "npi": [1447250253]}, {"billed_charge": 5.355, "npi": [1447250253]}, {"billed_charge": 3.4, "npi": [1447250253]}, {"billed_charge": 272.825, "npi": [1447250253]}, {"billed_charge": 3.52, "npi": [1447250253]}, {"billed_charge": 18.0, "npi": [1447250253]}, {"billed_charge": 1.9258, "npi": [1447250253]}, {"billed_charge": 1.925, "npi": [1447250253]}, {"billed_charge": 0.4594, "npi": [1447250253]}, {"billed_charge": 4.8, "npi": [1447250253]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["JW"], "providers": [{"billed_charge": 0.4705, "npi": [1447250253]}, {"billed_charge": 0.5615, "npi": [1447250253]}, {"billed_charge": 4.32, "npi": [1447250253]}, {"billed_charge": 4.8525, "npi": [1447250253]}]}]}]}, {"name": "Medical/Surgical Supplies and Devices - Sterile Supply", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0272", "description": "Med/Surg Supplies &Devices (also see 062x, extension of 027x", "allowed_amounts": [{"tin": {"type": "ein", "value": "756001743"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 10.0, "npi": [1336172105]}, {"billed_charge": 44.4444, "npi": [1336172105]}, {"billed_charge": 10.55, "npi": [1336172105]}, {"billed_charge": 6.0, "npi": [1336172105]}, {"billed_charge": 31.4848, "npi": [1336172105]}, {"billed_charge": 305.2222, "npi": [1336172105]}]}]}]}, {"name": "Pharmacy - IV Solutions", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0258", "description": "Pharmacy (also see 063x, an extension of 025x)", "allowed_amounts": [{"tin": {"type": "ein", "value": "751837454"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 40.0, "npi": [1447250253]}, {"billed_charge": 35.519, "npi": [1447250253]}, {"billed_charge": 49.8857, "npi": [1447250253]}, {"billed_charge": 45.48, "npi": [1447250253]}, {"billed_charge": 46.4444, "npi": [1447250253]}, {"billed_charge": 42.0, "npi": [1447250253]}, {"billed_charge": 46.0, "npi": [1447250253]}, {"billed_charge": 50.0, "npi": [1447250253]}, {"billed_charge": 49.68, "npi": [1447250253]}, {"billed_charge": 49.75, "npi": [1447250253]}, {"billed_charge": 31.5, "npi": [1447250253]}, {"billed_charge": 48.5054, "npi": [1447250253]}, {"billed_charge": 46.8, "npi": [1447250253]}, {"billed_charge": 49.3333, "npi": [1447250253]}, {"billed_charge": 45.7386, "npi": [1447250253]}, {"billed_charge": 47.5625, "npi": [1447250253]}, {"billed_charge": 49.0833, "npi": [1447250253]}, {"billed_charge": 48.0, "npi": [1447250253]}, {"billed_charge": 49.5116, "npi": [1447250253]}, {"billed_charge": 25.5, "npi": [1447250253]}, {"billed_charge": 47.3333, "npi": [1447250253]}, {"billed_charge": 30.0, "npi": [1447250253]}, {"billed_charge": 49.8095, "npi": [1447250253]}]}]}]}, {"name": "Laboratory - General", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0300", "description": "Laboratory", "allowed_amounts": [{"tin": {"type": "ein", "value": "756001743"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 205.25, "npi": [1336172105]}, {"billed_charge": 41.5, "npi": [1336172105]}, {"billed_charge": 296.5, "npi": [1336172105]}, {"billed_charge": 563.9167, "npi": [1336172105]}, {"billed_charge": 494.625, "npi": [1336172105]}, {"billed_charge": 286.75, "npi": [1336172105]}]}]}]}, {"name": "Laboratory - Bacteriology & Microbiology", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0306", "description": "Laboratory", "allowed_amounts": [{"tin": {"type": "ein", "value": "751837454"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 206.81, "billing_code_modifier": [""], "providers": [{"billed_charge": 174.88, "npi": [1447250253]}]}, {"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 253.5008, "npi": [1447250253]}, {"billed_charge": 284.4483, "npi": [1447250253]}, {"billed_charge": 173.75, "npi": [1447250253]}, {"billed_charge": 747.18, "npi": [1447250253]}, {"billed_charge": 250.3838, "npi": [1447250253]}, {"billed_charge": 123.65, "npi": [1447250253]}, {"billed_charge": 272.5425, "npi": [1447250253]}, {"billed_charge": 125.99, "npi": [1447250253]}, {"billed_charge": 476.0733, "npi": [1447250253]}, {"billed_charge": 513.9225, "npi": [1447250253]}, {"billed_charge": 277.11, "npi": [1447250253]}, {"billed_charge": 415.6043, "npi": [1447250253]}, {"billed_charge": 241.82, "npi": [1447250253]}, {"billed_charge": 120.7, "npi": [1447250253]}, {"billed_charge": 239.4782, "npi": [1447250253]}, {"billed_charge": 231.1325, "npi": [1447250253]}, {"billed_charge": 215.5, "npi": [1447250253]}, {"billed_charge": 174.88, "npi": [1447250253]}, {"billed_charge": 294.745, "npi": [1447250253]}, {"billed_charge": 293.935, "npi": [1447250253]}, {"billed_charge": 214.958, "npi": [1447250253]}, {"billed_charge": 278.0576, "npi": [1447250253]}, {"billed_charge": 504.698, "npi": [1447250253]}, {"billed_charge": 264.685, "npi": [1447250253]}, {"billed_charge": 380.1194, "npi": [1447250253]}, {"billed_charge": 254.2, "npi": [1447250253]}, {"billed_charge": 457.286, "npi": [1447250253]}, {"billed_charge": 298.8467, "npi": [1447250253]}, {"billed_charge": 591.0833, "npi": [1447250253]}, {"billed_charge": 357.2425, "npi": [1447250253]}, {"billed_charge": 254.0341, "npi": [1447250253]}, {"billed_charge": 1425.75, "npi": [1447250253]}, {"billed_charge": 227.364, "npi": [1447250253]}, {"billed_charge": 203.2842, "npi": [1447250253]}, {"billed_charge": 17.0, "npi": [1447250253]}, {"billed_charge": 282.44, "npi": [1447250253]}, {"billed_charge": 240.5129, "npi": [1447250253]}, {"billed_charge": 240.405, "npi": [1447250253]}, {"billed_charge": 374.35, "npi": [1447250253]}, {"billed_charge": 320.4333, "npi": [1447250253]}, {"billed_charge": 116.69, "npi": [1447250253]}, {"billed_charge": 340.52, "npi": [1447250253]}, {"billed_charge": 102.41, "npi": [1447250253]}, {"billed_charge": 202.7271, "npi": [1447250253]}, {"billed_charge": 382.8483, "npi": [1447250253]}, {"billed_charge": 255.47, "npi": [1447250253]}, {"billed_charge": 197.09, "npi": [1447250253]}, {"billed_charge": 249.7375, "npi": [1447250253]}, {"billed_charge": 219.455, "npi": [1447250253]}, {"billed_charge": 702.2633, "npi": [1447250253]}, {"billed_charge": 546.59, "npi": [1447250253]}]}, {"allowed_amount": 148.49, "billing_code_modifier": [""], "providers": [{"billed_charge": 102.41, "npi": [1447250253]}]}]}]}, {"name": "Laboratory - Bacteriology & Microbiology", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0306", "description": "Laboratory", "allowed_amounts": [{"tin": {"type": "ein", "value": "753175630"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 206.81, "billing_code_modifier": [""], "providers": [{"billed_charge": 520.0, "npi": [1285798918]}]}, {"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 43.0, "npi": [1285798918]}, {"billed_charge": 291.0, "npi": [1285798918]}, {"billed_charge": 103.0, "npi": [1285798918]}, {"billed_charge": 133.0, "npi": [1285798918]}, {"billed_charge": 105.0, "npi": [1285798918]}, {"billed_charge": 212.0, "npi": [1285798918]}, {"billed_charge": 338.0, "npi": [1285798918]}, {"billed_charge": 415.8, "npi": [1285798918]}]}, {"allowed_amount": 604.33, "billing_code_modifier": [""], "providers": [{"billed_charge": 1250.0, "npi": [1285798918]}]}, {"allowed_amount": 14.98, "billing_code_modifier": [""], "providers": [{"billed_charge": 119.0, "npi": [1285798918]}]}, {"allowed_amount": 123.4, "billing_code_modifier": [""], "providers": [{"billed_charge": 578.0, "npi": [1285798918]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["59"], "providers": [{"billed_charge": 103.0, "npi": [1285798918]}, {"billed_charge": 105.0, "npi": [1285798918]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["91"], "providers": [{"billed_charge": 133.0, "npi": [1285798918]}]}, {"allowed_amount": 34.92, "billing_code_modifier": [""], "providers": [{"billed_charge": 277.0, "npi": [1285798918]}]}]}]}, {"name": "GROUND MILEAGE PER STATUTE MILE", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "A0425", "description": "GROUND MILEAGE PER STATUTE MILE", "allowed_amounts": [{"tin": {"type": "ein", "value": "756000640"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 22.5, "billing_code_modifier": ["PH"], "providers": [{"billed_charge": 22.5, "npi": [1982742698]}]}, {"allowed_amount": 22.5, "billing_code_modifier": ["NH"], "providers": [{"billed_charge": 22.5, "npi": [1982742698]}]}, {"allowed_amount": 22.5, "billing_code_modifier": ["SH"], "providers": [{"billed_charge": 22.5, "npi": [1982742698]}]}, {"allowed_amount": 22.5, "billing_code_modifier": ["RH"], "providers": [{"billed_charge": 22.5, "npi": [1982742698]}]}]}]}, {"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": "472177648"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 719.0, "npi": [1790174860]}]}, {"allowed_amount": 126.14, "billing_code_modifier": [""], "providers": [{"billed_charge": 997.58, "npi": [1790174860]}, {"billed_charge": 719.0, "npi": [1790174860]}]}]}]}, {"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": "814594733"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 126.29, "billing_code_modifier": [""], "providers": [{"billed_charge": 206.0, "npi": [1891044434]}]}]}]}, {"name": "GROUND MILEAGE PER STATUTE MILE", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "A0425", "description": "GROUND MILEAGE PER STATUTE MILE", "allowed_amounts": [{"tin": {"type": "ein", "value": "300688582"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 30.3229, "billing_code_modifier": ["RH"], "providers": [{"billed_charge": 46.1, "npi": [1750676870]}]}, {"allowed_amount": 30.322, "billing_code_modifier": ["HH"], "providers": [{"billed_charge": 46.1, "npi": [1750676870]}]}, {"allowed_amount": 30.3229, "billing_code_modifier": ["HH"], "providers": [{"billed_charge": 46.1, "npi": [1750676870]}]}, {"allowed_amount": 30.32, "billing_code_modifier": ["HH"], "providers": [{"billed_charge": 46.1, "npi": [1750676870]}]}, {"allowed_amount": 30.3229, "billing_code_modifier": ["HE"], "providers": [{"billed_charge": 46.1, "npi": [1750676870]}]}, {"allowed_amount": 30.3233, "billing_code_modifier": ["PH"], "providers": [{"billed_charge": 46.1, "npi": [1750676870]}]}, {"allowed_amount": 30.323, "billing_code_modifier": ["PH"], "providers": [{"billed_charge": 46.1, "npi": [1750676870]}]}, {"allowed_amount": 30.325, "billing_code_modifier": ["HH"], "providers": [{"billed_charge": 46.1, "npi": [1750676870]}]}, {"allowed_amount": 30.3227, "billing_code_modifier": ["HH"], "providers": [{"billed_charge": 46.1, "npi": [1750676870]}]}, {"allowed_amount": 30.3224, "billing_code_modifier": ["HH"], "providers": [{"billed_charge": 46.1, "npi": [1750676870]}]}, {"allowed_amount": 30.3225, "billing_code_modifier": ["HH"], "providers": [{"billed_charge": 46.1, "npi": [1750676870]}]}, {"allowed_amount": 30.3233, "billing_code_modifier": ["HH"], "providers": [{"billed_charge": 46.1, "npi": [1750676870]}]}, {"allowed_amount": 30.3226, "billing_code_modifier": ["HH"], "providers": [{"billed_charge": 46.1, "npi": [1750676870]}]}, {"allowed_amount": 30.323, "billing_code_modifier": ["HH"], "providers": [{"billed_charge": 46.1, "npi": [1750676870]}]}]}]}, {"name": "Pharmacy - Extension of 25X - Drug Requiring Detailed Coding", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0636", "description": "Pharmacy - Extension of 25x", "allowed_amounts": [{"tin": {"type": "ein", "value": "750972805"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.49, "billing_code_modifier": ["JZ"], "providers": [{"billed_charge": 10.0, "npi": [1174533343]}]}, {"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 15.4287, "npi": [1174533343]}, {"billed_charge": 0.1277, "npi": [1174533343]}, {"billed_charge": 9.0, "npi": [1174533343]}, {"billed_charge": 22.6875, "npi": [1174533343]}, {"billed_charge": 22.6883, "npi": [1174533343]}, {"billed_charge": 12.5, "npi": [1174533343]}, {"billed_charge": 1.4599, "npi": [1174533343]}, {"billed_charge": 4.1975, "npi": [1174533343]}, {"billed_charge": 7.5, "npi": [1174533343]}, {"billed_charge": 10.0, "npi": [1174533343]}, {"billed_charge": 10.04, "npi": [1174533343]}, {"billed_charge": 3.42, "npi": [1174533343]}, {"billed_charge": 9.8618, "npi": [1174533343]}, {"billed_charge": 2.5, "npi": [1174533343]}, {"billed_charge": 50.0, "npi": [1174533343]}, {"billed_charge": 4.25, "npi": [1174533343]}, {"billed_charge": 2.1951, "npi": [1174533343]}, {"billed_charge": 0.3584, "npi": [1174533343]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["U8"], "providers": [{"billed_charge": 38.86, "npi": [1174533343]}, {"billed_charge": 7.5, "npi": [1174533343]}, {"billed_charge": 50.0, "npi": [1174533343]}, {"billed_charge": 0.2, "npi": [1174533343]}, {"billed_charge": 0.3584, "npi": [1174533343]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["JZ59"], "providers": [{"billed_charge": 9.0, "npi": [1174533343]}]}, {"allowed_amount": 0.48, "billing_code_modifier": [""], "providers": [{"billed_charge": 10.0, "npi": [1174533343]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["JZ"], "providers": [{"billed_charge": 9.0, "npi": [1174533343]}, {"billed_charge": 0.5472, "npi": [1174533343]}, {"billed_charge": 13.09, "npi": [1174533343]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["JW"], "providers": [{"billed_charge": 9.0, "npi": [1174533343]}]}, {"allowed_amount": 0.48, "billing_code_modifier": ["JW"], "providers": [{"billed_charge": 10.0, "npi": [1174533343]}]}]}]}, {"name": "STERIL WATER SALINE  and  OR DXT DILUENT/FLUSH 10 ML", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "A4216", "description": "STERIL WATER SALINE  and  OR DXT DILUENT/FLUSH 10 ML", "allowed_amounts": [{"tin": {"type": "ein", "value": "853503076"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 139.3, "npi": [1124623889]}]}]}]}, {"name": "Pharmacy - IV Solutions", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0258", "description": "Pharmacy (also see 063x, an extension of 025x)", "allowed_amounts": [{"tin": {"type": "ein", "value": "751844139"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 43.8333, "npi": [1265430177]}, {"billed_charge": 50.0, "npi": [1265430177]}, {"billed_charge": 47.0435, "npi": [1265430177]}, {"billed_charge": 39.5, "npi": [1265430177]}, {"billed_charge": 43.0, "npi": [1265430177]}, {"billed_charge": 43.9, "npi": [1265430177]}]}]}]}, {"name": "Emergency Room - General", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0450", "description": "Emergency Room", "allowed_amounts": [{"tin": {"type": "ein", "value": "432008974"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 308.31, "billing_code_modifier": [""], "providers": [{"billed_charge": 333.25, "npi": [1003883158]}]}, {"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 577.1667, "npi": [1003883158]}, {"billed_charge": 1545.75, "npi": [1003883158]}, {"billed_charge": 639.9773, "npi": [1003883158]}, {"billed_charge": 939.5, "npi": [1003883158]}, {"billed_charge": 333.25, "npi": [1003883158]}, {"billed_charge": 542.5, "npi": [1003883158]}, {"billed_charge": 861.5, "npi": [1003883158]}]}, {"allowed_amount": 604.81, "billing_code_modifier": [""], "providers": [{"billed_charge": 1521.25, "npi": [1003883158]}]}, {"allowed_amount": 67.875, "billing_code_modifier": ["59"], "providers": [{"billed_charge": 333.25, "npi": [1003883158]}]}, {"allowed_amount": 222.56, "billing_code_modifier": [""], "providers": [{"billed_charge": 537.75, "npi": [1003883158]}]}, {"allowed_amount": 67.874, "billing_code_modifier": [""], "providers": [{"billed_charge": 333.25, "npi": [1003883158]}]}, {"allowed_amount": 3791.1, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 2758.25, "npi": [1003883158]}]}, {"allowed_amount": 67.87, "billing_code_modifier": [""], "providers": [{"billed_charge": 333.25, "npi": [1003883158]}, {"billed_charge": 103.5, "npi": [1003883158]}]}, {"allowed_amount": 395.66, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 1042.5, "npi": [1003883158]}]}, {"allowed_amount": 395.66, "billing_code_modifier": [""], "providers": [{"billed_charge": 1042.5, "npi": [1003883158]}]}, {"allowed_amount": 863.2, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 2758.25, "npi": [1003883158]}]}, {"allowed_amount": 308.31, "billing_code_modifier": ["59"], "providers": [{"billed_charge": 333.25, "npi": [1003883158]}, {"billed_charge": 779.25, "npi": [1003883158]}]}, {"allowed_amount": 122.22, "billing_code_modifier": [""], "providers": [{"billed_charge": 332.25, "npi": [1003883158]}]}, {"allowed_amount": 604.81, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 1521.25, "npi": [1003883158]}]}]}]}, {"name": "Laboratory - Hematology", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0305", "description": "Laboratory", "allowed_amounts": [{"tin": {"type": "ein", "value": "472177648"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 243.1652, "npi": [1790174860]}, {"billed_charge": 133.0, "npi": [1790174860]}, {"billed_charge": 246.0, "npi": [1790174860]}, {"billed_charge": 211.67, "npi": [1790174860]}, {"billed_charge": 226.0, "npi": [1790174860]}, {"billed_charge": 250.34, "npi": [1790174860]}, {"billed_charge": 263.1133, "npi": [1790174860]}, {"billed_charge": 168.4444, "npi": [1790174860]}, {"billed_charge": 287.89, "npi": [1790174860]}, {"billed_charge": 243.17, "npi": [1790174860]}, {"billed_charge": 173.0, "npi": [1790174860]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["91"], "providers": [{"billed_charge": 250.34, "npi": [1790174860]}]}]}]}, {"name": "Pharmacy - Extension of 25X - Drug Requiring Detailed Coding", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0636", "description": "Pharmacy - Extension of 25x", "allowed_amounts": [{"tin": {"type": "ein", "value": "452694620"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.49, "billing_code_modifier": [""], "providers": [{"billed_charge": 23.19, "npi": [1033120423]}]}, {"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 20.1057, "npi": [1033120423]}, {"billed_charge": 29.71, "npi": [1033120423]}, {"billed_charge": 0.8986, "npi": [1033120423]}, {"billed_charge": 2.5315, "npi": [1033120423]}, {"billed_charge": 54.26, "npi": [1033120423]}, {"billed_charge": 7.1875, "npi": [1033120423]}, {"billed_charge": 30.83, "npi": [1033120423]}, {"billed_charge": 3.4324, "npi": [1033120423]}, {"billed_charge": 5.4863, "npi": [1033120423]}, {"billed_charge": 11.655, "npi": [1033120423]}, {"billed_charge": 52.19, "npi": [1033120423]}, {"billed_charge": 10.8575, "npi": [1033120423]}, {"billed_charge": 0.5552, "npi": [1033120423]}, {"billed_charge": 0.6421, "npi": [1033120423]}, {"billed_charge": 0.6364, "npi": [1033120423]}, {"billed_charge": 5.1325, "npi": [1033120423]}, {"billed_charge": 8.63, "npi": [1033120423]}, {"billed_charge": 25.95, "npi": [1033120423]}, {"billed_charge": 3.8135, "npi": [1033120423]}, {"billed_charge": 13.9614, "npi": [1033120423]}, {"billed_charge": 36.59, "npi": [1033120423]}, {"billed_charge": 0.751, "npi": [1033120423]}, {"billed_charge": 0.9102, "npi": [1033120423]}, {"billed_charge": 4.7, "npi": [1033120423]}, {"billed_charge": 15.1124, "npi": [1033120423]}, {"billed_charge": 52.42, "npi": [1033120423]}, {"billed_charge": 7.128, "npi": [1033120423]}, {"billed_charge": 72.72, "npi": [1033120423]}, {"billed_charge": 2.0935, "npi": [1033120423]}, {"billed_charge": 1.968, "npi": [1033120423]}, {"billed_charge": 12.505, "npi": [1033120423]}, {"billed_charge": 42.05, "npi": [1033120423]}, {"billed_charge": 30.66, "npi": [1033120423]}, {"billed_charge": 36.7, "npi": [1033120423]}, {"billed_charge": 54.95, "npi": [1033120423]}, {"billed_charge": 46.64, "npi": [1033120423]}, {"billed_charge": 6.412, "npi": [1033120423]}, {"billed_charge": 9.4125, "npi": [1033120423]}, {"billed_charge": 0.4297, "npi": [1033120423]}, {"billed_charge": 0.057, "npi": [1033120423]}, {"billed_charge": 58.07, "npi": [1033120423]}, {"billed_charge": 5.0571, "npi": [1033120423]}, {"billed_charge": 20.885, "npi": [1033120423]}, {"billed_charge": 0.0573, "npi": [1033120423]}, {"billed_charge": 4.943, "npi": [1033120423]}, {"billed_charge": 7.75, "npi": [1033120423]}, {"billed_charge": 0.3714, "npi": [1033120423]}, {"billed_charge": 2.875, "npi": [1033120423]}, {"billed_charge": 2.575, "npi": [1033120423]}, {"billed_charge": 48.53, "npi": [1033120423]}, {"billed_charge": 2.4077, "npi": [1033120423]}, {"billed_charge": 10.935, "npi": [1033120423]}, {"billed_charge": 3.9414, "npi": [1033120423]}, {"billed_charge": 1.1343, "npi": [1033120423]}, {"billed_charge": 46.55, "npi": [1033120423]}, {"billed_charge": 54.98, "npi": [1033120423]}, {"billed_charge": 16.375, "npi": [1033120423]}, {"billed_charge": 16.7025, "npi": [1033120423]}, {"billed_charge": 7.065, "npi": [1033120423]}, {"billed_charge": 0.8913, "npi": [1033120423]}, {"billed_charge": 7.7425, "npi": [1033120423]}, {"billed_charge": 44.12, "npi": [1033120423]}, {"billed_charge": 5.0775, "npi": [1033120423]}]}, {"allowed_amount": 0.485, "billing_code_modifier": ["JZ"], "providers": [{"billed_charge": 16.0, "npi": [1033120423]}]}, {"allowed_amount": 0.49, "billing_code_modifier": ["JW"], "providers": [{"billed_charge": 8.82, "npi": [1033120423]}]}, {"allowed_amount": 0.4825, "billing_code_modifier": [""], "providers": [{"billed_charge": 16.005, "npi": [1033120423]}]}, {"allowed_amount": 0.48, "billing_code_modifier": [""], "providers": [{"billed_charge": 23.19, "npi": [1033120423]}]}, {"allowed_amount": 0.495, "billing_code_modifier": [""], "providers": [{"billed_charge": 16.005, "npi": [1033120423]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["JZ"], "providers": [{"billed_charge": 0.829, "npi": [1033120423]}, {"billed_charge": 1.4088, "npi": [1033120423]}, {"billed_charge": 42.05, "npi": [1033120423]}, {"billed_charge": 5.0775, "npi": [1033120423]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["JW"], "providers": [{"billed_charge": 2.3008, "npi": [1033120423]}, {"billed_charge": 2.4027, "npi": [1033120423]}]}, {"allowed_amount": 0.48, "billing_code_modifier": ["JW"], "providers": [{"billed_charge": 8.82, "npi": [1033120423]}]}, {"allowed_amount": 0.485, "billing_code_modifier": [""], "providers": [{"billed_charge": 16.0, "npi": [1033120423]}, {"billed_charge": 16.005, "npi": [1033120423]}]}]}]}, {"name": "Laboratory - Bacteriology & Microbiology", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0306", "description": "Laboratory", "allowed_amounts": [{"tin": {"type": "ein", "value": "452694620"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 473.7306, "npi": [1033120423]}, {"billed_charge": 365.92, "npi": [1033120423]}, {"billed_charge": 149.97, "npi": [1033120423]}, {"billed_charge": 380.3, "npi": [1033120423]}, {"billed_charge": 311.53, "npi": [1033120423]}, {"billed_charge": 556.28, "npi": [1033120423]}, {"billed_charge": 257.945, "npi": [1033120423]}, {"billed_charge": 359.52, "npi": [1033120423]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["QW"], "providers": [{"billed_charge": 359.52, "npi": [1033120423]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["91QW"], "providers": [{"billed_charge": 359.52, "npi": [1033120423]}]}]}]}, {"name": "Laboratory - Chemistry", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0301", "description": "Laboratory", "allowed_amounts": [{"tin": {"type": "ein", "value": "452694620"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 255.2, "npi": [1033120423]}, {"billed_charge": 715.04, "npi": [1033120423]}, {"billed_charge": 140.15, "npi": [1033120423]}, {"billed_charge": 559.98, "npi": [1033120423]}, {"billed_charge": 218.5444, "npi": [1033120423]}, {"billed_charge": 161.97, "npi": [1033120423]}, {"billed_charge": 831.08, "npi": [1033120423]}, {"billed_charge": 410.71, "npi": [1033120423]}, {"billed_charge": 217.1096, "npi": [1033120423]}, {"billed_charge": 272.4, "npi": [1033120423]}, {"billed_charge": 303.5, "npi": [1033120423]}, {"billed_charge": 426.5, "npi": [1033120423]}, {"billed_charge": 247.89, "npi": [1033120423]}, {"billed_charge": 218.8772, "npi": [1033120423]}, {"billed_charge": 453.13, "npi": [1033120423]}, {"billed_charge": 183.38, "npi": [1033120423]}, {"billed_charge": 243.1297, "npi": [1033120423]}, {"billed_charge": 536.89, "npi": [1033120423]}, {"billed_charge": 461.78, "npi": [1033120423]}, {"billed_charge": 1312.87, "npi": [1033120423]}, {"billed_charge": 146.2, "npi": [1033120423]}, {"billed_charge": 524.62, "npi": [1033120423]}, {"billed_charge": 279.55, "npi": [1033120423]}, {"billed_charge": 296.37, "npi": [1033120423]}, {"billed_charge": 91.04, "npi": [1033120423]}, {"billed_charge": 170.57, "npi": [1033120423]}, {"billed_charge": 423.32, "npi": [1033120423]}, {"billed_charge": 378.83, "npi": [1033120423]}, {"billed_charge": 253.62, "npi": [1033120423]}, {"billed_charge": 236.6147, "npi": [1033120423]}, {"billed_charge": 152.56, "npi": [1033120423]}]}, {"allowed_amount": 5.7, "billing_code_modifier": ["91"], "providers": [{"billed_charge": 70.38, "npi": [1033120423]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["XU"], "providers": [{"billed_charge": 73.84, "npi": [1033120423]}, {"billed_charge": 461.78, "npi": [1033120423]}, {"billed_charge": 253.62, "npi": [1033120423]}]}, {"allowed_amount": 19.42, "billing_code_modifier": [""], "providers": [{"billed_charge": 452.61, "npi": [1033120423]}]}, {"allowed_amount": 5.6975, "billing_code_modifier": ["91"], "providers": [{"billed_charge": 70.38, "npi": [1033120423]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["QW"], "providers": [{"billed_charge": 255.2, "npi": [1033120423]}, {"billed_charge": 715.04, "npi": [1033120423]}, {"billed_charge": 247.89, "npi": [1033120423]}, {"billed_charge": 423.32, "npi": [1033120423]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["91"], "providers": [{"billed_charge": 272.4, "npi": [1033120423]}, {"billed_charge": 183.38, "npi": [1033120423]}, {"billed_charge": 152.56, "npi": [1033120423]}]}, {"allowed_amount": 5.698, "billing_code_modifier": ["91"], "providers": [{"billed_charge": 70.38, "npi": [1033120423]}]}]}]}, {"name": "Emergency Room - General", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0450", "description": "Emergency Room", "allowed_amounts": [{"tin": {"type": "ein", "value": "472177648"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 308.31, "billing_code_modifier": [""], "providers": [{"billed_charge": 1607.0, "npi": [1790174860]}, {"billed_charge": 1451.0, "npi": [1790174860]}, {"billed_charge": 833.09, "npi": [1790174860]}]}, {"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 2141.07, "npi": [1790174860]}, {"billed_charge": 661.0, "npi": [1790174860]}, {"billed_charge": 1500.825, "npi": [1790174860]}, {"billed_charge": 1133.0, "npi": [1790174860]}, {"billed_charge": 1843.5067, "npi": [1790174860]}, {"billed_charge": 1672.38, "npi": [1790174860]}, {"billed_charge": 2397.76, "npi": [1790174860]}, {"billed_charge": 1115.5386, "npi": [1790174860]}, {"billed_charge": 3962.43, "npi": [1790174860]}]}, {"allowed_amount": 67.875, "billing_code_modifier": [""], "providers": [{"billed_charge": 735.0, "npi": [1790174860]}, {"billed_charge": 472.78, "npi": [1790174860]}]}, {"allowed_amount": 604.81, "billing_code_modifier": [""], "providers": [{"billed_charge": 1835.0, "npi": [1790174860]}]}, {"allowed_amount": 222.56, "billing_code_modifier": [""], "providers": [{"billed_charge": 690.0, "npi": [1790174860]}]}, {"allowed_amount": 604.81, "billing_code_modifier": ["2527"], "providers": [{"billed_charge": 1835.0, "npi": [1790174860]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["XU"], "providers": [{"billed_charge": 1133.0, "npi": [1790174860]}]}, {"allowed_amount": 3791.1, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 3962.43, "npi": [1790174860]}]}, {"allowed_amount": 589.22, "billing_code_modifier": [""], "providers": [{"billed_charge": 1549.85, "npi": [1790174860]}]}, {"allowed_amount": 67.87, "billing_code_modifier": [""], "providers": [{"billed_charge": 226.0, "npi": [1790174860]}, {"billed_charge": 735.0, "npi": [1790174860]}, {"billed_charge": 472.78, "npi": [1790174860]}]}, {"allowed_amount": 863.2, "billing_code_modifier": [""], "providers": [{"billed_charge": 3962.43, "npi": [1790174860]}]}, {"allowed_amount": 104.355, "billing_code_modifier": [""], "providers": [{"billed_charge": 273.79, "npi": [1790174860]}]}, {"allowed_amount": 67.8733, "billing_code_modifier": [""], "providers": [{"billed_charge": 735.0, "npi": [1790174860]}]}, {"allowed_amount": 395.66, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 1179.46, "npi": [1790174860]}]}, {"allowed_amount": 395.66, "billing_code_modifier": [""], "providers": [{"billed_charge": 1179.46, "npi": [1790174860]}]}, {"allowed_amount": 308.31, "billing_code_modifier": ["XU"], "providers": [{"billed_charge": 1451.0, "npi": [1790174860]}]}, {"allowed_amount": 863.2, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 3962.43, "npi": [1790174860]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["59"], "providers": [{"billed_charge": 1133.0, "npi": [1790174860]}]}, {"allowed_amount": 122.22, "billing_code_modifier": [""], "providers": [{"billed_charge": 656.0, "npi": [1790174860]}]}, {"allowed_amount": 1197.29, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 3449.05, "npi": [1790174860]}]}, {"allowed_amount": 604.81, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 1835.0, "npi": [1790174860]}]}]}]}, {"name": "Emergency Room - General", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0450", "description": "Emergency Room", "allowed_amounts": [{"tin": {"type": "ein", "value": "752890358"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 308.31, "billing_code_modifier": [""], "providers": [{"billed_charge": 333.25, "npi": [1548291883]}, {"billed_charge": 779.25, "npi": [1548291883]}]}, {"allowed_amount": 222.56, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 537.75, "npi": [1548291883]}]}, {"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 542.5, "npi": [1548291883]}, {"billed_charge": 889.3056, "npi": [1548291883]}, {"billed_charge": 254.75, "npi": [1548291883]}]}, {"allowed_amount": 67.875, "billing_code_modifier": [""], "providers": [{"billed_charge": 333.25, "npi": [1548291883]}]}, {"allowed_amount": 604.81, "billing_code_modifier": [""], "providers": [{"billed_charge": 1521.25, "npi": [1548291883]}]}, {"allowed_amount": 67.875, "billing_code_modifier": ["59"], "providers": [{"billed_charge": 333.25, "npi": [1548291883]}, {"billed_charge": 103.5, "npi": [1548291883]}]}, {"allowed_amount": 222.56, "billing_code_modifier": [""], "providers": [{"billed_charge": 537.75, "npi": [1548291883]}]}, {"allowed_amount": 122.22, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 332.25, "npi": [1548291883]}]}, {"allowed_amount": 67.87, "billing_code_modifier": [""], "providers": [{"billed_charge": 333.25, "npi": [1548291883]}, {"billed_charge": 103.5, "npi": [1548291883]}]}, {"allowed_amount": 395.66, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 1042.5, "npi": [1548291883]}]}, {"allowed_amount": 395.66, "billing_code_modifier": [""], "providers": [{"billed_charge": 1042.5, "npi": [1548291883]}]}, {"allowed_amount": 863.2, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 2758.25, "npi": [1548291883]}]}, {"allowed_amount": 308.31, "billing_code_modifier": ["59"], "providers": [{"billed_charge": 333.25, "npi": [1548291883]}]}, {"allowed_amount": 122.22, "billing_code_modifier": [""], "providers": [{"billed_charge": 332.25, "npi": [1548291883]}]}, {"allowed_amount": 67.87, "billing_code_modifier": ["59"], "providers": [{"billed_charge": 333.25, "npi": [1548291883]}, {"billed_charge": 103.5, "npi": [1548291883]}]}, {"allowed_amount": 604.81, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 1521.25, "npi": [1548291883]}]}]}]}, {"name": "Laboratory - Hematology", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0305", "description": "Laboratory", "allowed_amounts": [{"tin": {"type": "ein", "value": "824052186"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 146.11, "npi": [1801826839]}, {"billed_charge": 164.5209, "npi": [1801826839]}, {"billed_charge": 183.63, "npi": [1801826839]}, {"billed_charge": 111.76, "npi": [1801826839]}, {"billed_charge": 181.6424, "npi": [1801826839]}, {"billed_charge": 140.91, "npi": [1801826839]}, {"billed_charge": 149.84, "npi": [1801826839]}]}]}]}, {"name": "Medical/Surgical Supplies and Devices - Sterile Supply", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0272", "description": "Med/Surg Supplies &Devices (also see 062x, extension of 027x", "allowed_amounts": [{"tin": {"type": "ein", "value": "472177648"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 24.1167, "npi": [1790174860]}, {"billed_charge": 14.9583, "npi": [1790174860]}, {"billed_charge": 5.0, "npi": [1790174860]}, {"billed_charge": 26.4658, "npi": [1790174860]}, {"billed_charge": 13.225, "npi": [1790174860]}, {"billed_charge": 14.62, "npi": [1790174860]}, {"billed_charge": 21.75, "npi": [1790174860]}, {"billed_charge": 21.45, "npi": [1790174860]}, {"billed_charge": 8.05, "npi": [1790174860]}, {"billed_charge": 12.775, "npi": [1790174860]}, {"billed_charge": 75.115, "npi": [1790174860]}, {"billed_charge": 10.3357, "npi": [1790174860]}, {"billed_charge": 125.5337, "npi": [1790174860]}, {"billed_charge": 56.95, "npi": [1790174860]}, {"billed_charge": 12.9, "npi": [1790174860]}, {"billed_charge": 51.6871, "npi": [1790174860]}, {"billed_charge": 7.9333, "npi": [1790174860]}, {"billed_charge": 47.15, "npi": [1790174860]}, {"billed_charge": 17.5, "npi": [1790174860]}, {"billed_charge": 22.65, "npi": [1790174860]}, {"billed_charge": 17.1125, "npi": [1790174860]}, {"billed_charge": 15.9667, "npi": [1790174860]}, {"billed_charge": 39.8167, "npi": [1790174860]}, {"billed_charge": 13.825, "npi": [1790174860]}, {"billed_charge": 22.35, "npi": [1790174860]}, {"billed_charge": 21.6, "npi": [1790174860]}, {"billed_charge": 20.55, "npi": [1790174860]}, {"billed_charge": 47.9946, "npi": [1790174860]}, {"billed_charge": 22.05, "npi": [1790174860]}, {"billed_charge": 36.1375, "npi": [1790174860]}]}]}]}, {"name": "Radiology - Diagnostic - General", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0320", "description": "Radiology - Diagnostic", "allowed_amounts": [{"tin": {"type": "ein", "value": "751047527"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 701.0, "npi": [1396779948]}, {"billed_charge": 1044.25, "npi": [1396779948]}, {"billed_charge": 620.6786, "npi": [1396779948]}, {"billed_charge": 909.0, "npi": [1396779948]}, {"billed_charge": 792.25, "npi": [1396779948]}, {"billed_charge": 664.25, "npi": [1396779948]}, {"billed_charge": 304.75, "npi": [1396779948]}]}, {"allowed_amount": 126.14, "billing_code_modifier": [""], "providers": [{"billed_charge": 792.25, "npi": [1396779948]}, {"billed_charge": 664.25, "npi": [1396779948]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["RT"], "providers": [{"billed_charge": 701.0, "npi": [1396779948]}, {"billed_charge": 664.25, "npi": [1396779948]}, {"billed_charge": 489.25, "npi": [1396779948]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["LT"], "providers": [{"billed_charge": 511.25, "npi": [1396779948]}, {"billed_charge": 701.0, "npi": [1396779948]}, {"billed_charge": 599.5, "npi": [1396779948]}, {"billed_charge": 608.5, "npi": [1396779948]}, {"billed_charge": 489.25, "npi": [1396779948]}]}]}]}, {"name": "Pharmacy - General", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0250", "description": "Pharmacy (also see 063x, an extension of 025x)", "allowed_amounts": [{"tin": {"type": "ein", "value": "752770738"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 1.5, "npi": [1770514077]}, {"billed_charge": 8.6695, "npi": [1770514077]}, {"billed_charge": 2.6633, "npi": [1770514077]}, {"billed_charge": 2.0, "npi": [1770514077]}, {"billed_charge": 3.195, "npi": [1770514077]}, {"billed_charge": 4.6732, "npi": [1770514077]}, {"billed_charge": 3.8137, "npi": [1770514077]}, {"billed_charge": 1.695, "npi": [1770514077]}, {"billed_charge": 30.0, "npi": [1770514077]}, {"billed_charge": 1.6667, "npi": [1770514077]}, {"billed_charge": 1.055, "npi": [1770514077]}, {"billed_charge": 3.81, "npi": [1770514077]}, {"billed_charge": 1.0, "npi": [1770514077]}, {"billed_charge": 0.625, "npi": [1770514077]}, {"billed_charge": 3.6474, "npi": [1770514077]}, {"billed_charge": 9.9505, "npi": [1770514077]}, {"billed_charge": 0.4, "npi": [1770514077]}, {"billed_charge": 2.5222, "npi": [1770514077]}, {"billed_charge": 7.3033, "npi": [1770514077]}, {"billed_charge": 0.25, "npi": [1770514077]}, {"billed_charge": 8.63, "npi": [1770514077]}, {"billed_charge": 10.0, "npi": [1770514077]}, {"billed_charge": 7.6786, "npi": [1770514077]}, {"billed_charge": 7.4435, "npi": [1770514077]}, {"billed_charge": 21.8475, "npi": [1770514077]}, {"billed_charge": 2.39, "npi": [1770514077]}, {"billed_charge": 1.15, "npi": [1770514077]}, {"billed_charge": 22.23, "npi": [1770514077]}, {"billed_charge": 50.0, "npi": [1770514077]}, {"billed_charge": 3.4067, "npi": [1770514077]}, {"billed_charge": 1.3333, "npi": [1770514077]}, {"billed_charge": 12.5, "npi": [1770514077]}]}]}]}, {"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": "751037591"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 366.74, "npi": [1124305065]}]}, {"allowed_amount": 126.14, "billing_code_modifier": [""], "providers": [{"billed_charge": 366.74, "npi": [1124305065]}, {"billed_charge": 656.37, "npi": [1124305065]}]}]}]}, {"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": "204816846"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 84.3, "billing_code_modifier": [""], "providers": [{"billed_charge": 125.0, "npi": [1184664401]}]}]}]}, {"name": "Laboratory - General", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0300", "description": "Laboratory", "allowed_amounts": [{"tin": {"type": "ein", "value": "751748586"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 41.5, "npi": [1508899204]}]}]}]}, {"name": "Laboratory - Chemistry", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0301", "description": "Laboratory", "allowed_amounts": [{"tin": {"type": "ein", "value": "752678857"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 278.25, "npi": [1417980202]}, {"billed_charge": 229.25, "npi": [1417980202]}, {"billed_charge": 335.75, "npi": [1417980202]}, {"billed_charge": 628.75, "npi": [1417980202]}, {"billed_charge": 177.9342, "npi": [1417980202]}, {"billed_charge": 442.5, "npi": [1417980202]}, {"billed_charge": 402.9643, "npi": [1417980202]}, {"billed_charge": 153.5, "npi": [1417980202]}, {"billed_charge": 225.75, "npi": [1417980202]}, {"billed_charge": 324.5, "npi": [1417980202]}, {"billed_charge": 366.337, "npi": [1417980202]}, {"billed_charge": 668.5, "npi": [1417980202]}, {"billed_charge": 679.25, "npi": [1417980202]}]}]}]}, {"name": "Intensive Care - Intermediate  (ICU)", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0206", "description": "Intensive Care Unit", "allowed_amounts": [{"tin": {"type": "ein", "value": "751837454"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 3838.53, "npi": [1447250253]}, {"billed_charge": 2565.3, "npi": [1447250253]}]}, {"allowed_amount": 11239.41, "billing_code_modifier": [""], "providers": [{"billed_charge": 2565.3, "npi": [1447250253]}]}, {"allowed_amount": 5023.04, "billing_code_modifier": [""], "providers": [{"billed_charge": 3838.53, "npi": [1447250253]}]}, {"allowed_amount": 3440.075, "billing_code_modifier": [""], "providers": [{"billed_charge": 2565.3, "npi": [1447250253]}]}, {"allowed_amount": 1671.0586, "billing_code_modifier": [""], "providers": [{"billed_charge": 2565.3, "npi": [1447250253]}]}, {"allowed_amount": 2165.274, "billing_code_modifier": [""], "providers": [{"billed_charge": 2565.3, "npi": [1447250253]}]}, {"allowed_amount": 3746.47, "billing_code_modifier": [""], "providers": [{"billed_charge": 2565.3, "npi": [1447250253]}]}]}]}, {"name": "Laboratory - Bacteriology & Microbiology", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0306", "description": "Laboratory", "allowed_amounts": [{"tin": {"type": "ein", "value": "751037591"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 236.1389, "npi": [1124305065]}, {"billed_charge": 448.72, "npi": [1124305065]}, {"billed_charge": 358.64, "npi": [1124305065]}, {"billed_charge": 340.52, "npi": [1124305065]}, {"billed_charge": 280.7, "npi": [1124305065]}, {"billed_charge": 197.09, "npi": [1124305065]}, {"billed_charge": 125.99, "npi": [1124305065]}, {"billed_charge": 546.59, "npi": [1124305065]}, {"billed_charge": 433.21, "npi": [1124305065]}, {"billed_charge": 465.18, "npi": [1124305065]}, {"billed_charge": 174.63, "npi": [1124305065]}, {"billed_charge": 357.84, "npi": [1124305065]}, {"billed_charge": 142.75, "npi": [1124305065]}, {"billed_charge": 215.5, "npi": [1124305065]}]}, {"allowed_amount": 148.49, "billing_code_modifier": [""], "providers": [{"billed_charge": 102.41, "npi": [1124305065]}]}]}]}, {"name": "Laboratory - Hematology", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0305", "description": "Laboratory", "allowed_amounts": [{"tin": {"type": "ein", "value": "751777119"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 146.11, "npi": [1073511762]}, {"billed_charge": 140.91, "npi": [1073511762]}, {"billed_charge": 248.29, "npi": [1073511762]}, {"billed_charge": 183.63, "npi": [1073511762]}, {"billed_charge": 188.775, "npi": [1073511762]}, {"billed_charge": 149.84, "npi": [1073511762]}, {"billed_charge": 164.625, "npi": [1073511762]}, {"billed_charge": 93.56, "npi": [1073511762]}]}]}]}, {"name": "Emergency Room - General", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0450", "description": "Emergency Room", "allowed_amounts": [{"tin": {"type": "ein", "value": "751977850"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 230.24, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 537.75, "npi": [1396778064]}]}, {"allowed_amount": 625.67, "billing_code_modifier": [""], "providers": [{"billed_charge": 1521.25, "npi": [1396778064]}]}, {"allowed_amount": 409.31, "billing_code_modifier": [""], "providers": [{"billed_charge": 1042.5, "npi": [1396778064]}]}, {"allowed_amount": 230.24, "billing_code_modifier": [""], "providers": [{"billed_charge": 537.75, "npi": [1396778064]}]}, {"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 760.375, "npi": [1396778064]}, {"billed_charge": 254.75, "npi": [1396778064]}, {"billed_charge": 2758.25, "npi": [1396778064]}]}, {"allowed_amount": 318.95, "billing_code_modifier": ["59"], "providers": [{"billed_charge": 333.25, "npi": [1396778064]}]}, {"allowed_amount": 892.97, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 2758.25, "npi": [1396778064]}]}, {"allowed_amount": 1040.4, "billing_code_modifier": ["T5"], "providers": [{"billed_charge": 647.5, "npi": [1396778064]}]}, {"allowed_amount": 126.44, "billing_code_modifier": [""], "providers": [{"billed_charge": 332.25, "npi": [1396778064]}]}, {"allowed_amount": 318.95, "billing_code_modifier": [""], "providers": [{"billed_charge": 779.25, "npi": [1396778064]}, {"billed_charge": 333.25, "npi": [1396778064]}]}, {"allowed_amount": 625.67, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 1521.25, "npi": [1396778064]}]}, {"allowed_amount": 126.44, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 332.25, "npi": [1396778064]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 2758.25, "npi": [1396778064]}, {"billed_charge": 332.25, "npi": [1396778064]}]}, {"allowed_amount": 70.22, "billing_code_modifier": [""], "providers": [{"billed_charge": 103.5, "npi": [1396778064]}, {"billed_charge": 333.25, "npi": [1396778064]}]}, {"allowed_amount": 70.215, "billing_code_modifier": [""], "providers": [{"billed_charge": 333.25, "npi": [1396778064]}]}, {"allowed_amount": 70.2167, "billing_code_modifier": [""], "providers": [{"billed_charge": 333.25, "npi": [1396778064]}]}, {"allowed_amount": 409.31, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 1042.5, "npi": [1396778064]}]}]}]}, {"name": "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": "270839735"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 84.4, "billing_code_modifier": [""], "providers": [{"billed_charge": 146.0, "npi": [1932309283]}]}]}]}, {"name": "Other Diagnostic Services - Peripheral Vascular Lab", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0921", "description": "Other Diagnostic Services", "allowed_amounts": [{"tin": {"type": "ein", "value": "751837454"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 151.54, "billing_code_modifier": ["RT"], "providers": [{"billed_charge": 1338.82, "npi": [1447250253]}]}, {"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 2001.42, "npi": [1447250253]}, {"billed_charge": 1670.12, "npi": [1447250253]}, {"billed_charge": 1741.09, "npi": [1447250253]}]}, {"allowed_amount": 151.54, "billing_code_modifier": ["LT"], "providers": [{"billed_charge": 1338.82, "npi": [1447250253]}]}, {"allowed_amount": 345.85, "billing_code_modifier": [""], "providers": [{"billed_charge": 1961.81, "npi": [1447250253]}, {"billed_charge": 2001.42, "npi": [1447250253]}, {"billed_charge": 1741.09, "npi": [1447250253]}]}]}]}, {"name": "Other Imaging Services - Ultrasound", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0402", "description": "Other Imaging Services", "allowed_amounts": [{"tin": {"type": "ein", "value": "752586857"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 151.54, "billing_code_modifier": [""], "providers": [{"billed_charge": 1101.64, "npi": [1992700983]}, {"billed_charge": 1269.06, "npi": [1992700983]}, {"billed_charge": 1049.03, "npi": [1992700983]}, {"billed_charge": 1152.88, "npi": [1992700983]}, {"billed_charge": 1072.02, "npi": [1992700983]}]}, {"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 765.0, "npi": [1992700983]}, {"billed_charge": 1101.64, "npi": [1992700983]}, {"billed_charge": 1020.91, "npi": [1992700983]}, {"billed_charge": 1214.7633, "npi": [1992700983]}, {"billed_charge": 1049.03, "npi": [1992700983]}, {"billed_charge": 1050.92, "npi": [1992700983]}, {"billed_charge": 1152.88, "npi": [1992700983]}, {"billed_charge": 848.33, "npi": [1992700983]}]}]}]}, {"name": "CT Scan - Head Scan", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0351", "description": "CT Scan", "allowed_amounts": [{"tin": {"type": "ein", "value": "752586857"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 151.54, "billing_code_modifier": [""], "providers": [{"billed_charge": 3178.59, "npi": [1992700983]}]}, {"allowed_amount": 622.69, "billing_code_modifier": [""], "providers": [{"billed_charge": 3178.59, "npi": [1992700983]}]}, {"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 2566.11, "npi": [1992700983]}, {"billed_charge": 11751.19, "npi": [1992700983]}, {"billed_charge": 3306.97, "npi": [1992700983]}, {"billed_charge": 3178.59, "npi": [1992700983]}]}, {"allowed_amount": 254.23, "billing_code_modifier": [""], "providers": [{"billed_charge": 3340.68, "npi": [1992700983]}, {"billed_charge": 3306.97, "npi": [1992700983]}]}]}]}, {"name": "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": "751837454"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 179.69, "npi": [1447250253]}]}]}]}, {"name": "CT Scan - Body Scan", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0352", "description": "CT Scan", "allowed_amounts": [{"tin": {"type": "ein", "value": "752586857"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 5896.8, "npi": [1992700983]}, {"billed_charge": 6093.885, "npi": [1992700983]}, {"billed_charge": 3339.84, "npi": [1992700983]}, {"billed_charge": 6484.35, "npi": [1992700983]}, {"billed_charge": 5242.105, "npi": [1992700983]}, {"billed_charge": 6290.97, "npi": [1992700983]}, {"billed_charge": 3150.74, "npi": [1992700983]}]}, {"allowed_amount": 254.23, "billing_code_modifier": [""], "providers": [{"billed_charge": 3665.78, "npi": [1992700983]}, {"billed_charge": 6290.97, "npi": [1992700983]}]}, {"allowed_amount": 345.85, "billing_code_modifier": [""], "providers": [{"billed_charge": 5896.8, "npi": [1992700983]}]}, {"allowed_amount": 505.67, "billing_code_modifier": [""], "providers": [{"billed_charge": 6484.35, "npi": [1992700983]}]}]}]}, {"name": "Emergency Room - General", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0450", "description": "Emergency Room", "allowed_amounts": [{"tin": {"type": "ein", "value": "751037591"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 308.31, "billing_code_modifier": [""], "providers": [{"billed_charge": 524.33, "npi": [1124305065]}]}, {"allowed_amount": 222.56, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 782.31, "npi": [1124305065]}]}, {"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 524.33, "npi": [1124305065]}, {"billed_charge": 788.36, "npi": [1124305065]}, {"billed_charge": 1283.4, "npi": [1124305065]}, {"billed_charge": 321.2, "npi": [1124305065]}, {"billed_charge": 392.06, "npi": [1124305065]}, {"billed_charge": 1479.985, "npi": [1124305065]}, {"billed_charge": 2989.84, "npi": [1124305065]}, {"billed_charge": 1512.455, "npi": [1124305065]}, {"billed_charge": 317.78, "npi": [1124305065]}, {"billed_charge": 361.12, "npi": [1124305065]}]}, {"allowed_amount": 67.875, "billing_code_modifier": [""], "providers": [{"billed_charge": 392.06, "npi": [1124305065]}, {"billed_charge": 317.78, "npi": [1124305065]}]}, {"allowed_amount": 604.81, "billing_code_modifier": [""], "providers": [{"billed_charge": 2122.8, "npi": [1124305065]}]}, {"allowed_amount": 67.875, "billing_code_modifier": ["XU"], "providers": [{"billed_charge": 392.06, "npi": [1124305065]}]}, {"allowed_amount": 222.56, "billing_code_modifier": [""], "providers": [{"billed_charge": 782.31, "npi": [1124305065]}]}, {"allowed_amount": 122.22, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 478.23, "npi": [1124305065]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["XU"], "providers": [{"billed_charge": 321.2, "npi": [1124305065]}, {"billed_charge": 392.06, "npi": [1124305065]}]}, {"allowed_amount": 67.8733, "billing_code_modifier": ["XU"], "providers": [{"billed_charge": 392.06, "npi": [1124305065]}]}, {"allowed_amount": 3791.1, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 3879.67, "npi": [1124305065]}, {"billed_charge": 2122.8, "npi": [1124305065]}, {"billed_charge": 11042.97, "npi": [1124305065]}]}, {"allowed_amount": 67.87, "billing_code_modifier": [""], "providers": [{"billed_charge": 392.06, "npi": [1124305065]}, {"billed_charge": 317.78, "npi": [1124305065]}]}, {"allowed_amount": 67.8733, "billing_code_modifier": [""], "providers": [{"billed_charge": 392.06, "npi": [1124305065]}, {"billed_charge": 317.78, "npi": [1124305065]}]}, {"allowed_amount": 395.66, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 1283.4, "npi": [1124305065]}]}, {"allowed_amount": 395.66, "billing_code_modifier": [""], "providers": [{"billed_charge": 1283.4, "npi": [1124305065]}]}, {"allowed_amount": 308.31, "billing_code_modifier": ["XU"], "providers": [{"billed_charge": 524.33, "npi": [1124305065]}, {"billed_charge": 814.34, "npi": [1124305065]}]}, {"allowed_amount": 863.2, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 3879.67, "npi": [1124305065]}]}, {"allowed_amount": 604.81, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 2122.8, "npi": [1124305065]}]}, {"allowed_amount": 1197.29, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 4233.71, "npi": [1124305065]}]}]}]}, {"name": "Laboratory - Chemistry", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0301", "description": "Laboratory", "allowed_amounts": [{"tin": {"type": "ein", "value": "751047527"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 482.375, "npi": [1396779948]}, {"billed_charge": 628.75, "npi": [1396779948]}, {"billed_charge": 257.75, "npi": [1396779948]}, {"billed_charge": 410.0, "npi": [1396779948]}, {"billed_charge": 348.5, "npi": [1396779948]}, {"billed_charge": 231.0, "npi": [1396779948]}, {"billed_charge": 112.75, "npi": [1396779948]}, {"billed_charge": 679.25, "npi": [1396779948]}, {"billed_charge": 328.8375, "npi": [1396779948]}, {"billed_charge": 229.25, "npi": [1396779948]}, {"billed_charge": 326.6786, "npi": [1396779948]}, {"billed_charge": 328.75, "npi": [1396779948]}, {"billed_charge": 561.75, "npi": [1396779948]}, {"billed_charge": 424.5, "npi": [1396779948]}, {"billed_charge": 343.8026, "npi": [1396779948]}, {"billed_charge": 278.25, "npi": [1396779948]}, {"billed_charge": 324.5, "npi": [1396779948]}, {"billed_charge": 49.25, "npi": [1396779948]}, {"billed_charge": 335.75, "npi": [1396779948]}, {"billed_charge": 497.2143, "npi": [1396779948]}, {"billed_charge": 471.3, "npi": [1396779948]}, {"billed_charge": 153.5, "npi": [1396779948]}, {"billed_charge": 291.25, "npi": [1396779948]}, {"billed_charge": 274.25, "npi": [1396779948]}, {"billed_charge": 177.1524, "npi": [1396779948]}, {"billed_charge": 225.2031, "npi": [1396779948]}, {"billed_charge": 333.6429, "npi": [1396779948]}, {"billed_charge": 408.9035, "npi": [1396779948]}, {"billed_charge": 314.3017, "npi": [1396779948]}, {"billed_charge": 442.5, "npi": [1396779948]}, {"billed_charge": 671.0, "npi": [1396779948]}, {"billed_charge": 334.25, "npi": [1396779948]}, {"billed_charge": 161.0, "npi": [1396779948]}, {"billed_charge": 225.75, "npi": [1396779948]}, {"billed_charge": 327.6389, "npi": [1396779948]}, {"billed_charge": 391.0476, "npi": [1396779948]}, {"billed_charge": 565.0, "npi": [1396779948]}, {"billed_charge": 340.0, "npi": [1396779948]}, {"billed_charge": 210.75, "npi": [1396779948]}, {"billed_charge": 477.25, "npi": [1396779948]}]}, {"allowed_amount": 19.42, "billing_code_modifier": [""], "providers": [{"billed_charge": 679.25, "npi": [1396779948]}]}, {"allowed_amount": 5.7, "billing_code_modifier": [""], "providers": [{"billed_charge": 140.0, "npi": [1396779948]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["91"], "providers": [{"billed_charge": 49.25, "npi": [1396779948]}, {"billed_charge": 335.75, "npi": [1396779948]}, {"billed_charge": 247.0, "npi": [1396779948]}]}]}]}, {"name": "Emergency Room - General", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "0450", "description": "Emergency Room", "allowed_amounts": [{"tin": {"type": "ein", "value": "752586857"}, "service_code": [""], "billing_class": "institutional", "payments": [{"allowed_amount": 308.31, "billing_code_modifier": [""], "providers": [{"billed_charge": 524.33, "npi": [1992700983]}, {"billed_charge": 814.34, "npi": [1992700983]}]}, {"allowed_amount": 222.56, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 782.31, "npi": [1992700983]}]}, {"allowed_amount": 0.0, "billing_code_modifier": [""], "providers": [{"billed_charge": 1288.854, "npi": [1992700983]}, {"billed_charge": 902.11, "npi": [1992700983]}, {"billed_charge": 753.62, "npi": [1992700983]}, {"billed_charge": 2379.02, "npi": [1992700983]}, {"billed_charge": 500.62, "npi": [1992700983]}, {"billed_charge": 4233.71, "npi": [1992700983]}, {"billed_charge": 468.18, "npi": [1992700983]}, {"billed_charge": 3879.67, "npi": [1992700983]}, {"billed_charge": 806.34, "npi": [1992700983]}, {"billed_charge": 1064.045, "npi": [1992700983]}, {"billed_charge": 321.2, "npi": [1992700983]}, {"billed_charge": 1029.62, "npi": [1992700983]}, {"billed_charge": 392.06, "npi": [1992700983]}, {"billed_charge": 524.33, "npi": [1992700983]}, {"billed_charge": 1366.97, "npi": [1992700983]}, {"billed_charge": 887.9629, "npi": [1992700983]}, {"billed_charge": 317.78, "npi": [1992700983]}, {"billed_charge": 361.12, "npi": [1992700983]}, {"billed_charge": 862.0, "npi": [1992700983]}]}, {"allowed_amount": 67.875, "billing_code_modifier": [""], "providers": [{"billed_charge": 392.06, "npi": [1992700983]}, {"billed_charge": 317.78, "npi": [1992700983]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["XS"], "providers": [{"billed_charge": 524.33, "npi": [1992700983]}]}, {"allowed_amount": 604.81, "billing_code_modifier": [""], "providers": [{"billed_charge": 2122.8, "npi": [1992700983]}]}, {"allowed_amount": 222.56, "billing_code_modifier": ["2527"], "providers": [{"billed_charge": 782.31, "npi": [1992700983]}]}, {"allowed_amount": 67.87, "billing_code_modifier": ["XU"], "providers": [{"billed_charge": 392.06, "npi": [1992700983]}]}, {"allowed_amount": 222.56, "billing_code_modifier": [""], "providers": [{"billed_charge": 782.31, "npi": [1992700983]}]}, {"allowed_amount": 122.22, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 478.23, "npi": [1992700983]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["XU"], "providers": [{"billed_charge": 321.2, "npi": [1992700983]}, {"billed_charge": 392.06, "npi": [1992700983]}, {"billed_charge": 524.33, "npi": [1992700983]}]}, {"allowed_amount": 781.74, "billing_code_modifier": [""], "providers": [{"billed_charge": 2911.14, "npi": [1992700983]}]}, {"allowed_amount": 3791.1, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 4233.71, "npi": [1992700983]}, {"billed_charge": 3879.67, "npi": [1992700983]}]}, {"allowed_amount": 589.22, "billing_code_modifier": [""], "providers": [{"billed_charge": 1075.22, "npi": [1992700983]}]}, {"allowed_amount": 67.87, "billing_code_modifier": [""], "providers": [{"billed_charge": 392.06, "npi": [1992700983]}, {"billed_charge": 317.78, "npi": [1992700983]}]}, {"allowed_amount": 863.2, "billing_code_modifier": [""], "providers": [{"billed_charge": 3879.67, "npi": [1992700983]}]}, {"allowed_amount": 0.0, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 4233.71, "npi": [1992700983]}, {"billed_charge": 3879.67, "npi": [1992700983]}]}, {"allowed_amount": 67.8733, "billing_code_modifier": [""], "providers": [{"billed_charge": 392.06, "npi": [1992700983]}, {"billed_charge": 317.78, "npi": [1992700983]}]}, {"allowed_amount": 395.66, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 1807.73, "npi": [1992700983]}, {"billed_charge": 1283.4, "npi": [1992700983]}]}, {"allowed_amount": 395.66, "billing_code_modifier": [""], "providers": [{"billed_charge": 1283.4, "npi": [1992700983]}]}, {"allowed_amount": 308.31, "billing_code_modifier": ["XU"], "providers": [{"billed_charge": 524.33, "npi": [1992700983]}]}, {"allowed_amount": 863.2, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 3879.67, "npi": [1992700983]}]}, {"allowed_amount": 44.12, "billing_code_modifier": [""], "providers": [{"billed_charge": 392.06, "npi": [1992700983]}]}, {"allowed_amount": 863.2, "billing_code_modifier": ["27"], "providers": [{"billed_charge": 3879.67, "npi": [1992700983]}]}, {"allowed_amount": 122.22, "billing_code_modifier": [""], "providers": [{"billed_charge": 478.23, "npi": [1992700983]}]}, {"allowed_amount": 604.81, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 2122.8, "npi": [1992700983]}]}, {"allowed_amount": 1197.29, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 4233.71, "npi": [1992700983]}]}, {"allowed_amount": 62.35, "billing_code_modifier": [""], "providers": [{"billed_charge": 524.33, "npi": [1992700983]}]}]}]}]}