{"reporting_entity_name": "GIIC_TPA","reporting_entity_type": "GIIC_TPA","last_updated_on": "2026-10-07","version": "1.0.0","out_of_network":[{"name":"Administration of a standardized, evidence-based social determinants of health risk assessment tool, 5-15 minutes","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G013659","description":"Administration of a standardized, evidence-based social determinants of health risk assessment tool, 5-15 minutes","allowed_amounts":[{"tin":{"type":"ein","value":"333710948"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":18.53,"providers":[{"billed_charge":45.00,"npi":[1982247367]}]}]}]},{"name":"Alcohol and\/or drug services","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"H0018","description":"Alcohol and\/or drug services","allowed_amounts":[{"tin":{"type":"ein","value":"990893423"},"service_code":[],"billing_class":"institutional","payments":[{"allowed_amount":1351.35,"providers":[{"billed_charge":4950.00,"npi":[1154179604]}]}]}]},{"name":"Ambulance Service Basic Life Support\/Emergency","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A0429RH","description":"Ambulance Service Basic Life Support\/Emergency","allowed_amounts":[{"tin":{"type":"ein","value":"232192638"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":432.03,"providers":[{"billed_charge":800.00,"npi":[1508852575]}]}]}]},{"name":"Ambulance Service Basic Life Support\/Emergency","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A0429RH","description":"Ambulance Service Basic Life Support\/Emergency","allowed_amounts":[{"tin":{"type":"ein","value":"261841118"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":436.27,"providers":[{"billed_charge":775.00,"npi":[1558533562]}]}]}]},{"name":"Ambulance Service Basic Life Support\/Emergency","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A0429SH","description":"Ambulance Service Basic Life Support\/Emergency","allowed_amounts":[{"tin":{"type":"ein","value":"232019356"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":606.42,"providers":[{"billed_charge":1050.00,"npi":[1659418796]}]}]}]},{"name":"Ambulance Service,Advanced Life Support\/Emergency Level 1","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A0427RH","description":"Ambulance Service,Advanced Life Support\/Emergency Level 1","allowed_amounts":[{"tin":{"type":"ein","value":"236398510"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":513.04,"providers":[{"billed_charge":1300.00,"npi":[1639167448]}]}]}]},{"name":"Ambulance Service,Advanced Life Support\/Emergency Level 1","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A0427RH","description":"Ambulance Service,Advanced Life Support\/Emergency Level 1","allowed_amounts":[{"tin":{"type":"ein","value":"251595839"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":524.92,"providers":[{"billed_charge":1500.00,"npi":[1184601742]}]}]}]},{"name":"Ambulance Service,Advanced Life Support\/Emergency Level 1","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A0427SH","description":"Ambulance Service,Advanced Life Support\/Emergency Level 1","allowed_amounts":[{"tin":{"type":"ein","value":"230998665"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":560.72,"providers":[{"billed_charge":1400.00,"npi":[1053470906]}]}]}]},{"name":"Anesthesia","billing_code_type":"RC","billing_code_type_version":"2026","billing_code":"0370","description":"Anesthesia","allowed_amounts":[{"tin":{"type":"ein","value":"141338467"},"service_code":[],"billing_class":"institutional","payments":[{"allowed_amount":0.00,"providers":[{"billed_charge":2345.00,"npi":[1124072715]}]}]}]},{"name":"Assay of estradiol","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82670","description":"Assay of estradiol","allowed_amounts":[{"tin":{"type":"ein","value":"133757370"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":35.91,"providers":[{"billed_charge":182.70,"npi":[1538144910]},{"billed_charge":212.98,"npi":[1063497451]}]}]}]},{"name":"Assay of ferritin","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82728","description":"Assay of ferritin","allowed_amounts":[{"tin":{"type":"ein","value":"133757370"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":17.50,"providers":[{"billed_charge":75.86,"npi":[1063497451]},{"billed_charge":82.95,"npi":[1063497451]},{"billed_charge":85.82,"npi":[1538144910]},{"billed_charge":89.54,"npi":[1932184322]}]}]}]},{"name":"Assay of folic acid serum","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82746","description":"Assay of folic acid serum","allowed_amounts":[{"tin":{"type":"ein","value":"133757370"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":18.90,"providers":[{"billed_charge":107.08,"npi":[1538144910]}]}]}]},{"name":"Assay of free testosterone","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84402","description":"Assay of free testosterone","allowed_amounts":[{"tin":{"type":"ein","value":"133757370"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":32.72,"providers":[{"billed_charge":194.07,"npi":[1063497451]},{"billed_charge":197.50,"npi":[1538144910]}]}]}]},{"name":"Assay of free thyroxine","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84439","description":"Assay of free thyroxine","allowed_amounts":[{"tin":{"type":"ein","value":"133757370"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":11.59,"providers":[{"billed_charge":122.85,"npi":[1063497451]},{"billed_charge":68.67,"npi":[1063497451]},{"billed_charge":80.97,"npi":[1063497451]},{"billed_charge":92.96,"npi":[1932184322]},{"billed_charge":97.74,"npi":[1538144910]}]}]}]},{"name":"Assay of gonadotropin (fsh)","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83001","description":"Assay of gonadotropin (fsh)","allowed_amounts":[{"tin":{"type":"ein","value":"133757370"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":23.90,"providers":[{"billed_charge":141.61,"npi":[1063497451]}]}]}]},{"name":"Assay of homocystine","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83090","description":"Assay of homocystine","allowed_amounts":[{"tin":{"type":"ein","value":"133757370"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":21.69,"providers":[{"billed_charge":198.17,"npi":[1538144910]}]}]}]},{"name":"Assay of insulin","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83525","description":"Assay of insulin","allowed_amounts":[{"tin":{"type":"ein","value":"133757370"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":14.70,"providers":[{"billed_charge":65.03,"npi":[1063497451]},{"billed_charge":88.20,"npi":[1538144910]},{"billed_charge":91.07,"npi":[1538144910]}]}]}]},{"name":"Assay of iron","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83540","description":"Assay of iron","allowed_amounts":[{"tin":{"type":"ein","value":"133757370"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":8.32,"providers":[{"billed_charge":33.08,"npi":[1063497451]},{"billed_charge":35.95,"npi":[1538144910]},{"billed_charge":36.10,"npi":[1063497451]}]}]}]},{"name":"Assay of magnesium","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83735","description":"Assay of magnesium","allowed_amounts":[{"tin":{"type":"ein","value":"133757370"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":8.61,"providers":[{"billed_charge":45.44,"npi":[1932184322]}]}]}]},{"name":"Assay of progesterone","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84144","description":"Assay of progesterone","allowed_amounts":[{"tin":{"type":"ein","value":"133757370"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":26.82,"providers":[{"billed_charge":139.65,"npi":[1538144910]},{"billed_charge":159.08,"npi":[1063497451]}]}]}]},{"name":"Assay of sex hormone globul","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84270","description":"Assay of sex hormone globul","allowed_amounts":[{"tin":{"type":"ein","value":"133757370"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":27.93,"providers":[{"billed_charge":150.28,"npi":[1063497451]}]}]}]},{"name":"Assay of somatomedin","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84305","description":"Assay of somatomedin","allowed_amounts":[{"tin":{"type":"ein","value":"133757370"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":27.32,"providers":[{"billed_charge":212.33,"npi":[1538144910]}]}]}]},{"name":"Assay of total testosterone","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84403","description":"Assay of total testosterone","allowed_amounts":[{"tin":{"type":"ein","value":"133757370"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":33.19,"providers":[{"billed_charge":196.96,"npi":[1063497451]},{"billed_charge":200.45,"npi":[1538144910]}]}]}]},{"name":"Assay of total thyroxine","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84436","description":"Assay of total thyroxine","allowed_amounts":[{"tin":{"type":"ein","value":"133757370"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":8.84,"providers":[{"billed_charge":49.07,"npi":[1538144910]}]}]}]},{"name":"Assay of urine creatinine","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82570","description":"Assay of urine creatinine","allowed_amounts":[{"tin":{"type":"ein","value":"133757370"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":6.65,"providers":[{"billed_charge":54.75,"npi":[1063497451]}]}]}]},{"name":"Assay thyroid stim hormone","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84443","description":"Assay thyroid stim hormone","allowed_amounts":[{"tin":{"type":"ein","value":"133757370"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":21.59,"providers":[{"billed_charge":151.08,"npi":[1063497451]}]}]}]},{"name":"Assay triiodothyronine (t3)","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84480","description":"Assay triiodothyronine (t3)","allowed_amounts":[{"tin":{"type":"ein","value":"133757370"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":18.23,"providers":[{"billed_charge":118.65,"npi":[1063497451]},{"billed_charge":121.52,"npi":[1538144910]}]}]}]},{"name":"Body mass index docd","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"3008F","description":"Body mass index docd","allowed_amounts":[{"tin":{"type":"ein","value":"333710948"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":2.00,"providers":[{"billed_charge":5.00,"npi":[1982247367]}]}]}]},{"name":"Body mass index docd","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"3008F","description":"Body mass index docd","allowed_amounts":[{"tin":{"type":"ein","value":"362657618"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":0.00,"providers":[{"billed_charge":0.00,"npi":[1457882946,1801863253,1902891377]}]}]}]},{"name":"Body mass index docd","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"3008F","description":"Body mass index docd","allowed_amounts":[{"tin":{"type":"ein","value":"853737205"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":0.01,"providers":[{"billed_charge":0.01,"npi":[1659307643]}]}]}]},{"name":"Breast tomosynthesis bi","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77063","description":"Breast tomosynthesis bi","allowed_amounts":[{"tin":{"type":"ein","value":"260609255"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":102.50,"providers":[{"billed_charge":250.00,"npi":[1538168331]}]}]}]},{"name":"Breast tomosynthesis bi","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77063","description":"Breast tomosynthesis bi","allowed_amounts":[{"tin":{"type":"ein","value":"822455940"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":104.31,"providers":[{"billed_charge":300.00,"npi":[1548789852]}]}]}]},{"name":"Brief emotional\/behav assmt","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96127","description":"Brief emotional\/behav assmt","allowed_amounts":[{"tin":{"type":"ein","value":"333710948"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":3.25,"providers":[{"billed_charge":25.00,"npi":[1982247367]}]},{"allowed_amount":6.50,"providers":[{"billed_charge":50.00,"npi":[1982247367]}]}]}]},{"name":"C-reactive protein","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86140","description":"C-reactive protein","allowed_amounts":[{"tin":{"type":"ein","value":"133757370"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":6.65,"providers":[{"billed_charge":84.00,"npi":[1063497451]}]}]}]},{"name":"C-reactive protein hs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86141","description":"C-reactive protein hs","allowed_amounts":[{"tin":{"type":"ein","value":"133757370"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":16.65,"providers":[{"billed_charge":112.82,"npi":[1063497451]},{"billed_charge":77.42,"npi":[1538144910]}]}]}]},{"name":"Chylmd trach dna amp probe","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87491","description":"Chylmd trach dna amp probe","allowed_amounts":[{"tin":{"type":"ein","value":"133757370"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":45.11,"providers":[{"billed_charge":129.15,"npi":[1063497451]}]}]}]},{"name":"Complete cbc automated","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85027","description":"Complete cbc automated","allowed_amounts":[{"tin":{"type":"ein","value":"133757370"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":8.31,"providers":[{"billed_charge":32.23,"npi":[1063497451]}]}]}]},{"name":"Complete cbc w\/auto diff wbc","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85025","description":"Complete cbc w\/auto diff wbc","allowed_amounts":[{"tin":{"type":"ein","value":"133757370"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":9.99,"providers":[{"billed_charge":32.44,"npi":[1063497451]},{"billed_charge":32.55,"npi":[1063497451]}]}]}]},{"name":"Complete cbc w\/auto diff wbc","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85025","description":"Complete cbc w\/auto diff wbc","allowed_amounts":[{"tin":{"type":"ein","value":"562112733"},"service_code":[],"billing_class":"institutional","payments":[{"allowed_amount":0.00,"providers":[{"billed_charge":156.91,"npi":[1053375253]}]}]}]},{"name":"Complete cbc w\/auto diff wbc","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85025","description":"Complete cbc w\/auto diff wbc","allowed_amounts":[{"tin":{"type":"ein","value":"843016042"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":6.85,"providers":[{"billed_charge":81.00,"npi":[1598315574]}]},{"allowed_amount":8.93,"providers":[{"billed_charge":81.00,"npi":[1598315574]}]}]}]},{"name":"Comprehen metabolic panel","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80053","description":"Comprehen metabolic panel","allowed_amounts":[{"tin":{"type":"ein","value":"133757370"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":13.60,"providers":[{"billed_charge":44.21,"npi":[1063497451]},{"billed_charge":48.30,"npi":[1063497451]},{"billed_charge":81.17,"npi":[1063497451]}]}]}]},{"name":"Comprehen metabolic panel","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80053","description":"Comprehen metabolic panel","allowed_amounts":[{"tin":{"type":"ein","value":"562112733"},"service_code":[],"billing_class":"institutional","payments":[{"allowed_amount":0.00,"providers":[{"billed_charge":356.90,"npi":[1053375253]}]}]}]},{"name":"Comprehen metabolic panel","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80053","description":"Comprehen metabolic panel","allowed_amounts":[{"tin":{"type":"ein","value":"843016042"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":11.84,"providers":[{"billed_charge":140.00,"npi":[1598315574]}]},{"allowed_amount":12.14,"providers":[{"billed_charge":140.00,"npi":[1598315574]}]}]}]},{"name":"Cytopath c\/v auto fluid redo","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88175","description":"Cytopath c\/v auto fluid redo","allowed_amounts":[{"tin":{"type":"ein","value":"133757370"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":34.05,"providers":[{"billed_charge":160.02,"npi":[1063497451]},{"billed_charge":99.75,"npi":[1063497451]}]}]}]},{"name":"Dehydroepiandrosterone","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82627","description":"Dehydroepiandrosterone","allowed_amounts":[{"tin":{"type":"ein","value":"133757370"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":28.59,"providers":[{"billed_charge":169.38,"npi":[1063497451]},{"billed_charge":240.26,"npi":[1538144910]}]}]}]},{"name":"Diast bp 80-89 mm hg","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"3079F","description":"Diast bp 80-89 mm hg","allowed_amounts":[{"tin":{"type":"ein","value":"853737205"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":0.01,"providers":[{"billed_charge":0.01,"npi":[1659307643]}]}]}]},{"name":"Emergency Dept Visit","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"9928425","description":"Emergency Dept Visit","allowed_amounts":[{"tin":{"type":"ein","value":"521272129"},"service_code":[],"billing_class":"institutional","payments":[{"allowed_amount":944.55,"providers":[{"billed_charge":2710.25,"npi":[1548378235]}]}]}]},{"name":"Emergency Dept Visit","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"9928425","description":"Emergency Dept Visit","allowed_amounts":[{"tin":{"type":"ein","value":"562112733"},"service_code":[],"billing_class":"institutional","payments":[{"allowed_amount":0.00,"providers":[{"billed_charge":1516.96,"npi":[1053375253]}]}]}]},{"name":"Emergency dept visit","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99284","description":"Emergency dept visit","allowed_amounts":[{"tin":{"type":"ein","value":"273953335"},"service_code":["23"],"billing_class":"professional","payments":[{"allowed_amount":205.20,"providers":[{"billed_charge":1280.00,"npi":[1447660410]}]}]}]},{"name":"Emergency dept visit","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99284","description":"Emergency dept visit","allowed_amounts":[{"tin":{"type":"ein","value":"461322238"},"service_code":["23"],"billing_class":"professional","payments":[{"allowed_amount":143.82,"providers":[{"billed_charge":305.00,"npi":[1346565181]}]}]}]},{"name":"Emergency dept visit","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99284","description":"Emergency dept visit","allowed_amounts":[{"tin":{"type":"ein","value":"815049865"},"service_code":["23"],"billing_class":"professional","payments":[{"allowed_amount":217.36,"providers":[{"billed_charge":1186.31,"npi":[1164915807]}]}]}]},{"name":"Emergency dept visit","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99285","description":"Emergency dept visit","allowed_amounts":[{"tin":{"type":"ein","value":"273953335"},"service_code":["23"],"billing_class":"professional","payments":[{"allowed_amount":572.78,"providers":[{"billed_charge":1870.00,"npi":[1700831302]}]}]}]},{"name":"Free assay (ft-3)","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84481","description":"Free assay (ft-3)","allowed_amounts":[{"tin":{"type":"ein","value":"133757370"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":21.77,"providers":[{"billed_charge":129.08,"npi":[1063497451]},{"billed_charge":183.74,"npi":[1538144910]},{"billed_charge":205.04,"npi":[1932184322]}]}]}]},{"name":"General health panel","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80050","description":"General health panel","allowed_amounts":[{"tin":{"type":"ein","value":"133757370"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":45.18,"providers":[{"billed_charge":182.45,"npi":[1063497451]},{"billed_charge":186.14,"npi":[1932184322]},{"billed_charge":189.15,"npi":[1063497451]},{"billed_charge":190.05,"npi":[1063497451]},{"billed_charge":192.92,"npi":[1538144910]},{"billed_charge":263.22,"npi":[1538144910]}]}]}]},{"name":"Glycosylated hemoglobin test","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83036","description":"Glycosylated hemoglobin test","allowed_amounts":[{"tin":{"type":"ein","value":"133757370"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":0.00,"providers":[{"billed_charge":144.21,"npi":[1538144910]}]},{"allowed_amount":12.46,"providers":[{"billed_charge":69.30,"npi":[1063497451]},{"billed_charge":72.17,"npi":[1538144910]},{"billed_charge":73.97,"npi":[1063497451]},{"billed_charge":75.89,"npi":[1932184322]}]}]}]},{"name":"Glycosylated hemoglobin test","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83036","description":"Glycosylated hemoglobin test","allowed_amounts":[{"tin":{"type":"ein","value":"843016042"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":13.53,"providers":[{"billed_charge":160.00,"npi":[1598315574]}]}]}]},{"name":"Ground Mileage, Per Statute Mile","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A0425RH","description":"Ground Mileage, Per Statute Mile","allowed_amounts":[{"tin":{"type":"ein","value":"232192638"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":118.95,"providers":[{"billed_charge":235.80,"npi":[1508852575]}]}]}]},{"name":"Ground Mileage, Per Statute Mile","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A0425RH","description":"Ground Mileage, Per Statute Mile","allowed_amounts":[{"tin":{"type":"ein","value":"236398510"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":82.35,"providers":[{"billed_charge":125.40,"npi":[1639167448]}]}]}]},{"name":"Ground Mileage, Per Statute Mile","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A0425RH","description":"Ground Mileage, Per Statute Mile","allowed_amounts":[{"tin":{"type":"ein","value":"251595839"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":306.15,"providers":[{"billed_charge":732.00,"npi":[1184601742]}]}]}]},{"name":"Ground Mileage, Per Statute Mile","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A0425RH","description":"Ground Mileage, Per Statute Mile","allowed_amounts":[{"tin":{"type":"ein","value":"261841118"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":272.58,"providers":[{"billed_charge":542.50,"npi":[1558533562]}]}]}]},{"name":"Hpv high-risk types","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87624","description":"Hpv high-risk types","allowed_amounts":[{"tin":{"type":"ein","value":"133757370"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":47.94,"providers":[{"billed_charge":152.88,"npi":[1063497451]}]}]}]},{"name":"IAAD IA HIV-1 AG W\/HIV-1 & HIV-2 ANTBDY SINGLE","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87389","description":"IAAD IA HIV-1 AG W\/HIV-1 & HIV-2 ANTBDY SINGLE","allowed_amounts":[{"tin":{"type":"ein","value":"133757370"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":29.94,"providers":[{"billed_charge":176.40,"npi":[1063497451]}]}]}]},{"name":"Im admin 1st\/only component","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90460","description":"Im admin 1st\/only component","allowed_amounts":[{"tin":{"type":"ein","value":"131740114"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":137.41,"providers":[{"billed_charge":149.00,"npi":[1861577249]}]}]}]},{"name":"Inj, propofol, 10 mg","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2704","description":"Inj, propofol, 10 mg","allowed_amounts":[{"tin":{"type":"ein","value":"141338467"},"service_code":[],"billing_class":"institutional","payments":[{"allowed_amount":8.62,"providers":[{"billed_charge":12.32,"npi":[1124072715]}]}]}]},{"name":"Injection, famotidine, 0.25 mg","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1308","description":"Injection, famotidine, 0.25 mg","allowed_amounts":[{"tin":{"type":"ein","value":"141338467"},"service_code":[],"billing_class":"institutional","payments":[{"allowed_amount":4.88,"providers":[{"billed_charge":6.97,"npi":[1124072715]}]}]}]},{"name":"Iron binding test","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83550","description":"Iron binding test","allowed_amounts":[{"tin":{"type":"ein","value":"133757370"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":11.24,"providers":[{"billed_charge":44.62,"npi":[1063497451]},{"billed_charge":47.49,"npi":[1538144910]},{"billed_charge":48.69,"npi":[1063497451]}]}]}]},{"name":"Lipid panel","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80061","description":"Lipid panel","allowed_amounts":[{"tin":{"type":"ein","value":"133757370"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":16.74,"providers":[{"billed_charge":102.90,"npi":[1063497451]},{"billed_charge":109.49,"npi":[1932184322]}]}]}]},{"name":"MOLECULAR PATHOLOGY PROCEDURE LEVEL 4","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81403","description":"MOLECULAR PATHOLOGY PROCEDURE LEVEL 4","allowed_amounts":[{"tin":{"type":"ein","value":"992210303"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":121.54,"providers":[{"billed_charge":121.54,"npi":[1518713072]}]}]}]},{"name":"MOLECULAR PATHOLOGY PROCEDURE LEVEL 5","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81404","description":"MOLECULAR PATHOLOGY PROCEDURE LEVEL 5","allowed_amounts":[{"tin":{"type":"ein","value":"992210303"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":322.52,"providers":[{"billed_charge":405.01,"npi":[1518713072]}]}]}]},{"name":"MOLECULAR PATHOLOGY PROCEDURE LEVEL 6","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81405","description":"MOLECULAR PATHOLOGY PROCEDURE LEVEL 6","allowed_amounts":[{"tin":{"type":"ein","value":"992210303"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":414.97,"providers":[{"billed_charge":637.09,"npi":[1518713072]}]}]}]},{"name":"MOLECULAR PATHOLOGY PROCEDURE LEVEL 7","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81406","description":"MOLECULAR PATHOLOGY PROCEDURE LEVEL 7","allowed_amounts":[{"tin":{"type":"ein","value":"992210303"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":999.92,"providers":[{"billed_charge":999.92,"npi":[1518713072]}]}]}]},{"name":"Med nutrition indiv subseq","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"9780395","description":"Med nutrition indiv subseq","allowed_amounts":[{"tin":{"type":"ein","value":"853953549"},"service_code":["02"],"billing_class":"professional","payments":[{"allowed_amount":89.60,"providers":[{"billed_charge":109.60,"npi":[1780212787]}]}]}]},{"name":"Metabolic panel total ca","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80048","description":"Metabolic panel total ca","allowed_amounts":[{"tin":{"type":"ein","value":"133757370"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":10.88,"providers":[{"billed_charge":43.94,"npi":[1063497451]}]}]}]},{"name":"Microsomal antibody each","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86376","description":"Microsomal antibody each","allowed_amounts":[{"tin":{"type":"ein","value":"133757370"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":18.71,"providers":[{"billed_charge":126.73,"npi":[1063497451]}]}]}]},{"name":"Mopath procedure level 8","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81407","description":"Mopath procedure level 8","allowed_amounts":[{"tin":{"type":"ein","value":"992210303"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":943.54,"providers":[{"billed_charge":943.54,"npi":[1518713072]}]}]}]},{"name":"N.gonorrhoeae dna amp prob","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87591","description":"N.gonorrhoeae dna amp prob","allowed_amounts":[{"tin":{"type":"ein","value":"133757370"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":45.11,"providers":[{"billed_charge":129.15,"npi":[1063497451]}]}]}]},{"name":"Neuromuscular Reeducation","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"97112GP","description":"Neuromuscular Reeducation","allowed_amounts":[{"tin":{"type":"ein","value":"455513255"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":70.36,"providers":[{"billed_charge":70.36,"npi":[1992326730]}]}]}]},{"name":"Neuromuscular Reeducation","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"97112GP","description":"Neuromuscular Reeducation","allowed_amounts":[{"tin":{"type":"ein","value":"873329338"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":23.46,"providers":[{"billed_charge":58.00,"npi":[1487424495]}]},{"allowed_amount":28.00,"providers":[{"billed_charge":58.00,"npi":[1487424495]}]},{"allowed_amount":56.00,"providers":[{"billed_charge":116.00,"npi":[1487424495]}]}]}]},{"name":"Ocular instrumnt screen bil","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99177","description":"Ocular instrumnt screen bil","allowed_amounts":[{"tin":{"type":"ein","value":"333710948"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":2.96,"providers":[{"billed_charge":45.00,"npi":[1982247367]}]}]}]},{"name":"Office\/outpatient visit est","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99213","description":"Office\/outpatient visit est","allowed_amounts":[{"tin":{"type":"ein","value":"202265068"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":133.49,"providers":[{"billed_charge":206.00,"npi":[1255409686]}]}]}]},{"name":"Office\/outpatient visit est","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99213","description":"Office\/outpatient visit est","allowed_amounts":[{"tin":{"type":"ein","value":"222740397"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":125.59,"providers":[{"billed_charge":353.00,"npi":[1427336429]}]}]}]},{"name":"Office\/outpatient visit est","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99213","description":"Office\/outpatient visit est","allowed_amounts":[{"tin":{"type":"ein","value":"362657618"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":166.51,"providers":[{"billed_charge":184.00,"npi":[1902891377]}]}]}]},{"name":"Office\/outpatient visit est","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99213","description":"Office\/outpatient visit est","allowed_amounts":[{"tin":{"type":"ein","value":"456002491"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":177.00,"providers":[{"billed_charge":177.00,"npi":[1124557566]}]}]}]},{"name":"Office\/outpatient visit est","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99214","description":"Office\/outpatient visit est","allowed_amounts":[{"tin":{"type":"ein","value":"205119197"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":119.02,"providers":[{"billed_charge":161.00,"npi":[1962613943]}]}]}]},{"name":"Office\/outpatient visit est","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99214","description":"Office\/outpatient visit est","allowed_amounts":[{"tin":{"type":"ein","value":"260609255"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":218.72,"providers":[{"billed_charge":393.59,"npi":[1629231816]}]}]}]},{"name":"Office\/outpatient visit est","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99214","description":"Office\/outpatient visit est","allowed_amounts":[{"tin":{"type":"ein","value":"272373546"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":140.70,"providers":[{"billed_charge":450.00,"npi":[1811608425]}]}]}]},{"name":"Office\/outpatient visit est","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99214","description":"Office\/outpatient visit est","allowed_amounts":[{"tin":{"type":"ein","value":"289483850"},"service_code":["02"],"billing_class":"professional","payments":[{"allowed_amount":85.69,"providers":[{"billed_charge":150.00,"npi":[1538283684]},{"billed_charge":200.00,"npi":[1538283684]}]}]}]},{"name":"Office\/outpatient visit est","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99214","description":"Office\/outpatient visit est","allowed_amounts":[{"tin":{"type":"ein","value":"362657618"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":234.77,"providers":[{"billed_charge":259.00,"npi":[1457882946]}]}]}]},{"name":"Office\/outpatient visit est","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99214","description":"Office\/outpatient visit est","allowed_amounts":[{"tin":{"type":"ein","value":"471869395"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":119.75,"providers":[{"billed_charge":252.00,"npi":[1609194943]}]}]}]},{"name":"Office\/outpatient visit est","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99214","description":"Office\/outpatient visit est","allowed_amounts":[{"tin":{"type":"ein","value":"562669185"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":265.88,"providers":[{"billed_charge":944.00,"npi":[1306846324]}]}]}]},{"name":"Office\/outpatient visit est","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99214","description":"Office\/outpatient visit est","allowed_amounts":[{"tin":{"type":"ein","value":"853737205"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":201.41,"providers":[{"billed_charge":558.00,"npi":[1659307643]}]}]}]},{"name":"Office\/outpatient visit est","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"9921495","description":"Office\/outpatient visit est","allowed_amounts":[{"tin":{"type":"ein","value":"202087865"},"service_code":["10"],"billing_class":"professional","payments":[{"allowed_amount":128.00,"providers":[{"billed_charge":175.00,"npi":[1922446210]}]}]}]},{"name":"Office\/outpatient visit est","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99215","description":"Office\/outpatient visit est","allowed_amounts":[{"tin":{"type":"ein","value":"289483850"},"service_code":["02"],"billing_class":"professional","payments":[{"allowed_amount":127.43,"providers":[{"billed_charge":200.00,"npi":[1538283684]}]},{"allowed_amount":156.00,"providers":[{"billed_charge":200.00,"npi":[1538283684]}]}]}]},{"name":"Office\/outpatient visit est","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99215","description":"Office\/outpatient visit est","allowed_amounts":[{"tin":{"type":"ein","value":"521998215"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":157.53,"providers":[{"billed_charge":275.00,"npi":[1225398241]}]}]}]},{"name":"Ondansetron hcl injection","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2405","description":"Ondansetron hcl injection","allowed_amounts":[{"tin":{"type":"ein","value":"141338467"},"service_code":[],"billing_class":"institutional","payments":[{"allowed_amount":0.83,"providers":[{"billed_charge":1.19,"npi":[1124072715]}]}]}]},{"name":"Pharmacy","billing_code_type":"RC","billing_code_type_version":"2026","billing_code":"0250","description":"Pharmacy","allowed_amounts":[{"tin":{"type":"ein","value":"141338467"},"service_code":[],"billing_class":"institutional","payments":[{"allowed_amount":200.16,"providers":[{"billed_charge":285.94,"npi":[1124072715]}]}]}]},{"name":"Pharmacy","billing_code_type":"RC","billing_code_type_version":"2026","billing_code":"0250","description":"Pharmacy","allowed_amounts":[{"tin":{"type":"ein","value":"562112733"},"service_code":[],"billing_class":"institutional","payments":[{"allowed_amount":9388.72,"providers":[{"billed_charge":599.35,"npi":[1053375253]}]}]}]},{"name":"Pharmacy - iv solutions","billing_code_type":"RC","billing_code_type_version":"2026","billing_code":"0258","description":"Pharmacy - iv solutions","allowed_amounts":[{"tin":{"type":"ein","value":"562112733"},"service_code":[],"billing_class":"institutional","payments":[{"allowed_amount":0.00,"providers":[{"billed_charge":29.70,"npi":[1053375253]}]}]}]},{"name":"Physical therapy evaluation: low complexity","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"97161GP","description":"Physical therapy evaluation: low complexity","allowed_amounts":[{"tin":{"type":"ein","value":"455513255"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":81.10,"providers":[{"billed_charge":81.10,"npi":[1992326730]}]}]}]},{"name":"Psytx pt&\/fam w\/e&m 45 min","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90836","description":"Psytx pt&\/fam w\/e&m 45 min","allowed_amounts":[{"tin":{"type":"ein","value":"289483850"},"service_code":["02"],"billing_class":"professional","payments":[{"allowed_amount":0.00,"providers":[{"billed_charge":200.00,"npi":[1538283684]}]}]}]},{"name":"Psytx pt&\/family 45 minutes","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90834","description":"Psytx pt&\/family 45 minutes","allowed_amounts":[{"tin":{"type":"ein","value":"204187233"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":81.00,"providers":[{"billed_charge":110.00,"npi":[1902977283]},{"billed_charge":95.00,"npi":[1902977283]}]},{"allowed_amount":95.00,"providers":[{"billed_charge":95.00,"npi":[1902977283]}]}]}]},{"name":"Psytx pt&\/family 45 minutes","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90834","description":"Psytx pt&\/family 45 minutes","allowed_amounts":[{"tin":{"type":"ein","value":"999999999"},"service_code":["10"],"billing_class":"professional","payments":[{"allowed_amount":190.00,"providers":[{"billed_charge":190.00,"npi":[]}]}]}]},{"name":"Psytx pt&\/family 60 minutes","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90837","description":"Psytx pt&\/family 60 minutes","allowed_amounts":[{"tin":{"type":"ein","value":"201220522"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":106.00,"providers":[{"billed_charge":225.00,"npi":[1497059349]}]}]}]},{"name":"Psytx pt&\/family 60 minutes","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90837","description":"Psytx pt&\/family 60 minutes","allowed_amounts":[{"tin":{"type":"ein","value":"999999999"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":350.00,"providers":[{"billed_charge":350.00,"npi":[]}]}]}]},{"name":"Rbc sed rate automated","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85652","description":"Rbc sed rate automated","allowed_amounts":[{"tin":{"type":"ein","value":"133757370"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":3.47,"providers":[{"billed_charge":37.80,"npi":[1063497451]}]}]}]},{"name":"Routine venipuncture","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36415","description":"Routine venipuncture","allowed_amounts":[{"tin":{"type":"ein","value":"133757370"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":2.75,"providers":[{"billed_charge":26.25,"npi":[1063497451,1538144910]},{"billed_charge":29.19,"npi":[1538144910]},{"billed_charge":32.82,"npi":[1932184322]}]}]}]},{"name":"Screening mammography, bilateral (2-view study of each breast), including computer-aided detection (CAD) when performed","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77067","description":"Screening mammography, bilateral (2-view study of each breast), including computer-aided detection (CAD) when performed","allowed_amounts":[{"tin":{"type":"ein","value":"260609255"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":322.50,"providers":[{"billed_charge":530.00,"npi":[1538168331]}]}]}]},{"name":"Screening mammography, bilateral (2-view study of each breast), including computer-aided detection (CAD) when performed","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77067","description":"Screening mammography, bilateral (2-view study of each breast), including computer-aided detection (CAD) when performed","allowed_amounts":[{"tin":{"type":"ein","value":"822455940"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":299.04,"providers":[{"billed_charge":500.00,"npi":[1548789852]}]}]}]},{"name":"Subsequent hospital care","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99233","description":"Subsequent hospital care","allowed_amounts":[{"tin":{"type":"ein","value":"851679076"},"service_code":["61"],"billing_class":"professional","payments":[{"allowed_amount":101.54,"providers":[{"billed_charge":200.00,"npi":[1881851004]}]}]}]},{"name":"Supplies For External Drug Infusion Pump, Per Cassette Or Bag","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4222NU","description":"Supplies For External Drug Infusion Pump, Per Cassette Or Bag","allowed_amounts":[{"tin":{"type":"ein","value":"202536458"},"service_code":["12"],"billing_class":"professional","payments":[{"allowed_amount":52.23,"providers":[{"billed_charge":52.23,"npi":[1477222834]}]}]}]},{"name":"Syphilis test non-trep qual","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86592","description":"Syphilis test non-trep qual","allowed_amounts":[{"tin":{"type":"ein","value":"133757370"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":5.48,"providers":[{"billed_charge":40.95,"npi":[1063497451]}]}]}]},{"name":"Therapeutic Activities","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"97530GP","description":"Therapeutic Activities","allowed_amounts":[{"tin":{"type":"ein","value":"873329338"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":35.00,"providers":[{"billed_charge":60.00,"npi":[1487424495]}]},{"allowed_amount":64.71,"providers":[{"billed_charge":120.00,"npi":[1487424495]}]},{"allowed_amount":70.00,"providers":[{"billed_charge":120.00,"npi":[1487424495]}]}]}]},{"name":"Therapeutic Exercises","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"97110GP","description":"Therapeutic Exercises","allowed_amounts":[{"tin":{"type":"ein","value":"455513255"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":15.39,"providers":[{"billed_charge":15.39,"npi":[1992326730]}]}]}]},{"name":"Therapeutic Exercises","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"97110GP","description":"Therapeutic Exercises","allowed_amounts":[{"tin":{"type":"ein","value":"873329338"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":41.90,"providers":[{"billed_charge":110.00,"npi":[1487424495]}]},{"allowed_amount":48.00,"providers":[{"billed_charge":110.00,"npi":[1487424495]}]},{"allowed_amount":62.85,"providers":[{"billed_charge":165.00,"npi":[1487424495]}]},{"allowed_amount":72.00,"providers":[{"billed_charge":165.00,"npi":[1487424495]}]}]}]},{"name":"Tobacco non-user","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"1036F","description":"Tobacco non-user","allowed_amounts":[{"tin":{"type":"ein","value":"362657618"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":0.00,"providers":[{"billed_charge":0.00,"npi":[1457882946,1801863253,1902891377]}]}]}]},{"name":"Total cortisol","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82533","description":"Total cortisol","allowed_amounts":[{"tin":{"type":"ein","value":"133757370"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":20.96,"providers":[{"billed_charge":105.77,"npi":[1538144910]},{"billed_charge":176.36,"npi":[1538144910]}]}]}]},{"name":"Urinalysis auto w\/o scope","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81003","description":"Urinalysis auto w\/o scope","allowed_amounts":[{"tin":{"type":"ein","value":"562112733"},"service_code":[],"billing_class":"institutional","payments":[{"allowed_amount":0.00,"providers":[{"billed_charge":74.99,"npi":[1053375253]}]}]}]},{"name":"Urinalysis auto w\/scope","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81001","description":"Urinalysis auto w\/scope","allowed_amounts":[{"tin":{"type":"ein","value":"133757370"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":4.07,"providers":[{"billed_charge":32.55,"npi":[1063497451]},{"billed_charge":37.80,"npi":[1063497451]}]}]}]},{"name":"Urinalysis auto w\/scope","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81001","description":"Urinalysis auto w\/scope","allowed_amounts":[{"tin":{"type":"ein","value":"843016042"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":3.64,"providers":[{"billed_charge":75.00,"npi":[1598315574]}]}]}]},{"name":"Urine pregnancy test","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81025","description":"Urine pregnancy test","allowed_amounts":[{"tin":{"type":"ein","value":"562112733"},"service_code":[],"billing_class":"institutional","payments":[{"allowed_amount":0.00,"providers":[{"billed_charge":167.50,"npi":[1053375253]}]}]}]},{"name":"Visit complexity inherent to evaluation and management associated with medical care services that serve as the continuing focal point for all needed health care services and\/o","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G2211","description":"Visit complexity inherent to evaluation and management associated with medical care services that serve as the continuing focal point for all needed health care services and\/o","allowed_amounts":[{"tin":{"type":"ein","value":"471869395"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":0.00,"providers":[{"billed_charge":44.00,"npi":[1609194943]}]}]}]},{"name":"Vitamin b-12","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82607","description":"Vitamin b-12","allowed_amounts":[{"tin":{"type":"ein","value":"133757370"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":19.37,"providers":[{"billed_charge":109.71,"npi":[1538144910]},{"billed_charge":111.30,"npi":[1063497451]},{"billed_charge":114.86,"npi":[1063497451]},{"billed_charge":117.89,"npi":[1932184322]}]}]}]},{"name":"Vitamin d 25 hydroxy","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82306","description":"Vitamin d 25 hydroxy","allowed_amounts":[{"tin":{"type":"ein","value":"133757370"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":38.04,"providers":[{"billed_charge":225.57,"npi":[1063497451]},{"billed_charge":250.19,"npi":[1932184322]},{"billed_charge":289.52,"npi":[1538144910]}]}]}]}]}