{"reporting_entity_name":"Network Health Administrative Services LLC","reporting_entity_type":"Network Health","last_updated_on":"2026-05-05","version":"1.0.0","out_of_network":[{"name":"AMB SERVICE BLS EMERGENCY TRANSPORT","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A0429","description":"AMB SERVICE BLS EMERGENCY TRANSPORT","allowed_amounts":[{"tin":{"type":"ein","value":"391307909"},"service_code":["41"],"billing_class":"institutional","payments":[{"allowed_amount":441.59,"providers":[{"billed_charge":2139.11,"npi":[1164449807]}]},{"allowed_amount":441.59,"providers":[{"billed_charge":778.92,"npi":[1164449807]}]},{"allowed_amount":450.75,"providers":[{"billed_charge":2139.11,"npi":[1164449807]}]},{"allowed_amount":450.75,"providers":[{"billed_charge":778.92,"npi":[1164449807]}]},{"allowed_amount":450.75,"providers":[{"billed_charge":901.03,"npi":[1164449807]}]},{"allowed_amount":778.92,"providers":[{"billed_charge":778.92,"npi":[1164449807]}]},{"allowed_amount":813.76,"providers":[{"billed_charge":815.76,"npi":[1164449807]}]},{"allowed_amount":815.76,"providers":[{"billed_charge":815.76,"npi":[1164449807]}]},{"allowed_amount":928.00,"providers":[{"billed_charge":928.00,"npi":[1164449807]}]},{"allowed_amount":937.87,"providers":[{"billed_charge":937.87,"npi":[1164449807]}]},{"allowed_amount":1144.31,"providers":[{"billed_charge":1338.88,"npi":[1164449807]}]},{"allowed_amount":1460.99,"providers":[{"billed_charge":1460.99,"npi":[1164449807]}]},{"allowed_amount":2210.26,"providers":[{"billed_charge":2210.26,"npi":[1164449807]}]},{"allowed_amount":2276.94,"providers":[{"billed_charge":2276.94,"npi":[1164449807]}]}]}]},{"name":"AMB SERVICE BLS EMERGENCY TRANSPORT","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A0429","description":"AMB SERVICE BLS EMERGENCY TRANSPORT","allowed_amounts":[{"tin":{"type":"ein","value":"391702433"},"service_code":["41"],"billing_class":"institutional","payments":[{"allowed_amount":441.59,"providers":[{"billed_charge":1100.00,"npi":[1609868090]}]},{"allowed_amount":441.59,"providers":[{"billed_charge":1351.00,"npi":[1609868090]}]},{"allowed_amount":445.92,"providers":[{"billed_charge":1351.00,"npi":[1609868090]}]},{"allowed_amount":450.75,"providers":[{"billed_charge":1100.00,"npi":[1609868090]}]},{"allowed_amount":450.75,"providers":[{"billed_charge":1351.00,"npi":[1609868090]}]},{"allowed_amount":455.17,"providers":[{"billed_charge":1351.00,"npi":[1609868090]}]},{"allowed_amount":901.50,"providers":[{"billed_charge":1100.00,"npi":[1609868090]}]},{"allowed_amount":901.50,"providers":[{"billed_charge":1351.00,"npi":[1609868090]}]},{"allowed_amount":910.34,"providers":[{"billed_charge":1351.00,"npi":[1609868090]}]},{"allowed_amount":1351.00,"providers":[{"billed_charge":1351.00,"npi":[1609868090]}]}]}]},{"name":"AMB SERVICE BLS NONEMERG TRANSPORT","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A0428","description":"AMB SERVICE BLS NONEMERG TRANSPORT","allowed_amounts":[{"tin":{"type":"ein","value":"391702433"},"service_code":["41"],"billing_class":"institutional","payments":[{"allowed_amount":275.99,"providers":[{"billed_charge":891.00,"npi":[1609868090]}]},{"allowed_amount":278.70,"providers":[{"billed_charge":891.00,"npi":[1609868090]}]},{"allowed_amount":281.72,"providers":[{"billed_charge":891.00,"npi":[1609868090]}]},{"allowed_amount":284.48,"providers":[{"billed_charge":891.00,"npi":[1609868090]}]},{"allowed_amount":563.44,"providers":[{"billed_charge":891.00,"npi":[1609868090]}]},{"allowed_amount":891.00,"providers":[{"billed_charge":891.00,"npi":[1609868090]}]}]}]},{"name":"AMB SRVC ALS EMERG TRANSPORT LEVL 1","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A0427","description":"AMB SRVC ALS EMERG TRANSPORT LEVL 1","allowed_amounts":[{"tin":{"type":"ein","value":"391397209"},"service_code":["41"],"billing_class":"institutional","payments":[{"allowed_amount":524.39,"providers":[{"billed_charge":1729.99,"npi":[1063579381]}]},{"allowed_amount":524.39,"providers":[{"billed_charge":1741.86,"npi":[1063579381]}]},{"allowed_amount":524.39,"providers":[{"billed_charge":1750.15,"npi":[1063579381]}]},{"allowed_amount":524.39,"providers":[{"billed_charge":1753.73,"npi":[1063579381]}]},{"allowed_amount":524.39,"providers":[{"billed_charge":1801.21,"npi":[1063579381]}]},{"allowed_amount":524.39,"providers":[{"billed_charge":1805.28,"npi":[1063579381]}]},{"allowed_amount":524.39,"providers":[{"billed_charge":1809.50,"npi":[1063579381]}]},{"allowed_amount":524.39,"providers":[{"billed_charge":1817.79,"npi":[1063579381]}]},{"allowed_amount":524.39,"providers":[{"billed_charge":1824.31,"npi":[1063579381]}]},{"allowed_amount":524.39,"providers":[{"billed_charge":1830.06,"npi":[1063579381]}]},{"allowed_amount":524.39,"providers":[{"billed_charge":1859.98,"npi":[1063579381]}]},{"allowed_amount":524.39,"providers":[{"billed_charge":1868.85,"npi":[1063579381]}]},{"allowed_amount":524.39,"providers":[{"billed_charge":1880.72,"npi":[1063579381]}]},{"allowed_amount":524.39,"providers":[{"billed_charge":1886.32,"npi":[1063579381]}]},{"allowed_amount":524.39,"providers":[{"billed_charge":1886.90,"npi":[1063579381]}]},{"allowed_amount":524.39,"providers":[{"billed_charge":1892.59,"npi":[1063579381]}]},{"allowed_amount":524.39,"providers":[{"billed_charge":1901.28,"npi":[1063579381]}]},{"allowed_amount":524.39,"providers":[{"billed_charge":1908.10,"npi":[1063579381]}]},{"allowed_amount":524.39,"providers":[{"billed_charge":1948.36,"npi":[1063579381]}]},{"allowed_amount":524.39,"providers":[{"billed_charge":1962.18,"npi":[1063579381]}]},{"allowed_amount":524.39,"providers":[{"billed_charge":1975.04,"npi":[1063579381]}]},{"allowed_amount":524.39,"providers":[{"billed_charge":1976.90,"npi":[1063579381]}]},{"allowed_amount":529.53,"providers":[{"billed_charge":1845.11,"npi":[1063579381]}]},{"allowed_amount":529.53,"providers":[{"billed_charge":1860.56,"npi":[1063579381]}]},{"allowed_amount":529.53,"providers":[{"billed_charge":1907.40,"npi":[1063579381]}]},{"allowed_amount":529.53,"providers":[{"billed_charge":1941.65,"npi":[1063579381]}]},{"allowed_amount":529.53,"providers":[{"billed_charge":1948.36,"npi":[1063579381]}]},{"allowed_amount":535.26,"providers":[{"billed_charge":1682.51,"npi":[1063579381]}]},{"allowed_amount":535.26,"providers":[{"billed_charge":1694.38,"npi":[1063579381]}]},{"allowed_amount":535.26,"providers":[{"billed_charge":1729.99,"npi":[1063579381]}]},{"allowed_amount":535.26,"providers":[{"billed_charge":1776.83,"npi":[1063579381]}]},{"allowed_amount":535.26,"providers":[{"billed_charge":1777.47,"npi":[1063579381]}]},{"allowed_amount":535.26,"providers":[{"billed_charge":1797.63,"npi":[1063579381]}]},{"allowed_amount":535.26,"providers":[{"billed_charge":1801.21,"npi":[1063579381]}]},{"allowed_amount":535.26,"providers":[{"billed_charge":1809.50,"npi":[1063579381]}]},{"allowed_amount":535.26,"providers":[{"billed_charge":1813.08,"npi":[1063579381]}]},{"allowed_amount":535.26,"providers":[{"billed_charge":1821.37,"npi":[1063579381]}]},{"allowed_amount":535.26,"providers":[{"billed_charge":1830.06,"npi":[1063579381]}]},{"allowed_amount":535.26,"providers":[{"billed_charge":1849.28,"npi":[1063579381]}]},{"allowed_amount":535.26,"providers":[{"billed_charge":1868.85,"npi":[1063579381]}]},{"allowed_amount":535.26,"providers":[{"billed_charge":1880.72,"npi":[1063579381]}]},{"allowed_amount":535.26,"providers":[{"billed_charge":1881.21,"npi":[1063579381]}]},{"allowed_amount":535.26,"providers":[{"billed_charge":1886.23,"npi":[1063579381]}]},{"allowed_amount":535.26,"providers":[{"billed_charge":1888.10,"npi":[1063579381]}]},{"allowed_amount":535.26,"providers":[{"billed_charge":1892.59,"npi":[1063579381]}]},{"allowed_amount":535.26,"providers":[{"billed_charge":1900.88,"npi":[1063579381]}]},{"allowed_amount":535.26,"providers":[{"billed_charge":1900.93,"npi":[1063579381]}]},{"allowed_amount":535.26,"providers":[{"billed_charge":1901.92,"npi":[1063579381]}]},{"allowed_amount":535.26,"providers":[{"billed_charge":1905.69,"npi":[1063579381]}]},{"allowed_amount":535.26,"providers":[{"billed_charge":1907.43,"npi":[1063579381]}]},{"allowed_amount":535.26,"providers":[{"billed_charge":1919.27,"npi":[1063579381]}]},{"allowed_amount":535.26,"providers":[{"billed_charge":1925.66,"npi":[1063579381]}]},{"allowed_amount":535.26,"providers":[{"billed_charge":1936.49,"npi":[1063579381]}]},{"allowed_amount":535.26,"providers":[{"billed_charge":1938.02,"npi":[1063579381]}]},{"allowed_amount":535.26,"providers":[{"billed_charge":1960.23,"npi":[1063579381]}]},{"allowed_amount":535.26,"providers":[{"billed_charge":1963.17,"npi":[1063579381]}]},{"allowed_amount":535.26,"providers":[{"billed_charge":1963.66,"npi":[1063579381]}]},{"allowed_amount":535.26,"providers":[{"billed_charge":1978.28,"npi":[1063579381]}]},{"allowed_amount":535.26,"providers":[{"billed_charge":1983.97,"npi":[1063579381]}]},{"allowed_amount":535.26,"providers":[{"billed_charge":2007.47,"npi":[1063579381]}]},{"allowed_amount":535.26,"providers":[{"billed_charge":2023.75,"npi":[1063579381]}]},{"allowed_amount":535.26,"providers":[{"billed_charge":2036.96,"npi":[1063579381]}]},{"allowed_amount":535.26,"providers":[{"billed_charge":2134.25,"npi":[1063579381]}]},{"allowed_amount":535.26,"providers":[{"billed_charge":2140.73,"npi":[1063579381]}]},{"allowed_amount":535.26,"providers":[{"billed_charge":2189.08,"npi":[1063579381]}]},{"allowed_amount":535.26,"providers":[{"billed_charge":2198.65,"npi":[1063579381]}]},{"allowed_amount":535.26,"providers":[{"billed_charge":2375.42,"npi":[1063579381]}]},{"allowed_amount":540.51,"providers":[{"billed_charge":1750.15,"npi":[1063579381]}]},{"allowed_amount":540.51,"providers":[{"billed_charge":1762.02,"npi":[1063579381]}]},{"allowed_amount":540.51,"providers":[{"billed_charge":1785.76,"npi":[1063579381]}]},{"allowed_amount":540.51,"providers":[{"billed_charge":1868.85,"npi":[1063579381]}]},{"allowed_amount":540.51,"providers":[{"billed_charge":1880.72,"npi":[1063579381]}]},{"allowed_amount":540.51,"providers":[{"billed_charge":1898.77,"npi":[1063579381]}]},{"allowed_amount":1070.52,"providers":[{"billed_charge":1853.80,"npi":[1063579381]}]},{"allowed_amount":1070.52,"providers":[{"billed_charge":2071.77,"npi":[1063579381]}]}]}]},{"name":"AMB SRVC ALS EMERG TRANSPORT LEVL 1","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A0427","description":"AMB SRVC ALS EMERG TRANSPORT LEVL 1","allowed_amounts":[{"tin":{"type":"ein","value":"391702433"},"service_code":["41"],"billing_class":"institutional","payments":[{"allowed_amount":524.39,"providers":[{"billed_charge":1605.00,"npi":[1609868090]}]},{"allowed_amount":529.53,"providers":[{"billed_charge":1605.00,"npi":[1609868090]}]},{"allowed_amount":535.26,"providers":[{"billed_charge":1605.00,"npi":[1609868090]}]},{"allowed_amount":540.51,"providers":[{"billed_charge":1605.00,"npi":[1609868090]}]},{"allowed_amount":1070.52,"providers":[{"billed_charge":1605.00,"npi":[1609868090]}]},{"allowed_amount":1605.00,"providers":[{"billed_charge":1605.00,"npi":[1609868090]}]}]}]},{"name":"AMB SRVC ALS EMERG TRANSPORT LEVL 1","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A0427","description":"AMB SRVC ALS EMERG TRANSPORT LEVL 1","allowed_amounts":[{"tin":{"type":"ein","value":"396005479"},"service_code":["41"],"billing_class":"institutional","payments":[{"allowed_amount":524.39,"providers":[{"billed_charge":1150.00,"npi":[1508860982]}]},{"allowed_amount":524.39,"providers":[{"billed_charge":975.00,"npi":[1508860982]}]},{"allowed_amount":535.26,"providers":[{"billed_charge":1150.00,"npi":[1508860982]}]},{"allowed_amount":535.26,"providers":[{"billed_charge":975.00,"npi":[1508860982]}]},{"allowed_amount":975.00,"providers":[{"billed_charge":975.00,"npi":[1508860982]}]}]}]},{"name":"AMB SRVC ALS EMERG TRANSPORT LEVL 1","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A0427","description":"AMB SRVC ALS EMERG TRANSPORT LEVL 1","allowed_amounts":[{"tin":{"type":"ein","value":"396005511"},"service_code":["41"],"billing_class":"institutional","payments":[{"allowed_amount":529.53,"providers":[{"billed_charge":1400.00,"npi":[1235186883, 1457332769]}]},{"allowed_amount":535.26,"providers":[{"billed_charge":1400.00,"npi":[1003090051, 1114075389, 1205887643, 1457332769]}]},{"allowed_amount":540.51,"providers":[{"billed_charge":1400.00,"npi":[1235186883, 1457332769]}]},{"allowed_amount":1400.00,"providers":[{"billed_charge":1400.00,"npi":[1114075389, 1457332769]}]}]}]},{"name":"AMB SRVC ALS EMERG TRANSPORT LEVL 1","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A0427","description":"AMB SRVC ALS EMERG TRANSPORT LEVL 1","allowed_amounts":[{"tin":{"type":"ein","value":"396005652"},"service_code":["41"],"billing_class":"institutional","payments":[{"allowed_amount":524.39,"providers":[{"billed_charge":1277.00,"npi":[1184730327]}]},{"allowed_amount":535.26,"providers":[{"billed_charge":1277.00,"npi":[1184730327]}]},{"allowed_amount":535.26,"providers":[{"billed_charge":1468.00,"npi":[1184730327]}]},{"allowed_amount":535.26,"providers":[{"billed_charge":1909.00,"npi":[1184730327]}]},{"allowed_amount":1070.52,"providers":[{"billed_charge":1468.00,"npi":[1184730327]}]},{"allowed_amount":1277.00,"providers":[{"billed_charge":1277.00,"npi":[1184730327]}]}]}]},{"name":"AMB SRVC ALS EMERG TRANSPORT LEVL 1","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A0427","description":"AMB SRVC ALS EMERG TRANSPORT LEVL 1","allowed_amounts":[{"tin":{"type":"ein","value":"396005686"},"service_code":["41"],"billing_class":"institutional","payments":[{"allowed_amount":535.26,"providers":[{"billed_charge":1200.00,"npi":[1184757486, 1619025889]}]},{"allowed_amount":540.51,"providers":[{"billed_charge":1200.00,"npi":[1184757486, 1619025889]}]},{"allowed_amount":540.51,"providers":[{"billed_charge":1211.00,"npi":[1184757486]}]},{"allowed_amount":540.51,"providers":[{"billed_charge":1240.00,"npi":[1184757486]}]},{"allowed_amount":540.51,"providers":[{"billed_charge":1246.00,"npi":[1184757486]}]},{"allowed_amount":540.51,"providers":[{"billed_charge":1305.00,"npi":[1184757486]}]},{"allowed_amount":540.51,"providers":[{"billed_charge":1306.00,"npi":[1184757486]}]},{"allowed_amount":540.51,"providers":[{"billed_charge":1590.00,"npi":[1184757486]}]},{"allowed_amount":1081.02,"providers":[{"billed_charge":1200.00,"npi":[1184757486]}]}]}]},{"name":"AMB SRVC ALS EMERG TRANSPORT LEVL 1","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A0427","description":"AMB SRVC ALS EMERG TRANSPORT LEVL 1","allowed_amounts":[{"tin":{"type":"ein","value":"396005759"},"service_code":["41"],"billing_class":"institutional","payments":[{"allowed_amount":529.53,"providers":[{"billed_charge":1097.50,"npi":[1568517688]}]},{"allowed_amount":540.51,"providers":[{"billed_charge":1097.50,"npi":[1568517688]}]},{"allowed_amount":658.50,"providers":[{"billed_charge":1097.50,"npi":[1568517688]}]}]}]},{"name":"AMB SRVC ALS EMERG TRANSPORT LEVL 1","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A0427","description":"AMB SRVC ALS EMERG TRANSPORT LEVL 1","allowed_amounts":[{"tin":{"type":"ein","value":"396005918"},"service_code":["41"],"billing_class":"institutional","payments":[{"allowed_amount":535.26,"providers":[{"billed_charge":1300.00,"npi":[1205887643, 1407691595, 1720850852, 1801818992, 1982693495]}]},{"allowed_amount":535.26,"providers":[{"billed_charge":1700.00,"npi":[1407691595]}]},{"allowed_amount":1070.52,"providers":[{"billed_charge":1300.00,"npi":[1407691595, 1801818992, 1982693495]}]},{"allowed_amount":1070.52,"providers":[{"billed_charge":1700.00,"npi":[1407691595]}]},{"allowed_amount":1300.00,"providers":[{"billed_charge":1300.00,"npi":[1407691595]}]}]}]},{"name":"AMB SRVC ALS EMERG TRANSPORT LEVL 1","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A0427","description":"AMB SRVC ALS EMERG TRANSPORT LEVL 1","allowed_amounts":[{"tin":{"type":"ein","value":"396006317"},"service_code":["41"],"billing_class":"institutional","payments":[{"allowed_amount":524.39,"providers":[{"billed_charge":1350.00,"npi":[1972679132]}]},{"allowed_amount":535.26,"providers":[{"billed_charge":1350.00,"npi":[1972679132]}]},{"allowed_amount":535.26,"providers":[{"billed_charge":1405.00,"npi":[1972679132]}]},{"allowed_amount":535.26,"providers":[{"billed_charge":1500.00,"npi":[1366424707, 1972679132]}]},{"allowed_amount":535.26,"providers":[{"billed_charge":1530.00,"npi":[1972679132]}]},{"allowed_amount":1070.52,"providers":[{"billed_charge":1350.00,"npi":[1972679132]}]},{"allowed_amount":1070.52,"providers":[{"billed_charge":1500.00,"npi":[1366424707, 1972679132]}]}]}]},{"name":"ASSAY OF TROPONIN QUANT","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84484","description":"ASSAY OF TROPONIN QUANT","allowed_amounts":[{"tin":{"type":"ein","value":"810977948"},"service_code":["01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "53", "54", "55", "56", "57", "58", "60", "61", "62", "65", "71", "72", "81", "99"],"billing_class":"professional","payments":[{"allowed_amount":0.00,"providers":[{"billed_charge":109.00,"npi":[1922043744, 1942749387]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":146.00,"npi":[1942749387]}]},{"allowed_amount":12.47,"providers":[{"billed_charge":102.96,"npi":[1942749387]}]},{"allowed_amount":103.55,"providers":[{"billed_charge":109.00,"npi":[1942749387]}]}]}]},{"name":"BASIC METABOLIC PNL TOTAL CA","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80048","description":"BASIC METABOLIC PNL TOTAL CA","allowed_amounts":[{"tin":{"type":"ein","value":"810977948"},"service_code":["01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "53", "54", "55", "56", "57", "58", "60", "61", "62", "65", "71", "72", "81", "99"],"billing_class":"professional","payments":[{"allowed_amount":0.00,"providers":[{"billed_charge":150.00,"npi":[1922043744, 1942749387]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":97.00,"npi":[1902437650, 1942749387]}]},{"allowed_amount":8.46,"providers":[{"billed_charge":100.00,"npi":[1942749387]}]},{"allowed_amount":8.46,"providers":[{"billed_charge":150.00,"npi":[1942749387]}]},{"allowed_amount":8.46,"providers":[{"billed_charge":97.00,"npi":[1902437650, 1942749387]}]},{"allowed_amount":8.46,"providers":[{"billed_charge":99.84,"npi":[1902437650]}]},{"allowed_amount":92.15,"providers":[{"billed_charge":97.00,"npi":[1902437650, 1942749387]}]}]}]},{"name":"CHIROPRACT MANJ 1-2 REGIONS","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98940","description":"CHIROPRACT MANJ 1-2 REGIONS","allowed_amounts":[{"tin":{"type":"ein","value":"352440762"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":25.82,"providers":[{"billed_charge":50.00,"npi":[1306926019, 1710079413]}]},{"allowed_amount":26.01,"providers":[{"billed_charge":50.00,"npi":[1306866306, 1306926019, 1356109623, 1710079413]}]},{"allowed_amount":50.00,"providers":[{"billed_charge":50.00,"npi":[1083162440, 1306926019]}]}]}]},{"name":"CHIROPRACT MANJ 3-4 REGIONS","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98941","description":"CHIROPRACT MANJ 3-4 REGIONS","allowed_amounts":[{"tin":{"type":"ein","value":"263727114"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":37.55,"providers":[{"billed_charge":69.00,"npi":[1225152333, 1700926854]}]},{"allowed_amount":37.55,"providers":[{"billed_charge":95.00,"npi":[1225152333]}]},{"allowed_amount":37.62,"providers":[{"billed_charge":95.00,"npi":[1225152333]}]},{"allowed_amount":75.48,"providers":[{"billed_charge":95.00,"npi":[1225152333]}]}]}]},{"name":"CHIROPRACT MANJ 3-4 REGIONS","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98941","description":"CHIROPRACT MANJ 3-4 REGIONS","allowed_amounts":[{"tin":{"type":"ein","value":"391972754"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":37.55,"providers":[{"billed_charge":41.10,"npi":[1508004227]}]},{"allowed_amount":37.55,"providers":[{"billed_charge":41.20,"npi":[1508004227]}]},{"allowed_amount":56.00,"providers":[{"billed_charge":65.00,"npi":[1508004227]}]}]}]},{"name":"CHIROPRACT MANJ 3-4 REGIONS","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98941","description":"CHIROPRACT MANJ 3-4 REGIONS","allowed_amounts":[{"tin":{"type":"ein","value":"813840694"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":37.55,"providers":[{"billed_charge":75.00,"npi":[1235299751, 1295890341, 1659840353, 1760628952, 1831635234, 1881752814, 1992866305]}]},{"allowed_amount":75.00,"providers":[{"billed_charge":75.00,"npi":[1831635234]}]}]}]},{"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":"430688874"},"service_code":["01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "53", "54", "55", "56", "57", "58", "60", "61", "62", "65", "71", "72", "81", "99"],"billing_class":"professional","payments":[{"allowed_amount":0.00,"providers":[{"billed_charge":281.00,"npi":[1386641207, 1922043744]}]},{"allowed_amount":7.77,"providers":[{"billed_charge":281.00,"npi":[1386641207]}]},{"allowed_amount":61.76,"providers":[{"billed_charge":281.00,"npi":[1386641207]}]},{"allowed_amount":74.05,"providers":[{"billed_charge":281.00,"npi":[1386641207]}]}]}]},{"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":"810977948"},"service_code":["01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "53", "54", "55", "56", "57", "58", "60", "61", "62", "65", "71", "72", "81", "99"],"billing_class":"professional","payments":[{"allowed_amount":0.00,"providers":[{"billed_charge":149.00,"npi":[1942749387]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":88.00,"npi":[1902437650, 1942749387]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":92.00,"npi":[1942749387]}]},{"allowed_amount":7.77,"providers":[{"billed_charge":149.00,"npi":[1942749387]}]},{"allowed_amount":7.77,"providers":[{"billed_charge":88.00,"npi":[1902437650, 1942749387]}]},{"allowed_amount":7.77,"providers":[{"billed_charge":91.52,"npi":[1902437650, 1942749387]}]},{"allowed_amount":7.77,"providers":[{"billed_charge":92.00,"npi":[1942749387]}]},{"allowed_amount":83.60,"providers":[{"billed_charge":88.00,"npi":[1902437650, 1942749387]}]},{"allowed_amount":141.55,"providers":[{"billed_charge":149.00,"npi":[1942749387]}]}]}]},{"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":"382084239"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":8.23,"providers":[{"billed_charge":105.79,"npi":[1891731626]}]},{"allowed_amount":10.56,"providers":[{"billed_charge":105.79,"npi":[1891731626]}]},{"allowed_amount":10.56,"providers":[{"billed_charge":71.39,"npi":[1891731626]}]},{"allowed_amount":10.56,"providers":[{"billed_charge":72.80,"npi":[1891731626]}]}]}]},{"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":"650825133"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":10.56,"providers":[{"billed_charge":39.00,"npi":[1902008170]}]},{"allowed_amount":11.09,"providers":[{"billed_charge":39.00,"npi":[1902008170]}]},{"allowed_amount":11.62,"providers":[{"billed_charge":39.00,"npi":[1902008170]}]}]}]},{"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":"810977948"},"service_code":["01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "53", "54", "55", "56", "57", "58", "60", "61", "62", "65", "71", "72", "81", "99"],"billing_class":"professional","payments":[{"allowed_amount":0.00,"providers":[{"billed_charge":123.00,"npi":[1902437650, 1922043744, 1942749387]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":125.00,"npi":[1942749387]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":209.00,"npi":[1942749387]}]},{"allowed_amount":10.56,"providers":[{"billed_charge":123.00,"npi":[1902437650, 1942749387]}]},{"allowed_amount":10.56,"providers":[{"billed_charge":124.80,"npi":[1902437650, 1942749387]}]},{"allowed_amount":10.56,"providers":[{"billed_charge":125.00,"npi":[1942749387]}]},{"allowed_amount":10.56,"providers":[{"billed_charge":209.00,"npi":[1942749387]}]},{"allowed_amount":198.55,"providers":[{"billed_charge":209.00,"npi":[1942749387]}]}]}]},{"name":"CT THORAX DX C-","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71250","description":"CT THORAX DX C-","allowed_amounts":[{"tin":{"type":"ein","value":"391835630"},"service_code":["01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "53", "54", "55", "56", "57", "58", "60", "61", "62", "65", "71", "72", "81", "99"],"billing_class":"professional","payments":[{"allowed_amount":0.00,"providers":[{"billed_charge":2767.00,"npi":[1922043744]}]},{"allowed_amount":101.05,"providers":[{"billed_charge":2767.00,"npi":[1922043744]}]},{"allowed_amount":102.72,"providers":[{"billed_charge":2767.00,"npi":[1922043744]}]},{"allowed_amount":415.24,"providers":[{"billed_charge":2767.00,"npi":[1922043744]}]},{"allowed_amount":2351.67,"providers":[{"billed_charge":2767.00,"npi":[1922043744]}]}]}]},{"name":"ELECTROCARDIOGRAM REPORT","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93010","description":"ELECTROCARDIOGRAM REPORT","allowed_amounts":[{"tin":{"type":"ein","value":"391446631"},"service_code":["23"],"billing_class":"professional","payments":[{"allowed_amount":6.34,"providers":[{"billed_charge":94.00,"npi":[1083695308]}]},{"allowed_amount":6.85,"providers":[{"billed_charge":94.00,"npi":[1083695308]}]},{"allowed_amount":7.46,"providers":[{"billed_charge":94.00,"npi":[1033384565, 1043703937, 1134418486, 1174044960, 1265468656, 1306208921, 1720548480, 1790978260]}]},{"allowed_amount":8.02,"providers":[{"billed_charge":94.00,"npi":[1033384565, 1043703937, 1134418486, 1174044960, 1306208921, 1720548480, 1790978260]}]},{"allowed_amount":8.06,"providers":[{"billed_charge":94.00,"npi":[1265468656]}]},{"allowed_amount":8.84,"providers":[{"billed_charge":94.00,"npi":[1134418486, 1265468656, 1720548480, 1790978260]}]},{"allowed_amount":10.27,"providers":[{"billed_charge":94.00,"npi":[1033384565, 1043703937, 1134418486, 1174044960, 1265468656, 1306208921, 1720548480, 1790978260]}]}]}]},{"name":"ELECTROCARDIOGRAM REPORT","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93010","description":"ELECTROCARDIOGRAM REPORT","allowed_amounts":[{"tin":{"type":"ein","value":"391499986"},"service_code":["23"],"billing_class":"professional","payments":[{"allowed_amount":0.00,"providers":[{"billed_charge":70.00,"npi":[1255996740, 1548466675, 1801874227]}]},{"allowed_amount":7.46,"providers":[{"billed_charge":70.00,"npi":[1093763740, 1093773244, 1346739042, 1376164418, 1396703534, 1417481128, 1497195309, 1548466675, 1578091500, 1649238940, 1710620786, 1730768383, 1750796132, 1780264580, 1891753109]}]},{"allowed_amount":8.02,"providers":[{"billed_charge":70.00,"npi":[1710620786]}]},{"allowed_amount":8.06,"providers":[{"billed_charge":70.00,"npi":[1093763740, 1093773244, 1346739042, 1376164418, 1396703534, 1417481128, 1497195309, 1538503982, 1548466675, 1578091500, 1629268412, 1649238940, 1730768383, 1750796132, 1780264580, 1891753109]}]},{"allowed_amount":8.84,"providers":[{"billed_charge":70.00,"npi":[1093763740, 1093773244, 1346739042, 1376164418, 1396703534, 1417481128, 1497195309, 1538503982, 1548466675, 1578091500, 1629268412, 1649238940, 1710620786, 1730768383, 1750796132, 1780264580, 1891753109]}]},{"allowed_amount":25.89,"providers":[{"billed_charge":70.00,"npi":[1093763740, 1093773244, 1346739042, 1376164418, 1396703534, 1538503982, 1578091500, 1629268412, 1649238940, 1750796132, 1780264580]}]},{"allowed_amount":44.10,"providers":[{"billed_charge":70.00,"npi":[1548466675]}]},{"allowed_amount":70.00,"providers":[{"billed_charge":70.00,"npi":[1679514509, 1750796132]}]}]}]},{"name":"ELECTROCARDIOGRAM REPORT","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93010","description":"ELECTROCARDIOGRAM REPORT","allowed_amounts":[{"tin":{"type":"ein","value":"922957680"},"service_code":["23"],"billing_class":"professional","payments":[{"allowed_amount":7.46,"providers":[{"billed_charge":71.00,"npi":[1134689987, 1144333501, 1407435886, 1710413240, 1841258969, 1962638064]}]},{"allowed_amount":8.02,"providers":[{"billed_charge":71.00,"npi":[1134689987, 1144333501, 1841258969, 1962638064]}]},{"allowed_amount":8.06,"providers":[{"billed_charge":71.00,"npi":[1407435886, 1710413240]}]},{"allowed_amount":29.82,"providers":[{"billed_charge":71.00,"npi":[1962638064]}]},{"allowed_amount":45.71,"providers":[{"billed_charge":71.00,"npi":[1144333501, 1407435886, 1710413240]}]},{"allowed_amount":71.00,"providers":[{"billed_charge":71.00,"npi":[1144333501]}]}]}]},{"name":"ELECTROCARDIOGRAM TRACING","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93005","description":"ELECTROCARDIOGRAM TRACING","allowed_amounts":[{"tin":{"type":"ein","value":"810977948"},"service_code":["01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "53", "54", "55", "56", "57", "58", "60", "61", "62", "65", "71", "72", "81", "99"],"billing_class":"professional","payments":[{"allowed_amount":0.00,"providers":[{"billed_charge":103.00,"npi":[1942749387]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":187.00,"npi":[1942749387]}]},{"allowed_amount":61.07,"providers":[{"billed_charge":103.00,"npi":[1942749387]}]},{"allowed_amount":61.07,"providers":[{"billed_charge":187.00,"npi":[1942749387]}]},{"allowed_amount":97.85,"providers":[{"billed_charge":103.00,"npi":[1942749387]}]}]}]},{"name":"EMERGENCY DEPT VISIT HI MDM","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99285","description":"EMERGENCY DEPT VISIT HI MDM","allowed_amounts":[{"tin":{"type":"ein","value":"391446631"},"service_code":["23"],"billing_class":"professional","payments":[{"allowed_amount":66.18,"providers":[{"billed_charge":1609.00,"npi":[1033384565, 1134418486, 1174044960, 1568048650, 1710449962, 1720548480, 1780326793, 1790978260, 1912535600]}]},{"allowed_amount":134.67,"providers":[{"billed_charge":1609.00,"npi":[1083695308, 1326456807, 1578148516]}]},{"allowed_amount":135.44,"providers":[{"billed_charge":1609.00,"npi":[1326456807, 1578148516]}]},{"allowed_amount":136.12,"providers":[{"billed_charge":1609.00,"npi":[1083695308, 1568090884]}]},{"allowed_amount":158.44,"providers":[{"billed_charge":1609.00,"npi":[1033384565, 1043703937, 1134418486, 1174044960, 1265468656, 1306208921, 1568048650, 1710449962, 1720548480, 1780326793, 1790978260, 1912535600]}]},{"allowed_amount":159.34,"providers":[{"billed_charge":1609.00,"npi":[1033384565, 1043703937, 1134418486, 1174044960, 1306208921, 1568048650, 1710449962, 1720548480, 1780326793, 1790978260, 1912535600]}]},{"allowed_amount":160.14,"providers":[{"billed_charge":1609.00,"npi":[1265468656]}]},{"allowed_amount":203.96,"providers":[{"billed_charge":1609.00,"npi":[1033384565, 1043703937, 1134418486, 1174044960, 1265468656, 1306208921, 1568048650, 1710449962, 1720548480, 1790978260, 1912535600]}]}]}]},{"name":"EMERGENCY DEPT VISIT HI MDM","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99285","description":"EMERGENCY DEPT VISIT HI MDM","allowed_amounts":[{"tin":{"type":"ein","value":"922957680"},"service_code":["23"],"billing_class":"professional","payments":[{"allowed_amount":134.67,"providers":[{"billed_charge":1415.00,"npi":[1003590027, 1225712524, 1457896581, 1508306671, 1740965326]}]},{"allowed_amount":135.44,"providers":[{"billed_charge":1415.00,"npi":[1003590027, 1740965326]}]},{"allowed_amount":136.12,"providers":[{"billed_charge":1415.00,"npi":[1225712524, 1457896581, 1508306671]}]},{"allowed_amount":158.44,"providers":[{"billed_charge":1415.00,"npi":[1134689987, 1144333501, 1184652257, 1407435886, 1437129715, 1710413240, 1841258969, 1932553179, 1942257258, 1962638064]}]},{"allowed_amount":159.34,"providers":[{"billed_charge":1415.00,"npi":[1134689987, 1144333501, 1841258969, 1942257258, 1962638064]}]},{"allowed_amount":160.14,"providers":[{"billed_charge":1415.00,"npi":[1003305368, 1184652257, 1407435886, 1437129715, 1710413240, 1932553179]}]},{"allowed_amount":442.00,"providers":[{"billed_charge":1415.00,"npi":[1134689987, 1508306671, 1942257258]}]},{"allowed_amount":470.04,"providers":[{"billed_charge":1415.00,"npi":[1003305368, 1437129715, 1932553179]}]},{"allowed_amount":525.57,"providers":[{"billed_charge":1415.00,"npi":[1003305368]}]},{"allowed_amount":580.76,"providers":[{"billed_charge":1415.00,"npi":[1003590027, 1134689987, 1144333501, 1184652257, 1225712524, 1407435886, 1457896581, 1710413240, 1740965326, 1841258969, 1942257258, 1962638064]}]},{"allowed_amount":596.65,"providers":[{"billed_charge":1415.00,"npi":[1962638064]}]},{"allowed_amount":834.24,"providers":[{"billed_charge":1415.00,"npi":[1003590027]}]}]}]},{"name":"EMERGENCY DEPT VISIT MOD MDM","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99284","description":"EMERGENCY DEPT VISIT MOD MDM","allowed_amounts":[{"tin":{"type":"ein","value":"922957680"},"service_code":["23"],"billing_class":"professional","payments":[{"allowed_amount":92.97,"providers":[{"billed_charge":962.00,"npi":[1508306671]}]},{"allowed_amount":93.55,"providers":[{"billed_charge":962.00,"npi":[1508306671]}]},{"allowed_amount":390.25,"providers":[{"billed_charge":962.00,"npi":[1508306671]}]}]}]},{"name":"GROUND MILEAGE PER STATUTE MILE","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A0425","description":"GROUND MILEAGE PER STATUTE MILE","allowed_amounts":[{"tin":{"type":"ein","value":"391307909"},"service_code":["41"],"billing_class":"institutional","payments":[{"allowed_amount":0.21,"providers":[{"billed_charge":21.20,"npi":[1164449807]}]},{"allowed_amount":4.27,"providers":[{"billed_charge":4.27,"npi":[1164449807]}]},{"allowed_amount":9.15,"providers":[{"billed_charge":21.20,"npi":[1164449807, 1487783361]}]},{"allowed_amount":9.15,"providers":[{"billed_charge":39.64,"npi":[1164449807]}]},{"allowed_amount":9.16,"providers":[{"billed_charge":21.20,"npi":[1164449807]}]},{"allowed_amount":9.17,"providers":[{"billed_charge":39.63,"npi":[1164449807]}]},{"allowed_amount":9.30,"providers":[{"billed_charge":39.60,"npi":[1164449807]}]},{"allowed_amount":9.33,"providers":[{"billed_charge":21.20,"npi":[1164449807, 1487783361]}]},{"allowed_amount":9.33,"providers":[{"billed_charge":39.63,"npi":[1164449807]}]},{"allowed_amount":9.33,"providers":[{"billed_charge":39.64,"npi":[1164449807]}]},{"allowed_amount":9.33,"providers":[{"billed_charge":39.65,"npi":[1164449807]}]},{"allowed_amount":9.35,"providers":[{"billed_charge":39.65,"npi":[1164449807]}]},{"allowed_amount":11.17,"providers":[{"billed_charge":39.64,"npi":[1164449807]}]},{"allowed_amount":19.08,"providers":[{"billed_charge":21.20,"npi":[1164449807]}]},{"allowed_amount":21.20,"providers":[{"billed_charge":21.20,"npi":[1164449807]}]},{"allowed_amount":35.68,"providers":[{"billed_charge":39.64,"npi":[1164449807]}]},{"allowed_amount":39.64,"providers":[{"billed_charge":39.64,"npi":[1164449807]}]}]}]},{"name":"GROUND MILEAGE PER STATUTE MILE","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A0425","description":"GROUND MILEAGE PER STATUTE MILE","allowed_amounts":[{"tin":{"type":"ein","value":"391397209"},"service_code":["41"],"billing_class":"institutional","payments":[{"allowed_amount":9.15,"providers":[{"billed_charge":26.62,"npi":[1063579381]}]},{"allowed_amount":9.33,"providers":[{"billed_charge":26.62,"npi":[1063579381]}]},{"allowed_amount":12.12,"providers":[{"billed_charge":26.62,"npi":[1063579381]}]},{"allowed_amount":12.33,"providers":[{"billed_charge":26.62,"npi":[1063579381]}]},{"allowed_amount":12.65,"providers":[{"billed_charge":26.62,"npi":[1063579381]}]},{"allowed_amount":12.72,"providers":[{"billed_charge":26.62,"npi":[1063579381]}]},{"allowed_amount":12.74,"providers":[{"billed_charge":26.62,"npi":[1063579381]}]},{"allowed_amount":13.08,"providers":[{"billed_charge":26.62,"npi":[1063579381]}]},{"allowed_amount":13.25,"providers":[{"billed_charge":26.62,"npi":[1063579381]}]},{"allowed_amount":13.36,"providers":[{"billed_charge":26.62,"npi":[1063579381]}]},{"allowed_amount":13.56,"providers":[{"billed_charge":26.62,"npi":[1063579381]}]},{"allowed_amount":13.59,"providers":[{"billed_charge":26.62,"npi":[1063579381]}]},{"allowed_amount":13.60,"providers":[{"billed_charge":26.62,"npi":[1063579381]}]},{"allowed_amount":13.66,"providers":[{"billed_charge":26.62,"npi":[1063579381]}]},{"allowed_amount":13.68,"providers":[{"billed_charge":26.62,"npi":[1063579381]}]},{"allowed_amount":13.86,"providers":[{"billed_charge":26.62,"npi":[1063579381]}]},{"allowed_amount":14.13,"providers":[{"billed_charge":26.62,"npi":[1063579381]}]},{"allowed_amount":18.66,"providers":[{"billed_charge":26.62,"npi":[1063579381]}]},{"allowed_amount":26.62,"providers":[{"billed_charge":26.62,"npi":[1063579381]}]}]}]},{"name":"GROUND MILEAGE PER STATUTE MILE","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A0425","description":"GROUND MILEAGE PER STATUTE MILE","allowed_amounts":[{"tin":{"type":"ein","value":"391405396"},"service_code":["41"],"billing_class":"institutional","payments":[{"allowed_amount":9.15,"providers":[{"billed_charge":23.75,"npi":[1588715213]}]},{"allowed_amount":9.15,"providers":[{"billed_charge":26.75,"npi":[1588715213]}]},{"allowed_amount":9.33,"providers":[{"billed_charge":23.75,"npi":[1588715213]}]},{"allowed_amount":14.13,"providers":[{"billed_charge":23.75,"npi":[1588715213]}]},{"allowed_amount":18.66,"providers":[{"billed_charge":23.75,"npi":[1588715213]}]},{"allowed_amount":20.73,"providers":[{"billed_charge":23.76,"npi":[1588715213]}]},{"allowed_amount":23.75,"providers":[{"billed_charge":23.75,"npi":[1588715213]}]},{"allowed_amount":23.76,"providers":[{"billed_charge":23.76,"npi":[1588715213]}]}]}]},{"name":"GROUND MILEAGE PER STATUTE MILE","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A0425","description":"GROUND MILEAGE PER STATUTE MILE","allowed_amounts":[{"tin":{"type":"ein","value":"391702433"},"service_code":["41"],"billing_class":"institutional","payments":[{"allowed_amount":9.13,"providers":[{"billed_charge":24.00,"npi":[1609868090]}]},{"allowed_amount":9.15,"providers":[{"billed_charge":24.00,"npi":[1003090051, 1184730327, 1609868090, 1821616574]}]},{"allowed_amount":9.16,"providers":[{"billed_charge":24.00,"npi":[1609868090]}]},{"allowed_amount":9.20,"providers":[{"billed_charge":24.00,"npi":[1609868090]}]},{"allowed_amount":9.27,"providers":[{"billed_charge":24.00,"npi":[1609868090]}]},{"allowed_amount":9.28,"providers":[{"billed_charge":24.00,"npi":[1609868090]}]},{"allowed_amount":9.29,"providers":[{"billed_charge":24.00,"npi":[1609868090]}]},{"allowed_amount":9.30,"providers":[{"billed_charge":24.00,"npi":[1609868090]}]},{"allowed_amount":9.31,"providers":[{"billed_charge":24.00,"npi":[1609868090]}]},{"allowed_amount":9.32,"providers":[{"billed_charge":24.00,"npi":[1609868090]}]},{"allowed_amount":9.33,"providers":[{"billed_charge":24.00,"npi":[1003090051, 1184730327, 1609868090, 1821616574]}]},{"allowed_amount":9.34,"providers":[{"billed_charge":24.00,"npi":[1609868090]}]},{"allowed_amount":9.35,"providers":[{"billed_charge":24.00,"npi":[1609868090]}]},{"allowed_amount":9.85,"providers":[{"billed_charge":24.00,"npi":[1609868090]}]},{"allowed_amount":10.09,"providers":[{"billed_charge":24.00,"npi":[1609868090]}]},{"allowed_amount":10.59,"providers":[{"billed_charge":24.00,"npi":[1609868090]}]},{"allowed_amount":10.75,"providers":[{"billed_charge":24.00,"npi":[1609868090]}]},{"allowed_amount":10.85,"providers":[{"billed_charge":24.00,"npi":[1609868090]}]},{"allowed_amount":10.87,"providers":[{"billed_charge":24.00,"npi":[1609868090]}]},{"allowed_amount":10.89,"providers":[{"billed_charge":24.00,"npi":[1609868090]}]},{"allowed_amount":10.91,"providers":[{"billed_charge":24.00,"npi":[1609868090]}]},{"allowed_amount":10.93,"providers":[{"billed_charge":24.00,"npi":[1609868090]}]},{"allowed_amount":11.00,"providers":[{"billed_charge":24.00,"npi":[1609868090]}]},{"allowed_amount":11.02,"providers":[{"billed_charge":24.00,"npi":[1609868090]}]},{"allowed_amount":11.05,"providers":[{"billed_charge":24.00,"npi":[1609868090]}]},{"allowed_amount":11.08,"providers":[{"billed_charge":24.00,"npi":[1609868090]}]},{"allowed_amount":11.10,"providers":[{"billed_charge":24.00,"npi":[1609868090]}]},{"allowed_amount":11.11,"providers":[{"billed_charge":24.00,"npi":[1609868090]}]},{"allowed_amount":11.15,"providers":[{"billed_charge":24.00,"npi":[1609868090]}]},{"allowed_amount":11.16,"providers":[{"billed_charge":24.00,"npi":[1609868090]}]},{"allowed_amount":11.19,"providers":[{"billed_charge":24.00,"npi":[1609868090]}]},{"allowed_amount":11.20,"providers":[{"billed_charge":24.00,"npi":[1609868090]}]},{"allowed_amount":11.21,"providers":[{"billed_charge":24.00,"npi":[1609868090]}]},{"allowed_amount":11.22,"providers":[{"billed_charge":24.00,"npi":[1609868090]}]},{"allowed_amount":11.26,"providers":[{"billed_charge":24.00,"npi":[1609868090]}]},{"allowed_amount":11.28,"providers":[{"billed_charge":24.00,"npi":[1609868090]}]},{"allowed_amount":11.30,"providers":[{"billed_charge":24.00,"npi":[1609868090]}]},{"allowed_amount":11.32,"providers":[{"billed_charge":24.00,"npi":[1609868090]}]},{"allowed_amount":11.41,"providers":[{"billed_charge":24.00,"npi":[1609868090]}]},{"allowed_amount":11.43,"providers":[{"billed_charge":24.00,"npi":[1609868090]}]},{"allowed_amount":11.44,"providers":[{"billed_charge":24.00,"npi":[1609868090]}]},{"allowed_amount":11.45,"providers":[{"billed_charge":24.00,"npi":[1609868090]}]},{"allowed_amount":11.46,"providers":[{"billed_charge":24.00,"npi":[1609868090]}]},{"allowed_amount":11.47,"providers":[{"billed_charge":24.00,"npi":[1609868090]}]},{"allowed_amount":11.51,"providers":[{"billed_charge":24.00,"npi":[1609868090]}]},{"allowed_amount":11.56,"providers":[{"billed_charge":24.00,"npi":[1609868090]}]},{"allowed_amount":11.60,"providers":[{"billed_charge":24.00,"npi":[1609868090]}]},{"allowed_amount":11.61,"providers":[{"billed_charge":24.00,"npi":[1609868090]}]},{"allowed_amount":11.63,"providers":[{"billed_charge":24.00,"npi":[1609868090]}]},{"allowed_amount":11.64,"providers":[{"billed_charge":24.00,"npi":[1609868090]}]},{"allowed_amount":11.65,"providers":[{"billed_charge":24.00,"npi":[1609868090]}]},{"allowed_amount":11.66,"providers":[{"billed_charge":24.00,"npi":[1609868090]}]},{"allowed_amount":11.78,"providers":[{"billed_charge":24.00,"npi":[1609868090]}]},{"allowed_amount":11.93,"providers":[{"billed_charge":24.00,"npi":[1609868090]}]},{"allowed_amount":12.17,"providers":[{"billed_charge":24.00,"npi":[1609868090]}]},{"allowed_amount":12.20,"providers":[{"billed_charge":24.00,"npi":[1609868090]}]},{"allowed_amount":12.21,"providers":[{"billed_charge":24.00,"npi":[1609868090]}]},{"allowed_amount":12.26,"providers":[{"billed_charge":24.00,"npi":[1609868090]}]},{"allowed_amount":12.42,"providers":[{"billed_charge":24.00,"npi":[1609868090]}]},{"allowed_amount":12.43,"providers":[{"billed_charge":24.00,"npi":[1609868090]}]},{"allowed_amount":12.44,"providers":[{"billed_charge":24.00,"npi":[1609868090]}]},{"allowed_amount":12.55,"providers":[{"billed_charge":24.00,"npi":[1609868090]}]},{"allowed_amount":12.57,"providers":[{"billed_charge":24.00,"npi":[1609868090]}]},{"allowed_amount":12.58,"providers":[{"billed_charge":24.00,"npi":[1609868090]}]},{"allowed_amount":12.60,"providers":[{"billed_charge":24.00,"npi":[1609868090]}]},{"allowed_amount":12.62,"providers":[{"billed_charge":24.00,"npi":[1609868090]}]},{"allowed_amount":12.63,"providers":[{"billed_charge":24.00,"npi":[1609868090]}]},{"allowed_amount":12.65,"providers":[{"billed_charge":24.00,"npi":[1609868090]}]},{"allowed_amount":12.87,"providers":[{"billed_charge":24.00,"npi":[1609868090]}]},{"allowed_amount":12.89,"providers":[{"billed_charge":24.00,"npi":[1609868090]}]},{"allowed_amount":12.94,"providers":[{"billed_charge":24.00,"npi":[1609868090]}]},{"allowed_amount":13.00,"providers":[{"billed_charge":24.00,"npi":[1609868090]}]},{"allowed_amount":13.11,"providers":[{"billed_charge":24.00,"npi":[1609868090]}]},{"allowed_amount":13.13,"providers":[{"billed_charge":24.00,"npi":[1609868090]}]},{"allowed_amount":13.19,"providers":[{"billed_charge":24.00,"npi":[1609868090]}]},{"allowed_amount":13.25,"providers":[{"billed_charge":24.00,"npi":[1609868090]}]},{"allowed_amount":13.35,"providers":[{"billed_charge":24.00,"npi":[1609868090]}]},{"allowed_amount":13.36,"providers":[{"billed_charge":24.00,"npi":[1609868090]}]},{"allowed_amount":13.38,"providers":[{"billed_charge":24.00,"npi":[1609868090]}]},{"allowed_amount":13.40,"providers":[{"billed_charge":24.00,"npi":[1609868090]}]},{"allowed_amount":13.86,"providers":[{"billed_charge":24.00,"npi":[1609868090]}]},{"allowed_amount":13.90,"providers":[{"billed_charge":24.00,"npi":[1609868090]}]},{"allowed_amount":14.10,"providers":[{"billed_charge":24.00,"npi":[1609868090]}]},{"allowed_amount":14.13,"providers":[{"billed_charge":24.00,"npi":[1609868090]}]},{"allowed_amount":14.14,"providers":[{"billed_charge":24.00,"npi":[1609868090]}]},{"allowed_amount":17.22,"providers":[{"billed_charge":24.00,"npi":[1609868090]}]},{"allowed_amount":17.49,"providers":[{"billed_charge":24.00,"npi":[1609868090]}]},{"allowed_amount":17.60,"providers":[{"billed_charge":24.00,"npi":[1609868090]}]},{"allowed_amount":17.65,"providers":[{"billed_charge":24.00,"npi":[1609868090]}]},{"allowed_amount":17.77,"providers":[{"billed_charge":24.00,"npi":[1609868090]}]},{"allowed_amount":17.89,"providers":[{"billed_charge":24.00,"npi":[1609868090]}]},{"allowed_amount":18.06,"providers":[{"billed_charge":24.00,"npi":[1609868090]}]},{"allowed_amount":18.20,"providers":[{"billed_charge":24.00,"npi":[1609868090]}]},{"allowed_amount":18.29,"providers":[{"billed_charge":24.00,"npi":[1609868090]}]},{"allowed_amount":18.41,"providers":[{"billed_charge":24.00,"npi":[1609868090]}]},{"allowed_amount":18.47,"providers":[{"billed_charge":24.00,"npi":[1184730327, 1609868090]}]},{"allowed_amount":18.49,"providers":[{"billed_charge":24.00,"npi":[1609868090]}]},{"allowed_amount":18.62,"providers":[{"billed_charge":24.00,"npi":[1609868090]}]},{"allowed_amount":18.66,"providers":[{"billed_charge":24.00,"npi":[1003090051, 1609868090]}]},{"allowed_amount":18.69,"providers":[{"billed_charge":24.00,"npi":[1609868090]}]},{"allowed_amount":18.72,"providers":[{"billed_charge":24.00,"npi":[1609868090]}]},{"allowed_amount":18.75,"providers":[{"billed_charge":24.00,"npi":[1609868090]}]},{"allowed_amount":18.77,"providers":[{"billed_charge":24.00,"npi":[1609868090]}]},{"allowed_amount":18.80,"providers":[{"billed_charge":24.00,"npi":[1609868090]}]},{"allowed_amount":18.83,"providers":[{"billed_charge":24.00,"npi":[1609868090]}]},{"allowed_amount":18.86,"providers":[{"billed_charge":24.00,"npi":[1609868090]}]},{"allowed_amount":18.90,"providers":[{"billed_charge":24.00,"npi":[1609868090]}]},{"allowed_amount":18.94,"providers":[{"billed_charge":24.00,"npi":[1609868090]}]},{"allowed_amount":18.98,"providers":[{"billed_charge":24.00,"npi":[1609868090]}]},{"allowed_amount":19.14,"providers":[{"billed_charge":24.00,"npi":[1609868090]}]},{"allowed_amount":19.21,"providers":[{"billed_charge":24.00,"npi":[1609868090]}]},{"allowed_amount":19.24,"providers":[{"billed_charge":24.00,"npi":[1184730327, 1609868090]}]},{"allowed_amount":19.30,"providers":[{"billed_charge":24.00,"npi":[1609868090]}]},{"allowed_amount":19.44,"providers":[{"billed_charge":24.00,"npi":[1609868090]}]},{"allowed_amount":19.50,"providers":[{"billed_charge":24.00,"npi":[1184730327, 1609868090]}]},{"allowed_amount":19.53,"providers":[{"billed_charge":24.00,"npi":[1609868090]}]},{"allowed_amount":19.64,"providers":[{"billed_charge":24.00,"npi":[1609868090]}]},{"allowed_amount":19.79,"providers":[{"billed_charge":24.00,"npi":[1609868090]}]},{"allowed_amount":19.99,"providers":[{"billed_charge":24.00,"npi":[1609868090]}]},{"allowed_amount":21.33,"providers":[{"billed_charge":24.00,"npi":[1609868090]}]},{"allowed_amount":21.53,"providers":[{"billed_charge":24.00,"npi":[1609868090]}]},{"allowed_amount":21.95,"providers":[{"billed_charge":24.00,"npi":[1609868090]}]},{"allowed_amount":23.33,"providers":[{"billed_charge":24.00,"npi":[1609868090]}]},{"allowed_amount":23.70,"providers":[{"billed_charge":24.00,"npi":[1609868090]}]},{"allowed_amount":24.00,"providers":[{"billed_charge":24.00,"npi":[1184730327, 1609868090]}]}]}]},{"name":"GROUND MILEAGE PER STATUTE MILE","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A0425","description":"GROUND MILEAGE PER STATUTE MILE","allowed_amounts":[{"tin":{"type":"ein","value":"396005479"},"service_code":["41"],"billing_class":"institutional","payments":[{"allowed_amount":9.15,"providers":[{"billed_charge":16.00,"npi":[1508860982]}]},{"allowed_amount":9.33,"providers":[{"billed_charge":16.00,"npi":[1508860982]}]},{"allowed_amount":16.00,"providers":[{"billed_charge":16.00,"npi":[1508860982]}]}]}]},{"name":"GROUND MILEAGE PER STATUTE MILE","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A0425","description":"GROUND MILEAGE PER STATUTE MILE","allowed_amounts":[{"tin":{"type":"ein","value":"396005511"},"service_code":["41"],"billing_class":"institutional","payments":[{"allowed_amount":9.33,"providers":[{"billed_charge":23.00,"npi":[1366424707, 1407691595, 1457332769, 1700830973, 1821616574]}]},{"allowed_amount":11.66,"providers":[{"billed_charge":23.00,"npi":[1457332769]}]},{"allowed_amount":12.32,"providers":[{"billed_charge":23.00,"npi":[1457332769]}]},{"allowed_amount":13.86,"providers":[{"billed_charge":23.00,"npi":[1235186883, 1366424707, 1457332769]}]},{"allowed_amount":14.13,"providers":[{"billed_charge":23.00,"npi":[1235186883, 1366424707, 1457332769, 1649222621]}]},{"allowed_amount":23.00,"providers":[{"billed_charge":23.00,"npi":[1366424707, 1407691595, 1457332769]}]}]}]},{"name":"GROUND MILEAGE PER STATUTE MILE","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A0425","description":"GROUND MILEAGE PER STATUTE MILE","allowed_amounts":[{"tin":{"type":"ein","value":"396005556"},"service_code":["41"],"billing_class":"institutional","payments":[{"allowed_amount":11.64,"providers":[{"billed_charge":20.00,"npi":[1760472229]}]},{"allowed_amount":11.67,"providers":[{"billed_charge":20.00,"npi":[1760472229]}]},{"allowed_amount":11.68,"providers":[{"billed_charge":20.00,"npi":[1760472229]}]},{"allowed_amount":11.70,"providers":[{"billed_charge":20.00,"npi":[1760472229]}]},{"allowed_amount":11.71,"providers":[{"billed_charge":20.00,"npi":[1760472229]}]},{"allowed_amount":11.81,"providers":[{"billed_charge":20.00,"npi":[1760472229]}]},{"allowed_amount":13.08,"providers":[{"billed_charge":20.00,"npi":[1760472229]}]},{"allowed_amount":13.86,"providers":[{"billed_charge":20.00,"npi":[1336254291, 1760472229]}]},{"allowed_amount":14.13,"providers":[{"billed_charge":20.00,"npi":[1336254291, 1619025889, 1760472229]}]},{"allowed_amount":18.66,"providers":[{"billed_charge":20.00,"npi":[1760472229, 1760596209]}]},{"allowed_amount":20.00,"providers":[{"billed_charge":20.00,"npi":[1760472229]}]}]}]},{"name":"GROUND MILEAGE PER STATUTE MILE","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A0425","description":"GROUND MILEAGE PER STATUTE MILE","allowed_amounts":[{"tin":{"type":"ein","value":"396005652"},"service_code":["41"],"billing_class":"institutional","payments":[{"allowed_amount":9.15,"providers":[{"billed_charge":24.00,"npi":[1003090051, 1184730327, 1609868090, 1821616574]}]},{"allowed_amount":9.33,"providers":[{"billed_charge":24.00,"npi":[1003090051, 1184730327, 1609868090, 1821616574]}]},{"allowed_amount":18.14,"providers":[{"billed_charge":24.00,"npi":[1184730327]}]},{"allowed_amount":18.47,"providers":[{"billed_charge":24.00,"npi":[1184730327, 1609868090]}]},{"allowed_amount":19.24,"providers":[{"billed_charge":24.00,"npi":[1184730327, 1609868090]}]},{"allowed_amount":19.50,"providers":[{"billed_charge":24.00,"npi":[1184730327, 1609868090]}]},{"allowed_amount":19.90,"providers":[{"billed_charge":24.00,"npi":[1184730327]}]},{"allowed_amount":24.00,"providers":[{"billed_charge":24.00,"npi":[1184730327, 1609868090]}]}]}]},{"name":"GROUND MILEAGE PER STATUTE MILE","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A0425","description":"GROUND MILEAGE PER STATUTE MILE","allowed_amounts":[{"tin":{"type":"ein","value":"396005686"},"service_code":["41"],"billing_class":"institutional","payments":[{"allowed_amount":9.33,"providers":[{"billed_charge":21.00,"npi":[1184757486]}]},{"allowed_amount":10.79,"providers":[{"billed_charge":21.00,"npi":[1184757486]}]},{"allowed_amount":10.95,"providers":[{"billed_charge":21.00,"npi":[1184757486]}]},{"allowed_amount":10.99,"providers":[{"billed_charge":21.00,"npi":[1184757486]}]},{"allowed_amount":11.01,"providers":[{"billed_charge":21.00,"npi":[1184757486]}]},{"allowed_amount":11.12,"providers":[{"billed_charge":21.00,"npi":[1184757486]}]},{"allowed_amount":11.14,"providers":[{"billed_charge":21.00,"npi":[1184757486]}]},{"allowed_amount":11.16,"providers":[{"billed_charge":21.00,"npi":[1184757486]}]},{"allowed_amount":11.17,"providers":[{"billed_charge":21.00,"npi":[1184757486]}]},{"allowed_amount":11.71,"providers":[{"billed_charge":21.00,"npi":[1184757486]}]},{"allowed_amount":11.97,"providers":[{"billed_charge":21.00,"npi":[1184757486]}]},{"allowed_amount":12.01,"providers":[{"billed_charge":21.00,"npi":[1184757486]}]},{"allowed_amount":12.05,"providers":[{"billed_charge":21.00,"npi":[1184757486]}]},{"allowed_amount":12.08,"providers":[{"billed_charge":21.00,"npi":[1184757486]}]},{"allowed_amount":12.09,"providers":[{"billed_charge":21.00,"npi":[1184757486]}]},{"allowed_amount":12.80,"providers":[{"billed_charge":21.00,"npi":[1184757486]}]},{"allowed_amount":13.16,"providers":[{"billed_charge":21.00,"npi":[1184757486]}]},{"allowed_amount":13.66,"providers":[{"billed_charge":21.00,"npi":[1184757486]}]},{"allowed_amount":14.13,"providers":[{"billed_charge":21.00,"npi":[1184757486]}]},{"allowed_amount":21.00,"providers":[{"billed_charge":21.00,"npi":[1184757486]}]}]}]},{"name":"GROUND MILEAGE PER STATUTE MILE","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A0425","description":"GROUND MILEAGE PER STATUTE MILE","allowed_amounts":[{"tin":{"type":"ein","value":"396005759"},"service_code":["41"],"billing_class":"institutional","payments":[{"allowed_amount":10.60,"providers":[{"billed_charge":19.70,"npi":[1568517688]}]},{"allowed_amount":10.62,"providers":[{"billed_charge":19.70,"npi":[1568517688]}]},{"allowed_amount":10.67,"providers":[{"billed_charge":19.70,"npi":[1568517688]}]},{"allowed_amount":10.87,"providers":[{"billed_charge":19.70,"npi":[1568517688]}]},{"allowed_amount":11.05,"providers":[{"billed_charge":19.70,"npi":[1568517688]}]},{"allowed_amount":11.09,"providers":[{"billed_charge":19.70,"npi":[1568517688]}]},{"allowed_amount":11.48,"providers":[{"billed_charge":19.70,"npi":[1568517688]}]},{"allowed_amount":11.56,"providers":[{"billed_charge":19.70,"npi":[1568517688]}]},{"allowed_amount":11.82,"providers":[{"billed_charge":19.70,"npi":[1568517688]}]},{"allowed_amount":11.95,"providers":[{"billed_charge":19.70,"npi":[1568517688]}]},{"allowed_amount":11.98,"providers":[{"billed_charge":19.70,"npi":[1568517688]}]},{"allowed_amount":12.13,"providers":[{"billed_charge":19.70,"npi":[1568517688]}]},{"allowed_amount":12.16,"providers":[{"billed_charge":19.70,"npi":[1568517688]}]},{"allowed_amount":12.22,"providers":[{"billed_charge":19.70,"npi":[1568517688]}]},{"allowed_amount":12.33,"providers":[{"billed_charge":19.70,"npi":[1568517688]}]},{"allowed_amount":12.34,"providers":[{"billed_charge":19.70,"npi":[1568517688]}]},{"allowed_amount":12.90,"providers":[{"billed_charge":19.70,"npi":[1568517688]}]},{"allowed_amount":12.95,"providers":[{"billed_charge":19.70,"npi":[1568517688]}]},{"allowed_amount":13.29,"providers":[{"billed_charge":19.70,"npi":[1568517688]}]},{"allowed_amount":13.68,"providers":[{"billed_charge":19.70,"npi":[1568517688]}]},{"allowed_amount":13.72,"providers":[{"billed_charge":19.70,"npi":[1568517688]}]},{"allowed_amount":13.82,"providers":[{"billed_charge":19.70,"npi":[1568517688]}]},{"allowed_amount":13.86,"providers":[{"billed_charge":19.70,"npi":[1568517688]}]},{"allowed_amount":14.13,"providers":[{"billed_charge":19.70,"npi":[1568517688]}]},{"allowed_amount":14.14,"providers":[{"billed_charge":19.70,"npi":[1568517688]}]}]}]},{"name":"GROUND MILEAGE PER STATUTE MILE","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A0425","description":"GROUND MILEAGE PER STATUTE MILE","allowed_amounts":[{"tin":{"type":"ein","value":"396005918"},"service_code":["41"],"billing_class":"institutional","payments":[{"allowed_amount":9.33,"providers":[{"billed_charge":23.00,"npi":[1366424707, 1407691595, 1457332769, 1700830973, 1821616574]}]},{"allowed_amount":17.60,"providers":[{"billed_charge":23.00,"npi":[1407691595]}]},{"allowed_amount":18.06,"providers":[{"billed_charge":23.00,"npi":[1407691595]}]},{"allowed_amount":18.66,"providers":[{"billed_charge":23.46,"npi":[1407691595]}]},{"allowed_amount":18.90,"providers":[{"billed_charge":23.00,"npi":[1407691595]}]},{"allowed_amount":19.39,"providers":[{"billed_charge":23.00,"npi":[1407691595]}]},{"allowed_amount":23.00,"providers":[{"billed_charge":23.00,"npi":[1366424707, 1407691595, 1457332769]}]}]}]},{"name":"GROUND MILEAGE PER STATUTE MILE","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A0425","description":"GROUND MILEAGE PER STATUTE MILE","allowed_amounts":[{"tin":{"type":"ein","value":"396006317"},"service_code":["41"],"billing_class":"institutional","payments":[{"allowed_amount":9.15,"providers":[{"billed_charge":25.00,"npi":[1700830973, 1972679132]}]},{"allowed_amount":9.30,"providers":[{"billed_charge":25.00,"npi":[1700830973, 1891745840, 1972679132]}]},{"allowed_amount":9.33,"providers":[{"billed_charge":25.00,"npi":[1063524585, 1700830973, 1891745840, 1972679132]}]},{"allowed_amount":15.55,"providers":[{"billed_charge":25.00,"npi":[1972679132]}]},{"allowed_amount":18.66,"providers":[{"billed_charge":25.00,"npi":[1891745840, 1972679132]}]},{"allowed_amount":19.44,"providers":[{"billed_charge":25.00,"npi":[1972679132]}]},{"allowed_amount":19.64,"providers":[{"billed_charge":25.00,"npi":[1972679132]}]}]}]},{"name":"GROUND MILEAGE PER STATUTE MILE","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A0425","description":"GROUND MILEAGE PER STATUTE MILE","allowed_amounts":[{"tin":{"type":"ein","value":"823031023"},"service_code":["41"],"billing_class":"institutional","payments":[{"allowed_amount":9.15,"providers":[{"billed_charge":39.00,"npi":[1588141345]}]},{"allowed_amount":9.15,"providers":[{"billed_charge":45.00,"npi":[1588141345]}]},{"allowed_amount":9.33,"providers":[{"billed_charge":39.00,"npi":[1588141345]}]},{"allowed_amount":9.33,"providers":[{"billed_charge":45.00,"npi":[1588141345]}]},{"allowed_amount":9.68,"providers":[{"billed_charge":45.00,"npi":[1588141345]}]},{"allowed_amount":10.38,"providers":[{"billed_charge":39.00,"npi":[1588141345]}]},{"allowed_amount":10.43,"providers":[{"billed_charge":45.00,"npi":[1588141345]}]},{"allowed_amount":10.45,"providers":[{"billed_charge":45.00,"npi":[1588141345]}]},{"allowed_amount":10.63,"providers":[{"billed_charge":45.00,"npi":[1588141345]}]},{"allowed_amount":10.71,"providers":[{"billed_charge":45.00,"npi":[1588141345]}]},{"allowed_amount":10.96,"providers":[{"billed_charge":45.00,"npi":[1588141345]}]},{"allowed_amount":11.05,"providers":[{"billed_charge":39.00,"npi":[1588141345]}]},{"allowed_amount":11.20,"providers":[{"billed_charge":45.00,"npi":[1588141345]}]},{"allowed_amount":11.28,"providers":[{"billed_charge":39.00,"npi":[1588141345]}]},{"allowed_amount":11.31,"providers":[{"billed_charge":45.00,"npi":[1588141345]}]},{"allowed_amount":11.37,"providers":[{"billed_charge":39.00,"npi":[1588141345]}]},{"allowed_amount":11.42,"providers":[{"billed_charge":45.00,"npi":[1588141345]}]},{"allowed_amount":11.47,"providers":[{"billed_charge":45.00,"npi":[1588141345]}]},{"allowed_amount":11.53,"providers":[{"billed_charge":45.00,"npi":[1588141345]}]},{"allowed_amount":11.58,"providers":[{"billed_charge":45.00,"npi":[1588141345]}]},{"allowed_amount":11.71,"providers":[{"billed_charge":39.00,"npi":[1588141345]}]},{"allowed_amount":12.13,"providers":[{"billed_charge":39.00,"npi":[1588141345]}]},{"allowed_amount":12.13,"providers":[{"billed_charge":45.00,"npi":[1588141345]}]},{"allowed_amount":12.50,"providers":[{"billed_charge":45.00,"npi":[1588141345]}]},{"allowed_amount":12.62,"providers":[{"billed_charge":45.00,"npi":[1588141345]}]},{"allowed_amount":13.06,"providers":[{"billed_charge":39.00,"npi":[1588141345]}]},{"allowed_amount":13.06,"providers":[{"billed_charge":45.00,"npi":[1588141345]}]},{"allowed_amount":13.86,"providers":[{"billed_charge":39.00,"npi":[1588141345]}]},{"allowed_amount":14.13,"providers":[{"billed_charge":39.00,"npi":[1588141345]}]},{"allowed_amount":14.13,"providers":[{"billed_charge":45.00,"npi":[1588141345]}]},{"allowed_amount":38.81,"providers":[{"billed_charge":38.81,"npi":[1588141345]}]}]}]},{"name":"HOS OP CLIN VISIT ASSESS + MGMT PT","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0463","description":"HOS OP CLIN VISIT ASSESS + MGMT PT","allowed_amounts":[{"tin":{"type":"ein","value":"391835630"},"billing_class":"institutional","payments":[{"allowed_amount":0.00,"providers":[{"billed_charge":262.00,"npi":[1922043744]}]},{"allowed_amount":25.74,"providers":[{"billed_charge":262.00,"npi":[1922043744]}]},{"allowed_amount":49.79,"providers":[{"billed_charge":262.00,"npi":[1922043744]}]},{"allowed_amount":51.47,"providers":[{"billed_charge":262.00,"npi":[1922043744]}]},{"allowed_amount":124.48,"providers":[{"billed_charge":262.00,"npi":[1922043744]}]},{"allowed_amount":125.81,"providers":[{"billed_charge":262.00,"npi":[1922043744]}]},{"allowed_amount":128.68,"providers":[{"billed_charge":262.00,"npi":[1922043744]}]},{"allowed_amount":128.68,"providers":[{"billed_charge":373.00,"npi":[1922043744]}]},{"allowed_amount":222.67,"providers":[{"billed_charge":262.00,"npi":[1922043744]}]},{"allowed_amount":222.70,"providers":[{"billed_charge":262.00,"npi":[1922043744]}]},{"allowed_amount":246.28,"providers":[{"billed_charge":262.00,"npi":[1922043744]}]}]}]},{"name":"IMMUNOHISTO ANTB 1ST STAIN","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88342","description":"IMMUNOHISTO ANTB 1ST STAIN","allowed_amounts":[{"tin":{"type":"ein","value":"474903308"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":52.89,"providers":[{"billed_charge":200.00,"npi":[1740733708]}]},{"allowed_amount":104.16,"providers":[{"billed_charge":200.00,"npi":[1740733708]}]},{"allowed_amount":111.68,"providers":[{"billed_charge":200.00,"npi":[1740733708]}]}]}]},{"name":"IMMUNOHISTO ANTB ADDL SLIDE","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88341","description":"IMMUNOHISTO ANTB ADDL SLIDE","allowed_amounts":[{"tin":{"type":"ein","value":"474903308"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":42.23,"providers":[{"billed_charge":200.00,"npi":[1740733708]}]},{"allowed_amount":89.01,"providers":[{"billed_charge":200.00,"npi":[1740733708]}]},{"allowed_amount":95.13,"providers":[{"billed_charge":200.00,"npi":[1740733708]}]}]}]},{"name":"MICRODISSECTION MANUAL","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88381","description":"MICRODISSECTION MANUAL","allowed_amounts":[{"tin":{"type":"ein","value":"474903308"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":92.16,"providers":[{"billed_charge":250.00,"npi":[1740733708]}]},{"allowed_amount":175.47,"providers":[{"billed_charge":250.00,"npi":[1740733708]}]},{"allowed_amount":175.81,"providers":[{"billed_charge":250.00,"npi":[1740733708]}]},{"allowed_amount":190.84,"providers":[{"billed_charge":250.00,"npi":[1740733708]}]},{"allowed_amount":194.25,"providers":[{"billed_charge":250.00,"npi":[1740733708]}]}]}]},{"name":"OFFICE O-P EST MOD 30 MIN","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99214","description":"OFFICE O-P EST MOD 30 MIN","allowed_amounts":[{"tin":{"type":"ein","value":"844201142"},"service_code":["20"],"billing_class":"professional","payments":[{"allowed_amount":93.52,"providers":[{"billed_charge":300.00,"npi":[1497931943]}]},{"allowed_amount":101.52,"providers":[{"billed_charge":300.00,"npi":[1497931943]}]},{"allowed_amount":110.13,"providers":[{"billed_charge":300.00,"npi":[1497931943]}]}]}]},{"name":"Pharmacy","billing_code_type":"RC","billing_code_type_version":"2026","billing_code":"0250","description":"Pharmacy","allowed_amounts":[{"tin":{"type":"ein","value":"390808443"},"billing_class":"institutional","payments":[{"allowed_amount":0.00,"providers":[{"billed_charge":0.33,"npi":[1538112230, 1558363986]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":1.68,"npi":[1538112230, 1841266194]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":11.82,"npi":[1538112230]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":118.73,"npi":[1538112230]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":118.87,"npi":[1538112230]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":16.68,"npi":[1538112230]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":172.25,"npi":[1538112230, 1558363986]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":26.09,"npi":[1538112230]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":26.62,"npi":[1538112230]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":3.36,"npi":[1538112230, 1558363986]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":3.48,"npi":[1538112230]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":3.50,"npi":[1538112230]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":32.65,"npi":[1538112230]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":4.12,"npi":[1538112230]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":52.63,"npi":[1538112230]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":6.28,"npi":[1538112230]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":8.05,"npi":[1538112230]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":8.47,"npi":[1538112230]}]},{"allowed_amount":0.23,"providers":[{"billed_charge":0.23,"npi":[1538112230]}]}]}]},{"name":"Pharmacy","billing_code_type":"RC","billing_code_type_version":"2026","billing_code":"0250","description":"Pharmacy","allowed_amounts":[{"tin":{"type":"ein","value":"410944601"},"billing_class":"institutional","payments":[{"allowed_amount":0.00,"providers":[{"billed_charge":1.91,"npi":[1841266194]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":12.08,"npi":[1841266194]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":14.29,"npi":[1841266194]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":15.35,"npi":[1841266194]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":18.35,"npi":[1841266194]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":18.48,"npi":[1841266194]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":18.95,"npi":[1841266194]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":22.93,"npi":[1841266194]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":26.28,"npi":[1841266194]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":3.87,"npi":[1841266194, 1922043744]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":38.87,"npi":[1841266194]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":4.27,"npi":[1841266194]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":4.79,"npi":[1841266194]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":41.53,"npi":[1841266194]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":44.83,"npi":[1841266194]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":53.48,"npi":[1841266194]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":62.98,"npi":[1841266194]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":8.27,"npi":[1841266194]}]},{"allowed_amount":5.01,"providers":[{"billed_charge":5.27,"npi":[1841266194]}]},{"allowed_amount":48.80,"providers":[{"billed_charge":51.37,"npi":[1841266194]}]}]}]},{"name":"SPECIALTY CARE TRANSPORT","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A0434","description":"SPECIALTY CARE TRANSPORT","allowed_amounts":[{"tin":{"type":"ein","value":"391307909"},"service_code":["41"],"billing_class":"institutional","payments":[{"allowed_amount":915.58,"providers":[{"billed_charge":4137.25,"npi":[1164449807]}]},{"allowed_amount":4137.25,"providers":[{"billed_charge":4137.25,"npi":[1164449807]}]},{"allowed_amount":4200.52,"providers":[{"billed_charge":4200.52,"npi":[1164449807]}]},{"allowed_amount":4537.76,"providers":[{"billed_charge":4537.76,"npi":[1164449807]}]},{"allowed_amount":4626.75,"providers":[{"billed_charge":4626.75,"npi":[1164449807]}]},{"allowed_amount":4969.58,"providers":[{"billed_charge":4969.58,"npi":[1164449807]}]},{"allowed_amount":5718.74,"providers":[{"billed_charge":5718.74,"npi":[1164449807]}]}]}]},{"name":"SPECIALTY CARE TRANSPORT","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A0434","description":"SPECIALTY CARE TRANSPORT","allowed_amounts":[{"tin":{"type":"ein","value":"823031023"},"service_code":["41"],"billing_class":"institutional","payments":[{"allowed_amount":896.98,"providers":[{"billed_charge":6485.00,"npi":[1588141345]}]},{"allowed_amount":905.78,"providers":[{"billed_charge":6485.00,"npi":[1588141345]}]},{"allowed_amount":905.78,"providers":[{"billed_charge":6585.00,"npi":[1588141345]}]},{"allowed_amount":905.78,"providers":[{"billed_charge":6735.00,"npi":[1588141345]}]},{"allowed_amount":915.58,"providers":[{"billed_charge":6025.00,"npi":[1588141345]}]},{"allowed_amount":915.58,"providers":[{"billed_charge":6085.00,"npi":[1588141345]}]},{"allowed_amount":915.58,"providers":[{"billed_charge":6485.00,"npi":[1588141345]}]},{"allowed_amount":915.58,"providers":[{"billed_charge":6635.00,"npi":[1588141345]}]},{"allowed_amount":915.58,"providers":[{"billed_charge":7460.00,"npi":[1588141345]}]},{"allowed_amount":915.58,"providers":[{"billed_charge":7535.00,"npi":[1588141345]}]},{"allowed_amount":915.58,"providers":[{"billed_charge":7560.00,"npi":[1588141345]}]},{"allowed_amount":924.56,"providers":[{"billed_charge":6485.00,"npi":[1588141345]}]},{"allowed_amount":924.56,"providers":[{"billed_charge":6585.00,"npi":[1588141345]}]},{"allowed_amount":924.56,"providers":[{"billed_charge":7110.00,"npi":[1588141345]}]},{"allowed_amount":924.56,"providers":[{"billed_charge":7460.00,"npi":[1588141345]}]},{"allowed_amount":924.56,"providers":[{"billed_charge":7535.00,"npi":[1588141345]}]},{"allowed_amount":1249.48,"providers":[{"billed_charge":5775.00,"npi":[1588141345]}]},{"allowed_amount":1249.48,"providers":[{"billed_charge":6600.00,"npi":[1588141345]}]}]}]},{"name":"TISSUE EXAM BY PATHOLOGIST","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88305","description":"TISSUE EXAM BY PATHOLOGIST","allowed_amounts":[{"tin":{"type":"ein","value":"352037910"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":19.52,"providers":[{"billed_charge":61.00,"npi":[1639911688]}]},{"allowed_amount":31.76,"providers":[{"billed_charge":61.00,"npi":[1639911688]}]},{"allowed_amount":41.48,"providers":[{"billed_charge":61.00,"npi":[1639911688]}]},{"allowed_amount":41.49,"providers":[{"billed_charge":61.00,"npi":[1639911688]}]},{"allowed_amount":61.00,"providers":[{"billed_charge":61.00,"npi":[1639911688]}]}]}]},{"name":"TISSUE EXAM BY PATHOLOGIST","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88305","description":"TISSUE EXAM BY PATHOLOGIST","allowed_amounts":[{"tin":{"type":"ein","value":"391145163"},"service_code":["22"],"billing_class":"professional","payments":[{"allowed_amount":34.27,"providers":[{"billed_charge":406.00,"npi":[1154494409, 1447337340, 1891968616]}]},{"allowed_amount":34.40,"providers":[{"billed_charge":406.00,"npi":[1154494409, 1225529654, 1447337340, 1891968616]}]},{"allowed_amount":60.22,"providers":[{"billed_charge":406.00,"npi":[1154494409, 1447337340]}]},{"allowed_amount":99.01,"providers":[{"billed_charge":406.00,"npi":[1154494409, 1225529654, 1447337340, 1891968616]}]},{"allowed_amount":406.00,"providers":[{"billed_charge":406.00,"npi":[1154494409, 1891968616]}]}]}]},{"name":"TRGT GEN SEQ DNA 324 GENES","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0037U","description":"TRGT GEN SEQ DNA 324 GENES","allowed_amounts":[{"tin":{"type":"ein","value":"271316416"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":3072.00,"providers":[{"billed_charge":5800.00,"npi":[1720688054]}]},{"allowed_amount":3500.00,"providers":[{"billed_charge":5800.00,"npi":[1720688054]}]}]}]},{"name":"TUMOR IMMUNOHISTOCHEM-MANUAL","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88360","description":"TUMOR IMMUNOHISTOCHEM-MANUAL","allowed_amounts":[{"tin":{"type":"ein","value":"474903308"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":63.71,"providers":[{"billed_charge":200.00,"npi":[1740733708]}]},{"allowed_amount":106.10,"providers":[{"billed_charge":200.00,"npi":[1740733708]}]},{"allowed_amount":111.58,"providers":[{"billed_charge":200.00,"npi":[1740733708]}]},{"allowed_amount":113.85,"providers":[{"billed_charge":200.00,"npi":[1740733708]}]},{"allowed_amount":118.34,"providers":[{"billed_charge":200.00,"npi":[1740733708]}]},{"allowed_amount":121.76,"providers":[{"billed_charge":200.00,"npi":[1740733708]}]},{"allowed_amount":133.37,"providers":[{"billed_charge":200.00,"npi":[1740733708]}]},{"allowed_amount":137.96,"providers":[{"billed_charge":200.00,"npi":[1740733708]}]},{"allowed_amount":145.77,"providers":[{"billed_charge":200.00,"npi":[1740733708]}]},{"allowed_amount":180.25,"providers":[{"billed_charge":200.00,"npi":[1740733708]}]}]}]},{"name":"TX-PRO-DX INJ NEW DRUG ADDON","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96375","description":"TX-PRO-DX INJ NEW DRUG ADDON","allowed_amounts":[{"tin":{"type":"ein","value":"391835630"},"service_code":["01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "53", "54", "55", "56", "57", "58", "60", "61", "62", "65", "71", "72", "81", "99"],"billing_class":"professional","payments":[{"allowed_amount":0.00,"providers":[{"billed_charge":239.00,"npi":[1922043744, 1942749387]}]},{"allowed_amount":44.57,"providers":[{"billed_charge":239.00,"npi":[1922043744]}]},{"allowed_amount":45.26,"providers":[{"billed_charge":239.00,"npi":[1922043744]}]},{"allowed_amount":203.13,"providers":[{"billed_charge":239.00,"npi":[1922043744]}]},{"allowed_amount":224.64,"providers":[{"billed_charge":239.00,"npi":[1922043744]}]}]}]},{"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":"810977948"},"service_code":["01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "53", "54", "55", "56", "57", "58", "60", "61", "62", "65", "71", "72", "81", "99"],"billing_class":"professional","payments":[{"allowed_amount":0.00,"providers":[{"billed_charge":44.00,"npi":[1184621211, 1902437650, 1942749387]}]},{"allowed_amount":0.00,"providers":[{"billed_charge":87.00,"npi":[1134255037, 1932361763, 1942749387]}]},{"allowed_amount":3.17,"providers":[{"billed_charge":37.44,"npi":[1902437650]}]},{"allowed_amount":3.17,"providers":[{"billed_charge":44.00,"npi":[1942749387]}]},{"allowed_amount":3.17,"providers":[{"billed_charge":87.00,"npi":[1942749387]}]},{"allowed_amount":41.80,"providers":[{"billed_charge":44.00,"npi":[1902437650, 1942749387]}]},{"allowed_amount":82.65,"providers":[{"billed_charge":87.00,"npi":[1942749387]}]}]}]},{"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":"201236503"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":29.60,"providers":[{"billed_charge":118.40,"npi":[1225110497]}]},{"allowed_amount":36.55,"providers":[{"billed_charge":118.40,"npi":[1225110497]}]},{"allowed_amount":40.55,"providers":[{"billed_charge":118.40,"npi":[1225110497]}]}]}]},{"name":"X-RAY EXAM CHEST 1 VIEW","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71045","description":"X-RAY EXAM CHEST 1 VIEW","allowed_amounts":[{"tin":{"type":"ein","value":"391824445"},"service_code":["21"],"billing_class":"professional","payments":[{"allowed_amount":8.03,"providers":[{"billed_charge":68.50,"npi":[1639186463]}]},{"allowed_amount":8.10,"providers":[{"billed_charge":68.50,"npi":[1639186463]}]},{"allowed_amount":54.80,"providers":[{"billed_charge":68.50,"npi":[1639186463]}]}]}]}]}