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"allowed_amounts": [ { "tin": { "type": "ein", "value": "350983617" }, "billing_class": "institutional", "payments": [ { "allowed_amount": 330, "providers": [ { "billed_charge": 330, "npi": [ 1336119478 ] } ] }, { "allowed_amount": 88.67, "providers": [ { "billed_charge": 226, "npi": [ 1619923919 ] } ] } ] } ] }, { "name": "Hydralazine hcl injection", "billing_code_type": "CPT", "billing_code_type_version": "2026-05-26", "billing_code": "J0360", "description": "Hydralazine hcl injection", "allowed_amounts": [ { "tin": { "type": "ein", "value": "350983617" }, "billing_class": "institutional", "payments": [ { "allowed_amount": 13.17, "providers": [ { "billed_charge": 24.54, "npi": [ 1336119478 ] } ] } ] } ] }, { "name": "Incobotulinumtoxin a", "billing_code_type": "CPT", "billing_code_type_version": "2026-05-26", "billing_code": "J0588", "description": "Incobotulinumtoxin a", "allowed_amounts": [ { "tin": { "type": "ein", "value": "272039417" }, "billing_class": "professional", "payments": [ { "allowed_amount": 716.85, "providers": [ { "billed_charge": 1100, "npi": [ 1144513375 ] } ] } ], "service_code": [ "11" ] } ] }, { "name": "Ceftriaxone sodium injection", "billing_code_type": "CPT", "billing_code_type_version": "2026-05-26", "billing_code": "J0696", "description": "Ceftriaxone sodium injection", "allowed_amounts": [ { "tin": { "type": "ein", "value": "350983617" }, "billing_class": "institutional", "payments": [ { "allowed_amount": 2.76, "providers": [ { "billed_charge": 17.52, "npi": [ 1336119478 ] } ] }, { "allowed_amount": 1.3, "providers": [ { "billed_charge": 78, "npi": [ 1144513375 ] } ] } ] } ] }, { "name": "Prochlorperazine injection", "billing_code_type": "CPT", "billing_code_type_version": "2026-05-26", "billing_code": "J0780", "description": "Prochlorperazine injection", "allowed_amounts": [ { "tin": { "type": "ein", "value": "350869066" }, "billing_class": "institutional", "payments": [ { "allowed_amount": 74.14, "providers": [ { "billed_charge": 74.14, "npi": [ 1306898960 ] } ] } ] } ] }, { "name": "Denosumab injection", "billing_code_type": "CPT", "billing_code_type_version": "2026-05-26", "billing_code": "J0897", "description": "Denosumab injection", "allowed_amounts": [ { "tin": { "type": "ein", "value": "350983617" }, "billing_class": "institutional", "payments": [ { "allowed_amount": 2631.6, "providers": [ { "billed_charge": 6667.67, "npi": [ 1336119478 ] } ] } ] } ] }, { "name": "Medroxyprogesterone acetate", "billing_code_type": "CPT", "billing_code_type_version": "2026-05-26", "billing_code": "J1050", "description": "Medroxyprogesterone acetate", "allowed_amounts": [ { "tin": { "type": "ein", "value": "205392766" }, "billing_class": "professional", "payments": [ { "allowed_amount": 87.07, "providers": [ { "billed_charge": 150, "npi": [ 1619105244 ] } ] } ], "service_code": [ "11" ] } ] }, { "name": "Dexamethasone sodium phos", "billing_code_type": "CPT", "billing_code_type_version": "2026-05-26", "billing_code": "J1100", "description": "Dexamethasone sodium phos", "allowed_amounts": [ { "tin": { "type": "ein", "value": "351955872" }, "billing_class": "institutional", "payments": [ { "allowed_amount": 3.3, "providers": [ { "billed_charge": 28.3, "npi": [ 1144266024 ] } ] } ] } ] }, { "name": "Diphenhydramine hcl injectio", "billing_code_type": "CPT", "billing_code_type_version": "2026-05-26", "billing_code": "J1200", "description": "Diphenhydramine hcl injectio", "allowed_amounts": [ { "tin": { "type": "ein", "value": "362657618" }, "billing_class": "professional", "payments": [ { "allowed_amount": 1.22, "providers": [ { "billed_charge": 3, "npi": [ 1801833983 ] } ] } ], "service_code": [ "11" ] } ] }, { "name": "Ketorolac tromethamine inj", "billing_code_type": "CPT", "billing_code_type_version": "2026-05-26", "billing_code": "J1885", "description": "Ketorolac tromethamine inj", "allowed_amounts": [ { "tin": { "type": "ein", "value": "350983617" }, "billing_class": "institutional", "payments": [ { "allowed_amount": 0.5, "providers": [ { "billed_charge": 10.06, "npi": [ 1336119478 ] } ] }, { "allowed_amount": 0.99, "providers": [ { "billed_charge": 29.35, "npi": [ 1144266024 ] } ] } ] } ] }, { "name": "Inj midazolam hydrochloride", "billing_code_type": "CPT", "billing_code_type_version": "2026-05-26", "billing_code": "J2250", "description": "Inj midazolam hydrochloride", "allowed_amounts": [ { "tin": { "type": "ein", "value": "350869066" }, "billing_class": "institutional", "payments": [ { "allowed_amount": 70.33, "providers": [ { "billed_charge": 70.33, "npi": [ 1306898960 ] } ] }, { "allowed_amount": 0.42, "providers": [ { "billed_charge": 4.183333333333334, "npi": [ 1336119478 ] }, { "billed_charge": 14.6, "npi": [ 1144266024 ] } ] } ] } ] }, { "name": "Injection, ocrelizumab, 1 mg", "billing_code_type": "CPT", "billing_code_type_version": "2026-05-26", "billing_code": "J2350", "description": "Injection, ocrelizumab, 1 mg", "allowed_amounts": [ { "tin": { "type": "ein", "value": "351955872" }, "billing_class": "professional", "payments": [ { "allowed_amount": 24024, "providers": [ { "billed_charge": 114651.42, "npi": [ 1518032622 ] } ] } ], "service_code": [ "12" ] } ] }, { "name": "Ondansetron hcl injection", "billing_code_type": "CPT", "billing_code_type_version": "2026-05-26", "billing_code": "J2405", "description": "Ondansetron hcl injection", "allowed_amounts": [ { "tin": { "type": "ein", "value": "350869066" }, "billing_class": "institutional", "payments": [ { "allowed_amount": 192.9, "providers": [ { "billed_charge": 192.9, "npi": [ 1306898960 ] } ] }, { "allowed_amount": 0.81, "providers": [ { "billed_charge": 17.42, "npi": [ 1336119478 ] } ] }, { "allowed_amount": 0.54, "providers": [ { "billed_charge": 14.35, "npi": [ 1144266024 ] } ] } ] } ] }, { "name": "Promethazine hcl injection", "billing_code_type": "CPT", "billing_code_type_version": "2026-05-26", "billing_code": "J2550", "description": "Promethazine hcl injection", "allowed_amounts": [ { "tin": { "type": "ein", "value": "350983617" }, "billing_class": "institutional", "payments": [ { "allowed_amount": 5.75, "providers": [ { "billed_charge": 5.75, "npi": [ 1336119478 ] } ] } ] } ] }, { "name": "Inj, propofol, 10 mg", "billing_code_type": "CPT", "billing_code_type_version": "2026-05-26", "billing_code": "J2704", "description": "Inj, propofol, 10 mg", "allowed_amounts": [ { "tin": { "type": "ein", "value": "350869066" }, "billing_class": "institutional", "payments": [ { "allowed_amount": 66.27, "providers": [ { "billed_charge": 66.27, "npi": [ 1306898960 ] } ] }, { "allowed_amount": 2.7, "providers": [ { "billed_charge": 91.3, "npi": [ 1144266024 ] } ] } ] } ] }, { "name": "Fentanyl citrate injection", "billing_code_type": "CPT", "billing_code_type_version": "2026-05-26", "billing_code": "J3010", "description": "Fentanyl citrate injection", "allowed_amounts": [ { "tin": { "type": "ein", "value": "350983617" }, "billing_class": "institutional", "payments": [ { "allowed_amount": 5.36, "providers": [ { "billed_charge": 26.58, "npi": [ 1336119478 ] } ] }, { "allowed_amount": 1.79, "providers": [ { "billed_charge": 16.55, "npi": [ 1144266024 ] } ] } ] } ] }, { "name": "Diazepam injection", "billing_code_type": "CPT", "billing_code_type_version": "2026-05-26", "billing_code": "J3360", "description": "Diazepam injection", "allowed_amounts": [ { "tin": { "type": "ein", "value": "350983617" }, "billing_class": "institutional", "payments": [ { "allowed_amount": 10.04, "providers": [ { "billed_charge": 75.95, "npi": [ 1336119478 ] } ] } ] } ] }, { "name": "Normal saline solution infus", "billing_code_type": "CPT", "billing_code_type_version": "2026-05-26", "billing_code": "J7030", "description": "Normal saline solution infus", "allowed_amounts": [ { "tin": { "type": "ein", "value": "381360529" }, "billing_class": "institutional", "payments": [ { "allowed_amount": 0.01, "providers": [ { "billed_charge": 0.01, "npi": [ 1922090554 ] } ] } ] } ] }, { "name": "Ringers lactate infusion", "billing_code_type": "CPT", "billing_code_type_version": "2026-05-26", "billing_code": "J7120", "description": "Ringers lactate infusion", "allowed_amounts": [ { "tin": { "type": "ein", "value": "350869066" }, "billing_class": "institutional", "payments": [ { "allowed_amount": 262.2, "providers": [ { "billed_charge": 262.2, "npi": [ 1306898960 ] } ] } ] } ] }, { "name": "Injection, inflectra", "billing_code_type": "CPT", "billing_code_type_version": "2026-05-26", "billing_code": "Q5103", "description": "Injection, inflectra", "allowed_amounts": [ { "tin": { "type": "ein", "value": "362657618" }, "billing_class": "professional", "payments": [ { "allowed_amount": 1328.4, "providers": [ { "billed_charge": 14750, "npi": [ 1801833983 ] } ] } ], "service_code": [ "11" ] } ] } ] }