{ "reporting_entity_name": "AMPS", "reporting_entity_type": "third party", "last_updated_on": "2026-09-26", "version": "v2.1.0", "out_of_network": [ { "name": "SURG: OTHER MAJOR CARDIOVASCULAR PROCEDURES W MCC", "billing_code_type": "MS-DRG", "billing_code_type_version": "2026-09-26", "billing_code": "270", "description": "SURG: OTHER MAJOR CARDIOVASCULAR PROCEDURES W MCC", "allowed_amounts": [ { "tin": { "type": "ein", "value": "916068143" }, "billing_class": "institutional", "payments": [ { "allowed_amount": 80806.91, "providers": [ { "billed_charge": 297949.78, "npi": [ 1134178999 ] } ] } ] } ] }, { "name": "Leg surgery procedure", "billing_code_type": "CPT", "billing_code_type_version": "2026-09-26", "billing_code": "27599", "description": "Leg surgery procedure", "allowed_amounts": [ { "tin": { "type": "ein", "value": "352528741" }, "billing_class": "professional", "payments": [ { "allowed_amount": 1987.98, "providers": [ { "billed_charge": 3898, "npi": [ 1104202761 ] } ] } ], "service_code": [ "22" ] } ] }, { "name": "Knee arthroscopy/surgery", "billing_code_type": "CPT", "billing_code_type_version": "2026-09-26", "billing_code": "29882", "description": "Knee arthroscopy/surgery", "allowed_amounts": [ { "tin": { "type": "ein", "value": "352528741" }, "billing_class": "professional", "payments": [ { "allowed_amount": 461.77, "providers": [ { "billed_charge": 3146, "npi": [ 1104202761 ] } ] } ], "service_code": [ "22" ] } ] }, { "name": "Knee arthroscopy/surgery", "billing_code_type": "CPT", "billing_code_type_version": "2026-09-26", "billing_code": "29888", "description": "Knee arthroscopy/surgery", "allowed_amounts": [ { "tin": { "type": "ein", "value": "352528741" }, "billing_class": "professional", "payments": [ { "allowed_amount": 742.64, "providers": [ { "billed_charge": 4482, "npi": [ 1104202761 ] } ] } ], "service_code": [ "22" ] } ] }, { "name": "Egd biopsy single/multiple", "billing_code_type": "CPT", "billing_code_type_version": "2026-09-26", "billing_code": "43239", "description": "Egd biopsy single/multiple", "allowed_amounts": [ { "tin": { "type": "ein", "value": "316402480" }, "billing_class": "institutional", "payments": [ { "allowed_amount": 156.6, "providers": [ { "billed_charge": 5539, "npi": [ 1720159338 ] } ] }, { "allowed_amount": 546.06, "providers": [ { "billed_charge": 797, "npi": [ 1992941108 ] } ] } ] } ] }, { "name": "N block inj sciatic sng", "billing_code_type": "CPT", "billing_code_type_version": "2026-09-26", "billing_code": "64445", "description": "N block inj sciatic sng", "allowed_amounts": [ { "tin": { "type": "ein", "value": "352528741" }, "billing_class": "professional", "payments": [ { "allowed_amount": 215.8, "providers": [ { "billed_charge": 560, "npi": [ 1104202761 ] } ] } ], "service_code": [ "22" ] } ] }, { "name": "N block inj fem single", "billing_code_type": "CPT", "billing_code_type_version": "2026-09-26", "billing_code": "64447", "description": "N block inj fem single", "allowed_amounts": [ { "tin": { "type": "ein", "value": "352528741" }, "billing_class": "professional", "payments": [ { "allowed_amount": 84.06, "providers": [ { "billed_charge": 679, "npi": [ 1104202761 ] } ] } ], "service_code": [ "22" ] } ] }, { "name": "Inj foramen epidural l/s", "billing_code_type": "CPT", "billing_code_type_version": "2026-09-26", "billing_code": "64483", "description": "Inj foramen epidural l/s", "allowed_amounts": [ { "tin": { "type": "ein", "value": "275078717" }, "billing_class": "professional", "payments": [ { "allowed_amount": 419.85, "providers": [ { "billed_charge": 3273, "npi": [ 1659883486 ] } ] } ], "service_code": [ "11" ] } ] }, { "name": "Inj paravert f jnt l/s 1 lev", "billing_code_type": "CPT", "billing_code_type_version": "2026-09-26", "billing_code": "64493", "description": "Inj paravert f jnt l/s 1 lev", "allowed_amounts": [ { "tin": { "type": "ein", "value": "275078717" }, "billing_class": "professional", "payments": [ { "allowed_amount": 452.2, "providers": [ { "billed_charge": 3198, "npi": [ 1659883486 ] } ] } ], "service_code": [ "11" ] } ] }, { "name": "Ct head/brain w/o dye", "billing_code_type": "CPT", "billing_code_type_version": "2026-09-26", "billing_code": "70450", "description": "Ct head/brain w/o dye", "allowed_amounts": [ { "tin": { "type": "ein", "value": "590878982" }, "billing_class": "institutional", "payments": [ { "allowed_amount": 135.43, "providers": [ { "billed_charge": 2185, "npi": [ 1245226190 ] } ] } ] } ] }, { "name": "Ct angiography neck", "billing_code_type": "CPT", "billing_code_type_version": "2026-09-26", "billing_code": "70498", "description": "Ct angiography neck", "allowed_amounts": [ { "tin": { "type": "ein", "value": "590878982" }, "billing_class": "institutional", "payments": [ { "allowed_amount": 346.5, "providers": [ { "billed_charge": 2185, "npi": [ 1245226190 ] } ] } ] } ] }, { "name": "Mri brain stem w/o dye", "billing_code_type": "CPT", "billing_code_type_version": "2026-09-26", "billing_code": "70551", "description": "Mri brain stem w/o dye", "allowed_amounts": [ { "tin": { "type": "ein", "value": "316402480" }, "billing_class": "institutional", "payments": [ { "allowed_amount": 237.77, "providers": [ { "billed_charge": 2000, "npi": [ 1720159338 ] } ] }, { "allowed_amount": 247.96, "providers": [ { "billed_charge": 2921, "npi": [ 1245226190 ] } ] }, { "allowed_amount": 89.45, "providers": [ { "billed_charge": 198, "npi": [ 1144249657 ] } ], "billing_code_modifier": [ "26" ] } ] } ] }, { "name": "X-ray exam chest 1 view", "billing_code_type": "CPT", "billing_code_type_version": "2026-09-26", "billing_code": "71045", "description": "X-ray exam chest 1 view", "allowed_amounts": [ { "tin": { "type": "ein", "value": "590878982" }, "billing_class": "institutional", "payments": [ { "allowed_amount": 32.37, "providers": [ { "billed_charge": 297, "npi": [ 1245226190 ] } ] }, { "allowed_amount": 10.88, "providers": [ { "billed_charge": 31, "npi": [ 1245277631 ] } ], "billing_code_modifier": [ "26" ] } ] } ] }, { "name": "X-ray exam chest 2 views", "billing_code_type": "CPT", "billing_code_type_version": "2026-09-26", "billing_code": "71046", "description": "X-ray exam chest 2 views", "allowed_amounts": [ { "tin": { "type": "ein", "value": "431560263" }, "billing_class": "professional", "payments": [ { "allowed_amount": 13.01, "providers": [ { "billed_charge": 37, "npi": [ 1245277631 ] } ], "billing_code_modifier": [ "26" ] }, { "allowed_amount": 26.87, "providers": [ { "billed_charge": 60, "npi": [ 1245277631 ] } ], "billing_code_modifier": [ "TC" ] } ], "service_code": [ "11" ] } ] }, { "name": "Ct thorax w/dye", "billing_code_type": "CPT", "billing_code_type_version": "2026-09-26", "billing_code": "71260", "description": "Ct thorax w/dye", "allowed_amounts": [ { "tin": { "type": "ein", "value": "311340739" }, "billing_class": "institutional", "payments": [ { "allowed_amount": 202.46, "providers": [ { "billed_charge": 2138, "npi": [ 1447359997 ] } ] } ] } ] }, { "name": "X-ray exam l-s spine 2/3 vws", "billing_code_type": "CPT", "billing_code_type_version": "2026-09-26", "billing_code": "72100", "description": "X-ray exam l-s spine 2/3 vws", "allowed_amounts": [ { "tin": { "type": "ein", "value": "204881619" }, "billing_class": "professional", "payments": [ { "allowed_amount": 14.04, "providers": [ { "billed_charge": 42, "npi": [ 1669499414 ] } ], "billing_code_modifier": [ "26" ] } ], "service_code": [ "19" ] } ] }, { "name": "X-ray exam hips bi 2 views", "billing_code_type": "CPT", "billing_code_type_version": "2026-09-26", "billing_code": "73521", "description": "X-ray exam hips bi 2 views", "allowed_amounts": [ { "tin": { "type": "ein", "value": "204881619" }, "billing_class": "professional", "payments": [ { "allowed_amount": 14.04, "providers": [ { "billed_charge": 29, "npi": [ 1669499414 ] } ], "billing_code_modifier": [ "26" ] } ], "service_code": [ "19" ] } ] }, { "name": "X-ray exam of ankle", "billing_code_type": "CPT", "billing_code_type_version": "2026-09-26", "billing_code": "73600", "description": "X-ray exam of ankle", "allowed_amounts": [ { "tin": { "type": "ein", "value": "620811256" }, "billing_class": "professional", "payments": [ { "allowed_amount": 29.75, "providers": [ { "billed_charge": 108, "npi": [ 1003835141 ] } ] } ], "service_code": [ "11" ] } ] }, { "name": "X-ray exam of foot", "billing_code_type": "CPT", "billing_code_type_version": "2026-09-26", "billing_code": "73630", "description": "X-ray exam of foot", "allowed_amounts": [ { "tin": { "type": "ein", "value": "620811256" }, "billing_class": "professional", "payments": [ { "allowed_amount": 31.81, "providers": [ { "billed_charge": 128, "npi": [ 1003835141 ] } ] } ], "service_code": [ "11" ] } ] }, { "name": "Ct lower extremity w/o dye", "billing_code_type": "CPT", "billing_code_type_version": "2026-09-26", "billing_code": "73700", "description": "Ct lower extremity w/o dye", "allowed_amounts": [ { "tin": { "type": "ein", "value": "620809858" }, "billing_class": "professional", "payments": [ { "allowed_amount": 59.99, "providers": [ { "billed_charge": 220, "npi": [ 1043260763 ] } ], "billing_code_modifier": [ "26" ] }, { "allowed_amount": 102.71, "providers": [ { "billed_charge": 610, "npi": [ 1003835141 ] } ], "billing_code_modifier": [ "TC" ] } ], "service_code": [ "11" ] } ] }, { "name": "X-ray exam abdomen 2 views", "billing_code_type": "CPT", "billing_code_type_version": "2026-09-26", "billing_code": "74019", "description": "X-ray exam abdomen 2 views", "allowed_amounts": [ { "tin": { "type": "ein", "value": "352528741" }, "billing_class": "professional", "payments": [ { "allowed_amount": 14.62, "providers": [ { "billed_charge": 38, "npi": [ 1104202761 ] } ], "billing_code_modifier": [ "26" ] } ], "service_code": [ "22" ] } ] }, { "name": "Ct abd & pelv w/contrast", "billing_code_type": "CPT", "billing_code_type_version": "2026-09-26", "billing_code": "74177", "description": "Ct abd & pelv w/contrast", "allowed_amounts": [ { "tin": { "type": "ein", "value": "311340739" }, "billing_class": "institutional", "payments": [ { "allowed_amount": 363.62, "providers": [ { "billed_charge": 2681, "npi": [ 1447359997 ] } ] } ] } ] }, { "name": "Ct angio hrt w/3d image", "billing_code_type": "CPT", "billing_code_type_version": "2026-09-26", "billing_code": "75574", "description": "Ct angio hrt w/3d image", "allowed_amounts": [ { "tin": { "type": "ein", "value": "453023019" }, "billing_class": "professional", "payments": [ { "allowed_amount": 167.89, "providers": [ { "billed_charge": 593.37, "npi": [ 1053688572 ] } ], "billing_code_modifier": [ "26" ] } ], "service_code": [ "22" ] } ] }, { "name": "Ophth us b & quant a", "billing_code_type": "CPT", "billing_code_type_version": "2026-09-26", "billing_code": "76510", "description": "Ophth us b & quant a", "allowed_amounts": [ { "tin": { "type": "ein", "value": "431560263" }, "billing_class": "professional", "payments": [ { "allowed_amount": 84.4, "providers": [ { "billed_charge": 422, "npi": [ 1245277631 ] } ] } ], "service_code": [ "11" ] } ] }, { "name": "Ob us < 14 wks single fetus", "billing_code_type": "CPT", "billing_code_type_version": "2026-09-26", "billing_code": "76801", "description": "Ob us < 14 wks single fetus", "allowed_amounts": [ { "tin": { "type": "ein", "value": "621226101" }, "billing_class": "professional", "payments": [ { "allowed_amount": 146.43, "providers": [ { "billed_charge": 215, "npi": [ 1306884911 ] } ] }, { "allowed_amount": 60.12, "providers": [ { "billed_charge": 219, "npi": [ 1043260763 ] } ], "billing_code_modifier": [ "26" ] } ], "service_code": [ "11" ] } ] }, { "name": "Breast tomosynthesis bi", "billing_code_type": "CPT", "billing_code_type_version": "2026-09-26", "billing_code": "77063", "description": "Breast tomosynthesis bi", "allowed_amounts": [ { "tin": { "type": "ein", "value": "135562308" }, "billing_class": "professional", "payments": [ { "allowed_amount": 37.69, "providers": [ { "billed_charge": 408, "npi": [ 1285826438 ] } ] } ], "service_code": [ "11" ] } ] }, { "name": "Scr mammo bi incl cad", "billing_code_type": "CPT", "billing_code_type_version": "2026-09-26", "billing_code": "77067", "description": "Scr mammo bi incl cad", "allowed_amounts": [ { "tin": { "type": "ein", "value": "135562308" }, "billing_class": "professional", "payments": [ { "allowed_amount": 146.84, "providers": [ { "billed_charge": 1032, "npi": [ 1285826438 ] } ] } ], "service_code": [ "11" ] } ] }, { "name": "X-rays for bone age", "billing_code_type": "CPT", "billing_code_type_version": "2026-09-26", "billing_code": "77072", "description": "X-rays for bone age", "allowed_amounts": [ { "tin": { "type": "ein", "value": "352528741" }, "billing_class": "professional", "payments": [ { "allowed_amount": 11.68, "providers": [ { "billed_charge": 36, "npi": [ 1104202761 ] } ], "billing_code_modifier": [ "26" ] } ], "service_code": [ "19" ] } ] }, { "name": "X-rays bone length studies", "billing_code_type": "CPT", "billing_code_type_version": "2026-09-26", "billing_code": "77073", "description": "X-rays bone length studies", "allowed_amounts": [ { "tin": { "type": "ein", "value": "352528741" }, "billing_class": "professional", "payments": [ { "allowed_amount": 17.89, "providers": [ { "billed_charge": 49, "npi": [ 1104202761 ] } ], "billing_code_modifier": [ "26" ] } ], "service_code": [ "19" ] } ] }, { "name": "Gastric emptying imag study", "billing_code_type": "CPT", "billing_code_type_version": "2026-09-26", "billing_code": "78264", "description": "Gastric emptying imag study", "allowed_amounts": [ { "tin": { "type": "ein", "value": "316402480" }, "billing_class": "institutional", "payments": [ { "allowed_amount": 347.39, "providers": [ { "billed_charge": 2373, "npi": [ 1720159338 ] } ] } ] } ] }, { "name": "Bone imaging whole body", "billing_code_type": "CPT", "billing_code_type_version": "2026-09-26", "billing_code": "78306", "description": "Bone imaging whole body", "allowed_amounts": [ { "tin": { "type": "ein", "value": "311340739" }, "billing_class": "institutional", "payments": [ { "allowed_amount": 311.14, "providers": [ { "billed_charge": 2478, "npi": [ 1447359997 ] } ] } ] } ] }, { "name": "Nuclear rx iv admin", "billing_code_type": "CPT", "billing_code_type_version": "2026-09-26", "billing_code": "79101", "description": "Nuclear rx iv admin", "allowed_amounts": [ { "tin": { "type": "ein", "value": "311322863" }, "billing_class": "institutional", "payments": [ { "allowed_amount": 177.26, "providers": [ { "billed_charge": 2151, "npi": [ 1124127683 ] }, { "billed_charge": 2151, "npi": [ 1447359997 ] } ] } ] } ] }, { "name": "Metabolic panel total ca", "billing_code_type": "CPT", "billing_code_type_version": "2026-09-26", "billing_code": "80048", "description": "Metabolic panel total ca", "allowed_amounts": [ { "tin": { "type": "ein", "value": "133757370" }, "billing_class": "professional", "payments": [ { "allowed_amount": 8.46, "providers": [ { "billed_charge": 36.99, "npi": [ 1285014282 ] }, { "billed_charge": 84.66, "npi": [ 1841236684 ] }, { "billed_charge": 84.66, "npi": [ 1932166386 ] }, { "billed_charge": 84.66, "npi": [ 1609812445 ] } ] } ], "service_code": [ "81" ] } ] }, { "name": "General health panel", "billing_code_type": "CPT", "billing_code_type_version": "2026-09-26", "billing_code": "80050", "description": "General health panel", "allowed_amounts": [ { "tin": { "type": "ein", "value": "113412370" }, "billing_class": "professional", "payments": [ { "allowed_amount": 35, "providers": [ { "billed_charge": 220, "npi": [ 1366543795 ] }, { "billed_charge": 317.18, "npi": [ 1841236684 ] }, { "billed_charge": 309.72, "npi": [ 1932166386 ] }, { "billed_charge": 226.86, "npi": [ 1740262880 ] } ] } ], "service_code": [ "81" ] } ] }, { "name": "Electrolyte panel", "billing_code_type": "CPT", "billing_code_type_version": "2026-09-26", "billing_code": "80051", "description": "Electrolyte panel", "allowed_amounts": [ { "tin": { "type": "ein", "value": "311322863" }, "billing_class": "institutional", "payments": [ { "allowed_amount": 9.11, "providers": [ { "billed_charge": 149, "npi": [ 1124127683 ] }, { "billed_charge": 80, "npi": [ 1720159338 ] } ] } ] } ] }, { "name": "Comprehen metabolic panel", "billing_code_type": "CPT", "billing_code_type_version": "2026-09-26", "billing_code": "80053", "description": "Comprehen metabolic panel", "allowed_amounts": [ { "tin": { "type": "ein", "value": "316402480" }, "billing_class": "institutional", "payments": [ { "allowed_amount": 22.705, "providers": [ { "billed_charge": 130, "npi": [ 1720159338 ] } ] }, { "allowed_amount": 13.73, "providers": [ { "billed_charge": 174, "npi": [ 1245226190 ] } ] }, { "allowed_amount": 10.56, "providers": [ { "billed_charge": 32, "npi": [ 1093016651 ] }, { "billed_charge": 48.3, "npi": [ 1063497451 ] }, { "billed_charge": 48.3, "npi": [ 1932184322 ] }, { "billed_charge": 77, "npi": [ 1710064811 ] } ] }, { "allowed_amount": 7.92, "providers": [ { "billed_charge": 79.3425, "npi": [ 1841236684 ] } ] }, { "allowed_amount": 10.56, "providers": [ { "billed_charge": 105.79, "npi": [ 1619040284 ] }, { "billed_charge": 105.79, "npi": [ 1932166386 ] }, { "billed_charge": 105.79, "npi": [ 1609812445 ] }, { "billed_charge": 105.79, "npi": [ 1609812445 ] }, { "billed_charge": 43.05, "npi": [ 1881679751 ] } ] } ] } ] }, { "name": "Lipid panel", "billing_code_type": "CPT", "billing_code_type_version": "2026-09-26", "billing_code": "80061", "description": "Lipid panel", "allowed_amounts": [ { "tin": { "type": "ein", "value": "590878982" }, "billing_class": "institutional", "payments": [ { "allowed_amount": 17.41, "providers": [ { "billed_charge": 116, "npi": [ 1245226190 ] } ] }, { "allowed_amount": 13.39, "providers": [ { "billed_charge": 198, "npi": [ 1366543795 ] }, { "billed_charge": 101.85, "npi": [ 1063497451 ] }, { "billed_charge": 76.42, "npi": [ 1285014282 ] }, { "billed_charge": 100.275, "npi": [ 1932184322 ] }, { "billed_charge": 96, "npi": [ 1710064811 ] }, { "billed_charge": 177.9, "npi": [ 1841236684 ] }, { "billed_charge": 177.9, "npi": [ 1619040284 ] }, { "billed_charge": 177.9, "npi": [ 1609812445 ] }, { "billed_charge": 177.9, "npi": [ 1609812445 ] }, { "billed_charge": 115.87, "npi": [ 1740262880 ] }, { "billed_charge": 102.9, "npi": [ 1881679751 ] } ] } ] } ] }, { "name": "Renal function panel", "billing_code_type": "CPT", "billing_code_type_version": "2026-09-26", "billing_code": "80069", "description": "Renal function panel", "allowed_amounts": [ { "tin": { "type": "ein", "value": "223137283" }, "billing_class": "professional", "payments": [ { "allowed_amount": 8.68, "providers": [ { "billed_charge": 91.71, "npi": [ 1841236684 ] } ] } ], "service_code": [ "81" ] } ] }, { "name": "Acute hepatitis panel", "billing_code_type": "CPT", "billing_code_type_version": "2026-09-26", "billing_code": "80074", "description": "Acute hepatitis panel", "allowed_amounts": [ { "tin": { "type": "ein", "value": "113412370" }, "billing_class": "professional", "payments": [ { "allowed_amount": 47.63, "providers": [ { "billed_charge": 246.42, "npi": [ 1366543795 ] } ] } ], "service_code": [ "81" ] } ] }, { "name": "Hepatic function panel", "billing_code_type": "CPT", "billing_code_type_version": "2026-09-26", "billing_code": "80076", "description": "Hepatic function panel", "allowed_amounts": [ { "tin": { "type": "ein", "value": "840611484" }, "billing_class": "professional", "payments": [ { "allowed_amount": 8.17, "providers": [ { "billed_charge": 43.05, "npi": [ 1881679751 ] } ] } ], "service_code": [ "81" ] } ] }, { "name": "Drug test prsmv chem anlyzr", "billing_code_type": "CPT", "billing_code_type_version": "2026-09-26", "billing_code": "80307", "description": "Drug test prsmv chem anlyzr", "allowed_amounts": [ { "tin": { "type": "ein", "value": "590878982" }, "billing_class": "institutional", "payments": [ { "allowed_amount": 80.78, "providers": [ { "billed_charge": 2061, "npi": [ 1245226190 ] } ] }, { "allowed_amount": 62.14, "providers": [ { "billed_charge": 481, "npi": [ 1841619731 ] } ] } ] } ] }, { "name": "Urinalysis auto w/scope", "billing_code_type": "CPT", "billing_code_type_version": "2026-09-26", "billing_code": "81001", "description": "Urinalysis auto w/scope", "allowed_amounts": [ { "tin": { "type": "ein", "value": "316402480" }, "billing_class": "institutional", "payments": [ { "allowed_amount": 13.876666666666667, "providers": [ { "billed_charge": 28, "npi": [ 1720159338 ] } ] }, { "allowed_amount": 3.17, "providers": [ { "billed_charge": 26, "npi": [ 1366543795 ] }, { "billed_charge": 37.8, "npi": [ 1063497451 ] }, { "billed_charge": 57.16, "npi": [ 1932166386 ] }, { "billed_charge": 39.9, "npi": [ 1740262880 ] } ] } ] } ] }, { "name": "Urinalysis auto w/o scope", "billing_code_type": "CPT", "billing_code_type_version": "2026-09-26", "billing_code": "81003", "description": "Urinalysis auto w/o scope", "allowed_amounts": [ { "tin": { "type": "ein", "value": "204483367" }, "billing_class": "professional", "payments": [ { "allowed_amount": 2.25, "providers": [ { "billed_charge": 8.31, "npi": [ 1346203536 ] }, { "billed_charge": 12.87, "npi": [ 1285014282 ] } ] } ], "service_code": [ "11" ] } ] }, { "name": "Urine pregnancy test", "billing_code_type": "CPT", "billing_code_type_version": "2026-09-26", "billing_code": "81025", "description": "Urine pregnancy test", "allowed_amounts": [ { "tin": { "type": "ein", "value": "840611484" }, "billing_class": "professional", "payments": [ { "allowed_amount": 8.61, "providers": [ { "billed_charge": 67.2, "npi": [ 1881679751 ] } ] } ], "service_code": [ "81" ] } ] }, { "name": "Cftr gene com variants", "billing_code_type": "CPT", "billing_code_type_version": "2026-09-26", "billing_code": "81220", "description": "Cftr gene com variants", "allowed_amounts": [ { "tin": { "type": "ein", "value": "133757370" }, "billing_class": "professional", "payments": [ { "allowed_amount": 556.6, "providers": [ { "billed_charge": 2017.62, "npi": [ 1750368700 ] } ] } ], "service_code": [ "81" ] } ] }, { "name": "Fmr1 gene detection", "billing_code_type": "CPT", "billing_code_type_version": "2026-09-26", "billing_code": "81243", "description": "Fmr1 gene detection", "allowed_amounts": [ { "tin": { "type": "ein", "value": "133757370" }, "billing_class": "professional", "payments": [ { "allowed_amount": 57.04, "providers": [ { "billed_charge": 206.77, "npi": [ 1750368700 ] } ] } ], "service_code": [ "81" ] } ] }, { "name": "Smn1 gene dos/deletion alys", "billing_code_type": "CPT", "billing_code_type_version": "2026-09-26", "billing_code": "81329", "description": "Smn1 gene dos/deletion alys", "allowed_amounts": [ { "tin": { "type": "ein", "value": "133757370" }, "billing_class": "professional", "payments": [ { "allowed_amount": 137, "providers": [ { "billed_charge": 496.61, "npi": [ 1750368700 ] } ] } ], "service_code": [ "81" ] } ] }, { "name": "Oncology colorectal scr", "billing_code_type": "CPT", "billing_code_type_version": "2026-09-26", "billing_code": "81528", "description": "Oncology colorectal scr", "allowed_amounts": [ { "tin": { "type": "ein", "value": "463095174" }, "billing_class": "professional", "payments": [ { "allowed_amount": 508.87, "providers": [ { "billed_charge": 681, "npi": [ 1629407069 ] } ] } ], "service_code": [ "81" ] } ] }, { "name": "Assay of serum albumin", "billing_code_type": "CPT", "billing_code_type_version": "2026-09-26", "billing_code": "82040", "description": "Assay of serum albumin", "allowed_amounts": [ { "tin": { "type": "ein", "value": "311322863" }, "billing_class": "institutional", "payments": [ { "allowed_amount": 6.44, "providers": [ { "billed_charge": 52, "npi": [ 1124127683 ] } ] }, { "allowed_amount": 4.66, "providers": [ { "billed_charge": 4.66, "npi": [ 1285014282 ] } ] } ] } ] }, { "name": "Ur albumin quantitative", "billing_code_type": "CPT", "billing_code_type_version": "2026-09-26", "billing_code": "82043", "description": "Ur albumin quantitative", "allowed_amounts": [ { "tin": { "type": "ein", "value": "316402480" }, "billing_class": "institutional", "payments": [ { "allowed_amount": 7.51, "providers": [ { "billed_charge": 77, "npi": [ 1720159338 ] } ] }, { "allowed_amount": 5.78, "providers": [ { "billed_charge": 28.91, "npi": [ 1285014282 ] }, { "billed_charge": 87.82, "npi": [ 1619040284 ] }, { "billed_charge": 87.82, "npi": [ 1609812445 ] } ] } ] } ] }, { "name": "Assay of apolipoprotein", "billing_code_type": "CPT", "billing_code_type_version": "2026-09-26", "billing_code": "82172", "description": "Assay of apolipoprotein", "allowed_amounts": [ { "tin": { "type": "ein", "value": "133757370" }, "billing_class": "professional", "payments": [ { "allowed_amount": 42.18, "providers": [ { "billed_charge": 97.65, "npi": [ 1063497451 ] } ] }, { "allowed_amount": 21.09, "providers": [ { "billed_charge": 29.72, "npi": [ 1740262880 ] } ] } ], "service_code": [ "81" ] } ] }, { "name": "Bilirubin total", "billing_code_type": "CPT", "billing_code_type_version": "2026-09-26", "billing_code": "82247", "description": "Bilirubin total", "allowed_amounts": [ { "tin": { "type": "ein", "value": "311322863" }, "billing_class": "institutional", "payments": [ { "allowed_amount": 6.53, "providers": [ { "billed_charge": 35, "npi": [ 1124127683 ] } ] }, { "allowed_amount": 4.66, "providers": [ { "billed_charge": 4.66, "npi": [ 1285014282 ] } ] } ] } ] }, { "name": "Vitamin d 25 hydroxy", "billing_code_type": "CPT", "billing_code_type_version": "2026-09-26", "billing_code": "82306", "description": "Vitamin d 25 hydroxy", "allowed_amounts": [ { "tin": { "type": "ein", "value": "113412370" }, "billing_class": "professional", "payments": [ { "allowed_amount": 29.6, "providers": [ { "billed_charge": 182.1, "npi": [ 1366543795 ] }, { "billed_charge": 275.165, "npi": [ 1063497451 ] }, { "billed_charge": 224, "npi": [ 1710064811 ] }, { "billed_charge": 290.49, "npi": [ 1841236684 ] }, { "billed_charge": 315.37, "npi": [ 1740262880 ] }, { "billed_charge": 243.6, "npi": [ 1881679751 ] } ] } ], "service_code": [ "81" ] } ] }, { "name": "Assay of calcium", "billing_code_type": "CPT", "billing_code_type_version": "2026-09-26", "billing_code": "82310", "description": "Assay of calcium", "allowed_amounts": [ { "tin": { "type": "ein", "value": "311322863" }, "billing_class": "institutional", "payments": [ { "allowed_amount": 6.71, "providers": [ { "billed_charge": 50, "npi": [ 1124127683 ] }, { "billed_charge": 55, "npi": [ 1720159338 ] } ] } ] } ] }, { "name": "Assay of calcium", "billing_code_type": "CPT", "billing_code_type_version": "2026-09-26", "billing_code": "82330", "description": "Assay of calcium", "allowed_amounts": [ { "tin": { "type": "ein", "value": "205657908" }, "billing_class": "professional", "payments": [ { "allowed_amount": 13.68, "providers": [ { "billed_charge": 95, "npi": [ 1710064811 ] } ] } ], "service_code": [ "81" ] } ] }, { "name": "Assay of ceruloplasmin", "billing_code_type": "CPT", "billing_code_type_version": "2026-09-26", "billing_code": "82390", "description": "Assay of ceruloplasmin", "allowed_amounts": [ { "tin": { "type": "ein", "value": "223137283" }, "billing_class": "professional", "payments": [ { "allowed_amount": 10.74, "providers": [ { "billed_charge": 94.57, "npi": [ 1841236684 ] } ] } ], "service_code": [ "81" ] } ] }, { "name": "Assay of ck (cpk)", "billing_code_type": "CPT", "billing_code_type_version": "2026-09-26", "billing_code": "82550", "description": "Assay of ck (cpk)", "allowed_amounts": [ { "tin": { "type": "ein", "value": "316402480" }, "billing_class": "institutional", "payments": [ { "allowed_amount": 8.46, "providers": [ { "billed_charge": 63, "npi": [ 1720159338 ] } ] }, { "allowed_amount": 6.51, "providers": [ { "billed_charge": 68.91, "npi": [ 1932166386 ] } ] } ] } ] }, { "name": "Assay of creatinine", "billing_code_type": "CPT", "billing_code_type_version": "2026-09-26", "billing_code": "82565", "description": "Assay of creatinine", "allowed_amounts": [ { "tin": { "type": "ein", "value": "311322863" }, "billing_class": "institutional", "payments": [ { "allowed_amount": 6.66, "providers": [ { "billed_charge": 60, "npi": [ 1124127683 ] }, { "billed_charge": 18, "npi": [ 1720159338 ] } ] } ] } ] }, { "name": "Assay of urine creatinine", "billing_code_type": "CPT", "billing_code_type_version": "2026-09-26", "billing_code": "82570", "description": "Assay of urine creatinine", "allowed_amounts": [ { "tin": { "type": "ein", "value": "133757370" }, "billing_class": "professional", "payments": [ { "allowed_amount": 5.18, "providers": [ { "billed_charge": 26.12, "npi": [ 1285014282 ] }, { "billed_charge": 75.19, "npi": [ 1841236684 ] }, { "billed_charge": 68.91, "npi": [ 1619040284 ] }, { "billed_charge": 68.91, "npi": [ 1609812445 ] } ] } ], "service_code": [ "81" ] } ] }, { "name": "Vitamin b-12", "billing_code_type": "CPT", "billing_code_type_version": "2026-09-26", "billing_code": "82607", "description": "Vitamin b-12", "allowed_amounts": [ { "tin": { "type": "ein", "value": "316402480" }, "billing_class": "institutional", "payments": [ { "allowed_amount": 45.24, "providers": [ { "billed_charge": 64, "npi": [ 1720159338 ] } ] }, { "allowed_amount": 15.08, "providers": [ { "billed_charge": 109.86, "npi": [ 1063497451 ] }, { "billed_charge": 144.58, "npi": [ 1932166386 ] }, { "billed_charge": 118.84, "npi": [ 1740262880 ] } ] } ] } ] }, { "name": "Dehydroepiandrosterone", "billing_code_type": "CPT", "billing_code_type_version": "2026-09-26", "billing_code": "82627", "description": "Dehydroepiandrosterone", "allowed_amounts": [ { "tin": { "type": "ein", "value": "133757370" }, "billing_class": "professional", "payments": [ { "allowed_amount": 22.23, "providers": [ { "billed_charge": 175.35, "npi": [ 1063497451 ] } ] } ], "service_code": [ "81" ] } ] }, { "name": "Dihydrotestosterone", "billing_code_type": "CPT", "billing_code_type_version": "2026-09-26", "billing_code": "82642", "description": "Dihydrotestosterone", "allowed_amounts": [ { "tin": { "type": "ein", "value": "133757370" }, "billing_class": "professional", "payments": [ { "allowed_amount": 29.28, "providers": [ { "billed_charge": 189, "npi": [ 1063497451 ] } ] } ], "service_code": [ "81" ] } ] }, { "name": "Assay of estradiol", "billing_code_type": "CPT", "billing_code_type_version": "2026-09-26", "billing_code": "82670", "description": "Assay of estradiol", "allowed_amounts": [ { "tin": { "type": "ein", "value": "133757370" }, "billing_class": "professional", "payments": [ { "allowed_amount": 27.94, "providers": [ { "billed_charge": 182.7, "npi": [ 1063497451 ] }, { "billed_charge": 192.15, "npi": [ 1265418669 ] }, { "billed_charge": 200.92, "npi": [ 1740262880 ] } ] } ], "service_code": [ "81" ] } ] }, { "name": "Assay of blood fatty acids", "billing_code_type": "CPT", "billing_code_type_version": "2026-09-26", "billing_code": "82725", "description": "Assay of blood fatty acids", "allowed_amounts": [ { "tin": { "type": "ein", "value": "133757370" }, "billing_class": "professional", "payments": [ { "allowed_amount": 18.77, "providers": [ { "billed_charge": 75.6, "npi": [ 1063497451 ] } ] } ], "service_code": [ "81" ] } ] }, { "name": "Assay of ferritin", "billing_code_type": "CPT", "billing_code_type_version": "2026-09-26", "billing_code": "82728", "description": "Assay of ferritin", "allowed_amounts": [ { "tin": { "type": "ein", "value": "316402480" }, "billing_class": "institutional", "payments": [ { "allowed_amount": 40.89, "providers": [ { "billed_charge": 67, "npi": [ 1720159338 ] } ] }, { "allowed_amount": 13.63, "providers": [ { "billed_charge": 82.95, "npi": [ 1063497451 ] }, { "billed_charge": 135.12, "npi": [ 1841236684 ] }, { "billed_charge": 135.12, "npi": [ 1932166386 ] }, { "billed_charge": 98.02, "npi": [ 1740262880 ] } ] } ] } ] }, { "name": "Assay of fetal fibronectin", "billing_code_type": "CPT", "billing_code_type_version": "2026-09-26", "billing_code": "82731", "description": "Assay of fetal fibronectin", "allowed_amounts": [ { "tin": { "type": "ein", "value": "840611484" }, "billing_class": "professional", "payments": [ { "allowed_amount": 64.41, "providers": [ { "billed_charge": 846.3, "npi": [ 1265418669 ] } ] } ], "service_code": [ "81" ] } ] }, { "name": "Assay of folic acid serum", "billing_code_type": "CPT", "billing_code_type_version": "2026-09-26", "billing_code": "82746", "description": "Assay of folic acid serum", "allowed_amounts": [ { "tin": { "type": "ein", "value": "316402480" }, "billing_class": "institutional", "payments": [ { "allowed_amount": 44.1, "providers": [ { "billed_charge": 60, "npi": [ 1720159338 ] } ] }, { "allowed_amount": 14.7, "providers": [ { "billed_charge": 101.25666666666666, "npi": [ 1063497451 ] }, { "billed_charge": 141.88, "npi": [ 1932166386 ] }, { "billed_charge": 116.05, "npi": [ 1740262880 ] } ] } ] } ] }, { "name": "Assay of ige", "billing_code_type": "CPT", "billing_code_type_version": "2026-09-26", "billing_code": "82785", "description": "Assay of ige", "allowed_amounts": [ { "tin": { "type": "ein", "value": "133757370" }, "billing_class": "professional", "payments": [ { "allowed_amount": 16.46, "providers": [ { "billed_charge": 87.38, "npi": [ 1538144910 ] } ] } ], "service_code": [ "81" ] } ] }, { "name": "Assay glucose blood quant", "billing_code_type": "CPT", "billing_code_type_version": "2026-09-26", "billing_code": "82947", "description": "Assay glucose blood quant", "allowed_amounts": [ { "tin": { "type": "ein", "value": "316402480" }, "billing_class": "institutional", "payments": [ { "allowed_amount": 5.11, "providers": [ { "billed_charge": 20, "npi": [ 1720159338 ] } ] } ] } ] }, { "name": "Glucose test", "billing_code_type": "CPT", "billing_code_type_version": "2026-09-26", "billing_code": "82950", "description": "Glucose test", "allowed_amounts": [ { "tin": { "type": "ein", "value": "840611484" }, "billing_class": "professional", "payments": [ { "allowed_amount": 4.75, "providers": [ { "billed_charge": 38.85, "npi": [ 1265418669 ] } ] } ], "service_code": [ "81" ] } ] }, { "name": "Assay of ggt", "billing_code_type": "CPT", "billing_code_type_version": "2026-09-26", "billing_code": "82977", "description": "Assay of ggt", "allowed_amounts": [ { "tin": { "type": "ein", "value": "133757370" }, "billing_class": "professional", "payments": [ { "allowed_amount": 7.2, "providers": [ { "billed_charge": 38.85, "npi": [ 1063497451 ] } ] } ], "service_code": [ "81" ] } ] }, { "name": "Assay of gonadotropin (fsh)", "billing_code_type": "CPT", "billing_code_type_version": "2026-09-26", "billing_code": "83001", "description": "Assay of gonadotropin (fsh)", "allowed_amounts": [ { "tin": { "type": "ein", "value": "133757370" }, "billing_class": "professional", "payments": [ { "allowed_amount": 18.58, "providers": [ { "billed_charge": 112.35, "npi": [ 1063497451 ] }, { "billed_charge": 134.4, "npi": [ 1265418669 ] } ] } ], "service_code": [ "81" ] } ] }, { "name": "Hemoglobin electrophoresis", "billing_code_type": "CPT", "billing_code_type_version": "2026-09-26", "billing_code": "83020", "description": "Hemoglobin electrophoresis", "allowed_amounts": [ { "tin": { "type": "ein", "value": "133757370" }, "billing_class": "professional", "payments": [ { "allowed_amount": 12.87, "providers": [ { "billed_charge": 123.9, "npi": [ 1295726032 ] }, { "billed_charge": 123.9, "npi": [ 1881679751 ] } ] } ], "service_code": [ "81" ] } ] }, { "name": "Glycosylated hemoglobin test", "billing_code_type": "CPT", "billing_code_type_version": "2026-09-26", "billing_code": "83036", "description": "Glycosylated hemoglobin test", "allowed_amounts": [ { "tin": { "type": "ein", "value": "316402480" }, "billing_class": "institutional", "payments": [ { "allowed_amount": 12.62, "providers": [ { "billed_charge": 97, "npi": [ 1720159338 ] }, { "billed_charge": 70, "npi": [ 1245226190 ] } ] }, { "allowed_amount": 9.71, "providers": [ { "billed_charge": 30, "npi": [ 1093016651 ] }, { "billed_charge": 69.3, "npi": [ 1063497451 ] }, { "billed_charge": 48.6, "npi": [ 1285014282 ] }, { "billed_charge": 89.2, "npi": [ 1841236684 ] }, { "billed_charge": 89.2, "npi": [ 1619040284 ] }, { "billed_charge": 89.2, "npi": [ 1609812445 ] }, { "billed_charge": 89.2, "npi": [ 1609812445 ] }, { "billed_charge": 90.67, "npi": [ 1740262880 ] }, { "billed_charge": 55.8, "npi": [ 1881679751 ] } ] } ] } ] }, { "name": "Assay of homocystine", "billing_code_type": "CPT", "billing_code_type_version": "2026-09-26", "billing_code": "83090", "description": "Assay of homocystine", "allowed_amounts": [ { "tin": { "type": "ein", "value": "133757370" }, "billing_class": "professional", "payments": [ { "allowed_amount": 17.92, "providers": [ { "billed_charge": 159.6, "npi": [ 1063497451 ] } ] } ], "service_code": [ "81" ] } ] }, { "name": "Immunoassay quant nos nonab", "billing_code_type": "CPT", "billing_code_type_version": "2026-09-26", "billing_code": "83520", "description": "Immunoassay quant nos nonab", "allowed_amounts": [ { "tin": { "type": "ein", "value": "133757370" }, "billing_class": "professional", "payments": [ { "allowed_amount": 17.27, "providers": [ { "billed_charge": 184.8, "npi": [ 1538144910 ] } ] } ], "service_code": [ "81" ] } ] }, { "name": "Assay of insulin", "billing_code_type": "CPT", "billing_code_type_version": "2026-09-26", "billing_code": "83525", "description": "Assay of insulin", "allowed_amounts": [ { "tin": { "type": "ein", "value": "133757370" }, "billing_class": "professional", "payments": [ { "allowed_amount": 11.43, "providers": [ { "billed_charge": 88.2, "npi": [ 1063497451 ] }, { "billed_charge": 108.52, "npi": [ 1740262880 ] } ] } ], "service_code": [ "81" ] } ] }, { "name": "Assay of iron", "billing_code_type": "CPT", "billing_code_type_version": "2026-09-26", "billing_code": "83540", "description": "Assay of iron", "allowed_amounts": [ { "tin": { "type": "ein", "value": "316402480" }, "billing_class": "institutional", "payments": [ { "allowed_amount": 19.41, "providers": [ { "billed_charge": 50, "npi": [ 1720159338 ] } ] }, { "allowed_amount": 6.47, "providers": [ { "billed_charge": 33.05, "npi": [ 1063497451 ] }, { "billed_charge": 45.72, "npi": [ 1932166386 ] }, { "billed_charge": 45.39, "npi": [ 1740262880 ] } ] } ] } ] }, { "name": "Iron binding test", "billing_code_type": "CPT", "billing_code_type_version": "2026-09-26", "billing_code": "83550", "description": "Iron binding test", "allowed_amounts": [ { "tin": { "type": "ein", "value": "316402480" }, "billing_class": "institutional", "payments": [ { "allowed_amount": 26.22, "providers": [ { "billed_charge": 49, "npi": [ 1720159338 ] } ] }, { "allowed_amount": 8.74, "providers": [ { "billed_charge": 44.65, "npi": [ 1063497451 ] }, { "billed_charge": 61.76, "npi": [ 1932166386 ] }, { "billed_charge": 58.25, "npi": [ 1740262880 ] } ] } ] } ] }, { "name": "Assay of lactic acid", "billing_code_type": "CPT", "billing_code_type_version": "2026-09-26", "billing_code": "83605", "description": "Assay of lactic acid", "allowed_amounts": [ { "tin": { "type": "ein", "value": "590878982" }, "billing_class": "institutional", "payments": [ { "allowed_amount": 15.04, "providers": [ { "billed_charge": 71, "npi": [ 1245226190 ] } ] } ] } ] }, { "name": "Lactate (ld) (ldh) enzyme", "billing_code_type": "CPT", "billing_code_type_version": "2026-09-26", "billing_code": "83615", "description": "Lactate (ld) (ldh) enzyme", "allowed_amounts": [ { "tin": { "type": "ein", "value": "133757370" }, "billing_class": "professional", "payments": [ { "allowed_amount": 6.04, "providers": [ { "billed_charge": 38.85, "npi": [ 1063497451 ] } ] } ], "service_code": [ "81" ] } ] }, { "name": "Assay of lipoprotein(a)", "billing_code_type": "CPT", "billing_code_type_version": "2026-09-26", "billing_code": "83695", "description": "Assay of lipoprotein(a)", "allowed_amounts": [ { "tin": { "type": "ein", "value": "133757370" }, "billing_class": "professional", "payments": [ { "allowed_amount": 14.32, "providers": [ { "billed_charge": 151.2, "npi": [ 1063497451 ] }, { "billed_charge": 171.52, "npi": [ 1740262880 ] } ] } ], "service_code": [ "81" ] } ] }, { "name": "Assay of blood lipoprotein", "billing_code_type": "CPT", "billing_code_type_version": "2026-09-26", "billing_code": "83721", "description": "Assay of blood lipoprotein", "allowed_amounts": [ { "tin": { "type": "ein", "value": "133757370" }, "billing_class": "professional", "payments": [ { "allowed_amount": 10.5, "providers": [ { "billed_charge": 83.3, "npi": [ 1063497451 ] }, { "billed_charge": 97.65, "npi": [ 1932184322 ] } ] } ], "service_code": [ "81" ] } ] }, { "name": "Assay of magnesium", "billing_code_type": "CPT", "billing_code_type_version": "2026-09-26", "billing_code": "83735", "description": "Assay of magnesium", "allowed_amounts": [ { "tin": { "type": "ein", "value": "316402480" }, "billing_class": "institutional", "payments": [ { "allowed_amount": 8.71, "providers": [ { "billed_charge": 70, "npi": [ 1720159338 ] } ] }, { "allowed_amount": 6.7, "providers": [ { "billed_charge": 65.1, "npi": [ 1063497451 ] }, { "billed_charge": 40, "npi": [ 1710064811 ] }, { "billed_charge": 66.21, "npi": [ 1841236684 ] }, { "billed_charge": 66.21, "npi": [ 1932166386 ] }, { "billed_charge": 66.21, "npi": [ 1609812445 ] } ] } ] } ] }, { "name": "Mass spectrometry qual/quan", "billing_code_type": "CPT", "billing_code_type_version": "2026-09-26", "billing_code": "83789", "description": "Mass spectrometry qual/quan", "allowed_amounts": [ { "tin": { "type": "ein", "value": "133757370" }, "billing_class": "professional", "payments": [ { "allowed_amount": 24.11, "providers": [ { "billed_charge": 77.7, "npi": [ 1063497451 ] } ] } ], "service_code": [ "81" ] } ] }, { "name": "Assay of parathormone", "billing_code_type": "CPT", "billing_code_type_version": "2026-09-26", "billing_code": "83970", "description": "Assay of parathormone", "allowed_amounts": [ { "tin": { "type": "ein", "value": "205657908" }, "billing_class": "professional", "payments": [ { "allowed_amount": 41.28, "providers": [ { "billed_charge": 180, "npi": [ 1710064811 ] }, { "billed_charge": 290.49, "npi": [ 1841236684 ] } ] } ], "service_code": [ "81" ] } ] }, { "name": "Assay alkaline phosphatase", "billing_code_type": "CPT", "billing_code_type_version": "2026-09-26", "billing_code": "84075", "description": "Assay alkaline phosphatase", "allowed_amounts": [ { "tin": { "type": "ein", "value": "311322863" }, "billing_class": "institutional", "payments": [ { "allowed_amount": 6.73, "providers": [ { "billed_charge": 53, "npi": [ 1124127683 ] } ] } ] } ] }, { "name": "Assay alkaline phosphatases", "billing_code_type": "CPT", "billing_code_type_version": "2026-09-26", "billing_code": "84080", "description": "Assay alkaline phosphatases", "allowed_amounts": [ { "tin": { "type": "ein", "value": "205657908" }, "billing_class": "professional", "payments": [ { "allowed_amount": 14.78, "providers": [ { "billed_charge": 101, "npi": [ 1710064811 ] } ] } ], "service_code": [ "81" ] } ] }, { "name": "Assay of phosphorus", "billing_code_type": "CPT", "billing_code_type_version": "2026-09-26", "billing_code": "84100", "description": "Assay of phosphorus", "allowed_amounts": [ { "tin": { "type": "ein", "value": "316402480" }, "billing_class": "institutional", "payments": [ { "allowed_amount": 6.16, "providers": [ { "billed_charge": 59, "npi": [ 1720159338 ] } ] }, { "allowed_amount": 4.74, "providers": [ { "billed_charge": 27, "npi": [ 1710064811 ] } ] } ] } ] }, { "name": "Assay of pregnenolone", "billing_code_type": "CPT", "billing_code_type_version": "2026-09-26", "billing_code": "84140", "description": "Assay of pregnenolone", "allowed_amounts": [ { "tin": { "type": "ein", "value": "133757370" }, "billing_class": "professional", "payments": [ { "allowed_amount": 20.67, "providers": [ { "billed_charge": 138.6, "npi": [ 1063497451 ] } ] } ], "service_code": [ "81" ] } ] }, { "name": "Assay of progesterone", "billing_code_type": "CPT", "billing_code_type_version": "2026-09-26", "billing_code": "84144", "description": "Assay of progesterone", "allowed_amounts": [ { "tin": { "type": "ein", "value": "133757370" }, "billing_class": "professional", "payments": [ { "allowed_amount": 20.86, "providers": [ { "billed_charge": 139.65, "npi": [ 1063497451 ] }, { "billed_charge": 144.9, "npi": [ 1265418669 ] }, { "billed_charge": 167.32, "npi": [ 1740262880 ] } ] } ], "service_code": [ "81" ] } ] }, { "name": "Procalcitonin (pct)", "billing_code_type": "CPT", "billing_code_type_version": "2026-09-26", "billing_code": "84145", "description": "Procalcitonin (pct)", "allowed_amounts": [ { "tin": { "type": "ein", "value": "590878982" }, "billing_class": "institutional", "payments": [ { "allowed_amount": 35.39, "providers": [ { "billed_charge": 210, "npi": [ 1245226190 ] } ] } ] } ] }, { "name": "Assay of psa total", "billing_code_type": "CPT", "billing_code_type_version": "2026-09-26", "billing_code": "84153", "description": "Assay of psa total", "allowed_amounts": [ { "tin": { "type": "ein", "value": "311322863" }, "billing_class": "institutional", "payments": [ { "allowed_amount": 23.91, "providers": [ { "billed_charge": 177, "npi": [ 1124127683 ] } ] }, { "allowed_amount": 55.17, "providers": [ { "billed_charge": 85, "npi": [ 1720159338 ] } ] }, { "allowed_amount": 18.39, "providers": [ { "billed_charge": 50, "npi": [ 1285014282 ] }, { "billed_charge": 112.35, "npi": [ 1932184322 ] } ] } ] } ] }, { "name": "Assay of protein serum", "billing_code_type": "CPT", "billing_code_type_version": "2026-09-26", "billing_code": "84155", "description": "Assay of protein serum", "allowed_amounts": [ { "tin": { "type": "ein", "value": "311322863" }, "billing_class": "institutional", "payments": [ { "allowed_amount": 4.77, "providers": [ { "billed_charge": 72, "npi": [ 1124127683 ] } ] }, { "allowed_amount": 3.67, "providers": [ { "billed_charge": 4.66, "npi": [ 1285014282 ] } ] } ] } ] }, { "name": "Assay of protein urine", "billing_code_type": "CPT", "billing_code_type_version": "2026-09-26", "billing_code": "84156", "description": "Assay of protein urine", "allowed_amounts": [ { "tin": { "type": "ein", "value": "223137283" }, "billing_class": "professional", "payments": [ { "allowed_amount": 3.67, "providers": [ { "billed_charge": 53.17, "npi": [ 1841236684 ] } ] } ], "service_code": [ "81" ] } ] }, { "name": "Assay of vitamin b-6", "billing_code_type": "CPT", "billing_code_type_version": "2026-09-26", "billing_code": "84207", "description": "Assay of vitamin b-6", "allowed_amounts": [ { "tin": { "type": "ein", "value": "133757370" }, "billing_class": "professional", "payments": [ { "allowed_amount": 28.1, "providers": [ { "billed_charge": 199.3, "npi": [ 1063497451 ] }, { "billed_charge": 302.67, "npi": [ 1932166386 ] } ] } ], "service_code": [ "81" ] } ] }, { "name": "Assay of sex hormone globul", "billing_code_type": "CPT", "billing_code_type_version": "2026-09-26", "billing_code": "84270", "description": "Assay of sex hormone globul", "allowed_amounts": [ { "tin": { "type": "ein", "value": "133757370" }, "billing_class": "professional", "payments": [ { "allowed_amount": 21.73, "providers": [ { "billed_charge": 148.05, "npi": [ 1063497451 ] } ] } ], "service_code": [ "81" ] } ] }, { "name": "Assay of somatomedin", "billing_code_type": "CPT", "billing_code_type_version": "2026-09-26", "billing_code": "84305", "description": "Assay of somatomedin", "allowed_amounts": [ { "tin": { "type": "ein", "value": "133757370" }, "billing_class": "professional", "payments": [ { "allowed_amount": 21.26, "providers": [ { "billed_charge": 309.75, "npi": [ 1063497451 ] }, { "billed_charge": 240.5, "npi": [ 1932166386 ] } ] } ], "service_code": [ "81" ] } ] }, { "name": "Assay of free testosterone", "billing_code_type": "CPT", "billing_code_type_version": "2026-09-26", "billing_code": "84402", "description": "Assay of free testosterone", "allowed_amounts": [ { "tin": { "type": "ein", "value": "133757370" }, "billing_class": "professional", "payments": [ { "allowed_amount": 25.47, "providers": [ { "billed_charge": 184.62, "npi": [ 1063497451 ] }, { "billed_charge": 209.65, "npi": [ 1265418669 ] }, { "billed_charge": 223.11, "npi": [ 1740262880 ] } ] } ], "service_code": [ "81" ] } ] }, { "name": "Assay of total testosterone", "billing_code_type": "CPT", "billing_code_type_version": "2026-09-26", "billing_code": "84403", "description": "Assay of total testosterone", "allowed_amounts": [ { "tin": { "type": "ein", "value": "316402480" }, "billing_class": "institutional", "payments": [ { "allowed_amount": 77.43, "providers": [ { "billed_charge": 139, "npi": [ 1720159338 ] } ] }, { "allowed_amount": 25.81, "providers": [ { "billed_charge": 187.08, "npi": [ 1063497451 ] }, { "billed_charge": 237.8, "npi": [ 1609812445 ] }, { "billed_charge": 212.45, "npi": [ 1265418669 ] }, { "billed_charge": 225.98, "npi": [ 1740262880 ] } ] } ] } ] }, { "name": "Assay of total thyroxine", "billing_code_type": "CPT", "billing_code_type_version": "2026-09-26", "billing_code": "84436", "description": "Assay of total thyroxine", "allowed_amounts": [ { "tin": { "type": "ein", "value": "133757370" }, "billing_class": "professional", "payments": [ { "allowed_amount": 6.87, "providers": [ { "billed_charge": 46.2, "npi": [ 1063497451 ] } ] } ], "service_code": [ "81" ] } ] }, { "name": "Assay of free thyroxine", "billing_code_type": "CPT", "billing_code_type_version": "2026-09-26", "billing_code": "84439", "description": "Assay of free thyroxine", "allowed_amounts": [ { "tin": { "type": "ein", "value": "316402480" }, "billing_class": "institutional", "payments": [ { "allowed_amount": 11.73, "providers": [ { "billed_charge": 67, "npi": [ 1720159338 ] } ] }, { "allowed_amount": 9.02, "providers": [ { "billed_charge": 108.93333333333334, "npi": [ 1063497451 ] }, { "billed_charge": 71.55, "npi": [ 1295726032 ] }, { "billed_charge": 175.64, "npi": [ 1619040284 ] }, { "billed_charge": 175.64, "npi": [ 1932166386 ] }, { "billed_charge": 156.82, "npi": [ 1740262880 ] }, { "billed_charge": 71.55, "npi": [ 1881679751 ] } ] } ] } ] }, { "name": "Assay thyroid stim hormone", "billing_code_type": "CPT", "billing_code_type_version": "2026-09-26", "billing_code": "84443", "description": "Assay thyroid stim hormone", "allowed_amounts": [ { "tin": { "type": "ein", "value": "316402480" }, "billing_class": "institutional", "payments": [ { "allowed_amount": 21.84, "providers": [ { "billed_charge": 73, "npi": [ 1720159338 ] } ] }, { "allowed_amount": 16.8, "providers": [ { "billed_charge": 117.55, "npi": [ 1063497451 ] }, { "billed_charge": 95.89, "npi": [ 1285014282 ] }, { "billed_charge": 133.2, "npi": [ 1295726032 ] }, { "billed_charge": 98.7, "npi": [ 1932184322 ] } ] }, { "allowed_amount": 8.4, "providers": [ { "billed_charge": 78.37, "npi": [ 1841236684 ] } ] }, { "allowed_amount": 16.8, "providers": [ { "billed_charge": 156.74, "npi": [ 1619040284 ] }, { "billed_charge": 156.74, "npi": [ 1609812445 ] }, { "billed_charge": 133.2, "npi": [ 1881679751 ] } ] } ] } ] }, { "name": "Transferase (ast) (sgot)", "billing_code_type": "CPT", "billing_code_type_version": "2026-09-26", "billing_code": "84450", "description": "Transferase (ast) (sgot)", "allowed_amounts": [ { "tin": { "type": "ein", "value": "311322863" }, "billing_class": "institutional", "payments": [ { "allowed_amount": 6.73, "providers": [ { "billed_charge": 36, "npi": [ 1124127683 ] } ] }, { "allowed_amount": 4.66, "providers": [ { "billed_charge": 4.66, "npi": [ 1285014282 ] } ] } ] } ] }, { "name": "Alanine amino (alt) (sgpt)", "billing_code_type": "CPT", "billing_code_type_version": "2026-09-26", "billing_code": "84460", "description": "Alanine amino (alt) (sgpt)", "allowed_amounts": [ { "tin": { "type": "ein", "value": "311322863" }, "billing_class": "institutional", "payments": [ { "allowed_amount": 6.89, "providers": [ { "billed_charge": 37, "npi": [ 1124127683 ] } ] }, { "allowed_amount": 4.66, "providers": [ { "billed_charge": 4.66, "npi": [ 1285014282 ] } ] }, { "allowed_amount": 5.3, "providers": [ { "billed_charge": 61.72, "npi": [ 1841236684 ] } ] } ] } ] }, { "name": "Assay triiodothyronine (t3)", "billing_code_type": "CPT", "billing_code_type_version": "2026-09-26", "billing_code": "84480", "description": "Assay triiodothyronine (t3)", "allowed_amounts": [ { "tin": { "type": "ein", "value": "133757370" }, "billing_class": "professional", "payments": [ { "allowed_amount": 14.18, "providers": [ { "billed_charge": 118.65, "npi": [ 1063497451 ] } ] } ], "service_code": [ "81" ] } ] }, { "name": "Free assay (ft-3)", "billing_code_type": "CPT", "billing_code_type_version": "2026-09-26", "billing_code": "84481", "description": "Free assay (ft-3)", "allowed_amounts": [ { "tin": { "type": "ein", "value": "133757370" }, "billing_class": "professional", "payments": [ { "allowed_amount": 16.94, "providers": [ { "billed_charge": 229.95, "npi": [ 1063497451 ] }, { "billed_charge": 271.59, "npi": [ 1932166386 ] }, { "billed_charge": 254.47, "npi": [ 1740262880 ] } ] } ], "service_code": [ "81" ] } ] }, { "name": "T3 reverse", "billing_code_type": "CPT", "billing_code_type_version": "2026-09-26", "billing_code": "84482", "description": "T3 reverse", "allowed_amounts": [ { "tin": { "type": "ein", "value": "133757370" }, "billing_class": "professional", "payments": [ { "allowed_amount": 15.76, "providers": [ { "billed_charge": 290.85, "npi": [ 1063497451 ] } ] } ], "service_code": [ "81" ] } ] }, { "name": "Assay of troponin quant", "billing_code_type": "CPT", "billing_code_type_version": "2026-09-26", "billing_code": "84484", "description": "Assay of troponin quant", "allowed_amounts": [ { "tin": { "type": "ein", "value": "590878982" }, "billing_class": "institutional", "payments": [ { "allowed_amount": 16.21, "providers": [ { "billed_charge": 88, "npi": [ 1245226190 ] } ] }, { "allowed_amount": 12.47, "providers": [ { "billed_charge": 163.48, "npi": [ 1841236684 ] } ] } ] } ] }, { "name": "Assay of urea nitrogen", "billing_code_type": "CPT", "billing_code_type_version": "2026-09-26", "billing_code": "84520", "description": "Assay of urea nitrogen", "allowed_amounts": [ { "tin": { "type": "ein", "value": "311322863" }, "billing_class": "institutional", "payments": [ { "allowed_amount": 5.14, "providers": [ { "billed_charge": 60, "npi": [ 1124127683 ] }, { "billed_charge": 25, "npi": [ 1720159338 ] } ] } ] } ] }, { "name": "Assay of blood/uric acid", "billing_code_type": "CPT", "billing_code_type_version": "2026-09-26", "billing_code": "84550", "description": "Assay of blood/uric acid", "allowed_amounts": [ { "tin": { "type": "ein", "value": "133757370" }, "billing_class": "professional", "payments": [ { "allowed_amount": 4.52, "providers": [ { "billed_charge": 38.85, "npi": [ 1063497451 ] } ] } ], "service_code": [ "81" ] } ] }, { "name": "Chorionic gonadotropin assay", "billing_code_type": "CPT", "billing_code_type_version": "2026-09-26", "billing_code": "84703", "description": "Chorionic gonadotropin assay", "allowed_amounts": [ { "tin": { "type": "ein", "value": "840611484" }, "billing_class": "professional", "payments": [ { "allowed_amount": 7.52, "providers": [ { "billed_charge": 115.5, "npi": [ 1881679751 ] } ] } ], "service_code": [ "81" ] } ] }, { "name": "Hematocrit", "billing_code_type": "CPT", "billing_code_type_version": "2026-09-26", "billing_code": "85014", "description": "Hematocrit", "allowed_amounts": [ { "tin": { "type": "ein", "value": "223137283" }, "billing_class": "professional", "payments": [ { "allowed_amount": 2.37, "providers": [ { "billed_charge": 9.29, "npi": [ 1841236684 ] } ] } ], "service_code": [ "81" ] } ] }, { "name": "Hemoglobin", "billing_code_type": "CPT", "billing_code_type_version": "2026-09-26", "billing_code": "85018", "description": "Hemoglobin", "allowed_amounts": [ { "tin": { "type": "ein", "value": "223137283" }, "billing_class": "professional", "payments": [ { "allowed_amount": 2.37, "providers": [ { "billed_charge": 9.29, "npi": [ 1841236684 ] } ] } ], "service_code": [ "81" ] } ] }, { "name": "Complete cbc w/auto diff wbc", "billing_code_type": "CPT", "billing_code_type_version": "2026-09-26", "billing_code": "85025", "description": "Complete cbc w/auto diff wbc", "allowed_amounts": [ { "tin": { "type": "ein", "value": "311322863" }, "billing_class": "institutional", "payments": [ { "allowed_amount": 10.1, "providers": [ { "billed_charge": 105, "npi": [ 1124127683 ] } ] }, { "allowed_amount": 14.503333333333334, "providers": [ { "billed_charge": 65, "npi": [ 1720159338 ] } ] }, { "allowed_amount": 7.77, "providers": [ { "billed_charge": 32.55, "npi": [ 1063497451 ] }, { "billed_charge": 44.33, "npi": [ 1285014282 ] }, { "billed_charge": 32.55, "npi": [ 1932184322 ] } ] }, { "allowed_amount": 3.885, "providers": [ { "billed_charge": 27.325, "npi": [ 1841236684 ] } ] }, { "allowed_amount": 7.77, "providers": [ { "billed_charge": 54.65, "npi": [ 1619040284 ] }, { "billed_charge": 54.65, "npi": [ 1932166386 ] }, { "billed_charge": 54.65, "npi": [ 1609812445 ] }, { "billed_charge": 32.55, "npi": [ 1265418669 ] }, { "billed_charge": 29.666666666666668, "npi": [ 1881679751 ] } ] } ] } ] }, { "name": "Complete cbc automated", "billing_code_type": "CPT", "billing_code_type_version": "2026-09-26", "billing_code": "85027", "description": "Complete cbc automated", "allowed_amounts": [ { "tin": { "type": "ein", "value": "590878982" }, "billing_class": "institutional", "payments": [ { "allowed_amount": 8.41, "providers": [ { "billed_charge": 47, "npi": [ 1245226190 ] } ] }, { "allowed_amount": 6.47, "providers": [ { "billed_charge": 40.44, "npi": [ 1932166386 ] }, { "billed_charge": 40.44, "npi": [ 1609812445 ] } ] } ] } ] }, { "name": "Heparin assay", "billing_code_type": "CPT", "billing_code_type_version": "2026-09-26", "billing_code": "85520", "description": "Heparin assay", "allowed_amounts": [ { "tin": { "type": "ein", "value": "590878982" }, "billing_class": "institutional", "payments": [ { "allowed_amount": 17.02, "providers": [ { "billed_charge": 69, "npi": [ 1245226190 ] } ] } ] } ] }, { "name": "Prothrombin time", "billing_code_type": "CPT", "billing_code_type_version": "2026-09-26", "billing_code": "85610", "description": "Prothrombin time", "allowed_amounts": [ { "tin": { "type": "ein", "value": "590878982" }, "billing_class": "institutional", "payments": [ { "allowed_amount": 5.58, "providers": [ { "billed_charge": 29, "npi": [ 1245226190 ] } ] } ] } ] }, { "name": "Rbc sed rate automated", "billing_code_type": "CPT", "billing_code_type_version": "2026-09-26", "billing_code": "85652", "description": "Rbc sed rate automated", "allowed_amounts": [ { "tin": { "type": "ein", "value": "113412370" }, "billing_class": "professional", "payments": [ { "allowed_amount": 2.7, "providers": [ { "billed_charge": 25, "npi": [ 1366543795 ] }, { "billed_charge": 37.8, "npi": [ 1063497451 ] } ] } ], "service_code": [ "81" ] } ] }, { "name": "Thromboplastin time partial", "billing_code_type": "CPT", "billing_code_type_version": "2026-09-26", "billing_code": "85730", "description": "Thromboplastin time partial", "allowed_amounts": [ { "tin": { "type": "ein", "value": "590878982" }, "billing_class": "institutional", "payments": [ { "allowed_amount": 7.81, "providers": [ { "billed_charge": 43, "npi": [ 1245226190 ] } ] } ] } ] }, { "name": "Allg spec ige crude xtrc ea", "billing_code_type": "CPT", "billing_code_type_version": "2026-09-26", "billing_code": "86003", "description": "Allg spec ige crude xtrc ea", "allowed_amounts": [ { "tin": { "type": "ein", "value": "133757370" }, "billing_class": "professional", "payments": [ { "allowed_amount": 156.6, "providers": [ { "billed_charge": 1071.66, "npi": [ 1538144910 ] } ] }, { "allowed_amount": 104.4, "providers": [ { "billed_charge": 783.79, "npi": [ 1609812445 ] } ] } ], "service_code": [ "81" ] } ] }, { "name": "Allg spec ige recomb ea", "billing_code_type": "CPT", "billing_code_type_version": "2026-09-26", "billing_code": "86008", "description": "Allg spec ige recomb ea", "allowed_amounts": [ { "tin": { "type": "ein", "value": "133757370" }, "billing_class": "professional", "payments": [ { "allowed_amount": 71.72, "providers": [ { "billed_charge": 287.86, "npi": [ 1538144910 ] } ] }, { "allowed_amount": 26.895, "providers": [ { "billed_charge": 78.38, "npi": [ 1609812445 ] } ] } ], "service_code": [ "81" ] } ] }, { "name": "Antinuclear antibodies", "billing_code_type": "CPT", "billing_code_type_version": "2026-09-26", "billing_code": "86038", "description": "Antinuclear antibodies", "allowed_amounts": [ { "tin": { "type": "ein", "value": "113412370" }, "billing_class": "professional", "payments": [ { "allowed_amount": 12.09, "providers": [ { "billed_charge": 74, "npi": [ 1366543795 ] }, { "billed_charge": 101.34, "npi": [ 1841236684 ] } ] } ], "service_code": [ "81" ] } ] }, { "name": "C-reactive protein", "billing_code_type": "CPT", "billing_code_type_version": "2026-09-26", "billing_code": "86140", "description": "C-reactive protein", "allowed_amounts": [ { "tin": { "type": "ein", "value": "113412370" }, "billing_class": "professional", "payments": [ { "allowed_amount": 5.18, "providers": [ { "billed_charge": 50, "npi": [ 1366543795 ] } ] } ], "service_code": [ "81" ] } ] }, { "name": "C-reactive protein hs", "billing_code_type": "CPT", "billing_code_type_version": "2026-09-26", "billing_code": "86141", "description": "C-reactive protein hs", "allowed_amounts": [ { "tin": { "type": "ein", "value": "133757370" }, "billing_class": "professional", "payments": [ { "allowed_amount": 12.95, "providers": [ { "billed_charge": 115.37, "npi": [ 1063497451 ] } ] } ], "service_code": [ "81" ] } ] }, { "name": "Complement antigen", "billing_code_type": "CPT", "billing_code_type_version": "2026-09-26", "billing_code": "86160", "description": "Complement antigen", "allowed_amounts": [ { "tin": { "type": "ein", "value": "316402480" }, "billing_class": "institutional", "payments": [ { "allowed_amount": 15.6, "providers": [ { "billed_charge": 108, "npi": [ 1720159338 ] } ] } ] } ] }, { "name": "Ccp antibody", "billing_code_type": "CPT", "billing_code_type_version": "2026-09-26", "billing_code": "86200", "description": "Ccp antibody", "allowed_amounts": [ { "tin": { "type": "ein", "value": "113412370" }, "billing_class": "professional", "payments": [ { "allowed_amount": 12.95, "providers": [ { "billed_charge": 38.85, "npi": [ 1366543795 ] } ] } ], "service_code": [ "81" ] } ] }, { "name": "Dna antibody native", "billing_code_type": "CPT", "billing_code_type_version": "2026-09-26", "billing_code": "86225", "description": "Dna antibody native", "allowed_amounts": [ { "tin": { "type": "ein", "value": "316402480" }, "billing_class": "institutional", "payments": [ { "allowed_amount": 17.86, "providers": [ { "billed_charge": 143, "npi": [ 1720159338 ] } ] }, { "allowed_amount": 13.74, "providers": [ { "billed_charge": 73.81, "npi": [ 1366543795 ] }, { "billed_charge": 132.97, "npi": [ 1932166386 ] } ] } ] } ] }, { "name": "Nuclear antigen antibody", "billing_code_type": "CPT", "billing_code_type_version": "2026-09-26", "billing_code": "86235", "description": "Nuclear antigen antibody", "allowed_amounts": [ { "tin": { "type": "ein", "value": "382084239" }, "billing_class": "professional", "payments": [ { "allowed_amount": 35.86, "providers": [ { "billed_charge": 265.94, "npi": [ 1932166386 ] } ] } ], "service_code": [ "81" ] } ] }, { "name": "Immunoassay tumor ca 125", "billing_code_type": "CPT", "billing_code_type_version": "2026-09-26", "billing_code": "86304", "description": "Immunoassay tumor ca 125", "allowed_amounts": [ { "tin": { "type": "ein", "value": "133757370" }, "billing_class": "professional", "payments": [ { "allowed_amount": 20.81, "providers": [ { "billed_charge": 174.3, "npi": [ 1285014282 ] } ] } ], "service_code": [ "81" ] } ] }, { "name": "Microsomal antibody each", "billing_code_type": "CPT", "billing_code_type_version": "2026-09-26", "billing_code": "86376", "description": "Microsomal antibody each", "allowed_amounts": [ { "tin": { "type": "ein", "value": "133757370" }, "billing_class": "professional", "payments": [ { "allowed_amount": 14.55, "providers": [ { "billed_charge": 101.31, "npi": [ 1063497451 ] } ] } ], "service_code": [ "81" ] } ] }, { "name": "Rheumatoid factor quant", "billing_code_type": "CPT", "billing_code_type_version": "2026-09-26", "billing_code": "86431", "description": "Rheumatoid factor quant", "allowed_amounts": [ { "tin": { "type": "ein", "value": "113412370" }, "billing_class": "professional", "payments": [ { "allowed_amount": 5.67, "providers": [ { "billed_charge": 17.01, "npi": [ 1366543795 ] } ] } ], "service_code": [ "81" ] } ] }, { "name": "Syphilis test non-trep qual", "billing_code_type": "CPT", "billing_code_type_version": "2026-09-26", "billing_code": "86592", "description": "Syphilis test non-trep qual", "allowed_amounts": [ { "tin": { "type": "ein", "value": "382084239" }, "billing_class": "professional", "payments": [ { "allowed_amount": 4.27, "providers": [ { "billed_charge": 45.93, "npi": [ 1932166386 ] }, { "billed_charge": 40.95, "npi": [ 1265418669 ] }, { "billed_charge": 40.95, "npi": [ 1881679751 ] } ] } ], "service_code": [ "81" ] } ] }, { "name": "Syphilis test non-trep quant", "billing_code_type": "CPT", "billing_code_type_version": "2026-09-26", "billing_code": "86593", "description": "Syphilis test non-trep quant", "allowed_amounts": [ { "tin": { "type": "ein", "value": "382084239" }, "billing_class": "professional", "payments": [ { "allowed_amount": 4.4, "providers": [ { "billed_charge": 45.93, "npi": [ 1932166386 ] } ] } ], "service_code": [ "81" ] } ] }, { "name": "Lyme disease antibody", "billing_code_type": "CPT", "billing_code_type_version": "2026-09-26", "billing_code": "86618", "description": "Lyme disease antibody", "allowed_amounts": [ { "tin": { "type": "ein", "value": "382084239" }, "billing_class": "professional", "payments": [ { "allowed_amount": 17.03, "providers": [ { "billed_charge": 214.84, "npi": [ 1932166386 ] } ] } ], "service_code": [ "81" ] } ] }, { "name": "Hep b core antibody total", "billing_code_type": "CPT", "billing_code_type_version": "2026-09-26", "billing_code": "86704", "description": "Hep b core antibody total", "allowed_amounts": [ { "tin": { "type": "ein", "value": "382084239" }, "billing_class": "professional", "payments": [ { "allowed_amount": 12.05, "providers": [ { "billed_charge": 114.86, "npi": [ 1932166386 ] }, { "billed_charge": 100.39, "npi": [ 1881679751 ] } ] } ], "service_code": [ "81" ] } ] }, { "name": "Hep b core antibody igm", "billing_code_type": "CPT", "billing_code_type_version": "2026-09-26", "billing_code": "86705", "description": "Hep b core antibody igm", "allowed_amounts": [ { "tin": { "type": "ein", "value": "840611484" }, "billing_class": "professional", "payments": [ { "allowed_amount": 11.77, "providers": [ { "billed_charge": 98.06, "npi": [ 1881679751 ] } ] } ], "service_code": [ "81" ] } ] }, { "name": "Hep b surface antibody", "billing_code_type": "CPT", "billing_code_type_version": "2026-09-26", "billing_code": "86706", "description": "Hep b surface antibody", "allowed_amounts": [ { "tin": { "type": "ein", "value": "382084239" }, "billing_class": "professional", "payments": [ { "allowed_amount": 10.74, "providers": [ { "billed_charge": 105.38, "npi": [ 1932166386 ] }, { "billed_charge": 91.35, "npi": [ 1881679751 ] } ] } ], "service_code": [ "81" ] } ] }, { "name": "Hepatitis a antibody", "billing_code_type": "CPT", "billing_code_type_version": "2026-09-26", "billing_code": "86708", "description": "Hepatitis a antibody", "allowed_amounts": [ { "tin": { "type": "ein", "value": "382084239" }, "billing_class": "professional", "payments": [ { "allowed_amount": 12.39, "providers": [ { "billed_charge": 132.42, "npi": [ 1932166386 ] } ] } ], "service_code": [ "81" ] } ] }, { "name": "Rubella antibody", "billing_code_type": "CPT", "billing_code_type_version": "2026-09-26", "billing_code": "86762", "description": "Rubella antibody", "allowed_amounts": [ { "tin": { "type": "ein", "value": "840611484" }, "billing_class": "professional", "payments": [ { "allowed_amount": 14.39, "providers": [ { "billed_charge": 73.5, "npi": [ 1881679751 ] } ] } ], "service_code": [ "81" ] } ] }, { "name": "Treponema pallidum", "billing_code_type": "CPT", "billing_code_type_version": "2026-09-26", "billing_code": "86780", "description": "Treponema pallidum", "allowed_amounts": [ { "tin": { "type": "ein", "value": "382084239" }, "billing_class": "professional", "payments": [ { "allowed_amount": 13.24, "providers": [ { "billed_charge": 114.86, "npi": [ 1932166386 ] } ] } ], "service_code": [ "81" ] } ] }, { "name": "Varicella-zoster antibody", "billing_code_type": "CPT", "billing_code_type_version": "2026-09-26", "billing_code": "86787", "description": "Varicella-zoster antibody", "allowed_amounts": [ { "tin": { "type": "ein", "value": "133757370" }, "billing_class": "professional", "payments": [ { "allowed_amount": 12.88, "providers": [ { "billed_charge": 93.45, "npi": [ 1295726032 ] }, { "billed_charge": 112.35, "npi": [ 1881679751 ] } ] } ], "service_code": [ "81" ] } ] }, { "name": "Thyroglobulin antibody", "billing_code_type": "CPT", "billing_code_type_version": "2026-09-26", "billing_code": "86800", "description": "Thyroglobulin antibody", "allowed_amounts": [ { "tin": { "type": "ein", "value": "133757370" }, "billing_class": "professional", "payments": [ { "allowed_amount": 15.91, "providers": [ { "billed_charge": 110.79, "npi": [ 1063497451 ] } ] } ], "service_code": [ "81" ] } ] }, { "name": "Hepatitis c ab test", "billing_code_type": "CPT", "billing_code_type_version": "2026-09-26", "billing_code": "86803", "description": "Hepatitis c ab test", "allowed_amounts": [ { "tin": { "type": "ein", "value": "133757370" }, "billing_class": "professional", "payments": [ { "allowed_amount": 14.27, "providers": [ { "billed_charge": 112.35, "npi": [ 1295726032 ] }, { "billed_charge": 174.3, "npi": [ 1619040284 ] }, { "billed_charge": 174.3, "npi": [ 1932166386 ] }, { "billed_charge": 66.35, "npi": [ 1881679751 ] } ] } ], "service_code": [ "81" ] } ] }, { "name": "Rbc antibody screen", "billing_code_type": "CPT", "billing_code_type_version": "2026-09-26", "billing_code": "86850", "description": "Rbc antibody screen", "allowed_amounts": [ { "tin": { "type": "ein", "value": "840611484" }, "billing_class": "professional", "payments": [ { "allowed_amount": 9.77, "providers": [ { "billed_charge": 44, "npi": [ 1881679751 ] } ] } ], "service_code": [ "81" ] } ] }, { "name": "Blood typing serologic abo", "billing_code_type": "CPT", "billing_code_type_version": "2026-09-26", "billing_code": "86900", "description": "Blood typing serologic abo", "allowed_amounts": [ { "tin": { "type": "ein", "value": "840611484" }, "billing_class": "professional", "payments": [ { "allowed_amount": 2.99, "providers": [ { "billed_charge": 45.68, "npi": [ 1881679751 ] } ] } ], "service_code": [ "81" ] } ] }, { "name": "Blood typing serologic rh(d)", "billing_code_type": "CPT", "billing_code_type_version": "2026-09-26", "billing_code": "86901", "description": "Blood typing serologic rh(d)", "allowed_amounts": [ { "tin": { "type": "ein", "value": "840611484" }, "billing_class": "professional", "payments": [ { "allowed_amount": 2.99, "providers": [ { "billed_charge": 45.67, "npi": [ 1881679751 ] } ] } ], "service_code": [ "81" ] } ] }, { "name": "Blood culture for bacteria", "billing_code_type": "CPT", "billing_code_type_version": "2026-09-26", "billing_code": "87040", "description": "Blood culture for bacteria", "allowed_amounts": [ { "tin": { "type": "ein", "value": "590878982" }, "billing_class": "institutional", "payments": [ { "allowed_amount": 13.42, "providers": [ { "billed_charge": 74, "npi": [ 1245226190 ] } ] } ] } ] }, { "name": "Culture othr specimn aerobic", "billing_code_type": "CPT", "billing_code_type_version": "2026-09-26", "billing_code": "87070", "description": "Culture othr specimn aerobic", "allowed_amounts": [ { "tin": { "type": "ein", "value": "840611484" }, "billing_class": "professional", "payments": [ { "allowed_amount": 8.62, "providers": [ { "billed_charge": 86.1, "npi": [ 1265418669 ] } ] } ], "service_code": [ "81" ] } ] }, { "name": "Urine culture/colony count", "billing_code_type": "CPT", "billing_code_type_version": "2026-09-26", "billing_code": "87086", "description": "Urine culture/colony count", "allowed_amounts": [ { "tin": { "type": "ein", "value": "382084239" }, "billing_class": "professional", "payments": [ { "allowed_amount": 8.07, "providers": [ { "billed_charge": 72.98, "npi": [ 1932166386 ] }, { "billed_charge": 72.98, "npi": [ 1609812445 ] }, { "billed_charge": 75.6, "npi": [ 1740262880 ] } ] } ], "service_code": [ "81" ] } ] }, { "name": "Urine bacteria culture", "billing_code_type": "CPT", "billing_code_type_version": "2026-09-26", "billing_code": "87088", "description": "Urine bacteria culture", "allowed_amounts": [ { "tin": { "type": "ein", "value": "316402480" }, "billing_class": "institutional", "payments": [ { "allowed_amount": 37.596666666666664, "providers": [ { "billed_charge": 78, "npi": [ 1720159338 ] } ] }, { "allowed_amount": 8.09, "providers": [ { "billed_charge": 39.19, "npi": [ 1609812445 ] } ] } ] } ] }, { "name": "Hepatitis b surface ag ia", "billing_code_type": "CPT", "billing_code_type_version": "2026-09-26", "billing_code": "87340", "description": "Hepatitis b surface ag ia", "allowed_amounts": [ { "tin": { "type": "ein", "value": "382084239" }, "billing_class": "professional", "payments": [ { "allowed_amount": 10.33, "providers": [ { "billed_charge": 101.34, "npi": [ 1932166386 ] }, { "billed_charge": 45.45, "npi": [ 1881679751 ] } ] } ], "service_code": [ "81" ] } ] }, { "name": "Hiv-1 ag w/hiv-1 & hiv-2 ab", "billing_code_type": "CPT", "billing_code_type_version": "2026-09-26", "billing_code": "87389", "description": "Hiv-1 ag w/hiv-1 & hiv-2 ab", "allowed_amounts": [ { "tin": { "type": "ein", "value": "133757370" }, "billing_class": "professional", "payments": [ { "allowed_amount": 24.08, "providers": [ { "billed_charge": 176.4, "npi": [ 1295726032 ] }, { "billed_charge": 129.93, "npi": [ 1619040284 ] }, { "billed_charge": 176.4, "npi": [ 1265418669 ] }, { "billed_charge": 110.5, "npi": [ 1881679751 ] } ] } ], "service_code": [ "81" ] } ] }, { "name": "Chylmd trach dna amp probe", "billing_code_type": "CPT", "billing_code_type_version": "2026-09-26", "billing_code": "87491", "description": "Chylmd trach dna amp probe", "allowed_amounts": [ { "tin": { "type": "ein", "value": "840611484" }, "billing_class": "professional", "payments": [ { "allowed_amount": 35.09, "providers": [ { "billed_charge": 97.82, "npi": [ 1881679751 ] } ] } ], "service_code": [ "81" ] } ] }, { "name": "N.gonorrhoeae dna amp prob", "billing_code_type": "CPT", "billing_code_type_version": "2026-09-26", "billing_code": "87591", "description": "N.gonorrhoeae dna amp prob", "allowed_amounts": [ { "tin": { "type": "ein", "value": "840611484" }, "billing_class": "professional", "payments": [ { "allowed_amount": 35.09, "providers": [ { "billed_charge": 97.82, "npi": [ 1881679751 ] } ] } ], "service_code": [ "81" ] } ] }, { "name": "Hpv high-risk types", "billing_code_type": "CPT", "billing_code_type_version": "2026-09-26", "billing_code": "87624", "description": "Hpv high-risk types", "allowed_amounts": [ { "tin": { "type": "ein", "value": "621695507" }, "billing_class": "professional", "payments": [ { "allowed_amount": 35.09, "providers": [ { "billed_charge": 110, "npi": [ 1003863580 ] }, { "billed_charge": 157.21, "npi": [ 1932166386 ] } ] } ], "service_code": [ "11" ] } ] }, { "name": "Strep a dna amp probe", "billing_code_type": "CPT", "billing_code_type_version": "2026-09-26", "billing_code": "87651", "description": "Strep a dna amp probe", "allowed_amounts": [ { "tin": { "type": "ein", "value": "431560263" }, "billing_class": "professional", "payments": [ { "allowed_amount": 35.09, "providers": [ { "billed_charge": 107, "npi": [ 1245277631 ] } ] } ], "service_code": [ "11" ] } ] }, { "name": "Strep a assay w/optic", "billing_code_type": "CPT", "billing_code_type_version": "2026-09-26", "billing_code": "87880", "description": "Strep a assay w/optic", "allowed_amounts": [ { "tin": { "type": "ein", "value": "043608389" }, "billing_class": "professional", "payments": [ { "allowed_amount": 15, "providers": [ { "billed_charge": 15, "npi": [ 9999999999 ] } ] }, { "allowed_amount": 16.53, "providers": [ { "billed_charge": 45, "npi": [ 1245277631 ] } ] } ], "service_code": [ "11" ] } ] }, { "name": "Cytopath c/v thin layer", "billing_code_type": "CPT", "billing_code_type_version": "2026-09-26", "billing_code": "88142", "description": "Cytopath c/v thin layer", "allowed_amounts": [ { "tin": { "type": "ein", "value": "133757370" }, "billing_class": "professional", "payments": [ { "allowed_amount": 20.26, "providers": [ { "billed_charge": 84, "npi": [ 1891770806 ] } ] } ], "service_code": [ "81" ] } ] }, { "name": "Cytopath c/v auto fluid redo", "billing_code_type": "CPT", "billing_code_type_version": "2026-09-26", "billing_code": "88175", "description": "Cytopath c/v auto fluid redo", "allowed_amounts": [ { "tin": { "type": "ein", "value": "112981029" }, "billing_class": "professional", "payments": [ { "allowed_amount": 26.61, "providers": [ { "billed_charge": 75, "npi": [ 1376587113 ] }, { "billed_charge": 99.75, "npi": [ 1295726032 ] }, { "billed_charge": 131.73, "npi": [ 1932166386 ] } ] } ], "service_code": [ "81" ] } ] }, { "name": "Tissue exam by pathologist", "billing_code_type": "CPT", "billing_code_type_version": "2026-09-26", "billing_code": "88305", "description": "Tissue exam by pathologist", "allowed_amounts": [ { "tin": { "type": "ein", "value": "316402480" }, "billing_class": "institutional", "payments": [ { "allowed_amount": 86.09, "providers": [ { "billed_charge": 598, "npi": [ 1720159338 ] } ] }, { "allowed_amount": 68.34, "providers": [ { "billed_charge": 210, "npi": [ 1669499414 ] } ], "billing_code_modifier": [ "26" ] } ] } ] }, { "name": "Immunohisto antb 1st stain", "billing_code_type": "CPT", "billing_code_type_version": "2026-09-26", "billing_code": "88342", "description": "Immunohisto antb 1st stain", "allowed_amounts": [ { "tin": { "type": "ein", "value": "316402480" }, "billing_class": "institutional", "payments": [ { "allowed_amount": 133.47, "providers": [ { "billed_charge": 386, "npi": [ 1720159338 ] } ] } ] } ] }, { "name": "Psytx w pt 30 minutes", "billing_code_type": "CPT", "billing_code_type_version": "2026-09-26", "billing_code": "90832", "description": "Psytx w pt 30 minutes", "allowed_amounts": [ { "tin": { "type": "ein", "value": "991363990" }, "billing_class": "professional", "payments": [ { "allowed_amount": 117.74, "providers": [ { "billed_charge": 125, "npi": [ 1437916186 ] } ] } ], "service_code": [ "10" ] } ] }, { "name": "Psytx w pt 45 minutes", "billing_code_type": "CPT", "billing_code_type_version": "2026-09-26", "billing_code": "90834", "description": "Psytx w pt 45 minutes", "allowed_amounts": [ { "tin": { "type": "ein", "value": "991363990" }, "billing_class": "professional", "payments": [ { "allowed_amount": 156.48, "providers": [ { "billed_charge": 175, "npi": [ 1437916186 ] } ] }, { "allowed_amount": 141.18, "providers": [ { "billed_charge": 220, "npi": [ 9999999999 ] } ] } ], "service_code": [ "11" ] } ] }, { "name": "Liver elastography", "billing_code_type": "CPT", "billing_code_type_version": "2026-09-26", "billing_code": "91200", "description": "Liver elastography", "allowed_amounts": [ { "tin": { "type": "ein", "value": "340714585" }, "billing_class": "institutional", "payments": [ { "allowed_amount": 40.87, "providers": [ { "billed_charge": 720, "npi": [ 1679525919 ] } ] } ] } ] }, { "name": "Eye exam&tx estab pt 1/>vst", "billing_code_type": "CPT", "billing_code_type_version": "2026-09-26", "billing_code": "92014", "description": "Eye exam&tx estab pt 1/>vst", "allowed_amounts": [ { "tin": { "type": "ein", "value": "431560263" }, "billing_class": "professional", "payments": [ { "allowed_amount": 145.49, "providers": [ { "billed_charge": 291, "npi": [ 1245277631 ] } ] } ], "service_code": [ "11" ] } ] }, { "name": "Cptr ophth dx img post segmt", "billing_code_type": "CPT", "billing_code_type_version": "2026-09-26", "billing_code": "92134", "description": "Cptr ophth dx img post segmt", "allowed_amounts": [ { "tin": { "type": "ein", "value": "431560263" }, "billing_class": "professional", "payments": [ { "allowed_amount": 33.9, "providers": [ { "billed_charge": 170, "npi": [ 1245277631 ] } ] } ], "service_code": [ "11" ] } ] }, { "name": "Eye exam with photos", "billing_code_type": "CPT", "billing_code_type_version": "2026-09-26", "billing_code": "92250", "description": "Eye exam with photos", "allowed_amounts": [ { "tin": { "type": "ein", "value": "431560263" }, "billing_class": "professional", "payments": [ { "allowed_amount": 38.68, "providers": [ { "billed_charge": 230, "npi": [ 1245277631 ] } ] } ], "service_code": [ "11" ] } ] }, { "name": "Pure tone hearing test air", "billing_code_type": "CPT", "billing_code_type_version": "2026-09-26", "billing_code": "92551", "description": "Pure tone hearing test air", "allowed_amounts": [ { "tin": { "type": "ein", "value": "020222215" }, "billing_class": "professional", "payments": [ { "allowed_amount": 19.39, "providers": [ { "billed_charge": 26, "npi": [ 1093787384 ] } ] } ], "service_code": [ "11" ] } ] }, { "name": "Electrocardiogram tracing", "billing_code_type": "CPT", "billing_code_type_version": "2026-09-26", "billing_code": "93005", "description": "Electrocardiogram tracing", "allowed_amounts": [ { "tin": { "type": "ein", "value": "590878982" }, "billing_class": "institutional", "payments": [ { "allowed_amount": 8.96, "providers": [ { "billed_charge": 369, "npi": [ 1245226190 ] } ] } ] } ] }, { "name": "Electrocardiogram report", "billing_code_type": "CPT", "billing_code_type_version": "2026-09-26", "billing_code": "93010", "description": "Electrocardiogram report", "allowed_amounts": [ { "tin": { "type": "ein", "value": "431560263" }, "billing_class": "professional", "payments": [ { "allowed_amount": 11.23, "providers": [ { "billed_charge": 28, "npi": [ 1245277631 ] } ] } ], "service_code": [ "21" ] } ] }, { "name": "Rem interrog evl pm/ids", "billing_code_type": "CPT", "billing_code_type_version": "2026-09-26", "billing_code": "93296", "description": "Rem interrog evl pm/ids", "allowed_amounts": [ { "tin": { "type": "ein", "value": "311340739" }, "billing_class": "institutional", "payments": [ { "allowed_amount": 37.7, "providers": [ { "billed_charge": 175, "npi": [ 1447359997 ] } ] } ] } ] }, { "name": "Tte w/doppler complete", "billing_code_type": "CPT", "billing_code_type_version": "2026-09-26", "billing_code": "93306", "description": "Tte w/doppler complete", "allowed_amounts": [ { "tin": { "type": "ein", "value": "316402480" }, "billing_class": "institutional", "payments": [ { "allowed_amount": 239.2, "providers": [ { "billed_charge": 2387, "npi": [ 1720159338 ] } ] } ] } ] }, { "name": "Pulmonary stress testing", "billing_code_type": "CPT", "billing_code_type_version": "2026-09-26", "billing_code": "94618", "description": "Pulmonary stress testing", "allowed_amounts": [ { "tin": { "type": "ein", "value": "431560263" }, "billing_class": "professional", "payments": [ { "allowed_amount": 27.28, "providers": [ { "billed_charge": 57, "npi": [ 1245277631 ] } ], "billing_code_modifier": [ "26" ] } ], "service_code": [ "22" ] } ] }, { "name": "Polysom 6/>yrs cpap 4/> parm", "billing_code_type": "CPT", "billing_code_type_version": "2026-09-26", "billing_code": "95811", "description": "Polysom 6/>yrs cpap 4/> parm", "allowed_amounts": [ { "tin": { "type": "ein", "value": "431560263" }, "billing_class": "professional", "payments": [ { "allowed_amount": 148.68, "providers": [ { "billed_charge": 491, "npi": [ 1245277631 ] } ], "billing_code_modifier": [ "26" ] } ], "service_code": [ "22" ] } ] }, { "name": "Chemo hormon antineopl sq/im", "billing_code_type": "CPT", "billing_code_type_version": "2026-09-26", "billing_code": "96402", "description": "Chemo hormon antineopl sq/im", "allowed_amounts": [ { "tin": { "type": "ein", "value": "316402480" }, "billing_class": "institutional", "payments": [ { "allowed_amount": 219.395, "providers": [ { "billed_charge": 392, "npi": [ 1720159338 ] } ] } ] } ] }, { "name": "Therapeutic exercises", "billing_code_type": "CPT", "billing_code_type_version": "2026-09-26", "billing_code": "97110", "description": "Therapeutic exercises", "allowed_amounts": [ { "tin": { "type": "ein", "value": "316402480" }, "billing_class": "institutional", "payments": [ { "allowed_amount": 112.605, "providers": [ { "billed_charge": 253.5, "npi": [ 1720159338 ] } ] } ] } ] }, { "name": "Neuromuscular reeducation", "billing_code_type": "CPT", "billing_code_type_version": "2026-09-26", "billing_code": "97112", "description": "Neuromuscular reeducation", "allowed_amounts": [ { "tin": { "type": "ein", "value": "316402480" }, "billing_class": "institutional", "payments": [ { "allowed_amount": 40.78, "providers": [ { "billed_charge": 173, "npi": [ 1720159338 ] } ] } ] } ] }, { "name": "97162", "billing_code_type": "CPT", "billing_code_type_version": "2026-09-26", "billing_code": "97162", "description": "97162", "allowed_amounts": [ { "tin": { "type": "ein", "value": "316402480" }, "billing_class": "institutional", "payments": [ { "allowed_amount": 404, "providers": [ { "billed_charge": 404, "npi": [ 1720159338 ] }, { "billed_charge": 404, "npi": [ 1720159338 ] } ] }, { "allowed_amount": 96.16, "providers": [ { "billed_charge": 410, "npi": [ 1245226190 ] }, { "billed_charge": 410, "npi": [ 1245226190 ] } ] } ] } ] }, { "name": "Ot eval mod complex 45 min", "billing_code_type": "CPT", "billing_code_type_version": "2026-09-26", "billing_code": "97166", "description": "Ot eval mod complex 45 min", "allowed_amounts": [ { "tin": { "type": "ein", "value": "590878982" }, "billing_class": "institutional", "payments": [ { "allowed_amount": 128.13, "providers": [ { "billed_charge": 471, "npi": [ 1245226190 ] } ] } ] } ] }, { "name": "Self care mngment training", "billing_code_type": "CPT", "billing_code_type_version": "2026-09-26", "billing_code": "97535", "description": "Self care mngment training", "allowed_amounts": [ { "tin": { "type": "ein", "value": "590878982" }, "billing_class": "institutional", "payments": [ { "allowed_amount": 30.78, "providers": [ { "billed_charge": 215, "npi": [ 1245226190 ] } ] } ] } ] }, { "name": "Ocular instrumnt screen bil", "billing_code_type": "CPT", "billing_code_type_version": "2026-09-26", "billing_code": "99177", "description": "Ocular instrumnt screen bil", "allowed_amounts": [ { "tin": { "type": "ein", "value": "020222215" }, "billing_class": "professional", "payments": [ { "allowed_amount": 6.89, "providers": [ { "billed_charge": 10, "npi": [ 1093787384 ] } ] } ], "service_code": [ "11" ] } ] }, { "name": "Office/outpatient visit new", "billing_code_type": "CPT", "billing_code_type_version": "2026-09-26", "billing_code": "99203", "description": "Office/outpatient visit new", "allowed_amounts": [ { "tin": { "type": "ein", "value": "204881619" }, "billing_class": "professional", "payments": [ { "allowed_amount": 138.56, "providers": [ { "billed_charge": 254, "npi": [ 1669499414 ] } ] }, { "allowed_amount": 149.69, "providers": [ { "billed_charge": 316, "npi": [ 1104202761 ] } ] }, { "allowed_amount": 140.63, "providers": [ { "billed_charge": 240, "npi": [ 1992941108 ] } ] } ], "service_code": [ "11" ] } ] }, { "name": "Office/outpatient visit new", "billing_code_type": "CPT", "billing_code_type_version": "2026-09-26", "billing_code": "99204", "description": "Office/outpatient visit new", "allowed_amounts": [ { "tin": { "type": "ein", "value": "620811256" }, "billing_class": "professional", "payments": [ { "allowed_amount": 207.68, "providers": [ { "billed_charge": 328, "npi": [ 1003835141 ] } ] } ], "service_code": [ "11" ] } ] }, { "name": "Office/outpatient visit est", "billing_code_type": "CPT", "billing_code_type_version": "2026-09-26", "billing_code": "99211", "description": "Office/outpatient visit est", "allowed_amounts": [ { "tin": { "type": "ein", "value": "911858433" }, "billing_class": "institutional", "payments": [ { "allowed_amount": 15.845, "providers": [ { "billed_charge": 120, "npi": [ 1356307581 ] } ] } ] } ] }, { "name": "Office/outpatient visit est", "billing_code_type": "CPT", "billing_code_type_version": "2026-09-26", "billing_code": "99212", "description": "Office/outpatient visit est", "allowed_amounts": [ { "tin": { "type": "ein", "value": "311322863" }, "billing_class": "institutional", "payments": [ { "allowed_amount": 39.75, "providers": [ { "billed_charge": 190, "npi": [ 1124127683 ] }, { "billed_charge": 189, "npi": [ 1720159338 ] } ] } ] } ] }, { "name": "Office/outpatient visit est", "billing_code_type": "CPT", "billing_code_type_version": "2026-09-26", "billing_code": "99213", "description": "Office/outpatient visit est", "allowed_amounts": [ { "tin": { "type": "ein", "value": "316402480" }, "billing_class": "institutional", "payments": [ { "allowed_amount": 115.5, "providers": [ { "billed_charge": 231, "npi": [ 1720159338 ] } ] }, { "allowed_amount": 113.71, "providers": [ { "billed_charge": 166, "npi": [ 1992941108 ] } ] }, { "allowed_amount": 111.7, "providers": [ { "billed_charge": 212, "npi": [ 1104202761 ] } ] }, { "allowed_amount": 118.11, "providers": [ { "billed_charge": 383, "npi": [ 1780621904 ] } ] }, { "allowed_amount": 110.48, "providers": [ { "billed_charge": 144, "npi": [ 1245277631 ] } ] }, { "allowed_amount": 111.7, "providers": [ { "billed_charge": 125, "npi": [ 1306884911 ] } ] }, { "allowed_amount": 113.71, "providers": [ { "billed_charge": 194, "npi": [ 1992941108 ] } ] } ] } ] }, { "name": "Office/outpatient visit est", "billing_code_type": "CPT", "billing_code_type_version": "2026-09-26", "billing_code": "99214", "description": "Office/outpatient visit est", "allowed_amounts": [ { "tin": { "type": "ein", "value": "020442645" }, "billing_class": "professional", "payments": [ { "allowed_amount": 172.2, "providers": [ { "billed_charge": 325, "npi": [ 1144275389 ] } ] }, { "allowed_amount": 167.81, "providers": [ { "billed_charge": 539, "npi": [ 1710924683 ] } ] }, { "allowed_amount": 172.2, "providers": [ { "billed_charge": 325, "npi": [ 1144275389 ] } ] }, { "allowed_amount": 188.31, "providers": [ { "billed_charge": 193, "npi": [ 9999999999 ] } ] }, { "allowed_amount": 195.43, "providers": [ { "billed_charge": 441.09, "npi": [ 1346203536 ] } ] }, { "allowed_amount": 162.29, "providers": [ { "billed_charge": 236, "npi": [ 1992941108 ] } ] }, { "allowed_amount": 159.2, "providers": [ { "billed_charge": 347, "npi": [ 1093016651 ] }, { "billed_charge": 347, "npi": [ 1093016651 ] } ] }, { "allowed_amount": 195.43, "providers": [ { "billed_charge": 1225, "npi": [ 1659883486 ] } ] }, { "allowed_amount": 172.26, "providers": [ { "billed_charge": 318, "npi": [ 1104202761 ] } ] }, { "allowed_amount": 159.2, "providers": [ { "billed_charge": 318, "npi": [ 1104202761 ] } ] }, { "allowed_amount": 157.84, "providers": [ { "billed_charge": 231.4, "npi": [ 1245277631 ] } ] }, { "allowed_amount": 159.2, "providers": [ { "billed_charge": 208, "npi": [ 1003835141 ] } ] }, { "allowed_amount": 162.29, "providers": [ { "billed_charge": 274, "npi": [ 1992941108 ] }, { "billed_charge": 274, "npi": [ 1992941108 ] } ] } ], "service_code": [ "10" ] } ] }, { "name": "Office/outpatient visit est", "billing_code_type": "CPT", "billing_code_type_version": "2026-09-26", "billing_code": "99215", "description": "Office/outpatient visit est", "allowed_amounts": [ { "tin": { "type": "ein", "value": "352528741" }, "billing_class": "professional", "payments": [ { "allowed_amount": 244.44, "providers": [ { "billed_charge": 429, "npi": [ 1104202761 ] } ] } ], "service_code": [ "11" ] } ] }, { "name": "Initial hospital care", "billing_code_type": "CPT", "billing_code_type_version": "2026-09-26", "billing_code": "99223", "description": "Initial hospital care", "allowed_amounts": [ { "tin": { "type": "ein", "value": "431560263" }, "billing_class": "professional", "payments": [ { "allowed_amount": 189.9, "providers": [ { "billed_charge": 333, "npi": [ 1245277631 ] } ] }, { "allowed_amount": 199.63, "providers": [ { "billed_charge": 1107, "npi": [ 1710684857 ] } ] } ], "service_code": [ "21" ] } ] }, { "name": "Subsequent hospital care", "billing_code_type": "CPT", "billing_code_type_version": "2026-09-26", "billing_code": "99232", "description": "Subsequent hospital care", "allowed_amounts": [ { "tin": { "type": "ein", "value": "426004813" }, "billing_class": "professional", "payments": [ { "allowed_amount": 83.65, "providers": [ { "billed_charge": 315, "npi": [ 1477554814 ] } ] }, { "allowed_amount": 85.66, "providers": [ { "billed_charge": 134, "npi": [ 1245277631 ] } ] } ], "service_code": [ "21" ] } ] }, { "name": "Subsequent hospital care", "billing_code_type": "CPT", "billing_code_type_version": "2026-09-26", "billing_code": "99233", "description": "Subsequent hospital care", "allowed_amounts": [ { "tin": { "type": "ein", "value": "922116659" }, "billing_class": "professional", "payments": [ { "allowed_amount": 136.25, "providers": [ { "billed_charge": 572, "npi": [ 1710684857 ] } ] } ], "service_code": [ "21" ] } ] }, { "name": "Hospital discharge day", "billing_code_type": "CPT", "billing_code_type_version": "2026-09-26", "billing_code": "99238", "description": "Hospital discharge day", "allowed_amounts": [ { "tin": { "type": "ein", "value": "922116659" }, "billing_class": "professional", "payments": [ { "allowed_amount": 94.9, "providers": [ { "billed_charge": 406, "npi": [ 1710684857 ] } ] } ], "service_code": [ "21" ] } ] }, { "name": "Hospital discharge day", "billing_code_type": "CPT", "billing_code_type_version": "2026-09-26", "billing_code": "99239", "description": "Hospital discharge day", "allowed_amounts": [ { "tin": { "type": "ein", "value": "431560263" }, "billing_class": "professional", "payments": [ { "allowed_amount": 127.94, "providers": [ { "billed_charge": 199, "npi": [ 1245277631 ] } ] } ], "service_code": [ "21" ] } ] }, { "name": "Office consultation", "billing_code_type": "CPT", "billing_code_type_version": "2026-09-26", "billing_code": "99243", "description": "Office consultation", "allowed_amounts": [ { "tin": { "type": "ein", "value": "352528741" }, "billing_class": "professional", "payments": [ { "allowed_amount": 142.83, "providers": [ { "billed_charge": 313, "npi": [ 1104202761 ] } ] } ], "service_code": [ "11" ] } ] }, { "name": "Emergency dept visit", "billing_code_type": "CPT", "billing_code_type_version": "2026-09-26", "billing_code": "99285", "description": "Emergency dept visit", "allowed_amounts": [ { "tin": { "type": "ein", "value": "590878982" }, "billing_class": "institutional", "payments": [ { "allowed_amount": 232, "providers": [ { "billed_charge": 4542, "npi": [ 1245226190 ] } ] }, { "allowed_amount": 235.1, "providers": [ { "billed_charge": 521, "npi": [ 1245277631 ] } ] }, { "allowed_amount": 249.84, "providers": [ { "billed_charge": 984, "npi": [ 1043917180 ] } ] } ] } ] }, { "name": "Prev visit est age 5-11", "billing_code_type": "CPT", "billing_code_type_version": "2026-09-26", "billing_code": "99393", "description": "Prev visit est age 5-11", "allowed_amounts": [ { "tin": { "type": "ein", "value": "020222215" }, "billing_class": "professional", "payments": [ { "allowed_amount": 138.14, "providers": [ { "billed_charge": 237, "npi": [ 1093787384 ] } ] } ], "service_code": [ "11" ] } ] }, { "name": "Prev visit est age 18-39", "billing_code_type": "CPT", "billing_code_type_version": "2026-09-26", "billing_code": "99395", "description": "Prev visit est age 18-39", "allowed_amounts": [ { "tin": { "type": "ein", "value": "431560263" }, "billing_class": "professional", "payments": [ { "allowed_amount": 141.6, "providers": [ { "billed_charge": 192, "npi": [ 1245277631 ] } ] } ], "service_code": [ "11" ] } ] }, { "name": "Prev visit est age 40-64", "billing_code_type": "CPT", "billing_code_type_version": "2026-09-26", "billing_code": "99396", "description": "Prev visit est age 40-64", "allowed_amounts": [ { "tin": { "type": "ein", "value": "352528741" }, "billing_class": "professional", "payments": [ { "allowed_amount": 151.85, "providers": [ { "billed_charge": 325, "npi": [ 1104202761 ] } ] } ], "service_code": [ "11" ] } ] }, { "name": "Per pm reeval est pat 65+ yr", "billing_code_type": "CPT", "billing_code_type_version": "2026-09-26", "billing_code": "99397", "description": "Per pm reeval est pat 65+ yr", "allowed_amounts": [ { "tin": { "type": "ein", "value": "352528741" }, "billing_class": "professional", "payments": [ { "allowed_amount": 163.61, "providers": [ { "billed_charge": 349, "npi": [ 1104202761 ] } ] } ], "service_code": [ "11" ] } ] }, { "name": "Tc99m medronate", "billing_code_type": "CPT", "billing_code_type_version": "2026-09-26", "billing_code": "A9503", "description": "Tc99m medronate", "allowed_amounts": [ { "tin": { "type": "ein", "value": "311340739" }, "billing_class": "institutional", "payments": [ { "allowed_amount": 19.5, "providers": [ { "billed_charge": 95, "npi": [ 1447359997 ] } ] } ] } ] }, { "name": "Tc99m sulfur colloid", "billing_code_type": "CPT", "billing_code_type_version": "2026-09-26", "billing_code": "A9541", "description": "Tc99m sulfur colloid", "allowed_amounts": [ { "tin": { "type": "ein", "value": "316402480" }, "billing_class": "institutional", "payments": [ { "allowed_amount": 27.04, "providers": [ { "billed_charge": 387.68, "npi": [ 1720159338 ] } ] } ] } ] }, { "name": "C8929 - TTE w or wo fol wcon,Doppler", "billing_code_type": "CPT", "billing_code_type_version": "2026-09-26", "billing_code": "C8929", "description": "C8929 - TTE w or wo fol wcon,Doppler", "allowed_amounts": [ { "tin": { "type": "ein", "value": "590878982" }, "billing_class": "institutional", "payments": [ { "allowed_amount": 3523, "providers": [ { "billed_charge": 3523, "npi": [ 1245226190 ] } ] } ] } ] }, { "name": "Psa screening", "billing_code_type": "CPT", "billing_code_type_version": "2026-09-26", "billing_code": "G0103", "description": "Psa screening", "allowed_amounts": [ { "tin": { "type": "ein", "value": "911858433" }, "billing_class": "institutional", "payments": [ { "allowed_amount": 25.1, "providers": [ { "billed_charge": 90, "npi": [ 1356307581 ] }, { "billed_charge": 90, "npi": [ 1356307581 ] } ] } ] } ] }, { "name": "Scr c/v cyto,thinlayer,rescr", "billing_code_type": "CPT", "billing_code_type_version": "2026-09-26", "billing_code": "G0145", "description": "Scr c/v cyto,thinlayer,rescr", "allowed_amounts": [ { "tin": { "type": "ein", "value": "621695507" }, "billing_class": "professional", "payments": [ { "allowed_amount": 35.76, "providers": [ { "billed_charge": 94, "npi": [ 1003863580 ] } ] } ], "service_code": [ "11" ] } ] }, { "name": "Hospital observation per hr", "billing_code_type": "CPT", "billing_code_type_version": "2026-09-26", "billing_code": "G0378", "description": "Hospital observation per hr", "allowed_amounts": [ { "tin": { "type": "ein", "value": "590878982" }, "billing_class": "institutional", "payments": [ { "allowed_amount": 3220.5, "providers": [ { "billed_charge": 3220.5, "npi": [ 1245226190 ] } ] } ] } ] }, { "name": "Dexamethasone sodium phos", "billing_code_type": "CPT", "billing_code_type_version": "2026-09-26", "billing_code": "J1100", "description": "Dexamethasone sodium phos", "allowed_amounts": [ { "tin": { "type": "ein", "value": "275078717" }, "billing_class": "professional", "payments": [ { "allowed_amount": 1.62, "providers": [ { "billed_charge": 10, "npi": [ 1659883486 ] } ] } ], "service_code": [ "11" ] } ] }, { "name": "Inj enoxaparin sodium", "billing_code_type": "CPT", "billing_code_type_version": "2026-09-26", "billing_code": "J1650", "description": "Inj enoxaparin sodium", "allowed_amounts": [ { "tin": { "type": "ein", "value": "590878982" }, "billing_class": "institutional", "payments": [ { "allowed_amount": 2.76, "providers": [ { "billed_charge": 36, "npi": [ 1245226190 ] } ] } ] } ] }, { "name": "Inj, propofol, 10 mg", "billing_code_type": "CPT", "billing_code_type_version": "2026-09-26", "billing_code": "J2704", "description": "Inj, propofol, 10 mg", "allowed_amounts": [ { "tin": { "type": "ein", "value": "316402480" }, "billing_class": "institutional", "payments": [ { "allowed_amount": 1.76, "providers": [ { "billed_charge": 31.72, "npi": [ 1720159338 ] } ] } ] } ] }, { "name": "Zoledronic acid 1mg", "billing_code_type": "CPT", "billing_code_type_version": "2026-09-26", "billing_code": "J3489", "description": "Zoledronic acid 1mg", "allowed_amounts": [ { "tin": { "type": "ein", "value": "316402480" }, "billing_class": "institutional", "payments": [ { "allowed_amount": 26.42, "providers": [ { "billed_charge": 243.04, "npi": [ 1720159338 ] } ] } ] } ] }, { "name": "Drugs unclassified injection", "billing_code_type": "CPT", "billing_code_type_version": "2026-09-26", "billing_code": "J3490", "description": "Drugs unclassified injection", "allowed_amounts": [ { "tin": { "type": "ein", "value": "275078717" }, "billing_class": "professional", "payments": [ { "allowed_amount": 14.85, "providers": [ { "billed_charge": 27, "npi": [ 1659883486 ] } ] } ], "service_code": [ "11" ] } ] }, { "name": "Normal saline solution infus", "billing_code_type": "CPT", "billing_code_type_version": "2026-09-26", "billing_code": "J7030", "description": "Normal saline solution infus", "allowed_amounts": [ { "tin": { "type": "ein", "value": "316402480" }, "billing_class": "institutional", "payments": [ { "allowed_amount": 2.59, "providers": [ { "billed_charge": 89.35, "npi": [ 1720159338 ] } ] } ] } ] }, { "name": "Leuprolide acetate suspnsion", "billing_code_type": "CPT", "billing_code_type_version": "2026-09-26", "billing_code": "J9217", "description": "Leuprolide acetate suspnsion", "allowed_amounts": [ { "tin": { "type": "ein", "value": "316402480" }, "billing_class": "institutional", "payments": [ { "allowed_amount": 18112.735, "providers": [ { "billed_charge": 35362.985, "npi": [ 1720159338 ] } ] } ] } ] }, { "name": "Ondansetron oral", "billing_code_type": "CPT", "billing_code_type_version": "2026-09-26", "billing_code": "Q0162", "description": "Ondansetron oral", "allowed_amounts": [ { "tin": { "type": "ein", "value": "311322863" }, "billing_class": "institutional", "payments": [ { "allowed_amount": 0.1, "providers": [ { "billed_charge": 3.3, "npi": [ 1124127683 ] }, { "billed_charge": 4.6, "npi": [ 1447359997 ] } ] } ] } ] }, { "name": "Inj sulf hexa lipid microsph", "billing_code_type": "CPT", "billing_code_type_version": "2026-09-26", "billing_code": "Q9950", "description": "Inj sulf hexa lipid microsph", "allowed_amounts": [ { "tin": { "type": "ein", "value": "590878982" }, "billing_class": "institutional", "payments": [ { "allowed_amount": 47.24, "providers": [ { "billed_charge": 348.6, "npi": [ 1245226190 ] } ] } ] } ] } ] }