{"reporting_entity_name": "First Choice Next, A Product of SHSC, Inc.","reporting_entity_type": "First Choice Next, A Product of SHSC, Inc.","last_updated_on": "2026-02-18","version": "2.0.0","out_of_network":[{"name":"Basic Metabolic Panel","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80048","description":"Basic Metabolic Panel","allowed_amounts":[{"tin":{"type":"ein","value":"582296052"},"service_code":[],"billing_class":"institutional","payments":[{"allowed_amount":14.81,"providers":[{"billed_charge":181.00,"npi":[1811237985]}]}]}]},{"name":"Basic Metabolic Panel","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80048","description":"Basic Metabolic Panel","allowed_amounts":[{"tin":{"type":"ein","value":"811723202"},"service_code":[],"billing_class":"institutional","payments":[{"allowed_amount":14.81,"providers":[{"billed_charge":181.00,"npi":[1639656713]}]}]}]},{"name":"Blood Count; Complete Cbc, Automated (Hgb, Hct, Rbc, Wbc, & Platelet) & Automated Differential Wbc","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85025","description":"Blood Count; Complete Cbc, Automated (Hgb, Hct, Rbc, Wbc, & Platelet) & Automated Differential Wbc","allowed_amounts":[{"tin":{"type":"ein","value":"582296052"},"service_code":[],"billing_class":"institutional","payments":[{"allowed_amount":13.60,"providers":[{"billed_charge":126.00,"npi":[1811237985]}]}]}]},{"name":"Blood Count; Complete Cbc, Automated (Hgb, Hct, Rbc, Wbc, & Platelet) & Automated Differential Wbc","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85025","description":"Blood Count; Complete Cbc, Automated (Hgb, Hct, Rbc, Wbc, & Platelet) & Automated Differential Wbc","allowed_amounts":[{"tin":{"type":"ein","value":"811723202"},"service_code":[],"billing_class":"institutional","payments":[{"allowed_amount":13.60,"providers":[{"billed_charge":126.00,"npi":[1639656713,1649726738]}]}]}]},{"name":"Blood Count; Complete Cbc, Automated (Hgb, Hct, Rbc, Wbc, & Platelet) & Automated Differential Wbc","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85025","description":"Blood Count; Complete Cbc, Automated (Hgb, Hct, Rbc, Wbc, & Platelet) & Automated Differential Wbc","allowed_amounts":[{"tin":{"type":"ein","value":"991177652"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":8.55,"providers":[{"billed_charge":23.00,"npi":[1760570675]}]},{"allowed_amount":9.48,"providers":[{"billed_charge":23.00,"npi":[1760570675]}]}]}]},{"name":"Collection, Venous Blood, Venipuncture","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36415","description":"Collection, Venous Blood, Venipuncture","allowed_amounts":[{"tin":{"type":"ein","value":"811723202"},"service_code":[],"billing_class":"institutional","payments":[{"allowed_amount":15.91,"providers":[{"billed_charge":28.00,"npi":[1639656713]}]}]}]},{"name":"Collection, Venous Blood, Venipuncture","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36415","description":"Collection, Venous Blood, Venipuncture","allowed_amounts":[{"tin":{"type":"ein","value":"881549656"},"service_code":["20"],"billing_class":"professional","payments":[{"allowed_amount":10.00,"providers":[{"billed_charge":19.00,"npi":[1093943466]}]}]}]},{"name":"Collection, Venous Blood, Venipuncture","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36415","description":"Collection, Venous Blood, Venipuncture","allowed_amounts":[{"tin":{"type":"ein","value":"991177652"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":10.00,"providers":[{"billed_charge":26.00,"npi":[1760570675]}]},{"allowed_amount":11.09,"providers":[{"billed_charge":26.00,"npi":[1760570675]}]}]}]},{"name":"Collection, Venous Blood, Venipuncture","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36415","description":"Collection, Venous Blood, Venipuncture","allowed_amounts":[{"tin":{"type":"ein","value":"994277174"},"service_code":["20"],"billing_class":"professional","payments":[{"allowed_amount":10.00,"providers":[{"billed_charge":22.00,"npi":[1982070553]}]}]}]},{"name":"Comprehensive Metabolic Panel","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80053","description":"Comprehensive Metabolic Panel","allowed_amounts":[{"tin":{"type":"ein","value":"811723202"},"service_code":[],"billing_class":"institutional","payments":[{"allowed_amount":18.48,"providers":[{"billed_charge":230.00,"npi":[1649726738]}]}]}]},{"name":"Computed tomography, abdomen and pelvis; with contrast material(s)","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74177","description":"Computed tomography, abdomen and pelvis; with contrast material(s)","allowed_amounts":[{"tin":{"type":"ein","value":"811723202"},"service_code":[],"billing_class":"institutional","payments":[{"allowed_amount":580.51,"providers":[{"billed_charge":4977.00,"npi":[1639656713]}]},{"allowed_amount":581.93,"providers":[{"billed_charge":4977.00,"npi":[1649726738]}]}]}]},{"name":"Electrocardiogram, Routine 12+ Leads; Tracing Only W\/O Interpretation & Report","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"93005XU","description":"Electrocardiogram, Routine 12+ Leads; Tracing Only W\/O Interpretation & Report","allowed_amounts":[{"tin":{"type":"ein","value":"582296052"},"service_code":[],"billing_class":"institutional","payments":[{"allowed_amount":384.72,"providers":[{"billed_charge":1716.00,"npi":[1811237985]}]}]}]},{"name":"Electrocardiogram, Routine 12+ Leads; Tracing Only W\/O Interpretation & Report","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"93005XU","description":"Electrocardiogram, Routine 12+ Leads; Tracing Only W\/O Interpretation & Report","allowed_amounts":[{"tin":{"type":"ein","value":"811723202"},"service_code":[],"billing_class":"institutional","payments":[{"allowed_amount":96.79,"providers":[{"billed_charge":429.00,"npi":[1649726738]}]}]}]},{"name":"Emergency department visit for the evaluation and management of a patient, which requires a medically appropriate history and\/or examination and high level of medical decision","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99285","description":"Emergency department visit for the evaluation and management of a patient, which requires a medically appropriate history and\/or examination and high level of medical decision","allowed_amounts":[{"tin":{"type":"ein","value":"271369141"},"service_code":["23"],"billing_class":"professional","payments":[{"allowed_amount":156.07,"providers":[{"billed_charge":1286.00,"npi":[1073337317]}]}]}]},{"name":"Emergency department visit for the evaluation and management of a patient, which requires a medically appropriate history and\/or examination and high level of medical decision","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99285","description":"Emergency department visit for the evaluation and management of a patient, which requires a medically appropriate history and\/or examination and high level of medical decision","allowed_amounts":[{"tin":{"type":"ein","value":"821910968"},"service_code":["23"],"billing_class":"professional","payments":[{"allowed_amount":180.49,"providers":[{"billed_charge":1870.00,"npi":[1821005075,1851887624,1871912790]}]}]}]},{"name":"Emergency department visit for the evaluation and management of a patient, which requires a medically appropriate history and\/or examination and high level of medical decision","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99285","description":"Emergency department visit for the evaluation and management of a patient, which requires a medically appropriate history and\/or examination and high level of medical decision","allowed_amounts":[{"tin":{"type":"ein","value":"831057917"},"service_code":["23"],"billing_class":"professional","payments":[{"allowed_amount":180.49,"providers":[{"billed_charge":706.20,"npi":[1801521729]}]}]}]},{"name":"Emergency department visit for the evaluation and management of a patient, which requires a medically appropriate history and\/or examination and high level of medical decision","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"9928525","description":"Emergency department visit for the evaluation and management of a patient, which requires a medically appropriate history and\/or examination and high level of medical decision","allowed_amounts":[{"tin":{"type":"ein","value":"271369141"},"service_code":["23"],"billing_class":"professional","payments":[{"allowed_amount":166.92,"providers":[{"billed_charge":1286.00,"npi":[1215933718]}]}]}]},{"name":"Emergency department visit for the evaluation and management of a patient, which requires a medically appropriate history and\/or examination and high level of medical decision","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"9928525","description":"Emergency department visit for the evaluation and management of a patient, which requires a medically appropriate history and\/or examination and high level of medical decision","allowed_amounts":[{"tin":{"type":"ein","value":"582296052"},"service_code":[],"billing_class":"institutional","payments":[{"allowed_amount":992.65,"providers":[{"billed_charge":2527.00,"npi":[1811237985]}]}]}]},{"name":"Emergency department visit for the evaluation and management of a patient, which requires a medically appropriate history and\/or examination and high level of medical decision","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"9928525","description":"Emergency department visit for the evaluation and management of a patient, which requires a medically appropriate history and\/or examination and high level of medical decision","allowed_amounts":[{"tin":{"type":"ein","value":"811723202"},"service_code":[],"billing_class":"institutional","payments":[{"allowed_amount":996.57,"providers":[{"billed_charge":2527.00,"npi":[1639656713]}]},{"allowed_amount":999.02,"providers":[{"billed_charge":2527.00,"npi":[1649726738]}]}]}]},{"name":"Emergency department visit for the evaluation and management of a patient, which requires a medically appropriate history and\/or examination and low level of medical decision","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99283","description":"Emergency department visit for the evaluation and management of a patient, which requires a medically appropriate history and\/or examination and low level of medical decision","allowed_amounts":[{"tin":{"type":"ein","value":"811723202"},"service_code":[],"billing_class":"institutional","payments":[{"allowed_amount":787.79,"providers":[{"billed_charge":1166.00,"npi":[1245786367]}]}]}]},{"name":"Emergency department visit for the evaluation and management of a patient, which requires a medically appropriate history and\/or examination and moderate level of medical deci","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99284","description":"Emergency department visit for the evaluation and management of a patient, which requires a medically appropriate history and\/or examination and moderate level of medical deci","allowed_amounts":[{"tin":{"type":"ein","value":"571004971"},"service_code":["23"],"billing_class":"professional","payments":[{"allowed_amount":105.78,"providers":[{"billed_charge":368.00,"npi":[1780197061]}]},{"allowed_amount":124.44,"providers":[{"billed_charge":368.00,"npi":[1013265685]}]},{"allowed_amount":137.21,"providers":[{"billed_charge":368.00,"npi":[1467795310]}]}]}]},{"name":"Emergency department visit for the evaluation and management of a patient, which requires a medically appropriate history and\/or examination and moderate level of medical deci","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99284","description":"Emergency department visit for the evaluation and management of a patient, which requires a medically appropriate history and\/or examination and moderate level of medical deci","allowed_amounts":[{"tin":{"type":"ein","value":"821910968"},"service_code":["23"],"billing_class":"professional","payments":[{"allowed_amount":105.78,"providers":[{"billed_charge":1280.00,"npi":[1477995470]}]},{"allowed_amount":124.44,"providers":[{"billed_charge":1280.00,"npi":[1629058425,1851887624]}]},{"allowed_amount":129.35,"providers":[{"billed_charge":1280.00,"npi":[1700446481]}]}]}]},{"name":"Hepatic Function Panel","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80076","description":"Hepatic Function Panel","allowed_amounts":[{"tin":{"type":"ein","value":"811723202"},"service_code":[],"billing_class":"institutional","payments":[{"allowed_amount":14.30,"providers":[{"billed_charge":157.00,"npi":[1639656713]}]}]}]},{"name":"Initial hospital inpatient or observation care, per day, for the evaluation and management of a patient, which requires a medically appropriate history and\/or examination and","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99223","description":"Initial hospital inpatient or observation care, per day, for the evaluation and management of a patient, which requires a medically appropriate history and\/or examination and","allowed_amounts":[{"tin":{"type":"ein","value":"943342387"},"service_code":["21"],"billing_class":"professional","payments":[{"allowed_amount":177.83,"providers":[{"billed_charge":1255.00,"npi":[1134489784]}]},{"allowed_amount":210.79,"providers":[{"billed_charge":1255.00,"npi":[1356364087]}]}]}]},{"name":"Inj Magnesium Sulfate","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3475","description":"Inj Magnesium Sulfate","allowed_amounts":[{"tin":{"type":"ein","value":"582296052"},"service_code":[],"billing_class":"institutional","payments":[{"allowed_amount":48.16,"providers":[{"billed_charge":240.80,"npi":[1811237985]}]}]}]},{"name":"Injection, lidocaine HCl , 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2003","description":"Injection, lidocaine HCl , 1 mg","allowed_amounts":[{"tin":{"type":"ein","value":"811723202"},"service_code":[],"billing_class":"institutional","payments":[{"allowed_amount":0.00,"providers":[{"billed_charge":42.80,"npi":[1639656713]}]}]}]},{"name":"Intravenous infusion, hydration; each additional hour (List separately in addition to code for primary procedure)","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96361","description":"Intravenous infusion, hydration; each additional hour (List separately in addition to code for primary procedure)","allowed_amounts":[{"tin":{"type":"ein","value":"811723202"},"service_code":[],"billing_class":"institutional","payments":[{"allowed_amount":150.36,"providers":[{"billed_charge":522.00,"npi":[1649726738]}]}]}]},{"name":"Invalid Procedure Code","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0000000","description":"Invalid Procedure Code","allowed_amounts":[{"tin":{"type":"ein","value":"571101380"},"service_code":[],"billing_class":"institutional","payments":[{"allowed_amount":0.00,"providers":[{"billed_charge":10.02,"npi":[1134232671]},{"billed_charge":39.06,"npi":[1134232671]},{"billed_charge":49.08,"npi":[1134232671]},{"billed_charge":59.10,"npi":[1134232671]},{"billed_charge":60.15,"npi":[1134232671]}]},{"allowed_amount":5990.21,"providers":[{"billed_charge":8800.00,"npi":[1134232671]}]}]}]},{"name":"Invalid Procedure Code","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0000000","description":"Invalid Procedure Code","allowed_amounts":[{"tin":{"type":"ein","value":"582296052"},"service_code":[],"billing_class":"institutional","payments":[{"allowed_amount":0.62,"providers":[{"billed_charge":3.10,"npi":[1811237985]}]},{"allowed_amount":11.80,"providers":[{"billed_charge":59.00,"npi":[1811237985]}]}]}]},{"name":"Invalid Procedure Code","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0000000","description":"Invalid Procedure Code","allowed_amounts":[{"tin":{"type":"ein","value":"811723202"},"service_code":[],"billing_class":"institutional","payments":[{"allowed_amount":0.00,"providers":[{"billed_charge":0.60,"npi":[1245786367]},{"billed_charge":1045.00,"npi":[1245786367]},{"billed_charge":1122.00,"npi":[1245786367]},{"billed_charge":118.00,"npi":[1245786367]},{"billed_charge":125.30,"npi":[1245786367]},{"billed_charge":13.50,"npi":[1245786367]},{"billed_charge":151.40,"npi":[1245786367]},{"billed_charge":167.90,"npi":[1245786367]},{"billed_charge":1824.00,"npi":[1245786367]},{"billed_charge":2054.00,"npi":[1245786367]},{"billed_charge":2272.00,"npi":[1245786367]},{"billed_charge":250.60,"npi":[1245786367]},{"billed_charge":251.00,"npi":[1245786367]},{"billed_charge":2527.00,"npi":[1245786367]},{"billed_charge":280.90,"npi":[1245786367]},{"billed_charge":29.50,"npi":[1245786367]},{"billed_charge":299.60,"npi":[1245786367]},{"billed_charge":42.80,"npi":[1245786367]},{"billed_charge":429.00,"npi":[1245786367]},{"billed_charge":4301.00,"npi":[1245786367]},{"billed_charge":460.00,"npi":[1245786367]},{"billed_charge":481.60,"npi":[1245786367]},{"billed_charge":561.00,"npi":[1245786367]},{"billed_charge":5881.00,"npi":[1245786367]},{"billed_charge":59.00,"npi":[1245786367]},{"billed_charge":63.30,"npi":[1245786367]},{"billed_charge":6302.00,"npi":[1245786367]},{"billed_charge":655.00,"npi":[1245786367]},{"billed_charge":69.60,"npi":[1245786367]},{"billed_charge":7754.00,"npi":[1245786367]},{"billed_charge":8.80,"npi":[1245786367]},{"billed_charge":894.00,"npi":[1245786367]},{"billed_charge":97.00,"npi":[1245786367]}]},{"allowed_amount":0.12,"providers":[{"billed_charge":0.60,"npi":[1639656713]}]},{"allowed_amount":0.18,"providers":[{"billed_charge":0.60,"npi":[1245786367]}]},{"allowed_amount":0.24,"providers":[{"billed_charge":1.20,"npi":[1649726738]}]},{"allowed_amount":0.48,"providers":[{"billed_charge":2.40,"npi":[1649726738]}]},{"allowed_amount":1.22,"providers":[{"billed_charge":6.10,"npi":[1649726738]}]},{"allowed_amount":5.90,"providers":[{"billed_charge":29.50,"npi":[1649726738]}]},{"allowed_amount":7.92,"providers":[{"billed_charge":39.60,"npi":[1639656713]}]},{"allowed_amount":8.56,"providers":[{"billed_charge":42.80,"npi":[1639656713]}]},{"allowed_amount":10.04,"providers":[{"billed_charge":50.20,"npi":[1639656713]}]},{"allowed_amount":11.56,"providers":[{"billed_charge":57.80,"npi":[1649726738]}]},{"allowed_amount":11.80,"providers":[{"billed_charge":59.00,"npi":[1649726738]}]},{"allowed_amount":17.12,"providers":[{"billed_charge":85.60,"npi":[1639656713,1649726738]}]},{"allowed_amount":17.70,"providers":[{"billed_charge":59.00,"npi":[1245786367]}]},{"allowed_amount":55.02,"providers":[{"billed_charge":275.11,"npi":[1639656713]}]},{"allowed_amount":693.60,"providers":[{"billed_charge":3468.00,"npi":[1639656713]}]},{"allowed_amount":723.20,"providers":[{"billed_charge":3616.00,"npi":[1639656713]}]},{"allowed_amount":26348.25,"providers":[{"billed_charge":4764.00,"npi":[1245786367]}]}]}]},{"name":"Lactate (Lactic Acid)","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83605","description":"Lactate (Lactic Acid)","allowed_amounts":[{"tin":{"type":"ein","value":"811723202"},"service_code":[],"billing_class":"institutional","payments":[{"allowed_amount":20.25,"providers":[{"billed_charge":240.00,"npi":[1649726738]}]}]}]},{"name":"Lipase","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83690","description":"Lipase","allowed_amounts":[{"tin":{"type":"ein","value":"811723202"},"service_code":[],"billing_class":"institutional","payments":[{"allowed_amount":12.06,"providers":[{"billed_charge":188.00,"npi":[1639656713,1649726738]}]}]}]},{"name":"Low osmolar contrast material, 300-399 mg\/ml iodine concentration, per ml","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q9967","description":"Low osmolar contrast material, 300-399 mg\/ml iodine concentration, per ml","allowed_amounts":[{"tin":{"type":"ein","value":"582296052"},"service_code":[],"billing_class":"institutional","payments":[{"allowed_amount":11.14,"providers":[{"billed_charge":55.70,"npi":[1811237985]}]}]}]},{"name":"Low osmolar contrast material, 300-399 mg\/ml iodine concentration, per ml","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q9967","description":"Low osmolar contrast material, 300-399 mg\/ml iodine concentration, per ml","allowed_amounts":[{"tin":{"type":"ein","value":"811723202"},"service_code":[],"billing_class":"institutional","payments":[{"allowed_amount":13.92,"providers":[{"billed_charge":69.60,"npi":[1639656713,1649726738]}]},{"allowed_amount":14.62,"providers":[{"billed_charge":73.10,"npi":[1649726738]}]}]}]},{"name":"Magnesium","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83735","description":"Magnesium","allowed_amounts":[{"tin":{"type":"ein","value":"582296052"},"service_code":[],"billing_class":"institutional","payments":[{"allowed_amount":11.73,"providers":[{"billed_charge":126.00,"npi":[1811237985]}]}]}]},{"name":"Magnesium","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83735","description":"Magnesium","allowed_amounts":[{"tin":{"type":"ein","value":"811723202"},"service_code":[],"billing_class":"institutional","payments":[{"allowed_amount":11.73,"providers":[{"billed_charge":126.00,"npi":[1649726738]}]}]}]},{"name":"Manual Therapy Techniques, 1+ Regions, Each 15 Min","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"97140GP","description":"Manual Therapy Techniques, 1+ Regions, Each 15 Min","allowed_amounts":[{"tin":{"type":"ein","value":"582504530"},"service_code":[],"billing_class":"institutional","payments":[{"allowed_amount":35.14,"providers":[{"billed_charge":237.00,"npi":[1730123175]}]}]}]},{"name":"Normal Saline Solution Infus","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7030","description":"Normal Saline Solution Infus","allowed_amounts":[{"tin":{"type":"ein","value":"582296052"},"service_code":[],"billing_class":"institutional","payments":[{"allowed_amount":37.40,"providers":[{"billed_charge":187.00,"npi":[1811237985]}]}]}]},{"name":"Normal Saline Solution Infus","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7030","description":"Normal Saline Solution Infus","allowed_amounts":[{"tin":{"type":"ein","value":"811723202"},"service_code":[],"billing_class":"institutional","payments":[{"allowed_amount":37.40,"providers":[{"billed_charge":187.00,"npi":[1649726738]}]}]}]},{"name":"Office or other outpatient visit for the evaluation and management of an established patient, which requires a medically appropriate history and\/or examination and low level o","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"9921325","description":"Office or other outpatient visit for the evaluation and management of an established patient, which requires a medically appropriate history and\/or examination and low level o","allowed_amounts":[{"tin":{"type":"ein","value":"843743303"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":93.02,"providers":[{"billed_charge":120.00,"npi":[1235268210]}]}]}]},{"name":"Office or other outpatient visit for the evaluation and management of an established patient, which requires a medically appropriate history and\/or examination and moderate le","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99214","description":"Office or other outpatient visit for the evaluation and management of an established patient, which requires a medically appropriate history and\/or examination and moderate le","allowed_amounts":[{"tin":{"type":"ein","value":"561896112"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":118.19,"providers":[{"billed_charge":275.00,"npi":[1457388316]}]}]}]},{"name":"Ondansetron Hcl Injection","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2405","description":"Ondansetron Hcl Injection","allowed_amounts":[{"tin":{"type":"ein","value":"811723202"},"service_code":[],"billing_class":"institutional","payments":[{"allowed_amount":8.56,"providers":[{"billed_charge":42.80,"npi":[1639656713,1649726738]}]}]}]},{"name":"Prothrombin Time","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85610","description":"Prothrombin Time","allowed_amounts":[{"tin":{"type":"ein","value":"811723202"},"service_code":[],"billing_class":"institutional","payments":[{"allowed_amount":7.51,"providers":[{"billed_charge":94.00,"npi":[1649726738]}]}]}]},{"name":"Radiologic examination, chest; 2 views","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71046","description":"Radiologic examination, chest; 2 views","allowed_amounts":[{"tin":{"type":"ein","value":"811723202"},"service_code":[],"billing_class":"institutional","payments":[{"allowed_amount":143.48,"providers":[{"billed_charge":460.00,"npi":[1649726738]}]},{"allowed_amount":250.51,"providers":[{"billed_charge":460.00,"npi":[1245786367]}]}]}]},{"name":"Radiologic examination, chest; single view","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71045","description":"Radiologic examination, chest; single view","allowed_amounts":[{"tin":{"type":"ein","value":"582296052"},"service_code":[],"billing_class":"institutional","payments":[{"allowed_amount":142.56,"providers":[{"billed_charge":385.00,"npi":[1811237985]}]}]}]},{"name":"Radiologic examination, chest; single view","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"7104526","description":"Radiologic examination, chest; single view","allowed_amounts":[{"tin":{"type":"ein","value":"570853635"},"service_code":["21","23"],"billing_class":"professional","payments":[{"allowed_amount":8.97,"providers":[{"billed_charge":38.00,"npi":[1407243926,1407384696,1629316575,1629456587]}]}]}]},{"name":"Radiologic examination, chest; single view","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"7104526","description":"Radiologic examination, chest; single view","allowed_amounts":[{"tin":{"type":"ein","value":"933380812"},"service_code":["23"],"billing_class":"professional","payments":[{"allowed_amount":8.97,"providers":[{"billed_charge":38.00,"npi":[1730138793]}]}]}]},{"name":"Screening digital breast tomosynthesis, bilateral (List separately in addition to code for primary procedure)","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"7706326","description":"Screening digital breast tomosynthesis, bilateral (List separately in addition to code for primary procedure)","allowed_amounts":[{"tin":{"type":"ein","value":"570853635"},"service_code":["22"],"billing_class":"professional","payments":[{"allowed_amount":26.70,"providers":[{"billed_charge":87.00,"npi":[1346390952]}]},{"allowed_amount":29.37,"providers":[{"billed_charge":87.00,"npi":[1366592958]}]}]}]},{"name":"Screening mammography, bilateral (2-view study of each breast), including computer-aided detection (CAD) when performed","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"7706726","description":"Screening mammography, bilateral (2-view study of each breast), including computer-aided detection (CAD) when performed","allowed_amounts":[{"tin":{"type":"ein","value":"570853635"},"service_code":["22"],"billing_class":"professional","payments":[{"allowed_amount":33.91,"providers":[{"billed_charge":108.00,"npi":[1346390952]}]},{"allowed_amount":37.30,"providers":[{"billed_charge":108.00,"npi":[1366592958]}]}]}]},{"name":"Subsequent hospital inpatient or observation care, per day, for the evaluation and management of a patient, which requires a medically appropriate history and\/or examination a","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99233","description":"Subsequent hospital inpatient or observation care, per day, for the evaluation and management of a patient, which requires a medically appropriate history and\/or examination a","allowed_amounts":[{"tin":{"type":"ein","value":"943342387"},"service_code":["21"],"billing_class":"professional","payments":[{"allowed_amount":122.11,"providers":[{"billed_charge":647.00,"npi":[1730688151]}]},{"allowed_amount":143.65,"providers":[{"billed_charge":647.00,"npi":[1336580802]}]}]}]},{"name":"Therapeutic Proc, 1+ Areas, Each 15 Min; Therapeutic Exercises","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"97110GP","description":"Therapeutic Proc, 1+ Areas, Each 15 Min; Therapeutic Exercises","allowed_amounts":[{"tin":{"type":"ein","value":"582504530"},"service_code":[],"billing_class":"institutional","payments":[{"allowed_amount":85.21,"providers":[{"billed_charge":396.00,"npi":[1730123175]}]},{"allowed_amount":122.26,"providers":[{"billed_charge":594.00,"npi":[1730123175]}]}]}]},{"name":"Therapeutic, prophylactic, or diagnostic injection (specify substance or drug); subcutaneous or intramuscular","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"96372XU","description":"Therapeutic, prophylactic, or diagnostic injection (specify substance or drug); subcutaneous or intramuscular","allowed_amounts":[{"tin":{"type":"ein","value":"811723202"},"service_code":[],"billing_class":"institutional","payments":[{"allowed_amount":115.97,"providers":[{"billed_charge":186.00,"npi":[1649726738]}]}]}]},{"name":"Thyroid Stimulating Hormone (Tsh)","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84443","description":"Thyroid Stimulating Hormone (Tsh)","allowed_amounts":[{"tin":{"type":"ein","value":"582296052"},"service_code":[],"billing_class":"institutional","payments":[{"allowed_amount":29.40,"providers":[{"billed_charge":216.00,"npi":[1811237985]}]}]}]},{"name":"Troponin, Quantitative","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84484","description":"Troponin, Quantitative","allowed_amounts":[{"tin":{"type":"ein","value":"582296052"},"service_code":[],"billing_class":"institutional","payments":[{"allowed_amount":21.82,"providers":[{"billed_charge":340.00,"npi":[1811237985]}]},{"allowed_amount":43.65,"providers":[{"billed_charge":680.00,"npi":[1811237985]}]}]}]},{"name":"Troponin, Quantitative","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84484","description":"Troponin, Quantitative","allowed_amounts":[{"tin":{"type":"ein","value":"811723202"},"service_code":[],"billing_class":"institutional","payments":[{"allowed_amount":43.65,"providers":[{"billed_charge":680.00,"npi":[1649726738]}]}]}]},{"name":"Urinalysis, Dip Stick\/Tablet Reagent; Automated W\/O Microscopy","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81001","description":"Urinalysis, Dip Stick\/Tablet Reagent; Automated W\/O Microscopy","allowed_amounts":[{"tin":{"type":"ein","value":"811723202"},"service_code":[],"billing_class":"institutional","payments":[{"allowed_amount":5.55,"providers":[{"billed_charge":97.00,"npi":[1639656713,1649726738]}]}]}]},{"name":"Urine Pregnancy Test, Visual Color Comparison Methods","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81025","description":"Urine Pregnancy Test, Visual Color Comparison Methods","allowed_amounts":[{"tin":{"type":"ein","value":"582296052"},"service_code":[],"billing_class":"institutional","payments":[{"allowed_amount":15.07,"providers":[{"billed_charge":137.00,"npi":[1811237985]}]}]}]},{"name":"Urine Pregnancy Test, Visual Color Comparison Methods","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81025","description":"Urine Pregnancy Test, Visual Color Comparison Methods","allowed_amounts":[{"tin":{"type":"ein","value":"811723202"},"service_code":[],"billing_class":"institutional","payments":[{"allowed_amount":15.07,"providers":[{"billed_charge":137.00,"npi":[1639656713]}]}]}]}]}
