{"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": "2026-06-24","version": "2.0.0","out_of_network":[{"name":"Ambulance service, advanced life support, emergency transfer, level 1 (ALS 1 emergency)","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A0427RH","description":"Ambulance service, advanced life support, emergency transfer, level 1 (ALS 1 emergency)","allowed_amounts":[{"tin":{"type":"ein","value":"576000312"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":558.51,"providers":[{"billed_charge":725.00,"npi":[1457428146]}]}]}]},{"name":"Ambulance service, advanced life support, emergency transfer, level 1 (ALS 1 emergency)","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A0427RH","description":"Ambulance service, advanced life support, emergency transfer, level 1 (ALS 1 emergency)","allowed_amounts":[{"tin":{"type":"ein","value":"582465552"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":574.35,"providers":[{"billed_charge":1866.00,"npi":[1891782595]}]}]}]},{"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":"260599536"},"service_code":[],"billing_class":"institutional","payments":[{"allowed_amount":13.60,"providers":[{"billed_charge":120.00,"npi":[1972001469]}]}]}]},{"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":"260599536"},"service_code":[],"billing_class":"institutional","payments":[{"allowed_amount":15.91,"providers":[{"billed_charge":31.00,"npi":[1972001469]}]}]}]},{"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":"260599536"},"service_code":[],"billing_class":"institutional","payments":[{"allowed_amount":18.48,"providers":[{"billed_charge":151.00,"npi":[1972001469]}]}]}]},{"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":"260599536"},"service_code":[],"billing_class":"institutional","payments":[{"allowed_amount":594.42,"providers":[{"billed_charge":5423.00,"npi":[1972001469]}]}]}]},{"name":"Computed tomography, abdomen and pelvis; with contrast material(s)","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"7417726","description":"Computed tomography, abdomen and pelvis; with contrast material(s)","allowed_amounts":[{"tin":{"type":"ein","value":"570853635"},"service_code":["22","23"],"billing_class":"professional","payments":[{"allowed_amount":89.10,"providers":[{"billed_charge":590.00,"npi":[1902006794,1972997120]}]}]}]},{"name":"Computed tomography, abdomen and pelvis; with contrast material(s)","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"7417726","description":"Computed tomography, abdomen and pelvis; with contrast material(s)","allowed_amounts":[{"tin":{"type":"ein","value":"570963518"},"service_code":["22"],"billing_class":"professional","payments":[{"allowed_amount":89.10,"providers":[{"billed_charge":1671.00,"npi":[1114149788]}]}]}]},{"name":"Critical Care, Evaluation & Management","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99291","description":"Critical Care, Evaluation & Management","allowed_amounts":[{"tin":{"type":"ein","value":"271369141"},"service_code":["23"],"billing_class":"professional","payments":[{"allowed_amount":896.04,"providers":[{"billed_charge":1693.00,"npi":[1619123502]}]}]}]},{"name":"Critical Care, Evaluation & Management","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99291","description":"Critical Care, Evaluation & Management","allowed_amounts":[{"tin":{"type":"ein","value":"571004971"},"service_code":["23"],"billing_class":"professional","payments":[{"allowed_amount":219.03,"providers":[{"billed_charge":565.00,"npi":[1780900100]}]}]}]},{"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":96.55,"providers":[{"billed_charge":450.00,"npi":[1427504554]}]}]}]},{"name":"Electrocardiogram, Routine W\/At Least 12 Leads; Interpretation & Report Only","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93010","description":"Electrocardiogram, Routine W\/At Least 12 Leads; Interpretation & Report Only","allowed_amounts":[{"tin":{"type":"ein","value":"571004971"},"service_code":["23"],"billing_class":"professional","payments":[{"allowed_amount":8.29,"providers":[{"billed_charge":34.00,"npi":[1588640643]}]}]}]},{"name":"Electrocardiogram, Routine W\/At Least 12 Leads; Interpretation & Report Only","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93010","description":"Electrocardiogram, Routine W\/At Least 12 Leads; Interpretation & Report Only","allowed_amounts":[{"tin":{"type":"ein","value":"650691102"},"service_code":["23"],"billing_class":"professional","payments":[{"allowed_amount":8.29,"providers":[{"billed_charge":80.00,"npi":[1538140223,1740704147]}]}]}]},{"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":738.36,"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":"650691102"},"service_code":["23"],"billing_class":"professional","payments":[{"allowed_amount":180.49,"providers":[{"billed_charge":1726.00,"npi":[1538140223,1740704147]}]}]}]},{"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":159.47,"providers":[{"billed_charge":1870.00,"npi":[1932762564]}]}]}]},{"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":[1104408566]}]},{"allowed_amount":184.02,"providers":[{"billed_charge":706.20,"npi":[1013581461]}]}]}]},{"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":"821910968"},"service_code":["23"],"billing_class":"professional","payments":[{"allowed_amount":72.95,"providers":[{"billed_charge":750.00,"npi":[1710188958]}]}]}]},{"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":124.44,"providers":[{"billed_charge":368.00,"npi":[1093732091]}]}]}]},{"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":[1962174193]}]},{"allowed_amount":124.44,"providers":[{"billed_charge":1280.00,"npi":[1063724557,1710188958]}]},{"allowed_amount":129.35,"providers":[{"billed_charge":1280.00,"npi":[1326073339]}]}]}]},{"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":"831057917"},"service_code":["23"],"billing_class":"professional","payments":[{"allowed_amount":107.84,"providers":[{"billed_charge":485.28,"npi":[1760940225]}]},{"allowed_amount":124.44,"providers":[{"billed_charge":485.28,"npi":[1518055466]}]},{"allowed_amount":126.87,"providers":[{"billed_charge":485.28,"npi":[1740243351]}]}]}]},{"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":"9928425","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":"260599536"},"service_code":[],"billing_class":"institutional","payments":[{"allowed_amount":708.75,"providers":[{"billed_charge":5213.40,"npi":[1972001469]}]}]}]},{"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":"9928425","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":"811723202"},"service_code":[],"billing_class":"institutional","payments":[{"allowed_amount":692.16,"providers":[{"billed_charge":1939.00,"npi":[1427504554]}]}]}]},{"name":"Ground Mileage, per statute mile","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A0425RH","description":"Ground Mileage, per statute mile","allowed_amounts":[{"tin":{"type":"ein","value":"576000312"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":30.20,"providers":[{"billed_charge":32.40,"npi":[1457428146]}]}]}]},{"name":"Ground Mileage, per statute mile","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A0425RH","description":"Ground Mileage, per statute mile","allowed_amounts":[{"tin":{"type":"ein","value":"582465552"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":133.42,"providers":[{"billed_charge":520.26,"npi":[1891782595]}]}]}]},{"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":"260599536"},"service_code":[],"billing_class":"institutional","payments":[{"allowed_amount":621.20,"providers":[{"billed_charge":3106.00,"npi":[1972001469]}]},{"allowed_amount":862.29,"providers":[{"billed_charge":4311.45,"npi":[1972001469]}]},{"allowed_amount":1731.35,"providers":[{"billed_charge":8656.75,"npi":[1972001469]}]}]}]},{"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":10.80,"npi":[1649726738]},{"billed_charge":107.00,"npi":[1649726738]},{"billed_charge":112.00,"npi":[1649726738]},{"billed_charge":118.00,"npi":[1649726738]},{"billed_charge":1350.00,"npi":[1649726738]},{"billed_charge":1356.00,"npi":[1649726738]},{"billed_charge":14.40,"npi":[1649726738]},{"billed_charge":14.60,"npi":[1649726738]},{"billed_charge":155.40,"npi":[1649726738]},{"billed_charge":158.70,"npi":[1649726738]},{"billed_charge":19.60,"npi":[1649726738]},{"billed_charge":2.40,"npi":[1649726738]},{"billed_charge":2148.00,"npi":[1649726738]},{"billed_charge":240.80,"npi":[1649726738]},{"billed_charge":29.50,"npi":[1649726738]},{"billed_charge":299.60,"npi":[1649726738]},{"billed_charge":3088.00,"npi":[1649726738]},{"billed_charge":374.00,"npi":[1649726738]},{"billed_charge":383.50,"npi":[1649726738]},{"billed_charge":3942.00,"npi":[1649726738]},{"billed_charge":42.80,"npi":[1649726738]},{"billed_charge":4605.00,"npi":[1649726738]},{"billed_charge":504.00,"npi":[1649726738]},{"billed_charge":561.00,"npi":[1649726738]},{"billed_charge":59.00,"npi":[1649726738]},{"billed_charge":630.60,"npi":[1649726738]},{"billed_charge":651.00,"npi":[1649726738]},{"billed_charge":654.00,"npi":[1649726738]},{"billed_charge":721.80,"npi":[1649726738]},{"billed_charge":748.00,"npi":[1649726738]},{"billed_charge":885.00,"npi":[1649726738]},{"billed_charge":9324.00,"npi":[1649726738]},{"billed_charge":97.00,"npi":[1649726738]}]},{"allowed_amount":5.90,"providers":[{"billed_charge":29.50,"npi":[1427504554]}]},{"allowed_amount":34.68,"providers":[{"billed_charge":173.40,"npi":[1427504554]}]},{"allowed_amount":21176.93,"providers":[{"billed_charge":4664.00,"npi":[1649726738]}]}]}]},{"name":"Level Iv - Surgical Pathology, Gross & Microscopic Exam","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"8830526","description":"Level Iv - Surgical Pathology, Gross & Microscopic Exam","allowed_amounts":[{"tin":{"type":"ein","value":"570560638"},"service_code":["22"],"billing_class":"professional","payments":[{"allowed_amount":37.37,"providers":[{"billed_charge":145.00,"npi":[1942361688]}]}]}]},{"name":"Office or other outpatient visit for the evaluation and management of a new patient, which requires a medically appropriate history and\/or examination and moderate level of me","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99204","description":"Office or other outpatient visit for the evaluation and management of a new patient, which requires a medically appropriate history and\/or examination and moderate level of me","allowed_amounts":[{"tin":{"type":"ein","value":"453191160"},"service_code":["20"],"billing_class":"professional","payments":[{"allowed_amount":153.46,"providers":[{"billed_charge":389.77,"npi":[1326020876]}]}]}]},{"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":"208870333"},"service_code":["20"],"billing_class":"professional","payments":[{"allowed_amount":121.40,"providers":[{"billed_charge":257.00,"npi":[1689437931]}]},{"allowed_amount":127.02,"providers":[{"billed_charge":257.00,"npi":[1336846294,1467297408]}]}]}]},{"name":"Psychotherapy, 60 minutes with patient","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"90837HO","description":"Psychotherapy, 60 minutes with patient","allowed_amounts":[{"tin":{"type":"ein","value":"871799309"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":124.44,"providers":[{"billed_charge":150.00,"npi":[1205501277]}]},{"allowed_amount":135.18,"providers":[{"billed_charge":150.00,"npi":[1205501277]}]}]}]},{"name":"Radiologic examination, chest; 2 views","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"7104626","description":"Radiologic examination, chest; 2 views","allowed_amounts":[{"tin":{"type":"ein","value":"570853635"},"service_code":["22"],"billing_class":"professional","payments":[{"allowed_amount":10.71,"providers":[{"billed_charge":45.00,"npi":[1235289851]}]}]}]},{"name":"Radiologic examination, chest; 2 views","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"7104626","description":"Radiologic examination, chest; 2 views","allowed_amounts":[{"tin":{"type":"ein","value":"570963518"},"service_code":["22"],"billing_class":"professional","payments":[{"allowed_amount":10.71,"providers":[{"billed_charge":183.00,"npi":[1104808179]}]}]}]},{"name":"Radiologic examination, chest; 2 views","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"7104626","description":"Radiologic examination, chest; 2 views","allowed_amounts":[{"tin":{"type":"ein","value":"571004971"},"service_code":["23"],"billing_class":"professional","payments":[{"allowed_amount":10.71,"providers":[{"billed_charge":35.00,"npi":[1558313494]}]}]}]},{"name":"Radiologic examination, chest; 2 views","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"7104626","description":"Radiologic examination, chest; 2 views","allowed_amounts":[{"tin":{"type":"ein","value":"933380812"},"service_code":["22"],"billing_class":"professional","payments":[{"allowed_amount":26.41,"providers":[{"billed_charge":54.00,"npi":[1720286230]}]}]}]},{"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":["23"],"billing_class":"professional","payments":[{"allowed_amount":8.97,"providers":[{"billed_charge":38.00,"npi":[1629456587,1972997120]}]}]}]},{"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":[1235523291]}]}]}]},{"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":"570825282"},"service_code":["22"],"billing_class":"professional","payments":[{"allowed_amount":29.37,"providers":[{"billed_charge":91.00,"npi":[1144280165]}]}]}]},{"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":29.37,"providers":[{"billed_charge":87.00,"npi":[1235289851,1366592958]}]},{"allowed_amount":73.38,"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":"570825282"},"service_code":["22"],"billing_class":"professional","payments":[{"allowed_amount":37.30,"providers":[{"billed_charge":109.00,"npi":[1144280165]}]}]}]},{"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":37.30,"providers":[{"billed_charge":108.00,"npi":[1235289851,1366592958]}]},{"allowed_amount":92.61,"providers":[{"billed_charge":108.00,"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":"933380812"},"service_code":["22"],"billing_class":"professional","payments":[{"allowed_amount":37.30,"providers":[{"billed_charge":159.00,"npi":[1871541714]}]}]}]},{"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":"99232","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":"475656579"},"service_code":["21"],"billing_class":"professional","payments":[{"allowed_amount":81.15,"providers":[{"billed_charge":292.00,"npi":[1205179868]}]}]}]},{"name":"Therapeutic, prophylactic, or diagnostic injection (specify substance or drug); intravenous push, single or initial subs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96374","description":"Therapeutic, prophylactic, or diagnostic injection (specify substance or drug); intravenous push, single or initial subs","allowed_amounts":[{"tin":{"type":"ein","value":"260599536"},"service_code":[],"billing_class":"institutional","payments":[{"allowed_amount":350.68,"providers":[{"billed_charge":357.00,"npi":[1972001469]}]}]}]},{"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":"260599536"},"service_code":[],"billing_class":"institutional","payments":[{"allowed_amount":5.55,"providers":[{"billed_charge":49.00,"npi":[1972001469]}]}]}]}]}