{"reporting_entity_name":"Northwest Administrators Inc.","reporting_entity_type":"Third Party","plan_id_type":"ein","plan_name":"General Employees Trust Fund ","plan_id":"237404790","plan_market_type":"group","last_updated_on":"2026-04-20","version":"1.0.0.0","out_of_network":[{"name":"Therapeutic procedure, 1 or more areas, each 15 minutes; therapeutic exercises to develop strength and endurance, range of motion and flexibility","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97110","description":"Therapeutic procedure, 1 or more areas, each 15 minutes; therapeutic exercises to develop strength and endurance, range of motion and flexibility","allowed_amounts":[{"tin":{"type":"npi","value":"1306138961"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":80.00,"providers":[{"billed_charge":80.00,"npi":[1306138961]}]}]},{"tin":{"type":"ein","value":"830770057"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":80.00,"providers":[{"billed_charge":80.00,"npi":[1871645218]}]}]},{"tin":{"type":"ein","value":"460846717"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":75.00,"providers":[{"billed_charge":75.00,"npi":[1629106117]}]}]},{"tin":{"type":"ein","value":"942728480"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":75.00,"providers":[{"billed_charge":75.00,"npi":[1124738828,1962002550]}]}]},{"tin":{"type":"ein","value":"883896399"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":50.00,"providers":[{"billed_charge":50.00,"npi":[1316532567]}]},{"allowed_amount":100.00,"providers":[{"billed_charge":100.00,"npi":[1316532567]}]}]},{"tin":{"type":"ein","value":"862226153"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":60.00,"providers":[{"billed_charge":60.00,"npi":[1851694541]}]}]},{"tin":{"type":"ein","value":"822125638"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":89.99,"providers":[{"billed_charge":89.99,"npi":[1346857182]}]}]},{"tin":{"type":"ein","value":"844151118"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":70.00,"providers":[{"billed_charge":70.00,"npi":[1881835700]}]}]},{"tin":{"type":"ein","value":"900240195"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":60.00,"providers":[{"billed_charge":60.00,"npi":[1912067562]}]}]},{"tin":{"type":"ein","value":"624338797"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":65.00,"providers":[{"billed_charge":65.00,"npi":[1710471453]}]}]},{"tin":{"type":"ein","value":"202125404"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":140.00,"providers":[{"billed_charge":140.00,"npi":[1477677029]}]}]},{"tin":{"type":"ein","value":"262107879"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":65.00,"providers":[{"billed_charge":65.00,"npi":[1255672762]}]},{"allowed_amount":130.00,"providers":[{"billed_charge":130.00,"npi":[1255672762]}]}]},{"tin":{"type":"ein","value":"472869385"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":50.00,"providers":[{"billed_charge":50.00,"npi":[1023211554]}]}]},{"tin":{"type":"ein","value":"850486358"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":150.00,"providers":[{"billed_charge":150.00,"npi":[1154773281]}]},{"allowed_amount":300.00,"providers":[{"billed_charge":300.00,"npi":[1154773281]}]}]},{"tin":{"type":"ein","value":"942250366"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":64.00,"providers":[{"billed_charge":64.00,"npi":[1508886250]}]}]},{"tin":{"type":"ein","value":"833948708"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":80.00,"providers":[{"billed_charge":80.00,"npi":[1528392529]}]}]}]},{"name":"Acupuncture, 1 or more needles; with electrical stimulation, each additional 15 minutes of personal one-on-one contact with the patient, with insertion of needle(s) (List separately in addition to code for primary procedure)","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97814","description":"Acupuncture, 1 or more needles; with electrical stimulation, each additional 15 minutes of personal one-on-one contact with the patient, with insertion of needle(s) (List separately in addition to code for primary procedure)","allowed_amounts":[{"tin":{"type":"ein","value":"990841809"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":180.00,"providers":[{"billed_charge":180.00,"npi":[1922571389,1467045989]}]}]},{"tin":{"type":"ein","value":"830770057"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":180.00,"providers":[{"billed_charge":180.00,"npi":[1871645218]}]}]},{"tin":{"type":"ein","value":"474004101"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":150.00,"providers":[{"billed_charge":150.00,"npi":[1245667781]}]}]},{"tin":{"type":"ein","value":"624338797"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":85.00,"providers":[{"billed_charge":85.00,"npi":[1710471453]}]},{"allowed_amount":170.00,"providers":[{"billed_charge":170.00,"npi":[1710471453]}]}]},{"tin":{"type":"ein","value":"202125404"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":70.00,"providers":[{"billed_charge":70.00,"npi":[1477677029]}]},{"allowed_amount":75.00,"providers":[{"billed_charge":75.00,"npi":[1477677029]}]}]},{"tin":{"type":"ein","value":"454857305"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":150.00,"providers":[{"billed_charge":150.00,"npi":[1427320647]}]}]},{"tin":{"type":"npi","value":"1306138961"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":160.00,"providers":[{"billed_charge":160.00,"npi":[1306138961]}]}]},{"tin":{"type":"ein","value":"831884549"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":140.00,"providers":[{"billed_charge":140.00,"npi":[1730499468]}]}]},{"tin":{"type":"ein","value":"815327343"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":120.00,"providers":[{"billed_charge":120.00,"npi":[1154860773]}]}]},{"tin":{"type":"ein","value":"844151118"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":70.00,"providers":[{"billed_charge":70.00,"npi":[1881835700]}]}]},{"tin":{"type":"ein","value":"833948708"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":100.00,"providers":[{"billed_charge":100.00,"npi":[1528392529]}]}]},{"tin":{"type":"ein","value":"463552566"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":120.00,"providers":[{"billed_charge":120.00,"npi":[1912044421]}]}]},{"tin":{"type":"ein","value":"822238001"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":170.00,"providers":[{"billed_charge":170.00,"npi":[1891238671]}]}]},{"tin":{"type":"ein","value":"900240195"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":90.00,"providers":[{"billed_charge":90.00,"npi":[1912067562]}]},{"allowed_amount":180.00,"providers":[{"billed_charge":180.00,"npi":[1912067562]}]}]},{"tin":{"type":"ein","value":"830728659"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":60.00,"providers":[{"billed_charge":60.00,"npi":[1386135630]}]}]}]},{"name":"Chiropractic manipulative treatment (CMT); spinal, 1-2 regions","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98940","description":"Chiropractic manipulative treatment (CMT); spinal, 1-2 regions","allowed_amounts":[{"tin":{"type":"ein","value":"943395280"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":60.00,"providers":[{"billed_charge":60.00,"npi":[1235169145]}]}]},{"tin":{"type":"ein","value":"942250366"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":85.00,"providers":[{"billed_charge":85.00,"npi":[1508886250]}]},{"allowed_amount":86.48,"providers":[{"billed_charge":87.00,"npi":[1508886250]}]}]},{"tin":{"type":"ein","value":"942659841"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":45.00,"providers":[{"billed_charge":45.00,"npi":[1710905484]}]}]},{"tin":{"type":"ein","value":"942974217"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":90.00,"providers":[{"billed_charge":90.00,"npi":[0]}]},{"allowed_amount":93.00,"providers":[{"billed_charge":93.00,"npi":[0]}]}]},{"tin":{"type":"ein","value":"825464322"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":73.00,"providers":[{"billed_charge":73.00,"npi":[1639649973,1952451387]}]}]},{"tin":{"type":"ein","value":"862226153"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":70.00,"providers":[{"billed_charge":70.00,"npi":[1851694541]}]}]}]},{"name":"Acupuncture, 1 or more needles; with electrical stimulation, initial 15 minutes of personal one-on-one contact with the patient","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97813","description":"Acupuncture, 1 or more needles; with electrical stimulation, initial 15 minutes of personal one-on-one contact with the patient","allowed_amounts":[{"tin":{"type":"ein","value":"830770057"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":110.00,"providers":[{"billed_charge":110.00,"npi":[1871645218]}]}]},{"tin":{"type":"ein","value":"474004101"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":90.00,"providers":[{"billed_charge":90.00,"npi":[1245667781]}]}]},{"tin":{"type":"npi","value":"1306138961"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":80.00,"providers":[{"billed_charge":80.00,"npi":[1306138961]}]}]},{"tin":{"type":"ein","value":"833948708"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":120.00,"providers":[{"billed_charge":120.00,"npi":[1528392529]}]}]},{"tin":{"type":"ein","value":"990841809"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":110.00,"providers":[{"billed_charge":110.00,"npi":[1467045989,1922571389]}]}]},{"tin":{"type":"ein","value":"624338797"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":110.00,"providers":[{"billed_charge":110.00,"npi":[1710471453]}]}]},{"tin":{"type":"ein","value":"831884549"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":100.00,"providers":[{"billed_charge":100.00,"npi":[1730499468]}]}]},{"tin":{"type":"ein","value":"815327343"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":95.00,"providers":[{"billed_charge":95.00,"npi":[1154860773]}]}]},{"tin":{"type":"ein","value":"900240195"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":120.00,"providers":[{"billed_charge":120.00,"npi":[1912067562]}]}]},{"tin":{"type":"ein","value":"844151118"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":100.00,"providers":[{"billed_charge":100.00,"npi":[1881835700]}]}]},{"tin":{"type":"ein","value":"454857305"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":95.00,"providers":[{"billed_charge":95.00,"npi":[1427320647]}]}]},{"tin":{"type":"ein","value":"463552566"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":100.00,"providers":[{"billed_charge":100.00,"npi":[1912044421]}]}]},{"tin":{"type":"ein","value":"822238001"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":130.00,"providers":[{"billed_charge":130.00,"npi":[1891238671]}]}]},{"tin":{"type":"ein","value":"830728659"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":70.00,"providers":[{"billed_charge":70.00,"npi":[1386135630]}]}]}]},{"name":"Manual therapy techniques (eg, mobilization/ manipulation, manual lymphatic drainage, manual traction), 1 or more regions, each 15 minutes","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97140","description":"Manual therapy techniques (eg, mobilization/ manipulation, manual lymphatic drainage, manual traction), 1 or more regions, each 15 minutes","allowed_amounts":[{"tin":{"type":"ein","value":"830770057"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":70.00,"providers":[{"billed_charge":70.00,"npi":[1871645218]}]}]},{"tin":{"type":"ein","value":"942250366"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":74.00,"providers":[{"billed_charge":74.00,"npi":[1508886250]}]},{"allowed_amount":76.00,"providers":[{"billed_charge":76.00,"npi":[1508886250]}]}]},{"tin":{"type":"ein","value":"883896399"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":50.00,"providers":[{"billed_charge":50.00,"npi":[1316532567]}]}]},{"tin":{"type":"ein","value":"460846717"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":75.00,"providers":[{"billed_charge":75.00,"npi":[1629106117]}]}]},{"tin":{"type":"npi","value":"1306138961"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":80.00,"providers":[{"billed_charge":80.00,"npi":[1306138961]}]}]},{"tin":{"type":"ein","value":"474004101"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":180.00,"providers":[{"billed_charge":180.00,"npi":[1245667781]}]}]},{"tin":{"type":"ein","value":"833948708"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":100.00,"providers":[{"billed_charge":100.00,"npi":[1528392529]}]}]},{"tin":{"type":"ein","value":"831884549"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":100.00,"providers":[{"billed_charge":100.00,"npi":[1730499468]}]}]},{"tin":{"type":"ein","value":"815327343"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":65.00,"providers":[{"billed_charge":65.00,"npi":[1154860773]}]}]},{"tin":{"type":"ein","value":"822125638"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":83.88,"providers":[{"billed_charge":89.99,"npi":[1346857182]}]},{"allowed_amount":89.99,"providers":[{"billed_charge":89.99,"npi":[1346857182]}]}]},{"tin":{"type":"ein","value":"472869385"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":45.00,"providers":[{"billed_charge":45.00,"npi":[1023211554]}]}]},{"tin":{"type":"ein","value":"824350502"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":0.00,"providers":[{"billed_charge":60.00,"npi":[1275899486]}]},{"allowed_amount":60.00,"providers":[{"billed_charge":60.00,"npi":[1275899486]}]}]},{"tin":{"type":"ein","value":"202125404"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":120.00,"providers":[{"billed_charge":120.00,"npi":[1477677029]}]},{"allowed_amount":140.00,"providers":[{"billed_charge":140.00,"npi":[1477677029]}]}]},{"tin":{"type":"ein","value":"844151118"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":70.00,"providers":[{"billed_charge":70.00,"npi":[1881835700]}]}]},{"tin":{"type":"ein","value":"862226153"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":130.00,"providers":[{"billed_charge":130.00,"npi":[1851694541]}]}]},{"tin":{"type":"ein","value":"463552566"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":100.00,"providers":[{"billed_charge":100.00,"npi":[1912044421]}]}]},{"tin":{"type":"ein","value":"872191244"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":80.00,"providers":[{"billed_charge":80.00,"npi":[1235169483]}]}]},{"tin":{"type":"ein","value":"272422441"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":65.00,"providers":[{"billed_charge":65.00,"npi":[1497071500]}]}]},{"tin":{"type":"ein","value":"822238001"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":85.00,"providers":[{"billed_charge":85.00,"npi":[1891238671]}]}]},{"tin":{"type":"ein","value":"454857305"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":75.00,"providers":[{"billed_charge":75.00,"npi":[1427320647]}]}]},{"tin":{"type":"ein","value":"624338797"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":130.00,"providers":[{"billed_charge":130.00,"npi":[1710471453]}]}]}]},{"name":"Psychotherapy, 45 minutes with patient","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90834","description":"Psychotherapy, 45 minutes with patient","allowed_amounts":[{"tin":{"type":"npi","value":"1598096919"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":250.00,"providers":[{"billed_charge":250.00,"npi":[1598096919]}]}]},{"tin":{"type":"ein","value":"471977926"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":185.00,"providers":[{"billed_charge":185.00,"npi":[1245622042]}]},{"allowed_amount":225.00,"providers":[{"billed_charge":225.00,"npi":[1245622042]}]}]},{"tin":{"type":"ein","value":"843773436"},"service_code":[],"billing_class":"institutional","payments":[{"allowed_amount":180.19,"providers":[{"billed_charge":1450.00,"npi":[1891320099]}]},{"allowed_amount":210.04,"providers":[{"billed_charge":1450.00,"npi":[1891320099]}]}]},{"tin":{"type":"ein","value":"570376820"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":0.00,"providers":[{"billed_charge":140.00,"npi":[1265595508]}]},{"allowed_amount":140.00,"providers":[{"billed_charge":140.00,"npi":[1265595508]}]}]},{"tin":{"type":"ein","value":"954842918"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":100.00,"providers":[{"billed_charge":100.00,"npi":[1255546131]}]},{"allowed_amount":135.00,"providers":[{"billed_charge":135.00,"npi":[1255546131]}]}]},{"tin":{"type":"ein","value":"941156528"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":210.00,"providers":[{"billed_charge":210.00,"npi":[0]}]}]},{"tin":{"type":"ein","value":"960000001"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":284.76,"providers":[{"billed_charge":285.00,"npi":[0]}]}]},{"tin":{"type":"ein","value":"872625667"},"service_code":["02"],"billing_class":"professional","payments":[{"allowed_amount":284.76,"providers":[{"billed_charge":285.00,"npi":[1871742288]}]}]}]},{"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 of medical decision making. When using total time on the date of the encounter for code selection, 20 minutes must be met or exceeded.","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99213","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 of medical decision making. When using total time on the date of the encounter for code selection, 20 minutes must be met or exceeded.","allowed_amounts":[{"tin":{"type":"npi","value":"1184671901"},"service_code":["02"],"billing_class":"professional","payments":[{"allowed_amount":175.00,"providers":[{"billed_charge":175.00,"npi":[1184671901]}]}]},{"tin":{"type":"ein","value":"942284365"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":0.00,"providers":[{"billed_charge":245.59,"npi":[1134157746]}]},{"allowed_amount":245.59,"providers":[{"billed_charge":245.59,"npi":[1477295350]}]}]},{"tin":{"type":"ein","value":"830770057"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":100.00,"providers":[{"billed_charge":100.00,"npi":[1871645218]}]},{"allowed_amount":120.00,"providers":[{"billed_charge":120.00,"npi":[1871645218]}]}]},{"tin":{"type":"npi","value":"1548415979"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":115.00,"providers":[{"billed_charge":115.00,"npi":[1548415979]}]}]},{"tin":{"type":"ein","value":"460846717"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":0.00,"providers":[{"billed_charge":130.00,"npi":[1629106117]}]}]},{"tin":{"type":"ein","value":"943159355"},"service_code":["22"],"billing_class":"professional","payments":[{"allowed_amount":315.00,"providers":[{"billed_charge":315.00,"npi":[1245604354,1477970515]}]}]},{"tin":{"type":"ein","value":"946000509"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":0.00,"providers":[{"billed_charge":78.00,"npi":[1386719086]}]},{"allowed_amount":49.00,"providers":[{"billed_charge":49.00,"npi":[1285711036,1053726653,1003918848]}]},{"allowed_amount":78.00,"providers":[{"billed_charge":78.00,"npi":[1386719086]}]},{"allowed_amount":140.00,"providers":[{"billed_charge":140.00,"npi":[1386719086]}]}]},{"tin":{"type":"ein","value":"942728480"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":190.00,"providers":[{"billed_charge":220.00,"npi":[1912085812,1356794929]}]},{"allowed_amount":195.00,"providers":[{"billed_charge":250.00,"npi":[1629232251]}]},{"allowed_amount":220.00,"providers":[{"billed_charge":220.00,"npi":[1629216353,1407128119,1376621987,1295752863,1689917080,1639602998,1467526061,1619242708,1952433740,1134156953,1407993694,1902544729,1386025930]}]},{"allowed_amount":250.00,"providers":[{"billed_charge":250.00,"npi":[1275690836,1538785274]}]}]},{"tin":{"type":"ein","value":"941667294"},"service_code":["11","02"],"billing_class":"professional","payments":[{"allowed_amount":220.80,"providers":[{"billed_charge":220.80,"npi":[1356495261]}]}]},{"tin":{"type":"ein","value":"237304921"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":395.00,"providers":[{"billed_charge":443.00,"npi":[1639706336]}]},{"allowed_amount":397.83,"providers":[{"billed_charge":443.00,"npi":[1457396723,1003809765]}]}]},{"tin":{"type":"ein","value":"460570398"},"service_code":["20"],"billing_class":"professional","payments":[{"allowed_amount":277.00,"providers":[{"billed_charge":277.00,"npi":[1023590502]}]}]},{"tin":{"type":"ein","value":"946000417"},"service_code":["02","53","22"],"billing_class":"professional","payments":[{"allowed_amount":92.00,"providers":[{"billed_charge":92.00,"npi":[1770926636]}]},{"allowed_amount":397.83,"providers":[{"billed_charge":878.80,"npi":[1659426013]},{"billed_charge":525.00,"npi":[1881649549,1235266222,1033444120]}]}]},{"tin":{"type":"ein","value":"824406008"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":306.48,"providers":[{"billed_charge":650.00,"npi":[1215073853]}]},{"allowed_amount":340.00,"providers":[{"billed_charge":650.00,"npi":[1215073853]}]}]},{"tin":{"type":"ein","value":"943407388"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":0.00,"providers":[{"billed_charge":220.00,"npi":[1770508830]}]}]},{"tin":{"type":"ein","value":"941743078"},"service_code":["11","02"],"billing_class":"professional","payments":[{"allowed_amount":0.00,"providers":[{"billed_charge":253.44,"npi":[1679539340]}]},{"allowed_amount":253.44,"providers":[{"billed_charge":253.44,"npi":[1679539340,1679509954,1760412381]}]}]},{"tin":{"type":"ein","value":"946000509"},"service_code":["22"],"billing_class":"professional","payments":[{"allowed_amount":0.00,"providers":[{"billed_charge":78.00,"npi":[1386719086]}]},{"allowed_amount":49.00,"providers":[{"billed_charge":49.00,"npi":[1285711036,1053726653,1003918848]}]},{"allowed_amount":78.00,"providers":[{"billed_charge":78.00,"npi":[1386719086]}]},{"allowed_amount":140.00,"providers":[{"billed_charge":140.00,"npi":[1386719086]}]}]},{"tin":{"type":"ein","value":"831884549"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":120.00,"providers":[{"billed_charge":120.00,"npi":[1730499468]}]}]},{"tin":{"type":"ein","value":"941713704"},"service_code":["11","10"],"billing_class":"professional","payments":[{"allowed_amount":0.00,"providers":[{"billed_charge":230.00,"npi":[1760966089]}]},{"allowed_amount":230.00,"providers":[{"billed_charge":230.00,"npi":[1760966089,1508870650,1689978397]}]}]},{"tin":{"type":"ein","value":"872191244"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":120.00,"providers":[{"billed_charge":120.00,"npi":[1235169483]}]}]},{"tin":{"type":"ein","value":"830728659"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":150.00,"providers":[{"billed_charge":150.00,"npi":[1386135630]}]}]},{"tin":{"type":"ein","value":"993950201"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":140.00,"providers":[{"billed_charge":140.00,"npi":[1285676551]}]}]},{"tin":{"type":"ein","value":"862226153"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":0.00,"providers":[{"billed_charge":200.00,"npi":[1851694541]}]}]},{"tin":{"type":"npi","value":"1427313345"},"service_code":["02"],"billing_class":"professional","payments":[{"allowed_amount":175.00,"providers":[{"billed_charge":175.00,"npi":[1427313345]}]}]},{"tin":{"type":"ein","value":"946000532"},"service_code":["19"],"billing_class":"professional","payments":[{"allowed_amount":224.00,"providers":[{"billed_charge":224.00,"npi":[1831292994]}]}]},{"tin":{"type":"ein","value":"272422441"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":100.00,"providers":[{"billed_charge":100.00,"npi":[1497071500]}]}]}]},{"name":"Alcohol and/or drug services; intensive outpatient (treatment program that operates at least 3 hours/day and at least 3 days/week and is based on an individualized treatment plan), including assessment, counseling; crisis intervention, and activity therapies or education (Not payable by Medicare)","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"H0015","description":"Alcohol and/or drug services; intensive outpatient (treatment program that operates at least 3 hours/day and at least 3 days/week and is based on an individualized treatment plan), including assessment, counseling; crisis intervention, and activity therapies or education (Not payable by Medicare)","allowed_amounts":[{"tin":{"type":"ein","value":"822806827"},"service_code":[],"billing_class":"institutional","payments":[{"allowed_amount":302.02,"providers":[{"billed_charge":2900.00,"npi":[1851898811]}]},{"allowed_amount":318.20,"providers":[{"billed_charge":2900.00,"npi":[1851898811]}]}]}]},{"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 level of medical decision making. When using total time on the date of the encounter for code selection, 30 minutes must be met or exceeded.","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 level of medical decision making. When using total time on the date of the encounter for code selection, 30 minutes must be met or exceeded.","allowed_amounts":[{"tin":{"type":"ein","value":"943190508"},"service_code":["02"],"billing_class":"professional","payments":[{"allowed_amount":305.00,"providers":[{"billed_charge":305.00,"npi":[1023149440]}]}]},{"tin":{"type":"ein","value":"942728480"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":265.00,"providers":[{"billed_charge":330.00,"npi":[1114252707,1568683704]}]},{"allowed_amount":330.00,"providers":[{"billed_charge":330.00,"npi":[1699425744,1083062640,1982915112,1780716472,1952689838]}]},{"allowed_amount":370.00,"providers":[{"billed_charge":370.00,"npi":[1780716472]}]}]},{"tin":{"type":"ein","value":"943372130"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":408.27,"providers":[{"billed_charge":408.27,"npi":[1740384866]}]}]},{"tin":{"type":"ein","value":"922172448"},"service_code":["20"],"billing_class":"professional","payments":[{"allowed_amount":206.00,"providers":[{"billed_charge":206.00,"npi":[1174284202]}]}]},{"tin":{"type":"ein","value":"237304921"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":592.69,"providers":[{"billed_charge":649.00,"npi":[1639706336]}]}]},{"tin":{"type":"ein","value":"942284365"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":342.79,"providers":[{"billed_charge":342.79,"npi":[1134157746]}]}]},{"tin":{"type":"ein","value":"460570398"},"service_code":["20"],"billing_class":"professional","payments":[{"allowed_amount":390.00,"providers":[{"billed_charge":390.00,"npi":[1487344230,1982948295]}]}]},{"tin":{"type":"npi","value":"1851312300"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":285.00,"providers":[{"billed_charge":285.00,"npi":[1851312300]}]}]},{"tin":{"type":"npi","value":"1558471540"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":310.00,"providers":[{"billed_charge":310.00,"npi":[1558471540]}]}]},{"tin":{"type":"ein","value":"941713704"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":340.00,"providers":[{"billed_charge":340.00,"npi":[1144400656]}]}]},{"tin":{"type":"ein","value":"843457571"},"service_code":["02"],"billing_class":"professional","payments":[{"allowed_amount":508.70,"providers":[{"billed_charge":800.00,"npi":[1972572824]}]}]},{"tin":{"type":"ein","value":"946000509"},"service_code":["22"],"billing_class":"professional","payments":[{"allowed_amount":78.00,"providers":[{"billed_charge":78.00,"npi":[1386719086]}]},{"allowed_amount":80.00,"providers":[{"billed_charge":80.00,"npi":[1609803972]}]}]},{"tin":{"type":"ein","value":"946000509"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":78.00,"providers":[{"billed_charge":78.00,"npi":[1386719086]}]},{"allowed_amount":80.00,"providers":[{"billed_charge":80.00,"npi":[1609803972]}]}]},{"tin":{"type":"ein","value":"883110788"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":295.00,"providers":[{"billed_charge":295.00,"npi":[1679701858]}]}]},{"tin":{"type":"ein","value":"880940511"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":250.00,"providers":[{"billed_charge":250.00,"npi":[1265496301]}]}]},{"tin":{"type":"ein","value":"813962162"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":400.00,"providers":[{"billed_charge":400.00,"npi":[1306087424]}]}]},{"tin":{"type":"ein","value":"946000417"},"service_code":["71"],"billing_class":"professional","payments":[{"allowed_amount":598.69,"providers":[{"billed_charge":745.00,"npi":[1205975497]}]}]}]},{"name":"Therapeutic procedure, 1 or more areas, each 15 minutes; neuromuscular reeducation of movement, balance, coordination, kinesthetic sense, posture, and/or proprioception for sitting and/or standing activities","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97112","description":"Therapeutic procedure, 1 or more areas, each 15 minutes; neuromuscular reeducation of movement, balance, coordination, kinesthetic sense, posture, and/or proprioception for sitting and/or standing activities","allowed_amounts":[{"tin":{"type":"ein","value":"943407388"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":55.00,"providers":[{"billed_charge":55.00,"npi":[1770508830]}]}]},{"tin":{"type":"ein","value":"883896399"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":60.00,"providers":[{"billed_charge":60.00,"npi":[1316532567]}]}]},{"tin":{"type":"ein","value":"262107879"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":130.00,"providers":[{"billed_charge":130.00,"npi":[1255672762]}]}]},{"tin":{"type":"ein","value":"822125638"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":89.99,"providers":[{"billed_charge":89.99,"npi":[1346857182]}]}]}]},{"name":"Ground mileage, per statute mile","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A0425","description":"Ground mileage, per statute mile","allowed_amounts":[{"tin":{"type":"ein","value":"680358779"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":459.00,"providers":[{"billed_charge":459.00,"npi":[1720088198]}]}]},{"tin":{"type":"ein","value":"770324739"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":105.43,"providers":[{"billed_charge":105.43,"npi":[1659305902]}]},{"allowed_amount":527.15,"providers":[{"billed_charge":527.15,"npi":[1659305902]}]},{"allowed_amount":1792.31,"providers":[{"billed_charge":1792.31,"npi":[1659305902]}]}]},{"tin":{"type":"ein","value":"203318788"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":202.50,"providers":[{"billed_charge":202.50,"npi":[1225176050]}]},{"allowed_amount":270.00,"providers":[{"billed_charge":270.00,"npi":[1225176050]}]},{"allowed_amount":472.50,"providers":[{"billed_charge":472.50,"npi":[1225176050]}]}]},{"tin":{"type":"ein","value":"946000509"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":77.40,"providers":[{"billed_charge":77.40,"npi":[1316339609]}]},{"allowed_amount":232.20,"providers":[{"billed_charge":232.20,"npi":[1316339609]}]},{"allowed_amount":541.80,"providers":[{"billed_charge":541.80,"npi":[1316339609]}]}]},{"tin":{"type":"ein","value":"946000417"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":39.20,"providers":[{"billed_charge":39.20,"npi":[1376600965]}]},{"allowed_amount":147.00,"providers":[{"billed_charge":147.00,"npi":[1376600965]}]}]},{"tin":{"type":"ein","value":"201783317"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":375.00,"providers":[{"billed_charge":375.00,"npi":[1053475905]}]}]},{"tin":{"type":"ein","value":"911830550"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":224.70,"providers":[{"billed_charge":224.70,"npi":[1649270497]}]}]},{"tin":{"type":"ein","value":"956000776"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":336.00,"providers":[{"billed_charge":336.00,"npi":[1043904485]}]}]},{"tin":{"type":"ein","value":"946000410"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":266.00,"providers":[{"billed_charge":266.00,"npi":[1811054745]}]}]},{"tin":{"type":"ein","value":"731498164"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":1238.05,"providers":[{"billed_charge":1238.05,"npi":[1922391226]}]}]},{"tin":{"type":"ein","value":"946000447"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":33.00,"providers":[{"billed_charge":33.00,"npi":[1679572176]}]}]},{"tin":{"type":"ein","value":"680117710"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":430.08,"providers":[{"billed_charge":430.08,"npi":[1558981787]}]}]}]},{"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":"943159355"},"service_code":["21"],"billing_class":"professional","payments":[{"allowed_amount":35.00,"providers":[{"billed_charge":42.00,"npi":[1689196446]}]},{"allowed_amount":40.00,"providers":[{"billed_charge":40.00,"npi":[1275577173,1831716307,1184851081]}]},{"allowed_amount":42.00,"providers":[{"billed_charge":42.00,"npi":[1184851081,1275577173,1831716307,1427443951,1386128643,1336137025,1114556321,1386900249]}]}]},{"tin":{"type":"ein","value":"942728480"},"service_code":["21"],"billing_class":"professional","payments":[{"allowed_amount":33.00,"providers":[{"billed_charge":33.00,"npi":[1407514326]}]}]}]},{"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 straightforward medical decision making. When using total time on the date of the encounter for code selection, 10 minutes must be met or exceeded.","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99212","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 straightforward medical decision making. When using total time on the date of the encounter for code selection, 10 minutes must be met or exceeded.","allowed_amounts":[{"tin":{"type":"ein","value":"942728480"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":120.00,"providers":[{"billed_charge":145.00,"npi":[1417250358,1205219029,1174608830]}]},{"allowed_amount":145.00,"providers":[{"billed_charge":145.00,"npi":[1083062640,1801843792,1417229501,1558594796]}]},{"allowed_amount":160.00,"providers":[{"billed_charge":160.00,"npi":[1447338025,1437618428]}]}]},{"tin":{"type":"ein","value":"941743078"},"service_code":["11","02"],"billing_class":"professional","payments":[{"allowed_amount":156.65,"providers":[{"billed_charge":156.65,"npi":[1679539340]}]}]},{"tin":{"type":"ein","value":"942284365"},"service_code":["02"],"billing_class":"professional","payments":[{"allowed_amount":155.16,"providers":[{"billed_charge":155.16,"npi":[1134157746]}]}]},{"tin":{"type":"ein","value":"946000532"},"service_code":["10"],"billing_class":"professional","payments":[{"allowed_amount":120.00,"providers":[{"billed_charge":120.00,"npi":[1982023016]}]}]},{"tin":{"type":"ein","value":"624338797"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":65.00,"providers":[{"billed_charge":65.00,"npi":[1710471453]}]}]},{"tin":{"type":"ein","value":"237304921"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":246.54,"providers":[{"billed_charge":269.00,"npi":[1639706336]}]}]},{"tin":{"type":"ein","value":"943372130"},"service_code":["02"],"billing_class":"professional","payments":[{"allowed_amount":180.97,"providers":[{"billed_charge":180.97,"npi":[1740384866]}]}]},{"tin":{"type":"ein","value":"844151118"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":80.00,"providers":[{"billed_charge":80.00,"npi":[1881835700]}]}]},{"tin":{"type":"ein","value":"941667294"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":150.68,"providers":[{"billed_charge":150.68,"npi":[1356495261]}]}]}]},{"name":"Therapeutic activities, direct (one-on-one) patient contact (use of dynamic activities to improve functional performance), each 15 minutes","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97530","description":"Therapeutic activities, direct (one-on-one) patient contact (use of dynamic activities to improve functional performance), each 15 minutes","allowed_amounts":[{"tin":{"type":"ein","value":"822125638"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":89.99,"providers":[{"billed_charge":89.99,"npi":[1346857182]}]}]},{"tin":{"type":"ein","value":"624338797"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":75.00,"providers":[{"billed_charge":75.00,"npi":[1710471453]}]},{"allowed_amount":150.00,"providers":[{"billed_charge":150.00,"npi":[1710471453]}]},{"allowed_amount":300.00,"providers":[{"billed_charge":300.00,"npi":[1710471453]}]}]},{"tin":{"type":"ein","value":"262107879"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":130.00,"providers":[{"billed_charge":130.00,"npi":[1255672762]}]}]}]},{"name":"Application of a modality to 1 or more areas; infrared","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97026","description":"Application of a modality to 1 or more areas; infrared","allowed_amounts":[{"tin":{"type":"ein","value":"830770057"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":51.25,"providers":[{"billed_charge":60.00,"npi":[1871645218]}]},{"allowed_amount":51.78,"providers":[{"billed_charge":60.00,"npi":[1871645218]}]}]},{"tin":{"type":"ein","value":"472869385"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":25.00,"providers":[{"billed_charge":25.00,"npi":[1023211554]}]}]},{"tin":{"type":"ein","value":"815327343"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":35.00,"providers":[{"billed_charge":35.00,"npi":[1154860773]}]}]},{"tin":{"type":"ein","value":"990841809"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":30.00,"providers":[{"billed_charge":30.00,"npi":[1467045989,1922571389]}]}]},{"tin":{"type":"ein","value":"272422441"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":35.00,"providers":[{"billed_charge":35.00,"npi":[1497071500]}]}]},{"tin":{"type":"ein","value":"830728659"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":45.00,"providers":[{"billed_charge":45.00,"npi":[1386135630]}]}]},{"tin":{"type":"ein","value":"822238001"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":50.00,"providers":[{"billed_charge":50.00,"npi":[1891238671]}]}]},{"tin":{"type":"ein","value":"844151118"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":35.00,"providers":[{"billed_charge":35.00,"npi":[1881835700]}]}]}]},{"name":"Application of a modality to 1 or more areas; traction, mechanical","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97012","description":"Application of a modality to 1 or more areas; traction, mechanical","allowed_amounts":[{"tin":{"type":"ein","value":"943407388"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":40.00,"providers":[{"billed_charge":40.00,"npi":[1770508830]}]}]},{"tin":{"type":"ein","value":"942250366"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":51.36,"providers":[{"billed_charge":60.00,"npi":[1508886250]}]},{"allowed_amount":60.00,"providers":[{"billed_charge":60.00,"npi":[1508886250]}]},{"allowed_amount":60.47,"providers":[{"billed_charge":62.00,"npi":[1508886250]}]}]},{"tin":{"type":"ein","value":"460846717"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":45.00,"providers":[{"billed_charge":45.00,"npi":[1629106117]}]}]}]},{"name":"Collection of venous blood by venipuncture","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36415","description":"Collection of venous blood by venipuncture","allowed_amounts":[{"tin":{"type":"ein","value":"941105628"},"service_code":[],"billing_class":"institutional","payments":[{"allowed_amount":0.00,"providers":[{"billed_charge":68.00,"npi":[1982774337]}]},{"allowed_amount":68.00,"providers":[{"billed_charge":68.00,"npi":[1649605403,1134299522,1427123132]}]},{"allowed_amount":71.00,"providers":[{"billed_charge":71.00,"npi":[1649605403,1427123132]}]}]},{"tin":{"type":"ein","value":"942728480"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":26.46,"providers":[{"billed_charge":66.00,"npi":[1851454011]},{"billed_charge":56.00,"npi":[1851454011]}]},{"allowed_amount":30.75,"providers":[{"billed_charge":56.00,"npi":[1851454011,1083777163]}]}]},{"tin":{"type":"ein","value":"946000532"},"service_code":[],"billing_class":"institutional","payments":[{"allowed_amount":32.00,"providers":[{"billed_charge":32.00,"npi":[1003985755]}]}]},{"tin":{"type":"ein","value":"237304921"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":4.41,"providers":[{"billed_charge":4.41,"npi":[1457396723]}]}]},{"tin":{"type":"ein","value":"460570398"},"service_code":["20","11"],"billing_class":"professional","payments":[{"allowed_amount":21.37,"providers":[{"billed_charge":30.00,"npi":[1881444792,1790073252]}]}]}]},{"name":"Acupuncture, 1 or more needles; without electrical stimulation, initial 15 minutes of personal one-on-one contact with the patient","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97810","description":"Acupuncture, 1 or more needles; without electrical stimulation, initial 15 minutes of personal one-on-one contact with the patient","allowed_amounts":[{"tin":{"type":"ein","value":"272422441"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":95.00,"providers":[{"billed_charge":95.00,"npi":[1497071500]}]}]},{"tin":{"type":"ein","value":"824350502"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":0.00,"providers":[{"billed_charge":100.00,"npi":[1275899486]}]},{"allowed_amount":100.00,"providers":[{"billed_charge":100.00,"npi":[1275899486]}]}]},{"tin":{"type":"ein","value":"624338797"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":90.00,"providers":[{"billed_charge":90.00,"npi":[1710471453]}]}]},{"tin":{"type":"ein","value":"202125404"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":95.00,"providers":[{"billed_charge":95.00,"npi":[1477677029]}]}]},{"tin":{"type":"ein","value":"815327343"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":95.00,"providers":[{"billed_charge":95.00,"npi":[1154860773]}]}]},{"tin":{"type":"ein","value":"453786239"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":120.00,"providers":[{"billed_charge":120.00,"npi":[1093086910]}]}]}]},{"name":"Chiropractic manipulative treatment (CMT); extraspinal, 1 or more regions","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98943","description":"Chiropractic manipulative treatment (CMT); extraspinal, 1 or more regions","allowed_amounts":[{"tin":{"type":"ein","value":"460846717"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":65.00,"providers":[{"billed_charge":65.00,"npi":[1629106117]}]}]},{"tin":{"type":"ein","value":"862226153"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":60.00,"providers":[{"billed_charge":60.00,"npi":[1851694541]}]}]},{"tin":{"type":"ein","value":"472869385"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":60.00,"providers":[{"billed_charge":60.00,"npi":[1023211554]}]}]},{"tin":{"type":"ein","value":"943407388"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":70.00,"providers":[{"billed_charge":70.00,"npi":[1770508830]}]}]},{"tin":{"type":"ein","value":"942250366"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":39.39,"providers":[{"billed_charge":79.00,"npi":[1508886250]}]},{"allowed_amount":39.81,"providers":[{"billed_charge":79.00,"npi":[1508886250]},{"billed_charge":81.00,"npi":[1508886250]}]}]}]},{"name":"Psychotherapy, 60 minutes with patient","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90837","description":"Psychotherapy, 60 minutes with patient","allowed_amounts":[{"tin":{"type":"ein","value":"946000417"},"service_code":["02"],"billing_class":"professional","payments":[{"allowed_amount":364.66,"providers":[{"billed_charge":848.24,"npi":[1194276949]}]},{"allowed_amount":367.60,"providers":[{"billed_charge":848.24,"npi":[1194276949]}]}]},{"tin":{"type":"ein","value":"547687920"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":275.00,"providers":[{"billed_charge":275.00,"npi":[1609991918]}]}]},{"tin":{"type":"ein","value":"960000001"},"service_code":["11","02","10"],"billing_class":"professional","payments":[{"allowed_amount":175.00,"providers":[{"billed_charge":175.00,"npi":[0]}]},{"allowed_amount":260.00,"providers":[{"billed_charge":260.00,"npi":[0]}]},{"allowed_amount":338.25,"providers":[{"billed_charge":380.00,"npi":[0]}]}]},{"tin":{"type":"ein","value":"883072494"},"service_code":["10"],"billing_class":"professional","payments":[{"allowed_amount":260.00,"providers":[{"billed_charge":260.00,"npi":[1942933130]}]}]},{"tin":{"type":"ein","value":"602034135"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":100.36,"providers":[{"billed_charge":100.36,"npi":[1386835635]}]}]},{"tin":{"type":"ein","value":"954842918"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":135.00,"providers":[{"billed_charge":135.00,"npi":[1255546131]}]}]},{"tin":{"type":"ein","value":"460932864"},"service_code":["61"],"billing_class":"professional","payments":[{"allowed_amount":270.00,"providers":[{"billed_charge":270.00,"npi":[1194900241]}]}]}]},{"name":"Influenza virus vaccine, trivalent (IIV3), split virus, preservative free, 0.5 mL dosage, for intramuscular use","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90656","description":"Influenza virus vaccine, trivalent (IIV3), split virus, preservative free, 0.5 mL dosage, for intramuscular use","allowed_amounts":[{"tin":{"type":"ein","value":"942728480"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":35.81,"providers":[{"billed_charge":39.00,"npi":[1689816621]}]},{"allowed_amount":37.28,"providers":[{"billed_charge":39.00,"npi":[1497112627]}]},{"allowed_amount":39.00,"providers":[{"billed_charge":39.00,"npi":[1407472327,1689816621,1629216353,1689917080,1801537303,1407128119,1912085796,1295752863,1801815535,1699425744]}]},{"allowed_amount":63.00,"providers":[{"billed_charge":63.00,"npi":[1689816621,1336498179]}]}]},{"tin":{"type":"ein","value":"237304921"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":34.00,"providers":[{"billed_charge":34.00,"npi":[1639706336]}]}]},{"tin":{"type":"ein","value":"942284365"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":67.52,"providers":[{"billed_charge":73.73,"npi":[1477295350]}]}]},{"tin":{"type":"ein","value":"941743078"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":0.00,"providers":[{"billed_charge":0.00,"npi":[1184789976]}]},{"allowed_amount":39.68,"providers":[{"billed_charge":39.68,"npi":[1679509954]}]}]},{"tin":{"type":"npi","value":"1427313345"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":12.37,"providers":[{"billed_charge":12.37,"npi":[1427313345]}]}]}]},{"name":"Hemoglobin; glycosylated (A1C)","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83036","description":"Hemoglobin; glycosylated (A1C)","allowed_amounts":[{"tin":{"type":"ein","value":"853392173"},"service_code":["21"],"billing_class":"professional","payments":[{"allowed_amount":0.00,"providers":[{"billed_charge":30.00,"npi":[1093943052]}]}]},{"tin":{"type":"ein","value":"942728480"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":0.00,"providers":[{"billed_charge":63.00,"npi":[1851454011]}]},{"allowed_amount":63.00,"providers":[{"billed_charge":63.00,"npi":[1851454011]}]},{"allowed_amount":67.15,"providers":[{"billed_charge":71.00,"npi":[1851454011]}]}]},{"tin":{"type":"ein","value":"941105628"},"service_code":[],"billing_class":"institutional","payments":[{"allowed_amount":133.00,"providers":[{"billed_charge":133.00,"npi":[1427123132]}]},{"allowed_amount":142.00,"providers":[{"billed_charge":142.00,"npi":[1427123132]}]}]},{"tin":{"type":"ein","value":"942284365"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":21.85,"providers":[{"billed_charge":21.85,"npi":[1477295350,1134157746]}]}]},{"tin":{"type":"ein","value":"946000509"},"service_code":[],"billing_class":"institutional","payments":[{"allowed_amount":32.00,"providers":[{"billed_charge":32.00,"npi":[1386719086]}]}]},{"tin":{"type":"ein","value":"941743078"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":68.58,"providers":[{"billed_charge":68.58,"npi":[1679509954]}]}]},{"tin":{"type":"ein","value":"946000417"},"service_code":[],"billing_class":"institutional","payments":[{"allowed_amount":189.53,"providers":[{"billed_charge":297.00,"npi":[1083648810]}]}]}]},{"name":"Acupuncture, 1 or more needles; without electrical stimulation, each additional 15 minutes of personal one-on-one contact with the patient, with insertion of needle(s) (List separately in addition to code for primary procedure)","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97811","description":"Acupuncture, 1 or more needles; without electrical stimulation, each additional 15 minutes of personal one-on-one contact with the patient, with insertion of needle(s) (List separately in addition to code for primary procedure)","allowed_amounts":[{"tin":{"type":"ein","value":"624338797"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":70.00,"providers":[{"billed_charge":70.00,"npi":[1710471453]}]}]},{"tin":{"type":"ein","value":"202125404"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":140.00,"providers":[{"billed_charge":140.00,"npi":[1477677029]}]}]},{"tin":{"type":"ein","value":"824350502"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":0.00,"providers":[{"billed_charge":90.00,"npi":[1275899486]}]},{"allowed_amount":75.38,"providers":[{"billed_charge":90.00,"npi":[1275899486]}]},{"allowed_amount":90.00,"providers":[{"billed_charge":90.00,"npi":[1275899486]}]}]},{"tin":{"type":"ein","value":"272422441"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":120.00,"providers":[{"billed_charge":120.00,"npi":[1497071500]}]}]},{"tin":{"type":"ein","value":"815327343"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":120.00,"providers":[{"billed_charge":120.00,"npi":[1154860773]}]}]},{"tin":{"type":"ein","value":"453786239"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":180.00,"providers":[{"billed_charge":180.00,"npi":[1093086910]}]}]}]}]}