{"reporting_entity_name": "Samaritan Health Plans","reporting_entity_type": "Samaritan Health Plans","last_updated_on": "2026-04-16","version": "1.0.0","out_of_network":[{"name":"Administration of 1 vaccine","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90471","description":"Administration of 1 vaccine","allowed_amounts":[{"tin":{"type":"ein","value":"870737748"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":46.52,"providers":[{"billed_charge":56.28,"npi":[1134133143]}]}]}]},{"name":"Antibody; Treponema Pallidum","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86780","description":"Antibody; Treponema Pallidum","allowed_amounts":[{"tin":{"type":"ein","value":"941461843"},"service_code":[],"billing_class":"institutional","payments":[{"allowed_amount":113.05,"providers":[{"billed_charge":133.00,"npi":[1740215219]}]}]}]},{"name":"Blood count; complete (CBC), automated (Hgb, Hct, RBC, WBC and platelet count) and automated differential WBC count","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85025","description":"Blood count; complete (CBC), automated (Hgb, Hct, RBC, WBC and platelet count) and automated differential WBC count","allowed_amounts":[{"tin":{"type":"ein","value":"542183222"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":0.00,"providers":[{"billed_charge":37.20,"npi":[1992865828]}]}]}]},{"name":"Blood count; complete (CBC), automated (Hgb, Hct, RBC, WBC and platelet count) and automated differential WBC count","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85025","description":"Blood count; complete (CBC), automated (Hgb, Hct, RBC, WBC and platelet count) and automated differential WBC count","allowed_amounts":[{"tin":{"type":"ein","value":"941461843"},"service_code":[],"billing_class":"institutional","payments":[{"allowed_amount":293.25,"providers":[{"billed_charge":345.00,"npi":[1740215219]}]}]}]},{"name":"Body Mass Index (BMI), documented (PV)1","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"3008F","description":"Body Mass Index (BMI), documented (PV)1","allowed_amounts":[{"tin":{"type":"ein","value":"870737748"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":0.00,"providers":[{"billed_charge":0.01,"npi":[1134133143]}]}]}]},{"name":"C-Reactive Protein","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86140","description":"C-Reactive Protein","allowed_amounts":[{"tin":{"type":"ein","value":"542183222"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":0.00,"providers":[{"billed_charge":25.20,"npi":[1992865828]}]}]}]},{"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":"542183222"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":0.00,"providers":[{"billed_charge":50.40,"npi":[1992865828]}]}]}]},{"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":"941461843"},"service_code":[],"billing_class":"institutional","payments":[{"allowed_amount":1382.74,"providers":[{"billed_charge":1626.75,"npi":[1740215219]}]}]}]},{"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":"931044853"},"service_code":["23"],"billing_class":"professional","payments":[{"allowed_amount":474.93,"providers":[{"billed_charge":1219.00,"npi":[1487271219]}]}]}]},{"name":"Diast BP 80-89 MM HG","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"3079F","description":"Diast BP 80-89 MM HG","allowed_amounts":[{"tin":{"type":"ein","value":"870737748"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":0.00,"providers":[{"billed_charge":0.01,"npi":[1134133143]}]}]}]},{"name":"Diast BP < 80 MM HG","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"3078F","description":"Diast BP < 80 MM HG","allowed_amounts":[{"tin":{"type":"ein","value":"870737748"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":0.00,"providers":[{"billed_charge":0.01,"npi":[1154985463]}]}]}]},{"name":"Emergency Dept Visit, 3 Key Components: Detailed Hx; Detailed Exam; Med Decision Mod Complexity","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"9928425","description":"Emergency Dept Visit, 3 Key Components: Detailed Hx; Detailed Exam; Med Decision Mod Complexity","allowed_amounts":[{"tin":{"type":"ein","value":"941461843"},"service_code":[],"billing_class":"institutional","payments":[{"allowed_amount":5906.01,"providers":[{"billed_charge":6948.25,"npi":[1740215219]}]}]}]},{"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":"931044853"},"service_code":["23"],"billing_class":"professional","payments":[{"allowed_amount":387.14,"providers":[{"billed_charge":945.00,"npi":[1609139062]}]}]}]},{"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":"942494000"},"service_code":["23"],"billing_class":"professional","payments":[{"allowed_amount":1157.40,"providers":[{"billed_charge":1286.00,"npi":[1033776109]}]}]}]},{"name":"Gonadotropin, chorionic (reproductive hormone) level","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84702","description":"Gonadotropin, chorionic (reproductive hormone) level","allowed_amounts":[{"tin":{"type":"ein","value":"941461843"},"service_code":[],"billing_class":"institutional","payments":[{"allowed_amount":734.49,"providers":[{"billed_charge":864.11,"npi":[1740215219]}]}]}]},{"name":"Ground Mileage","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A0425RH","description":"Ground Mileage","allowed_amounts":[{"tin":{"type":"ein","value":"205640086"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":28.00,"providers":[{"billed_charge":40.00,"npi":[1992891980]}]},{"allowed_amount":87.50,"providers":[{"billed_charge":125.00,"npi":[1992891980]}]}]}]},{"name":"Infectious Agent Detection by Nucleic Acid (DNA Or RNA); Vancomycin Resistance, Amplified Probe Technique","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87500","description":"Infectious Agent Detection by Nucleic Acid (DNA Or RNA); Vancomycin Resistance, Amplified Probe Technique","allowed_amounts":[{"tin":{"type":"ein","value":"453194060"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":18.60,"providers":[{"billed_charge":50.00,"npi":[1659655124]}]}]}]},{"name":"Infectious Agent Detection by Nucleic Acid (DNA or RNA); Staphylococcus Aureus, Amplified Probe Technique","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"8764059","description":"Infectious Agent Detection by Nucleic Acid (DNA or RNA); Staphylococcus Aureus, Amplified Probe Technique","allowed_amounts":[{"tin":{"type":"ein","value":"453194060"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":18.60,"providers":[{"billed_charge":50.00,"npi":[1659655124]}]}]}]},{"name":"Infectious Agent Detection by Nucleic Acid (DNA or RNA); Streptococcus, Group B, Amplified Probe Technique","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"8765359","description":"Infectious Agent Detection by Nucleic Acid (DNA or RNA); Streptococcus, Group B, Amplified Probe Technique","allowed_amounts":[{"tin":{"type":"ein","value":"453194060"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":18.60,"providers":[{"billed_charge":50.00,"npi":[1659655124]}]}]}]},{"name":"Infectious Agent Detection by Nucleic Acid (DNA or RNA); Trichomonas Vaginalis, Amplified Probe Technique","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87661","description":"Infectious Agent Detection by Nucleic Acid (DNA or RNA); Trichomonas Vaginalis, Amplified Probe Technique","allowed_amounts":[{"tin":{"type":"ein","value":"941461843"},"service_code":[],"billing_class":"institutional","payments":[{"allowed_amount":192.47,"providers":[{"billed_charge":226.44,"npi":[1740215219]}]}]}]},{"name":"Infectious Agent, Nucleic Acid (Dna\/Rna), Multiple Organisms; Amplified Probe(S) Technique","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87801","description":"Infectious Agent, Nucleic Acid (Dna\/Rna), Multiple Organisms; Amplified Probe(S) Technique","allowed_amounts":[{"tin":{"type":"ein","value":"453194060"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":174.69,"providers":[{"billed_charge":300.00,"npi":[1659655124]}]}]}]},{"name":"Infectious Agent, Nucleic Acid (Dna\/Rna), Nos; Amplified Probe Technique, Ea Organism","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"8779859","description":"Infectious Agent, Nucleic Acid (Dna\/Rna), Nos; Amplified Probe Technique, Ea Organism","allowed_amounts":[{"tin":{"type":"ein","value":"453194060"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":378.43,"providers":[{"billed_charge":1200.00,"npi":[1659655124]}]}]}]},{"name":"Infectious Agent, Nucleic Acid (Dna\/Rna); Candida, Amplified Probe","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"8748159","description":"Infectious Agent, Nucleic Acid (Dna\/Rna); Candida, Amplified Probe","allowed_amounts":[{"tin":{"type":"ein","value":"453194060"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":116.44,"providers":[{"billed_charge":200.00,"npi":[1659655124]}]}]}]},{"name":"Infectious Agent, Nucleic Acid (Dna\/Rna); Gardnerella Vaginalis, Amplified Probe","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"8751159","description":"Infectious Agent, Nucleic Acid (Dna\/Rna); Gardnerella Vaginalis, Amplified Probe","allowed_amounts":[{"tin":{"type":"ein","value":"453194060"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":18.60,"providers":[{"billed_charge":50.00,"npi":[1659655124]}]}]}]},{"name":"Infectious agent detection by nucleic acid (DNA or RNA); Chlamydia trachomatis, amplified probe technique","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87491","description":"Infectious agent detection by nucleic acid (DNA or RNA); Chlamydia trachomatis, amplified probe technique","allowed_amounts":[{"tin":{"type":"ein","value":"941461843"},"service_code":[],"billing_class":"institutional","payments":[{"allowed_amount":224.48,"providers":[{"billed_charge":264.10,"npi":[1740215219]}]}]}]},{"name":"Infectious agent detection by nucleic acid (DNA or RNA); Herpes simplex virus, amplified probe technique","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87529","description":"Infectious agent detection by nucleic acid (DNA or RNA); Herpes simplex virus, amplified probe technique","allowed_amounts":[{"tin":{"type":"ein","value":"941461843"},"service_code":[],"billing_class":"institutional","payments":[{"allowed_amount":99.88,"providers":[{"billed_charge":117.50,"npi":[1740215219]}]}]}]},{"name":"Infectious agent detection by nucleic acid (DNA or RNA); Neisseria gonorrhoeae, amplified probe technique","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87591","description":"Infectious agent detection by nucleic acid (DNA or RNA); Neisseria gonorrhoeae, amplified probe technique","allowed_amounts":[{"tin":{"type":"ein","value":"941461843"},"service_code":[],"billing_class":"institutional","payments":[{"allowed_amount":217.90,"providers":[{"billed_charge":256.35,"npi":[1740215219]}]}]}]},{"name":"Infectious agent detection by nucleic acid (DNA or RNA); Streptococcus, group A, amplified probe technique","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87651","description":"Infectious agent detection by nucleic acid (DNA or RNA); Streptococcus, group A, amplified probe technique","allowed_amounts":[{"tin":{"type":"ein","value":"941461843"},"service_code":[],"billing_class":"institutional","payments":[{"allowed_amount":200.65,"providers":[{"billed_charge":236.06,"npi":[1740215219]}]}]}]},{"name":"Level IV - Surgical Pathology, Gross & Microscopic Exam","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88305","description":"Level IV - Surgical Pathology, Gross & Microscopic Exam","allowed_amounts":[{"tin":{"type":"ein","value":"870737749"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":461.10,"providers":[{"billed_charge":568.96,"npi":[1255413209]}]}]}]},{"name":"Lipase","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83690","description":"Lipase","allowed_amounts":[{"tin":{"type":"ein","value":"542183222"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":0.00,"providers":[{"billed_charge":33.60,"npi":[1992865828]}]}]}]},{"name":"Medical\/Surgical Supplies and Devices - Sterile Supply","billing_code_type":"RC","billing_code_type_version":"2026","billing_code":"0272","description":"Medical\/Surgical Supplies and Devices - Sterile Supply","allowed_amounts":[{"tin":{"type":"ein","value":"941461843"},"service_code":[],"billing_class":"institutional","payments":[{"allowed_amount":309.40,"providers":[{"billed_charge":364.00,"npi":[1740215219]}]}]}]},{"name":"Medication list documented in medical record (COA)2","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"1159F","description":"Medication list documented in medical record (COA)2","allowed_amounts":[{"tin":{"type":"ein","value":"542183222"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":0.00,"providers":[{"billed_charge":0.00,"npi":[1992865828]}]}]}]},{"name":"Microdissection (ie, Sample Preparation of Microscopically Identified Target); Manual","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88381","description":"Microdissection (ie, Sample Preparation of Microscopically Identified Target); Manual","allowed_amounts":[{"tin":{"type":"ein","value":"260691876"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":86.40,"providers":[{"billed_charge":200.00,"npi":[1043344435]}]}]}]},{"name":"Most recent systolic blood pressure less than 130 mm Hg (DM) (HTN, CKD, CAD)","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"3074F","description":"Most recent systolic blood pressure less than 130 mm Hg (DM) (HTN, CKD, CAD)","allowed_amounts":[{"tin":{"type":"ein","value":"870737748"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":0.00,"providers":[{"billed_charge":0.01,"npi":[1134133143,1154985463]}]}]}]},{"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":"204615687"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":111.83,"providers":[{"billed_charge":210.56,"npi":[1043252786,1619284742]}]}]}]},{"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":"462708284"},"service_code":["20"],"billing_class":"professional","payments":[{"allowed_amount":182.82,"providers":[{"billed_charge":305.00,"npi":[1306837521]}]}]}]},{"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":"542183222"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":266.87,"providers":[{"billed_charge":266.87,"npi":[1992865828]}]}]}]},{"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":"870737748"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":202.43,"providers":[{"billed_charge":350.30,"npi":[1154985463]}]}]}]},{"name":"Office\/Op Visit, Est Pt, 2 Key Components: Expand Prob Hx; Expand Prob Exam;Med Decision Low Complex","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"9921325","description":"Office\/Op Visit, Est Pt, 2 Key Components: Expand Prob Hx; Expand Prob Exam;Med Decision Low Complex","allowed_amounts":[{"tin":{"type":"ein","value":"870737748"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":134.65,"providers":[{"billed_charge":248.45,"npi":[1134133143]}]}]}]},{"name":"Office\/Op Visit, Est Pt, 2 Key Components:Comprehensive Hx;Comprehensiv Exam;Med Decisn High Complex","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"9921595","description":"Office\/Op Visit, Est Pt, 2 Key Components:Comprehensive Hx;Comprehensiv Exam;Med Decisn High Complex","allowed_amounts":[{"tin":{"type":"ein","value":"943281660"},"service_code":["02"],"billing_class":"professional","payments":[{"allowed_amount":602.94,"providers":[{"billed_charge":773.00,"npi":[1447404439]}]}]}]},{"name":"Pain severity quantified; no pain present","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"1126F","description":"Pain severity quantified; no pain present","allowed_amounts":[{"tin":{"type":"ein","value":"870737748"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":0.00,"providers":[{"billed_charge":0.01,"npi":[1134133143]}]}]}]},{"name":"Pharmacy","billing_code_type":"RC","billing_code_type_version":"2026","billing_code":"0250","description":"Pharmacy","allowed_amounts":[{"tin":{"type":"ein","value":"941461843"},"service_code":[],"billing_class":"institutional","payments":[{"allowed_amount":2.78,"providers":[{"billed_charge":3.27,"npi":[1740215219]}]},{"allowed_amount":6.94,"providers":[{"billed_charge":8.16,"npi":[1740215219]}]},{"allowed_amount":73.30,"providers":[{"billed_charge":86.23,"npi":[1740215219]}]}]}]},{"name":"Screening For Depression Performed (Dem)","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"3725F","description":"Screening For Depression Performed (Dem)","allowed_amounts":[{"tin":{"type":"ein","value":"870737748"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":0.00,"providers":[{"billed_charge":0.01,"npi":[1134133143]}]}]}]},{"name":"Telehealth transmission, per minute, professional services bill separately","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"T1014","description":"Telehealth transmission, per minute, professional services bill separately","allowed_amounts":[{"tin":{"type":"ein","value":"943281660"},"service_code":["02"],"billing_class":"professional","payments":[{"allowed_amount":11.23,"providers":[{"billed_charge":14.40,"npi":[1447404439]}]},{"allowed_amount":11.51,"providers":[{"billed_charge":14.76,"npi":[1447404439]}]}]}]},{"name":"Triamcinolone Acetonide Inj","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3301","description":"Triamcinolone Acetonide Inj","allowed_amounts":[{"tin":{"type":"ein","value":"870737748"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":3.31,"providers":[{"billed_charge":7.59,"npi":[1134133143]}]}]}]},{"name":"Ultrasound, breast, unilateral, real time with image documentation, including axilla when performed; limited","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"7664226","description":"Ultrasound, breast, unilateral, real time with image documentation, including axilla when performed; limited","allowed_amounts":[{"tin":{"type":"ein","value":"331321918"},"service_code":["22"],"billing_class":"professional","payments":[{"allowed_amount":71.75,"providers":[{"billed_charge":106.95,"npi":[1629052444]}]}]}]},{"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":"941461843"},"service_code":[],"billing_class":"institutional","payments":[{"allowed_amount":293.25,"providers":[{"billed_charge":345.00,"npi":[1740215219]}]}]}]},{"name":"Urine pregnancy test","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81025","description":"Urine pregnancy test","allowed_amounts":[{"tin":{"type":"ein","value":"204615687"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":6.64,"providers":[{"billed_charge":20.00,"npi":[1619284742]}]}]}]},{"name":"Visit complexity inherent to evaluation and management associated with medical care services that serve as the continuing focal point for all needed health care services and\/o","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G221195","description":"Visit complexity inherent to evaluation and management associated with medical care services that serve as the continuing focal point for all needed health care services and\/o","allowed_amounts":[{"tin":{"type":"ein","value":"943281660"},"service_code":["02"],"billing_class":"professional","payments":[{"allowed_amount":65.52,"providers":[{"billed_charge":84.00,"npi":[1447404439]}]}]}]}]}
