{"hospital_name": "Valley Baptist Medical Center Brownsville", "last_updated_on": "2026-04-01", "version": "3.0.0", "pid": "1514681850", "rid": "10154", "location_name": ["Valley Baptist Medical Center Brownsville"], "hospital_address": ["1040 W Jefferson St, Brownsville, TX 78520"], "type_2_npi": ["1184911877"], "license_information": {"license_number": "100105", "state": "TX"}, "attestation": {"attestation": "To the best of its knowledge and belief, this hospital has included all applicable standard charge information in accordance with the requirements of 45 CFR 180.50, and the information encoded is true, accurate, and complete as of the date in the file. This hospital has included all payer-specific negotiated charges in dollars that can be expressed as a dollar amount. For payer-specific negotiated charges that cannot be expressed as a dollar amount in the machine-readable file or not knowable in advance, the hospital attests that the payer-specific negotiated charge is based on a contractual algorithm, percentage or formula that precludes the provision of a dollar amount and has provided all necessary information available to the hospital for the public to be able to derive the dollar amount, including, but not limited to, the specific fee schedule or components referenced in such percentage, algorithm or formula.", "confirm_attestation": true, "attester_name": "Geoffrey Vines"}, "standard_charge_information": [{"description": "11-DEOXYXORTISL", "code_information": [{"code": "82634", "type": "CPT"}, {"code": "7252517", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 1818.0, "discounted_cash": 1363.5, "setting": "both", "billing_class": "facility"}]}, {"description": "17-HYDROXY PREGNENOLONE", "code_information": [{"code": "84143", "type": "CPT"}, {"code": "7258414", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 179.0, "discounted_cash": 134.25, "setting": "both", "billing_class": "facility"}]}, {"description": "21 HYDROXYLASE AB", "code_information": [{"code": "83516", "type": "CPT"}, {"code": "7250439", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 90.0, "discounted_cash": 67.5, "setting": "both", "billing_class": "facility"}]}, {"description": "3 HYDROXY 3 METHYLGLUTARYL", "code_information": [{"code": "83516", "type": "CPT"}, {"code": "7253619", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 491.0, "discounted_cash": 368.25, "setting": "both", "billing_class": "facility"}]}, {"description": "3D IMAGING W POSTPROCESS", "code_information": [{"code": "76377", "type": "CPT"}, {"code": "5057637", "type": "CDM"}, {"code": "350", "type": "RC"}], "standard_charges": [{"gross_charge": 3465.0, "discounted_cash": 2598.75, "setting": "both", "billing_class": "facility"}]}, {"description": "3D IMAGING W POSTPROCESS", "code_information": [{"code": "76377", "type": "CPT"}, {"code": "5116377", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 4091.0, "discounted_cash": 3068.25, "setting": "both", "billing_class": "facility"}]}, {"description": "3D IMAGNG NO POSTPROCESS", "code_information": [{"code": "76376", "type": "CPT"}, {"code": "5057636", "type": "CDM"}, {"code": "350", "type": "RC"}], "standard_charges": [{"gross_charge": 1943.0, "discounted_cash": 1457.25, "setting": "both", "billing_class": "facility"}]}, {"description": "3D IMAGNG NO POSTPROCESS", "code_information": [{"code": "76376", "type": "CPT"}, {"code": "5256376", "type": "CDM"}, {"code": "350", "type": "RC"}], "standard_charges": [{"gross_charge": 1943.0, "discounted_cash": 1457.25, "setting": "both", "billing_class": "facility"}]}, {"description": "51 SOD CHROM PER 50 UCI", "code_information": [{"code": "A4641", "type": "HCPCS"}, {"code": "5190091", "type": "CDM"}, {"code": "343", "type": "RC"}], "standard_charges": [{"gross_charge": 331.0, "discounted_cash": 248.25, "setting": "both", "billing_class": "facility"}]}, {"description": "A-2 MACROGLOBULIN", "code_information": [{"code": "83883", "type": "CPT"}, {"code": "7253868", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 83.0, "discounted_cash": 62.25, "setting": "both", "billing_class": "facility"}]}, {"description": "AA 10% 100ML TPN", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5413173", "type": "CDM"}, {"code": "258", "type": "RC"}], "standard_charges": [{"gross_charge": 778.0, "discounted_cash": 583.5, "setting": "both", "billing_class": "facility"}]}, {"description": "AA 10% 1L TPN", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5413180", "type": "CDM"}, {"code": "258", "type": "RC"}], "standard_charges": [{"gross_charge": 535.0, "discounted_cash": 401.25, "setting": "both", "billing_class": "facility"}]}, {"description": "AA 10% 500ML TPN", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5413175", "type": "CDM"}, {"code": "258", "type": "RC"}], "standard_charges": [{"gross_charge": 995.0, "discounted_cash": 746.25, "setting": "both", "billing_class": "facility"}]}, {"description": "AA 10% PER 1ML TPN", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5413186", "type": "CDM"}, {"code": "258", "type": "RC"}], "standard_charges": [{"gross_charge": 1.0, "discounted_cash": 0.75, "setting": "both", "billing_class": "facility"}]}, {"description": "AA 3% ELEC 1L TPN", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5413030", "type": "CDM"}, {"code": "258", "type": "RC"}], "standard_charges": [{"gross_charge": 1036.0, "discounted_cash": 777.0, "setting": "both", "billing_class": "facility"}]}, {"description": "AA 4.25% D5 2L TPN", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5412024", "type": "CDM"}, {"code": "258", "type": "RC"}], "standard_charges": [{"gross_charge": 895.0, "discounted_cash": 671.25, "setting": "both", "billing_class": "facility"}]}, {"description": "AA 4.25% D5 EL/CA 1L TPN", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5412011", "type": "CDM"}, {"code": "258", "type": "RC"}], "standard_charges": [{"gross_charge": 1065.0, "discounted_cash": 798.75, "setting": "both", "billing_class": "facility"}]}, {"description": "AA 4.25%D5 EL/CA 2L TPN", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5412012", "type": "CDM"}, {"code": "258", "type": "RC"}], "standard_charges": [{"gross_charge": 1063.0, "discounted_cash": 797.25, "setting": "both", "billing_class": "facility"}]}, {"description": "AA 5% D15 1L TPN", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5413183", "type": "CDM"}, {"code": "258", "type": "RC"}], "standard_charges": [{"gross_charge": 1274.0, "discounted_cash": 955.5, "setting": "both", "billing_class": "facility"}]}, {"description": "AA 5% D15 2L TPN", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5412023", "type": "CDM"}, {"code": "258", "type": "RC"}], "standard_charges": [{"gross_charge": 993.0, "discounted_cash": 744.75, "setting": "both", "billing_class": "facility"}]}, {"description": "AA 5% D15 EL/CA 1L TPN", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5412033", "type": "CDM"}, {"code": "258", "type": "RC"}], "standard_charges": [{"gross_charge": 1083.0, "discounted_cash": 812.25, "setting": "both", "billing_class": "facility"}]}, {"description": "AA 5% D15 EL/CA 2L TPN", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5412004", "type": "CDM"}, {"code": "258", "type": "RC"}], "standard_charges": [{"gross_charge": 2267.0, "discounted_cash": 1700.25, "setting": "both", "billing_class": "facility"}]}, {"description": "AA 5% D20 EL/CA 1L TPN", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5412021", "type": "CDM"}, {"code": "258", "type": "RC"}], "standard_charges": [{"gross_charge": 1204.0, "discounted_cash": 903.0, "setting": "both", "billing_class": "facility"}]}, {"description": "AA 5% D20 EL/CA 2L TPN", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5412003", "type": "CDM"}, {"code": "258", "type": "RC"}], "standard_charges": [{"gross_charge": 1068.0, "discounted_cash": 801.0, "setting": "both", "billing_class": "facility"}]}, {"description": "AA 5% D25 EL/CA 1L TPN", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5412029", "type": "CDM"}, {"code": "258", "type": "RC"}], "standard_charges": [{"gross_charge": 1391.0, "discounted_cash": 1043.25, "setting": "both", "billing_class": "facility"}]}, {"description": "AA 8% D14 ELEC 1000ML TPN", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5413222", "type": "CDM"}, {"code": "258", "type": "RC"}], "standard_charges": [{"gross_charge": 832.0, "discounted_cash": 624.0, "setting": "both", "billing_class": "facility"}]}, {"description": "AA 8% D14 ELEC 2000ML TPN", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5413218", "type": "CDM"}, {"code": "258", "type": "RC"}], "standard_charges": [{"gross_charge": 989.0, "discounted_cash": 741.75, "setting": "both", "billing_class": "facility"}]}, {"description": "AB DETECTION NOS DFA", "code_information": [{"code": "87299", "type": "CPT"}, {"code": "4107299", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 247.0, "discounted_cash": 185.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ABACAVIR/LAMIVUDINE TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5300007", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 576.0, "discounted_cash": 432.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ABACAVIR/LAMIVUDINE TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5300007", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 576.0, "discounted_cash": 432.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ABD AORTOGRPHY BY SERIAL", "code_information": [{"code": "75625", "type": "CPT"}, {"code": "4615627", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 8178.0, "discounted_cash": 6133.5, "setting": "both", "billing_class": "facility"}]}, {"description": "ABD AORTOGRPHY BY SERIAL", "code_information": [{"code": "75625", "type": "CPT"}, {"code": "4915627", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 11122.0, "discounted_cash": 8341.5, "setting": "both", "billing_class": "facility"}]}, {"description": "ABD ART/VEN FLOW ABD COMP", "code_information": [{"code": "93975", "type": "CPT"}, {"code": "5062015", "type": "CDM"}, {"code": "921", "type": "RC"}], "standard_charges": [{"gross_charge": 4672.0, "discounted_cash": 3504.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ABD ART/VEN FLOW ABD COMP", "code_information": [{"code": "93975", "type": "CPT"}, {"code": "5112015", "type": "CDM"}, {"code": "921", "type": "RC"}], "standard_charges": [{"gross_charge": 4377.0, "discounted_cash": 3282.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ABD ART/VEN FLOW LTD", "code_information": [{"code": "93976", "type": "CPT"}, {"code": "5062017", "type": "CDM"}, {"code": "921", "type": "RC"}], "standard_charges": [{"gross_charge": 671.0, "discounted_cash": 503.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ABD ART/VEN FLOW LTD", "code_information": [{"code": "93976", "type": "CPT"}, {"code": "5112017", "type": "CDM"}, {"code": "921", "type": "RC"}], "standard_charges": [{"gross_charge": 921.0, "discounted_cash": 690.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ABD PARACENTESIS W/IMAGE", "code_information": [{"code": "4919083", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 2391.0, "discounted_cash": 1793.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ABD PARACENTESIS W/IMAGE", "code_information": [{"code": "5059083", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 2847.0, "discounted_cash": 2135.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ABD PARACENTESIS W/IMAGE", "code_information": [{"code": "5069083", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 2972.0, "discounted_cash": 2229.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ABD PARACENTESIS W/OIMAG", "code_information": [{"code": "4919082", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 2611.0, "discounted_cash": 1958.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ABDOMEN 1 VIEW", "code_information": [{"code": "74018", "type": "CPT"}, {"code": "4904018", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 1219.0, "discounted_cash": 914.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ABDOMEN 1 VIEW", "code_information": [{"code": "74018", "type": "CPT"}, {"code": "5114018", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 1038.0, "discounted_cash": 778.5, "setting": "both", "billing_class": "facility"}]}, {"description": "ABDOMEN 2 VIEWS", "code_information": [{"code": "74019", "type": "CPT"}, {"code": "4904019", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 1154.0, "discounted_cash": 865.5, "setting": "both", "billing_class": "facility"}]}, {"description": "ABDOMEN 2 VIEWS", "code_information": [{"code": "74019", "type": "CPT"}, {"code": "5114019", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 1101.0, "discounted_cash": 825.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ABDOMEN 3/+ VIEWS", "code_information": [{"code": "74021", "type": "CPT"}, {"code": "4904021", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 1101.0, "discounted_cash": 825.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ABG W CALC O2 SAT", "code_information": [{"code": "82803", "type": "CPT"}, {"code": "5501806", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 1337.0, "discounted_cash": 1002.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ABG W O2 DIRECT", "code_information": [{"code": "82805", "type": "CPT"}, {"code": "5500152", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 2773.0, "discounted_cash": 2079.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ABLATION-AV NODE", "code_information": [{"code": "93650", "type": "CPT"}, {"code": "4610650", "type": "CDM"}, {"code": "480", "type": "RC"}], "standard_charges": [{"gross_charge": 29658.0, "discounted_cash": 22243.5, "setting": "both", "billing_class": "facility"}]}, {"description": "ABLATN RENL TUMORS CRYO", "code_information": [{"code": "4910135", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 22255.0, "discounted_cash": 16691.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ABLATN RENL TUMORS CRYO", "code_information": [{"code": "5050593", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 22256.0, "discounted_cash": 16692.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ACAMPROSATE 333MG EC TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5300025", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 85.0, "discounted_cash": 63.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ACAMPROSATE 333MG EC TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5300025", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 85.0, "discounted_cash": 63.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ACARBOSE 25MG", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5300004", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 78.0, "discounted_cash": 58.5, "setting": "both", "billing_class": "facility"}]}, {"description": "ACARBOSE 25MG", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5300004", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 78.0, "discounted_cash": 58.5, "setting": "both", "billing_class": "facility"}]}, {"description": "ACEBUTOLOL 200MG CAP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5300008", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 78.0, "discounted_cash": 58.5, "setting": "both", "billing_class": "facility"}]}, {"description": "ACEBUTOLOL 200MG CAP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5300008", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 78.0, "discounted_cash": 58.5, "setting": "both", "billing_class": "facility"}]}, {"description": "ACELL MTRX SIMPLIDERM", "code_information": [{"code": "Q4100", "type": "HCPCS"}, {"code": "4020482", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 5376.0, "discounted_cash": 4032.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ACELL MTRX SIMPLIDERM", "code_information": [{"code": "Q4100", "type": "HCPCS"}, {"code": "4020482", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 5376.0, "discounted_cash": 4032.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ACETABULR COMP", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "8131000", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 19918.0, "discounted_cash": 14938.5, "setting": "both", "billing_class": "facility"}]}, {"description": "ACETABULR SEAL", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "8131005", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 5853.0, "discounted_cash": 4389.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ACETAZOLAM PER1ML CMPDLQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5314026", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 14.0, "discounted_cash": 10.5, "setting": "both", "billing_class": "facility"}]}, {"description": "ACETAZOLAM PER1ML CMPDLQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5314026", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 14.0, "discounted_cash": 10.5, "setting": "both", "billing_class": "facility"}]}, {"description": "ACETAZOLAMI UPTO 500MGIJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J1120", "type": "HCPCS"}, {"code": "5318004", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 1598.0, "discounted_cash": 1198.5, "setting": "both", "billing_class": "facility"}]}, {"description": "ACETAZOLAMI UPTO 500MGIJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J1120", "type": "HCPCS"}, {"code": "5318004", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 1598.0, "discounted_cash": 1198.5, "setting": "both", "billing_class": "facility"}]}, {"description": "ACETAZOLAMID 500MG XR CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5300102", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 110.0, "discounted_cash": 82.5, "setting": "both", "billing_class": "facility"}]}, {"description": "ACETAZOLAMID 500MG XR CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5300102", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 110.0, "discounted_cash": 82.5, "setting": "both", "billing_class": "facility"}]}, {"description": "ACETAZOLAMIDE 250MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5300098", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 61.0, "discounted_cash": 45.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ACETAZOLAMIDE 250MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5300098", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 61.0, "discounted_cash": 45.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ACETONE QUALITATIVE", "code_information": [{"code": "82009", "type": "CPT"}, {"code": "4102007", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 520.0, "discounted_cash": 390.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ACETONE QUALITATIVE", "code_information": [{"code": "82009", "type": "CPT"}, {"code": "4172009", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 5.71, "discounted_cash": 4.28, "setting": "both", "billing_class": "facility"}]}, {"description": "ACETONE QUALITATIVE/2", "code_information": [{"code": "82009", "type": "CPT"}, {"code": "4102009", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 508.0, "discounted_cash": 381.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ACETONE QUANTITATIVE", "code_information": [{"code": "82010", "type": "CPT"}, {"code": "4102004", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 621.0, "discounted_cash": 465.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ACETONE QUANTITATIVE", "code_information": [{"code": "82010", "type": "CPT"}, {"code": "7252010", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 27.0, "discounted_cash": 20.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ACETONE QUANTITATIVE/2", "code_information": [{"code": "82010", "type": "CPT"}, {"code": "7252015", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 463.0, "discounted_cash": 347.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ACETYLCHOLINE CL1%2ML OS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5330044", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 550.0, "discounted_cash": 412.5, "setting": "both", "billing_class": "facility"}]}, {"description": "ACETYLCYSTEIN PER100MGIJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0132", "type": "HCPCS"}, {"code": "5318016", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 2034.0, "discounted_cash": 1525.5, "setting": "both", "billing_class": "facility"}]}, {"description": "ACETYLCYSTEIN PER100MGIJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0132", "type": "HCPCS"}, {"code": "5318016", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 2034.0, "discounted_cash": 1525.5, "setting": "both", "billing_class": "facility"}]}, {"description": "ACETYLCYSTEINE 10%4ML IS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5330065", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 322.0, "discounted_cash": 241.5, "setting": "both", "billing_class": "facility"}]}, {"description": "ACETYLCYSTEINE 10%4ML IS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5330065", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 322.0, "discounted_cash": 241.5, "setting": "both", "billing_class": "facility"}]}, {"description": "ACETYLCYSTEINE 20%4ML IS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5330079", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 160.0, "discounted_cash": 120.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ACETYLCYSTEINE10%10ML IS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5330067", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 407.0, "discounted_cash": 305.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ACETYLCYSTEINE10%30ML IS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5330072", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 356.0, "discounted_cash": 267.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ACETYLCYSTEINE20%10ML IS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5330086", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 568.0, "discounted_cash": 426.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ACETYLCYSTEINE20%30ML IS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5330093", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 142.0, "discounted_cash": 106.5, "setting": "both", "billing_class": "facility"}]}, {"description": "ACHR ANTIBODY", "code_information": [{"code": "83519", "type": "CPT"}, {"code": "7253580", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 329.0, "discounted_cash": 246.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ACHR ANTIBODY/2", "code_information": [{"code": "83519", "type": "CPT"}, {"code": "7253581", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 130.0, "discounted_cash": 97.5, "setting": "both", "billing_class": "facility"}]}, {"description": "ACHR ANTIBODY/3", "code_information": [{"code": "83519", "type": "CPT"}, {"code": "7258385", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 136.0, "discounted_cash": 102.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ACROMIOCLAVICULAR JTS BI", "code_information": [{"code": "73050", "type": "CPT"}, {"code": "4903050", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 1301.0, "discounted_cash": 975.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ACTH", "code_information": [{"code": "82024", "type": "CPT"}, {"code": "7252024", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 1359.0, "discounted_cash": 1019.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ACTH STIMULATION PANEL", "code_information": [{"code": "80400", "type": "CPT"}, {"code": "4100400", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 171.0, "discounted_cash": 128.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ACTIN SMOOTH MUSCLE AB", "code_information": [{"code": "86015", "type": "CPT"}, {"code": "7250516", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 229.0, "discounted_cash": 171.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ACTINOMYCES AB", "code_information": [{"code": "86602", "type": "CPT"}, {"code": "7256589", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 108.0, "discounted_cash": 81.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ACTINOMYCES AB/2", "code_information": [{"code": "86602", "type": "CPT"}, {"code": "7256599", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 108.0, "discounted_cash": 81.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ACTINOMYCES AB/3", "code_information": [{"code": "86602", "type": "CPT"}, {"code": "7256602", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 210.0, "discounted_cash": 157.5, "setting": "both", "billing_class": "facility"}]}, {"description": "ACTINOMYCES AB/4", "code_information": [{"code": "86602", "type": "CPT"}, {"code": "7256603", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 210.0, "discounted_cash": 157.5, "setting": "both", "billing_class": "facility"}]}, {"description": "ACUTE GI BLOOD LOSS IMG", "code_information": [{"code": "78278", "type": "CPT"}, {"code": "5208280", "type": "CDM"}, {"code": "341", "type": "RC"}], "standard_charges": [{"gross_charge": 5525.0, "discounted_cash": 4143.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ACUTE HEPATITIS PANEL", "code_information": [{"code": "80074", "type": "CPT"}, {"code": "4100074", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 1420.0, "discounted_cash": 1065.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ACUTE HEPATITIS PANEL", "code_information": [{"code": "80074", "type": "CPT"}, {"code": "4170074", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 25.69, "discounted_cash": 19.27, "setting": "both", "billing_class": "facility"}]}, {"description": "ACUTE HEPATITIS PANEL", "code_information": [{"code": "80074", "type": "CPT"}, {"code": "7250074", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 55.0, "discounted_cash": 41.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ACYCLOVIR 200MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5300160", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 61.0, "discounted_cash": 45.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ACYCLOVIR 200MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5300160", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 61.0, "discounted_cash": 45.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ACYCLOVIR 400MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5300162", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 66.0, "discounted_cash": 49.5, "setting": "both", "billing_class": "facility"}]}, {"description": "ACYCLOVIR 400MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5300162", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 66.0, "discounted_cash": 49.5, "setting": "both", "billing_class": "facility"}]}, {"description": "ACYCLOVIR 40MG/ML 1ML LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5314031", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 85.0, "discounted_cash": 63.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ACYCLOVIR 40MG/ML 1ML LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5314031", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 85.0, "discounted_cash": 63.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ACYCLOVIR 40MG/ML 5ML LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5314035", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 66.0, "discounted_cash": 49.5, "setting": "both", "billing_class": "facility"}]}, {"description": "ACYCLOVIR 40MG/ML 5ML LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5314035", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 66.0, "discounted_cash": 49.5, "setting": "both", "billing_class": "facility"}]}, {"description": "ACYCLOVIR 5% 30GM OI", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5334036", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 697.0, "discounted_cash": 522.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ACYCLOVIR 5% 30GM OI", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5334036", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 697.0, "discounted_cash": 522.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ACYCLOVIR PER 5MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0133", "type": "HCPCS"}, {"code": "5318015", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 4.0, "discounted_cash": 3.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ACYCLOVIR PER 5MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0133", "type": "HCPCS"}, {"code": "5318015", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 4.0, "discounted_cash": 3.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ACYLCARNITINES QN EA SPC", "code_information": [{"code": "82017", "type": "CPT"}, {"code": "7252005", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 313.0, "discounted_cash": 234.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ADAMTS 13 ACTIVITY", "code_information": [{"code": "85397", "type": "CPT"}, {"code": "7258539", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 657.0, "discounted_cash": 492.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ADENOSINE DEAMINASE", "code_information": [{"code": "84311", "type": "CPT"}, {"code": "7256366", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 360.0, "discounted_cash": 270.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ADENOSINE DEAMINASE", "code_information": [{"code": "84311", "type": "CPT"}, {"code": "7256367", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 238.0, "discounted_cash": 178.5, "setting": "both", "billing_class": "facility"}]}, {"description": "ADENOSINE PER 1MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0153", "type": "HCPCS"}, {"code": "5318047", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 143.0, "discounted_cash": 107.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ADENOSINE PER 1MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0153", "type": "HCPCS"}, {"code": "5318047", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 143.0, "discounted_cash": 107.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ADENOVIRUS AB", "code_information": [{"code": "86603", "type": "CPT"}, {"code": "7256911", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 412.0, "discounted_cash": 309.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ADENOVIRUS AG DFA", "code_information": [{"code": "87260", "type": "CPT"}, {"code": "4102028", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 43.0, "discounted_cash": 32.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ADENOVIRUS AG DFA", "code_information": [{"code": "87260", "type": "CPT"}, {"code": "7252028", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 165.0, "discounted_cash": 123.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ADENOVIRUS IA", "code_information": [{"code": "87301", "type": "CPT"}, {"code": "7257305", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 108.0, "discounted_cash": 81.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ADMIN DAY ADULT LEVEL II", "code_information": [{"code": "1990028", "type": "CDM"}, {"code": "199", "type": "RC"}], "standard_charges": [{"gross_charge": 3689.0, "discounted_cash": 2766.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ADMIN DAY ADULT LEVEL II", "code_information": [{"code": "2000028", "type": "CDM"}, {"code": "199", "type": "RC"}], "standard_charges": [{"gross_charge": 3689.0, "discounted_cash": 2766.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ADMIN DAY ADULT LEVEL II", "code_information": [{"code": "2010028", "type": "CDM"}, {"code": "199", "type": "RC"}], "standard_charges": [{"gross_charge": 3689.0, "discounted_cash": 2766.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ADMIN DAY ADULT LEVEL II", "code_information": [{"code": "2120028", "type": "CDM"}, {"code": "199", "type": "RC"}], "standard_charges": [{"gross_charge": 3689.0, "discounted_cash": 2766.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ADMIN DAY ADULT LEVEL II", "code_information": [{"code": "2150028", "type": "CDM"}, {"code": "199", "type": "RC"}], "standard_charges": [{"gross_charge": 3689.0, "discounted_cash": 2766.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ADMIN DAY ADULT LEVEL II", "code_information": [{"code": "2300028", "type": "CDM"}, {"code": "199", "type": "RC"}], "standard_charges": [{"gross_charge": 3689.0, "discounted_cash": 2766.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ADMIN DAY ADULT LEVEL II", "code_information": [{"code": "2310028", "type": "CDM"}, {"code": "199", "type": "RC"}], "standard_charges": [{"gross_charge": 3689.0, "discounted_cash": 2766.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ADMIN DAY ADULT LEVEL II", "code_information": [{"code": "2320028", "type": "CDM"}, {"code": "199", "type": "RC"}], "standard_charges": [{"gross_charge": 3689.0, "discounted_cash": 2766.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ADMIN DAY ADULT LEVEL II", "code_information": [{"code": "2400028", "type": "CDM"}, {"code": "199", "type": "RC"}], "standard_charges": [{"gross_charge": 3689.0, "discounted_cash": 2766.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ADMIN DAY ADULT LEVEL II", "code_information": [{"code": "2500028", "type": "CDM"}, {"code": "199", "type": "RC"}], "standard_charges": [{"gross_charge": 3689.0, "discounted_cash": 2766.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ADMIN DAY LEVEL I", "code_information": [{"code": "1990027", "type": "CDM"}, {"code": "169", "type": "RC"}], "standard_charges": [{"gross_charge": 3689.0, "discounted_cash": 2766.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ADMIN DAY LEVEL I", "code_information": [{"code": "2000027", "type": "CDM"}, {"code": "169", "type": "RC"}], "standard_charges": [{"gross_charge": 3689.0, "discounted_cash": 2766.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ADMIN DAY LEVEL I", "code_information": [{"code": "2010027", "type": "CDM"}, {"code": "169", "type": "RC"}], "standard_charges": [{"gross_charge": 3689.0, "discounted_cash": 2766.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ADMIN DAY LEVEL I", "code_information": [{"code": "2120027", "type": "CDM"}, {"code": "169", "type": "RC"}], "standard_charges": [{"gross_charge": 3689.0, "discounted_cash": 2766.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ADMIN DAY LEVEL I", "code_information": [{"code": "2150027", "type": "CDM"}, {"code": "169", "type": "RC"}], "standard_charges": [{"gross_charge": 3689.0, "discounted_cash": 2766.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ADMIN DAY LEVEL I", "code_information": [{"code": "2300027", "type": "CDM"}, {"code": "169", "type": "RC"}], "standard_charges": [{"gross_charge": 3689.0, "discounted_cash": 2766.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ADMIN DAY LEVEL I", "code_information": [{"code": "2310027", "type": "CDM"}, {"code": "169", "type": "RC"}], "standard_charges": [{"gross_charge": 3689.0, "discounted_cash": 2766.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ADMIN DAY LEVEL I", "code_information": [{"code": "2320027", "type": "CDM"}, {"code": "169", "type": "RC"}], "standard_charges": [{"gross_charge": 3689.0, "discounted_cash": 2766.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ADMIN DAY LEVEL I", "code_information": [{"code": "2400027", "type": "CDM"}, {"code": "169", "type": "RC"}], "standard_charges": [{"gross_charge": 3689.0, "discounted_cash": 2766.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ADMIN DAY LEVEL I", "code_information": [{"code": "2500027", "type": "CDM"}, {"code": "169", "type": "RC"}], "standard_charges": [{"gross_charge": 3689.0, "discounted_cash": 2766.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ADPTR MOLD HIP SPCR NECK", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "4010671", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 10150.0, "discounted_cash": 7612.5, "setting": "both", "billing_class": "facility"}]}, {"description": "ADRENAL ANTIBODIES", "code_information": [{"code": "86255", "type": "CPT"}, {"code": "7256243", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 60.0, "discounted_cash": 45.0, "setting": "both", "billing_class": "facility"}]}, {"description": "AFFINITY PER SQ CM", "code_information": [{"code": "Q4159", "type": "HCPCS"}, {"code": "4020487", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 1954.0, "discounted_cash": 1465.5, "setting": "both", "billing_class": "facility"}]}, {"description": "AFFINITY PER SQ CM", "code_information": [{"code": "Q4159", "type": "HCPCS"}, {"code": "4020487", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 1954.0, "discounted_cash": 1465.5, "setting": "both", "billing_class": "facility"}]}, {"description": "AFO PLSTC/OTHER PREFAB", "code_information": [{"code": "L1930", "type": "HCPCS"}, {"code": "8130079", "type": "CDM"}, {"code": "274", "type": "RC"}], "standard_charges": [{"gross_charge": 1820.0, "discounted_cash": 1365.0, "setting": "both", "billing_class": "facility"}]}, {"description": "AG DETECTION POLYVAL DFA", "code_information": [{"code": "87300", "type": "CPT"}, {"code": "7257300", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 122.0, "discounted_cash": 91.5, "setting": "both", "billing_class": "facility"}]}, {"description": "AGGLUTININS FEBRIL EA AG/4", "code_information": [{"code": "86000", "type": "CPT"}, {"code": "7256086", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 53.0, "discounted_cash": 39.75, "setting": "both", "billing_class": "facility"}]}, {"description": "AL AC/CA ACET PK PW", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5334107", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 85.0, "discounted_cash": 63.75, "setting": "both", "billing_class": "facility"}]}, {"description": "AL AC/CA ACET PK PW", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5334107", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 85.0, "discounted_cash": 63.75, "setting": "both", "billing_class": "facility"}]}, {"description": "AL OH 320/5 30ML LQ", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5314162", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 72.0, "discounted_cash": 54.0, "setting": "both", "billing_class": "facility"}]}, {"description": "AL OH 320/5 30ML LQ", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5314162", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 72.0, "discounted_cash": 54.0, "setting": "both", "billing_class": "facility"}]}, {"description": "AL OH 320/5 5ML LQ", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5314161", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 85.0, "discounted_cash": 63.75, "setting": "both", "billing_class": "facility"}]}, {"description": "AL OH 320/5 5ML LQ", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5314161", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 85.0, "discounted_cash": 63.75, "setting": "both", "billing_class": "facility"}]}, {"description": "AL/MG OH 30ML LQ", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5314076", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 85.0, "discounted_cash": 63.75, "setting": "both", "billing_class": "facility"}]}, {"description": "AL/MG OH 30ML LQ", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5314076", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 85.0, "discounted_cash": 63.75, "setting": "both", "billing_class": "facility"}]}, {"description": "AL/MG OH/SIM 30ML ES LQ", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5314119", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 85.0, "discounted_cash": 63.75, "setting": "both", "billing_class": "facility"}]}, {"description": "AL/MG OH/SIM 30ML ES LQ", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5314119", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 85.0, "discounted_cash": 63.75, "setting": "both", "billing_class": "facility"}]}, {"description": "AL/MG OH/SIM 30ML LQ", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5314131", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 85.0, "discounted_cash": 63.75, "setting": "both", "billing_class": "facility"}]}, {"description": "AL/MG OH/SIM 30ML LQ", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5314131", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 85.0, "discounted_cash": 63.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ALA DELTA AMINOLVLN ACID", "code_information": [{"code": "82135", "type": "CPT"}, {"code": "7252135", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 141.0, "discounted_cash": 105.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ALBENDAZOLE 200MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5300201", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 736.0, "discounted_cash": 552.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ALBENDAZOLE 200MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5300201", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 736.0, "discounted_cash": 552.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ALBUMIN 25% PER 50ML IJ", "code_information": [{"code": "P9047", "type": "HCPCS"}, {"code": "5318063", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 1311.0, "discounted_cash": 983.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ALBUMIN 25% PER 50ML IJ", "code_information": [{"code": "P9047", "type": "HCPCS"}, {"code": "5318063", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 1311.0, "discounted_cash": 983.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ALBUMIN 5% PER 250ML IJ", "code_information": [{"code": "P9045", "type": "HCPCS"}, {"code": "5318032", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 1902.0, "discounted_cash": 1426.5, "setting": "both", "billing_class": "facility"}]}, {"description": "ALBUMIN 5% PER 250ML IJ", "code_information": [{"code": "P9045", "type": "HCPCS"}, {"code": "5318032", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 1902.0, "discounted_cash": 1426.5, "setting": "both", "billing_class": "facility"}]}, {"description": "ALBUMIN 5% PER 50ML IJ", "code_information": [{"code": "P9041", "type": "HCPCS"}, {"code": "5318031", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 638.0, "discounted_cash": 478.5, "setting": "both", "billing_class": "facility"}]}, {"description": "ALBUMIN 5% PER 50ML IJ", "code_information": [{"code": "P9041", "type": "HCPCS"}, {"code": "5318031", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 638.0, "discounted_cash": 478.5, "setting": "both", "billing_class": "facility"}]}, {"description": "ALBUMIN QUANT OTH SRC", "code_information": [{"code": "82042", "type": "CPT"}, {"code": "4172045", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 7.14, "discounted_cash": 5.36, "setting": "both", "billing_class": "facility"}]}, {"description": "ALBUMIN QUANT OTH SRC", "code_information": [{"code": "82042", "type": "CPT"}, {"code": "7252045", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 34.0, "discounted_cash": 25.5, "setting": "both", "billing_class": "facility"}]}, {"description": "ALBUMIN QUANT OTH SRC/2", "code_information": [{"code": "82042", "type": "CPT"}, {"code": "4102045", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 450.0, "discounted_cash": 337.5, "setting": "both", "billing_class": "facility"}]}, {"description": "ALBUMIN QUANT OTH SRC/2", "code_information": [{"code": "82042", "type": "CPT"}, {"code": "7252111", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 401.0, "discounted_cash": 300.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ALBUMIN SERUM", "code_information": [{"code": "82040", "type": "CPT"}, {"code": "4102040", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 377.0, "discounted_cash": 282.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ALBUMIN SERUM", "code_information": [{"code": "82040", "type": "CPT"}, {"code": "4172040", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 1.12, "discounted_cash": 0.84, "setting": "both", "billing_class": "facility"}]}, {"description": "ALBUMIN SERUM", "code_information": [{"code": "82040", "type": "CPT"}, {"code": "7252040", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 401.0, "discounted_cash": 300.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ALBUTEROL .083% 3ML IS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5330116", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 85.0, "discounted_cash": 63.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ALBUTEROL .083% 3ML IS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5330116", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 85.0, "discounted_cash": 63.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ALBUTEROL 4MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5300223", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 78.0, "discounted_cash": 58.5, "setting": "both", "billing_class": "facility"}]}, {"description": "ALBUTEROL 4MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5300223", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 78.0, "discounted_cash": 58.5, "setting": "both", "billing_class": "facility"}]}, {"description": "ALBUTEROL HFA 18GM IH", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3535", "type": "HCPCS"}, {"code": "5330113", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 800.0, "discounted_cash": 600.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ALBUTEROL HFA 18GM IH", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3535", "type": "HCPCS"}, {"code": "5330113", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 800.0, "discounted_cash": 600.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ALBUTEROL HFA 6.7GM IH", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3535", "type": "HCPCS"}, {"code": "5330120", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 831.0, "discounted_cash": 623.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ALBUTEROL HFA 6.7GM IH", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3535", "type": "HCPCS"}, {"code": "5330120", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 831.0, "discounted_cash": 623.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ALBUTEROL HFA 8.5GM IH", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3535", "type": "HCPCS"}, {"code": "5330112", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 708.0, "discounted_cash": 531.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ALBUTEROL HFA 8.5GM IH", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3535", "type": "HCPCS"}, {"code": "5330112", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 708.0, "discounted_cash": 531.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ALBUTEROL PER DOSE IH", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3535", "type": "HCPCS"}, {"code": "5330124", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 796.0, "discounted_cash": 597.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ALBUTEROL PER DOSE IH", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3535", "type": "HCPCS"}, {"code": "5330124", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 796.0, "discounted_cash": 597.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ALBUTEROL/IPRATR 4GM IH", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3535", "type": "HCPCS"}, {"code": "5330130", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 3581.0, "discounted_cash": 2685.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ALBUTEROL/IPRATR 4GM IH", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3535", "type": "HCPCS"}, {"code": "5330130", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 3581.0, "discounted_cash": 2685.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ALBUTEROL2.5MG/.5ML UDIS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5330125", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 85.0, "discounted_cash": 63.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ALBUTEROL2.5MG/.5ML UDIS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5330125", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 85.0, "discounted_cash": 63.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ALCOHOL BIOMARKERS", "code_information": [{"code": "80321", "type": "CPT"}, {"code": "7250360", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 329.0, "discounted_cash": 246.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ALCOHOLS/2", "code_information": [{"code": "80320", "type": "CPT"}, {"code": "7252055", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 81.0, "discounted_cash": 60.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ALCOHOLS/3", "code_information": [{"code": "80320", "type": "CPT"}, {"code": "7252065", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 43.0, "discounted_cash": 32.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ALCOHOLS/4", "code_information": [{"code": "80320", "type": "CPT"}, {"code": "7252078", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 60.0, "discounted_cash": 45.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ALDOLASE", "code_information": [{"code": "82085", "type": "CPT"}, {"code": "7252085", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 351.0, "discounted_cash": 263.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ALDOSTERONE", "code_information": [{"code": "82088", "type": "CPT"}, {"code": "7252087", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 1349.0, "discounted_cash": 1011.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ALDOSTERONE/2", "code_information": [{"code": "82088", "type": "CPT"}, {"code": "7252089", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 288.0, "discounted_cash": 216.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ALENDRONATE 10MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5300230", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 109.0, "discounted_cash": 81.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ALENDRONATE 10MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5300230", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 109.0, "discounted_cash": 81.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ALENDRONATE 70MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5300233", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 398.0, "discounted_cash": 298.5, "setting": "both", "billing_class": "facility"}]}, {"description": "ALENDRONATE 70MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5300233", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 398.0, "discounted_cash": 298.5, "setting": "both", "billing_class": "facility"}]}, {"description": "ALISKIREN 150MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5300242", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 135.0, "discounted_cash": 101.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ALISKIREN 150MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5300242", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 135.0, "discounted_cash": 101.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ALKALOIDS NOS/2", "code_information": [{"code": "80323", "type": "CPT"}, {"code": "4102398", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 1080.0, "discounted_cash": 810.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ALKALOIDS NOS/2", "code_information": [{"code": "80323", "type": "CPT"}, {"code": "7253887", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 109.0, "discounted_cash": 81.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ALLOGRFT AMNIOTIC MEMBRN", "code_information": [{"code": "C1762", "type": "HCPCS"}, {"code": "4027051", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 19066.0, "discounted_cash": 14299.5, "setting": "both", "billing_class": "facility"}]}, {"description": "ALLOGRFT AMNIOTIC MEMBRN", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3590", "type": "HCPCS"}, {"code": "4020507", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 25635.0, "discounted_cash": 19226.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ALLOGRFT AMNIOTIC MEMBRN", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3590", "type": "HCPCS"}, {"code": "4020507", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 25635.0, "discounted_cash": 19226.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ALLOGRFT AMNIOTIC PROVENDA", "code_information": [{"code": "Q4100", "type": "HCPCS"}, {"code": "4020453", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 22208.0, "discounted_cash": 16656.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ALLOGRFT BN EXTENSURE H2", "code_information": [{"code": "C1762", "type": "HCPCS"}, {"code": "4020506", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 32732.0, "discounted_cash": 24549.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ALLOGRFT BN W/VIAB CELLS", "code_information": [{"code": "C1762", "type": "HCPCS"}, {"code": "4020510", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 63658.0, "discounted_cash": 47743.5, "setting": "both", "billing_class": "facility"}]}, {"description": "ALLOGRFT CMC SPEEDSPIRAL", "code_information": [{"code": "C1762", "type": "HCPCS"}, {"code": "4020553", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 28015.0, "discounted_cash": 21011.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ALLOGRFT ECM CTM THK 4CMX7CM", "code_information": [{"code": "C1762", "type": "HCPCS"}, {"code": "4020552", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 58007.0, "discounted_cash": 43505.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ALLOGRFT HUM PLCNTL TISS", "code_information": [{"code": "C1765", "type": "HCPCS"}, {"code": "4027055", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 16657.0, "discounted_cash": 12492.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ALLOGRFT SPACER CERVICAL", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8240497", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 37416.0, "discounted_cash": 28062.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ALLOGRFT SPD SPRL CMC ARTHR CL", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "4013312", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 27845.0, "discounted_cash": 20883.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ALLOGRFT UMBILICAL CORD", "code_information": [{"code": "Q4100", "type": "HCPCS"}, {"code": "4027061", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 19486.0, "discounted_cash": 14614.5, "setting": "both", "billing_class": "facility"}]}, {"description": "ALLOGRFT UMBILICAL CORD", "code_information": [{"code": "Q4100", "type": "HCPCS"}, {"code": "4027061", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 19486.0, "discounted_cash": 14614.5, "setting": "both", "billing_class": "facility"}]}, {"description": "ALLOPATCH HD PER SQ CM", "code_information": [{"code": "Q4128", "type": "HCPCS"}, {"code": "4020520", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 691.0, "discounted_cash": 518.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ALLOPATCH HD PER SQ CM", "code_information": [{"code": "Q4128", "type": "HCPCS"}, {"code": "4020520", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 691.0, "discounted_cash": 518.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ALLOPATCH PLIABL 2X2 PER SQ CM", "code_information": [{"code": "Q4128", "type": "HCPCS"}, {"code": "4027077", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 749.0, "discounted_cash": 561.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ALLOPATCH PLIABL 2X2 PER SQ CM", "code_information": [{"code": "Q4128", "type": "HCPCS"}, {"code": "4027077", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 749.0, "discounted_cash": 561.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ALLOPATCH PLIABL 4X4 PER SQ CM", "code_information": [{"code": "Q4128", "type": "HCPCS"}, {"code": "4027064", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 548.0, "discounted_cash": 411.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ALLOPATCH PLIABL 4X4 PER SQ CM", "code_information": [{"code": "Q4128", "type": "HCPCS"}, {"code": "4027064", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 548.0, "discounted_cash": 411.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ALLOPATCH PLIABL 4X8 PER SQ CM", "code_information": [{"code": "Q4128", "type": "HCPCS"}, {"code": "4027063", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 719.0, "discounted_cash": 539.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ALLOPATCH PLIABL 4X8 PER SQ CM", "code_information": [{"code": "Q4128", "type": "HCPCS"}, {"code": "4027063", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 719.0, "discounted_cash": 539.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ALLOPURINOL100MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5300244", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 61.0, "discounted_cash": 45.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ALLOPURINOL100MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5300244", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 61.0, "discounted_cash": 45.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ALLOPURINOL300MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5300248", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 64.0, "discounted_cash": 48.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ALLOPURINOL300MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5300248", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 64.0, "discounted_cash": 48.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ALLRGN SPEC IGE EA", "code_information": [{"code": "86003", "type": "CPT"}, {"code": "4109010", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 699.0, "discounted_cash": 524.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ALLRGN SPEC IGE EA", "code_information": [{"code": "86003", "type": "CPT"}, {"code": "7256004", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 13.0, "discounted_cash": 9.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ALLRGN SPEC IGE EA/22", "code_information": [{"code": "86003", "type": "CPT"}, {"code": "7256053", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 47.0, "discounted_cash": 35.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ALLRGN SPEC IGE EA/24", "code_information": [{"code": "86003", "type": "CPT"}, {"code": "7258600", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 47.0, "discounted_cash": 35.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ALLRGN SPEC IGG EA/3", "code_information": [{"code": "86001", "type": "CPT"}, {"code": "7256064", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 512.0, "discounted_cash": 384.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ALPHA FETO PROTEIN SERUM", "code_information": [{"code": "82105", "type": "CPT"}, {"code": "4102114", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 771.0, "discounted_cash": 578.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ALPHA FETO PROTEIN SERUM", "code_information": [{"code": "82105", "type": "CPT"}, {"code": "4172114", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 17.13, "discounted_cash": 12.85, "setting": "both", "billing_class": "facility"}]}, {"description": "ALPHA FETO PROTEIN SERUM", "code_information": [{"code": "82105", "type": "CPT"}, {"code": "7252114", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 17.0, "discounted_cash": 12.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ALPHA FETO PROTEIN SERUM/2", "code_information": [{"code": "82105", "type": "CPT"}, {"code": "7252118", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 92.0, "discounted_cash": 69.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ALPHA SUBUNIT", "code_information": [{"code": "83520", "type": "CPT"}, {"code": "7252666", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 197.0, "discounted_cash": 147.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ALPHA1PROT INH PER10MGIJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0256", "type": "HCPCS"}, {"code": "5318082", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 65.0, "discounted_cash": 48.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ALPHA1PROT INH PER10MGIJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0256", "type": "HCPCS"}, {"code": "5318082", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 65.0, "discounted_cash": 48.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ALPRAZOLAM .25MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5300294", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 71.0, "discounted_cash": 53.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ALPRAZOLAM .25MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5300294", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 71.0, "discounted_cash": 53.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ALPRAZOLAM .5MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5300298", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 77.0, "discounted_cash": 57.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ALPRAZOLAM .5MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5300298", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 77.0, "discounted_cash": 57.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ALPROSTADIL NEO PER1MLIJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5318073", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 2450.0, "discounted_cash": 1837.5, "setting": "both", "billing_class": "facility"}]}, {"description": "ALPROSTADL NEO PER1MCGIJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5318067", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 2.0, "discounted_cash": 1.5, "setting": "both", "billing_class": "facility"}]}, {"description": "ALPROSTADL PER1.25MCG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0270", "type": "HCPCS"}, {"code": "5318074", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 4.0, "discounted_cash": 3.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ALPROSTADL PER1.25MCG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0270", "type": "HCPCS"}, {"code": "5318074", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 4.0, "discounted_cash": 3.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ALTEPLASE PER 1MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J2997", "type": "HCPCS"}, {"code": "5318092", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 635.0, "discounted_cash": 476.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ALTEPLASE PER 1MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J2997", "type": "HCPCS"}, {"code": "5318092", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 635.0, "discounted_cash": 476.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ALUMINUM", "code_information": [{"code": "82108", "type": "CPT"}, {"code": "7252110", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 964.0, "discounted_cash": 723.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ALVIMOPAN 12MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5300420", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 885.0, "discounted_cash": 663.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ALVIMOPAN 12MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5300420", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 885.0, "discounted_cash": 663.75, "setting": "both", "billing_class": "facility"}]}, {"description": "AMANTADINE 100MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5300476", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 61.0, "discounted_cash": 45.75, "setting": "both", "billing_class": "facility"}]}, {"description": "AMANTADINE 100MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5300476", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 61.0, "discounted_cash": 45.75, "setting": "both", "billing_class": "facility"}]}, {"description": "AMB PROC 1ST 30MIN", "code_information": [{"code": "3603000", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 3194.0, "discounted_cash": 2395.5, "setting": "both", "billing_class": "facility"}]}, {"description": "AMIKACIN", "code_information": [{"code": "80150", "type": "CPT"}, {"code": "4102124", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 238.0, "discounted_cash": 178.5, "setting": "both", "billing_class": "facility"}]}, {"description": "AMIKACIN", "code_information": [{"code": "80150", "type": "CPT"}, {"code": "7252124", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 160.0, "discounted_cash": 120.0, "setting": "both", "billing_class": "facility"}]}, {"description": "AMIKACIN PER 100MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0278", "type": "HCPCS"}, {"code": "5318114", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 34.0, "discounted_cash": 25.5, "setting": "both", "billing_class": "facility"}]}, {"description": "AMIKACIN PER 100MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0278", "type": "HCPCS"}, {"code": "5318114", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 34.0, "discounted_cash": 25.5, "setting": "both", "billing_class": "facility"}]}, {"description": "AMIKACIN/2", "code_information": [{"code": "80150", "type": "CPT"}, {"code": "4102126", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 238.0, "discounted_cash": 178.5, "setting": "both", "billing_class": "facility"}]}, {"description": "AMIKACIN/2", "code_information": [{"code": "80150", "type": "CPT"}, {"code": "7252126", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 160.0, "discounted_cash": 120.0, "setting": "both", "billing_class": "facility"}]}, {"description": "AMIKACIN/3", "code_information": [{"code": "80150", "type": "CPT"}, {"code": "4102129", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 238.0, "discounted_cash": 178.5, "setting": "both", "billing_class": "facility"}]}, {"description": "AMIKACIN/3", "code_information": [{"code": "80150", "type": "CPT"}, {"code": "7252127", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 160.0, "discounted_cash": 120.0, "setting": "both", "billing_class": "facility"}]}, {"description": "AMILORIDE 5MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5300522", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 45.0, "discounted_cash": 33.75, "setting": "both", "billing_class": "facility"}]}, {"description": "AMILORIDE 5MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5300522", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 45.0, "discounted_cash": 33.75, "setting": "both", "billing_class": "facility"}]}, {"description": "AMINO ACID SINGLE QUAL", "code_information": [{"code": "82127", "type": "CPT"}, {"code": "7258212", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 541.0, "discounted_cash": 405.75, "setting": "both", "billing_class": "facility"}]}, {"description": "AMINO ACIDS 6+ QNT", "code_information": [{"code": "82139", "type": "CPT"}, {"code": "4102139", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 1167.0, "discounted_cash": 875.25, "setting": "both", "billing_class": "facility"}]}, {"description": "AMINO ACIDS 6+ QNT/2", "code_information": [{"code": "82139", "type": "CPT"}, {"code": "7258213", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 616.0, "discounted_cash": 462.0, "setting": "both", "billing_class": "facility"}]}, {"description": "AMINO ACIDS 6+ QNT/4", "code_information": [{"code": "82139", "type": "CPT"}, {"code": "7258220", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 616.0, "discounted_cash": 462.0, "setting": "both", "billing_class": "facility"}]}, {"description": "AMINO ACIDS QNT SNGL/8", "code_information": [{"code": "82131", "type": "CPT"}, {"code": "7252620", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 1624.0, "discounted_cash": 1218.0, "setting": "both", "billing_class": "facility"}]}, {"description": "AMINO ACIDS QUAL MULT/2", "code_information": [{"code": "82128", "type": "CPT"}, {"code": "7252129", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 744.0, "discounted_cash": 558.0, "setting": "both", "billing_class": "facility"}]}, {"description": "AMINOCAPRO AC 250 1ML LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5314182", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 85.0, "discounted_cash": 63.75, "setting": "both", "billing_class": "facility"}]}, {"description": "AMINOCAPRO AC 250 1ML LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5314182", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 85.0, "discounted_cash": 63.75, "setting": "both", "billing_class": "facility"}]}, {"description": "AMINOCAPROIC ACID PER 1GM IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0281", "type": "HCPCS"}, {"code": "5318150", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 36.0, "discounted_cash": 27.0, "setting": "both", "billing_class": "facility"}]}, {"description": "AMINOCAPROIC ACID PER 1GM IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0281", "type": "HCPCS"}, {"code": "5318150", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 36.0, "discounted_cash": 27.0, "setting": "both", "billing_class": "facility"}]}, {"description": "AMINOCAPROIC ACID500MGTB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5300549", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 71.0, "discounted_cash": 53.25, "setting": "both", "billing_class": "facility"}]}, {"description": "AMINOCAPROIC ACID500MGTB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5300549", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 71.0, "discounted_cash": 53.25, "setting": "both", "billing_class": "facility"}]}, {"description": "AMINOEXCEL PER SQ CM", "code_information": [{"code": "Q4137", "type": "HCPCS"}, {"code": "4020590", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 729.0, "discounted_cash": 546.75, "setting": "both", "billing_class": "facility"}]}, {"description": "AMINOEXCEL PER SQ CM", "code_information": [{"code": "Q4137", "type": "HCPCS"}, {"code": "4020590", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 729.0, "discounted_cash": 546.75, "setting": "both", "billing_class": "facility"}]}, {"description": "AMINOPHYLLIN UPTO250MGIJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0280", "type": "HCPCS"}, {"code": "5318177", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 65.0, "discounted_cash": 48.75, "setting": "both", "billing_class": "facility"}]}, {"description": "AMINOPHYLLIN UPTO250MGIJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0280", "type": "HCPCS"}, {"code": "5318177", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 65.0, "discounted_cash": 48.75, "setting": "both", "billing_class": "facility"}]}, {"description": "AMINOTC FLD SCAN(SPECTRO", "code_information": [{"code": "82143", "type": "CPT"}, {"code": "7252265", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 180.0, "discounted_cash": 135.0, "setting": "both", "billing_class": "facility"}]}, {"description": "AMIODAR PER30MG PMXIV IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0282", "type": "HCPCS"}, {"code": "5318198", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 62.0, "discounted_cash": 46.5, "setting": "both", "billing_class": "facility"}]}, {"description": "AMIODAR PER30MG PMXIV IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0282", "type": "HCPCS"}, {"code": "5318198", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 62.0, "discounted_cash": 46.5, "setting": "both", "billing_class": "facility"}]}, {"description": "AMIODARONE", "code_information": [{"code": "80151", "type": "CPT"}, {"code": "7250284", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 181.0, "discounted_cash": 135.75, "setting": "both", "billing_class": "facility"}]}, {"description": "AMIODARONE 200MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5300625", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 83.0, "discounted_cash": 62.25, "setting": "both", "billing_class": "facility"}]}, {"description": "AMIODARONE 200MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5300625", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 83.0, "discounted_cash": 62.25, "setting": "both", "billing_class": "facility"}]}, {"description": "AMIODARONE NEO PER1MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5318196", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 0.62, "discounted_cash": 0.47, "setting": "both", "billing_class": "facility"}]}, {"description": "AMIODARONE PER 30MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0282", "type": "HCPCS"}, {"code": "5318199", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 14.0, "discounted_cash": 10.5, "setting": "both", "billing_class": "facility"}]}, {"description": "AMIODARONE PER 30MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0282", "type": "HCPCS"}, {"code": "5318199", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 14.0, "discounted_cash": 10.5, "setting": "both", "billing_class": "facility"}]}, {"description": "AMITRIPTYLINE 10MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5300634", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 61.0, "discounted_cash": 45.75, "setting": "both", "billing_class": "facility"}]}, {"description": "AMITRIPTYLINE 10MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5300634", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 61.0, "discounted_cash": 45.75, "setting": "both", "billing_class": "facility"}]}, {"description": "AMITRIPTYLINE 25MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5300638", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 61.0, "discounted_cash": 45.75, "setting": "both", "billing_class": "facility"}]}, {"description": "AMITRIPTYLINE 25MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5300638", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 61.0, "discounted_cash": 45.75, "setting": "both", "billing_class": "facility"}]}, {"description": "AMLODIPINE 2.5MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5300660", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 61.0, "discounted_cash": 45.75, "setting": "both", "billing_class": "facility"}]}, {"description": "AMLODIPINE 2.5MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5300660", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 61.0, "discounted_cash": 45.75, "setting": "both", "billing_class": "facility"}]}, {"description": "AMLODIPINE 5MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5300661", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 71.0, "discounted_cash": 53.25, "setting": "both", "billing_class": "facility"}]}, {"description": "AMLODIPINE 5MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5300661", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 71.0, "discounted_cash": 53.25, "setting": "both", "billing_class": "facility"}]}, {"description": "AMLODIPN/BENAZPR 5/10 CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5300663", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 102.0, "discounted_cash": 76.5, "setting": "both", "billing_class": "facility"}]}, {"description": "AMLODIPN/BENAZPR 5/10 CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5300663", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 102.0, "discounted_cash": 76.5, "setting": "both", "billing_class": "facility"}]}, {"description": "AMLODIPN/BENAZPR 5/20 CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5300664", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 110.0, "discounted_cash": 82.5, "setting": "both", "billing_class": "facility"}]}, {"description": "AMLODIPN/BENAZPR 5/20 CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5300664", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 110.0, "discounted_cash": 82.5, "setting": "both", "billing_class": "facility"}]}, {"description": "AMMONIA", "code_information": [{"code": "82140", "type": "CPT"}, {"code": "4102140", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 1126.0, "discounted_cash": 844.5, "setting": "both", "billing_class": "facility"}]}, {"description": "AMMONIA", "code_information": [{"code": "82140", "type": "CPT"}, {"code": "4172140", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 5.71, "discounted_cash": 4.28, "setting": "both", "billing_class": "facility"}]}, {"description": "AMMONIA AROMATIC IH", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5330219", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 66.0, "discounted_cash": 49.5, "setting": "both", "billing_class": "facility"}]}, {"description": "AMMONIUM LACT12%225ML LT", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5336087", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 279.0, "discounted_cash": 209.25, "setting": "both", "billing_class": "facility"}]}, {"description": "AMMONIUM LACT12%225ML LT", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5336087", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 279.0, "discounted_cash": 209.25, "setting": "both", "billing_class": "facility"}]}, {"description": "AMNIOBAND 3CMX4CM PER SQ CM", "code_information": [{"code": "Q4151", "type": "HCPCS"}, {"code": "4020605", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 1286.0, "discounted_cash": 964.5, "setting": "both", "billing_class": "facility"}]}, {"description": "AMNIOBAND 3CMX4CM PER SQ CM", "code_information": [{"code": "Q4151", "type": "HCPCS"}, {"code": "4020605", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 1286.0, "discounted_cash": 964.5, "setting": "both", "billing_class": "facility"}]}, {"description": "AMNIOBAND PER 1MG", "code_information": [{"code": "Q4168", "type": "HCPCS"}, {"code": "4020593", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 180.0, "discounted_cash": 135.0, "setting": "both", "billing_class": "facility"}]}, {"description": "AMNIOBAND PER 1MG", "code_information": [{"code": "Q4168", "type": "HCPCS"}, {"code": "4020593", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 180.0, "discounted_cash": 135.0, "setting": "both", "billing_class": "facility"}]}, {"description": "AMNIOCENTESIS DIAG", "code_information": [{"code": "5061145", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 4088.0, "discounted_cash": 3066.0, "setting": "both", "billing_class": "facility"}]}, {"description": "AMNIOEFFECT LYOPHILIZED AMNION", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3590", "type": "HCPCS"}, {"code": "4027040", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 12363.0, "discounted_cash": 9272.25, "setting": "both", "billing_class": "facility"}]}, {"description": "AMNIOEFFECT LYOPHILIZED AMNION", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3590", "type": "HCPCS"}, {"code": "4027040", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 12363.0, "discounted_cash": 9272.25, "setting": "both", "billing_class": "facility"}]}, {"description": "AMNIOEXCEL 4CMX5CM PER SQ CM", "code_information": [{"code": "Q4137", "type": "HCPCS"}, {"code": "4020583", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 1151.0, "discounted_cash": 863.25, "setting": "both", "billing_class": "facility"}]}, {"description": "AMNIOEXCEL 4CMX5CM PER SQ CM", "code_information": [{"code": "Q4137", "type": "HCPCS"}, {"code": "4020583", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 1151.0, "discounted_cash": 863.25, "setting": "both", "billing_class": "facility"}]}, {"description": "AMNIOEXCEL PLUS 3CMX4CM SQ CM", "code_information": [{"code": "Q4137", "type": "HCPCS"}, {"code": "4020595", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 1286.0, "discounted_cash": 964.5, "setting": "both", "billing_class": "facility"}]}, {"description": "AMNIOEXCEL PLUS 3CMX4CM SQ CM", "code_information": [{"code": "Q4137", "type": "HCPCS"}, {"code": "4020595", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 1286.0, "discounted_cash": 964.5, "setting": "both", "billing_class": "facility"}]}, {"description": "AMNIOEXCEL PLUS 3X3 PER SQ CM", "code_information": [{"code": "Q4137", "type": "HCPCS"}, {"code": "4020597", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 1167.0, "discounted_cash": 875.25, "setting": "both", "billing_class": "facility"}]}, {"description": "AMNIOEXCEL PLUS 3X3 PER SQ CM", "code_information": [{"code": "Q4137", "type": "HCPCS"}, {"code": "4020597", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 1167.0, "discounted_cash": 875.25, "setting": "both", "billing_class": "facility"}]}, {"description": "AMNIOEXCEL PLUS 5X8 PER SQ CM", "code_information": [{"code": "Q4137", "type": "HCPCS"}, {"code": "4020609", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 1110.0, "discounted_cash": 832.5, "setting": "both", "billing_class": "facility"}]}, {"description": "AMNIOEXCEL PLUS 5X8 PER SQ CM", "code_information": [{"code": "Q4137", "type": "HCPCS"}, {"code": "4020609", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 1110.0, "discounted_cash": 832.5, "setting": "both", "billing_class": "facility"}]}, {"description": "AMOXIC/CLAV250/5 5MLPWLQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5314237", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 149.0, "discounted_cash": 111.75, "setting": "both", "billing_class": "facility"}]}, {"description": "AMOXIC/CLAV250/5 5MLPWLQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5314237", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 149.0, "discounted_cash": 111.75, "setting": "both", "billing_class": "facility"}]}, {"description": "AMOXICILLIN 250/5 5ML LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5314253", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 87.0, "discounted_cash": 65.25, "setting": "both", "billing_class": "facility"}]}, {"description": "AMOXICILLIN 250/5 5ML LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5314253", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 87.0, "discounted_cash": 65.25, "setting": "both", "billing_class": "facility"}]}, {"description": "AMOXICILLIN 250MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5300723", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 71.0, "discounted_cash": 53.25, "setting": "both", "billing_class": "facility"}]}, {"description": "AMOXICILLIN 250MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5300723", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 71.0, "discounted_cash": 53.25, "setting": "both", "billing_class": "facility"}]}, {"description": "AMOXICILLIN 500MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5300725", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 61.0, "discounted_cash": 45.75, "setting": "both", "billing_class": "facility"}]}, {"description": "AMOXICILLIN 500MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5300725", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 61.0, "discounted_cash": 45.75, "setting": "both", "billing_class": "facility"}]}, {"description": "AMOXICILLIN PED DS LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5314255", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 85.0, "discounted_cash": 63.75, "setting": "both", "billing_class": "facility"}]}, {"description": "AMOXICILLIN PED DS LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5314255", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 85.0, "discounted_cash": 63.75, "setting": "both", "billing_class": "facility"}]}, {"description": "AMOXICILLIN/CLAV 250MGTB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5300712", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 162.0, "discounted_cash": 121.5, "setting": "both", "billing_class": "facility"}]}, {"description": "AMOXICILLIN/CLAV 250MGTB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5300712", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 162.0, "discounted_cash": 121.5, "setting": "both", "billing_class": "facility"}]}, {"description": "AMOXICILLIN/CLAV 500MGTB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5300715", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 95.0, "discounted_cash": 71.25, "setting": "both", "billing_class": "facility"}]}, {"description": "AMOXICILLIN/CLAV 500MGTB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5300715", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 95.0, "discounted_cash": 71.25, "setting": "both", "billing_class": "facility"}]}, {"description": "AMOXICILLIN/CLAV 875MGTB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5300713", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 136.0, "discounted_cash": 102.0, "setting": "both", "billing_class": "facility"}]}, {"description": "AMOXICILLIN/CLAV 875MGTB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5300713", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 136.0, "discounted_cash": 102.0, "setting": "both", "billing_class": "facility"}]}, {"description": "AMOXICILLN 400/5 5ML LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5314258", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 66.0, "discounted_cash": 49.5, "setting": "both", "billing_class": "facility"}]}, {"description": "AMOXICILLN 400/5 5ML LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5314258", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 66.0, "discounted_cash": 49.5, "setting": "both", "billing_class": "facility"}]}, {"description": "AMOXICILN 250/5 100ML LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5314254", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 189.0, "discounted_cash": 141.75, "setting": "both", "billing_class": "facility"}]}, {"description": "AMOXICILN 250/5 100ML LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5314254", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 189.0, "discounted_cash": 141.75, "setting": "both", "billing_class": "facility"}]}, {"description": "AMPHIPHYSIN AB", "code_information": [{"code": "83516", "type": "CPT"}, {"code": "7253487", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 557.0, "discounted_cash": 417.75, "setting": "both", "billing_class": "facility"}]}, {"description": "AMPHOT B LIPOS PER10MGIJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0289", "type": "HCPCS"}, {"code": "5318251", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 629.0, "discounted_cash": 471.75, "setting": "both", "billing_class": "facility"}]}, {"description": "AMPHOT B LIPOS PER10MGIJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0289", "type": "HCPCS"}, {"code": "5318251", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 629.0, "discounted_cash": 471.75, "setting": "both", "billing_class": "facility"}]}, {"description": "AMPHOTER B LC PER 10MGIJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0287", "type": "HCPCS"}, {"code": "5318243", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 376.0, "discounted_cash": 282.0, "setting": "both", "billing_class": "facility"}]}, {"description": "AMPHOTER B LC PER 10MGIJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0287", "type": "HCPCS"}, {"code": "5318243", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 376.0, "discounted_cash": 282.0, "setting": "both", "billing_class": "facility"}]}, {"description": "AMPHOTERICIN B 50MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0285", "type": "HCPCS"}, {"code": "5318245", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 1323.0, "discounted_cash": 992.25, "setting": "both", "billing_class": "facility"}]}, {"description": "AMPHOTERICIN B 50MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0285", "type": "HCPCS"}, {"code": "5318245", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 1323.0, "discounted_cash": 992.25, "setting": "both", "billing_class": "facility"}]}, {"description": "AMPIC/SUL PER1.5GMIVPBIJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0295", "type": "HCPCS"}, {"code": "5318294", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 342.0, "discounted_cash": 256.5, "setting": "both", "billing_class": "facility"}]}, {"description": "AMPIC/SUL PER1.5GMIVPBIJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0295", "type": "HCPCS"}, {"code": "5318294", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 342.0, "discounted_cash": 256.5, "setting": "both", "billing_class": "facility"}]}, {"description": "AMPICIL/SUL PER1.5GM IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0295", "type": "HCPCS"}, {"code": "5318292", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 203.0, "discounted_cash": 152.25, "setting": "both", "billing_class": "facility"}]}, {"description": "AMPICIL/SUL PER1.5GM IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0295", "type": "HCPCS"}, {"code": "5318292", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 203.0, "discounted_cash": 152.25, "setting": "both", "billing_class": "facility"}]}, {"description": "AMPICILLIN 250MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5300746", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 85.0, "discounted_cash": 63.75, "setting": "both", "billing_class": "facility"}]}, {"description": "AMPICILLIN 250MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5300746", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 85.0, "discounted_cash": 63.75, "setting": "both", "billing_class": "facility"}]}, {"description": "AMPICILLIN 250MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0290", "type": "HCPCS"}, {"code": "5318264", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 114.0, "discounted_cash": 85.5, "setting": "both", "billing_class": "facility"}]}, {"description": "AMPICILLIN 250MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0290", "type": "HCPCS"}, {"code": "5318264", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 114.0, "discounted_cash": 85.5, "setting": "both", "billing_class": "facility"}]}, {"description": "AMPICILLIN 500MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5300750", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 66.0, "discounted_cash": 49.5, "setting": "both", "billing_class": "facility"}]}, {"description": "AMPICILLIN 500MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5300750", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 66.0, "discounted_cash": 49.5, "setting": "both", "billing_class": "facility"}]}, {"description": "AMPICILLIN PER 500MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0290", "type": "HCPCS"}, {"code": "5318265", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 165.0, "discounted_cash": 123.75, "setting": "both", "billing_class": "facility"}]}, {"description": "AMPICILLIN PER 500MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0290", "type": "HCPCS"}, {"code": "5318265", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 165.0, "discounted_cash": 123.75, "setting": "both", "billing_class": "facility"}]}, {"description": "AMPICILLINPER500MGIVPBIJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0290", "type": "HCPCS"}, {"code": "5318266", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 198.0, "discounted_cash": 148.5, "setting": "both", "billing_class": "facility"}]}, {"description": "AMPICILLINPER500MGIVPBIJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0290", "type": "HCPCS"}, {"code": "5318266", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 198.0, "discounted_cash": 148.5, "setting": "both", "billing_class": "facility"}]}, {"description": "AMPUTATION OF TOE", "code_information": [{"code": "6908820", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 11447.0, "discounted_cash": 8585.25, "setting": "both", "billing_class": "facility"}]}, {"description": "AMPUTATION OF TOE", "code_information": [{"code": "6908820", "type": "CDM"}, {"code": "361", "type": "RC"}], "standard_charges": [{"gross_charge": 11447.0, "discounted_cash": 8585.25, "setting": "both", "billing_class": "facility"}]}, {"description": "AMYLASE", "code_information": [{"code": "82150", "type": "CPT"}, {"code": "4102150", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 847.0, "discounted_cash": 635.25, "setting": "both", "billing_class": "facility"}]}, {"description": "AMYLASE", "code_information": [{"code": "82150", "type": "CPT"}, {"code": "4122150", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 5.0, "discounted_cash": 3.75, "setting": "both", "billing_class": "facility"}]}, {"description": "AMYLASE", "code_information": [{"code": "82150", "type": "CPT"}, {"code": "4172150", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 4.29, "discounted_cash": 3.22, "setting": "both", "billing_class": "facility"}]}, {"description": "AMYLASE", "code_information": [{"code": "82150", "type": "CPT"}, {"code": "7252150", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 17.0, "discounted_cash": 12.75, "setting": "both", "billing_class": "facility"}]}, {"description": "AMYLASE/2", "code_information": [{"code": "82150", "type": "CPT"}, {"code": "4102151", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 712.0, "discounted_cash": 534.0, "setting": "both", "billing_class": "facility"}]}, {"description": "AMYLASE/2", "code_information": [{"code": "82150", "type": "CPT"}, {"code": "4172151", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 4.29, "discounted_cash": 3.22, "setting": "both", "billing_class": "facility"}]}, {"description": "AMYLASE/3", "code_information": [{"code": "82150", "type": "CPT"}, {"code": "4102152", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 671.0, "discounted_cash": 503.25, "setting": "both", "billing_class": "facility"}]}, {"description": "AMYLASE/3", "code_information": [{"code": "82150", "type": "CPT"}, {"code": "4172152", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 4.29, "discounted_cash": 3.22, "setting": "both", "billing_class": "facility"}]}, {"description": "AMYLASE/4", "code_information": [{"code": "82150", "type": "CPT"}, {"code": "4172153", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 18.55, "discounted_cash": 13.91, "setting": "both", "billing_class": "facility"}]}, {"description": "AMYLASE/4", "code_information": [{"code": "82150", "type": "CPT"}, {"code": "7252153", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 579.0, "discounted_cash": 434.25, "setting": "both", "billing_class": "facility"}]}, {"description": "AMYLASE/5", "code_information": [{"code": "82150", "type": "CPT"}, {"code": "4102154", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 712.0, "discounted_cash": 534.0, "setting": "both", "billing_class": "facility"}]}, {"description": "AMYLASE/5", "code_information": [{"code": "82150", "type": "CPT"}, {"code": "4172154", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 19.98, "discounted_cash": 14.99, "setting": "both", "billing_class": "facility"}]}, {"description": "AMYLASE/5", "code_information": [{"code": "82150", "type": "CPT"}, {"code": "7252664", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 130.0, "discounted_cash": 97.5, "setting": "both", "billing_class": "facility"}]}, {"description": "AMYLOID BETA-PROTEIN", "code_information": [{"code": "83519", "type": "CPT"}, {"code": "7253494", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 613.0, "discounted_cash": 459.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ANABOLIC STEROIDS 1-2", "code_information": [{"code": "80327", "type": "CPT"}, {"code": "7252651", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 377.0, "discounted_cash": 282.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ANAGRELIDE 0.5MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5300755", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 184.0, "discounted_cash": 138.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ANAGRELIDE 0.5MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5300755", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 184.0, "discounted_cash": 138.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ANASTROZOLE 1MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5300762", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 203.0, "discounted_cash": 152.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ANASTROZOLE 1MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5300762", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 203.0, "discounted_cash": 152.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ANCH BIO-SWIVELOCK", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "4020598", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 6834.0, "discounted_cash": 5125.5, "setting": "both", "billing_class": "facility"}]}, {"description": "ANCH CORKSCREW", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "4020600", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 5324.0, "discounted_cash": 3993.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ANCH LEAD SPINL STIM", "code_information": [{"code": "L8699", "type": "HCPCS"}, {"code": "8178125", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 5259.0, "discounted_cash": 3944.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ANCH LUPINE BR W ORTHCRD", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "4020649", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 6173.0, "discounted_cash": 4629.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ANCH PEEK PUSH LCK", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "4010685", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 7763.0, "discounted_cash": 5822.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ANCH ROTATOR", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8031026", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 3491.0, "discounted_cash": 2618.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ANCH SCRW BIO-INTRAFIX", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8131013", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 4699.0, "discounted_cash": 3524.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ANCH SUT ALLTHREAD", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "4010699", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 5742.0, "discounted_cash": 4306.5, "setting": "both", "billing_class": "facility"}]}, {"description": "ANCH SUT BIO-SUTURETAK", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "4020700", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 3545.0, "discounted_cash": 2658.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ANCH SUT BIOCRKSCRW FT", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "4010700", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 5426.0, "discounted_cash": 4069.5, "setting": "both", "billing_class": "facility"}]}, {"description": "ANCH SUT FOOTPRINT PK", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "4010710", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 4998.0, "discounted_cash": 3748.5, "setting": "both", "billing_class": "facility"}]}, {"description": "ANCH/SCRW BN/BN TISS/BN", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8240005", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 2429.0, "discounted_cash": 1821.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ANCH/SCRW BN/BN TISS/BN4", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8240014", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 3095.0, "discounted_cash": 2321.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ANCH/SCRW BN/BN TISS/BN5", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8240016", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 3207.0, "discounted_cash": 2405.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ANCH/SCRW BN/BN TISS/BN6", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8240017", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 25218.0, "discounted_cash": 18913.5, "setting": "both", "billing_class": "facility"}]}, {"description": "ANCH/SCRW BN/BN TISS/BN7", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8240018", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 23289.0, "discounted_cash": 17466.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ANDROSTENEDIONE", "code_information": [{"code": "82157", "type": "CPT"}, {"code": "7252157", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 1219.0, "discounted_cash": 914.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ANESTHESIA EA ADD 15 MIN", "code_information": [{"code": "3703561", "type": "CDM"}, {"code": "370", "type": "RC"}], "standard_charges": [{"gross_charge": 1723.0, "discounted_cash": 1292.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ANESTHESIA INIT 30 MIN", "code_information": [{"code": "3703560", "type": "CDM"}, {"code": "370", "type": "RC"}], "standard_charges": [{"gross_charge": 3858.0, "discounted_cash": 2893.5, "setting": "both", "billing_class": "facility"}]}, {"description": "ANGIO ADRENAL UNILAT SEL", "code_information": [{"code": "75731", "type": "CPT"}, {"code": "4915732", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 8457.0, "discounted_cash": 6342.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ANGIO EXIST CATH F/U STU", "code_information": [{"code": "75898", "type": "CPT"}, {"code": "4615898", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 5461.0, "discounted_cash": 4095.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ANGIO EXIST CATH F/U STU", "code_information": [{"code": "75898", "type": "CPT"}, {"code": "4915898", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 6049.0, "discounted_cash": 4536.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ANGIO EXTREMITY BILAT", "code_information": [{"code": "75716", "type": "CPT"}, {"code": "4615718", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 9915.0, "discounted_cash": 7436.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ANGIO EXTREMITY BILAT", "code_information": [{"code": "75716", "type": "CPT"}, {"code": "4915718", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 12374.0, "discounted_cash": 9280.5, "setting": "both", "billing_class": "facility"}]}, {"description": "ANGIO EXTREMITY UNILAT", "code_information": [{"code": "75710", "type": "CPT"}, {"code": "4615712", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 11343.0, "discounted_cash": 8507.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ANGIO EXTREMITY UNILAT", "code_information": [{"code": "75710", "type": "CPT"}, {"code": "4905798", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 11343.0, "discounted_cash": 8507.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ANGIO EXTREMITY UNILAT", "code_information": [{"code": "75710", "type": "CPT"}, {"code": "4915712", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 11343.0, "discounted_cash": 8507.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ANGIO IC VERT SEL", "code_information": [{"code": "4616234", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 30267.0, "discounted_cash": 22700.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ANGIO PELVIC SELECT/SUP", "code_information": [{"code": "75736", "type": "CPT"}, {"code": "4915737", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 8457.0, "discounted_cash": 6342.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ANGIO PULM NON-SEL CATH", "code_information": [{"code": "75746", "type": "CPT"}, {"code": "4615747", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 4610.0, "discounted_cash": 3457.5, "setting": "both", "billing_class": "facility"}]}, {"description": "ANGIO PULM SEL BI", "code_information": [{"code": "75743", "type": "CPT"}, {"code": "4615744", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 7907.0, "discounted_cash": 5930.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ANGIO PULM SEL BI", "code_information": [{"code": "75743", "type": "CPT"}, {"code": "4915744", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 7231.0, "discounted_cash": 5423.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ANGIO PULMONARY UNI SLCT", "code_information": [{"code": "75741", "type": "CPT"}, {"code": "4615742", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 8536.0, "discounted_cash": 6402.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ANGIO PULMONARY UNI SLCT", "code_information": [{"code": "75741", "type": "CPT"}, {"code": "4915742", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 8536.0, "discounted_cash": 6402.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ANGIO SELECT EA ADD VESL", "code_information": [{"code": "75774", "type": "CPT"}, {"code": "4613540", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 2953.0, "discounted_cash": 2214.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ANGIO SPINAL SELECTIVE", "code_information": [{"code": "75705", "type": "CPT"}, {"code": "4615706", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 31497.0, "discounted_cash": 23622.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ANGIO VISCERAL SEL/SUPSEL", "code_information": [{"code": "75726", "type": "CPT"}, {"code": "4915729", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 14540.0, "discounted_cash": 10905.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ANGIOTENSIN CONV ENZYME", "code_information": [{"code": "82164", "type": "CPT"}, {"code": "7252164", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 630.0, "discounted_cash": 472.5, "setting": "both", "billing_class": "facility"}]}, {"description": "ANGIOTENSIN II", "code_information": [{"code": "82163", "type": "CPT"}, {"code": "7252163", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 574.0, "discounted_cash": 430.5, "setting": "both", "billing_class": "facility"}]}, {"description": "ANGIPLASTY ART INIT+S&I", "code_information": [{"code": "4617246", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 24368.0, "discounted_cash": 18276.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ANGIPLASTY ART INIT+S&I", "code_information": [{"code": "4917246", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 24368.0, "discounted_cash": 18276.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ANGIPLASTY VEN INIT+S&I", "code_information": [{"code": "4917248", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 20637.0, "discounted_cash": 15477.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ANKLE 2 VIEWS", "code_information": [{"code": "73600", "type": "CPT"}, {"code": "4903600", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 1388.0, "discounted_cash": 1041.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ANKLE 2 VIEWS", "code_information": [{"code": "73600", "type": "CPT"}, {"code": "5113600", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 1662.0, "discounted_cash": 1246.5, "setting": "both", "billing_class": "facility"}]}, {"description": "ANKLE 2 VIEWS", "code_information": [{"code": "73600", "type": "CPT"}, {"code": "6813600", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 469.0, "discounted_cash": 351.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ANKLE 3 VIEWS MINIMUM", "code_information": [{"code": "73610", "type": "CPT"}, {"code": "4903610", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 2805.0, "discounted_cash": 2103.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ANKLE 3 VIEWS MINIMUM", "code_information": [{"code": "73610", "type": "CPT"}, {"code": "5113610", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 1624.0, "discounted_cash": 1218.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ANKLE 3 VIEWS MINIMUM", "code_information": [{"code": "73610", "type": "CPT"}, {"code": "6813610", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 533.0, "discounted_cash": 399.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ANKLE ARTHROGRAPHY", "code_information": [{"code": "73615", "type": "CPT"}, {"code": "4903615", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 2578.0, "discounted_cash": 1933.5, "setting": "both", "billing_class": "facility"}]}, {"description": "ANTEGRADE NEPHROSTOGRAM", "code_information": [{"code": "74425", "type": "CPT"}, {"code": "4904425", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 1570.0, "discounted_cash": 1177.5, "setting": "both", "billing_class": "facility"}]}, {"description": "ANTEGRADE NEPHROSTOGRAM", "code_information": [{"code": "74425", "type": "CPT"}, {"code": "4914425", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 1912.0, "discounted_cash": 1434.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ANTI HMGCR AB", "code_information": [{"code": "83520", "type": "CPT"}, {"code": "7253613", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 264.0, "discounted_cash": 198.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ANTI NMDA RECEPTOR AB", "code_information": [{"code": "86255", "type": "CPT"}, {"code": "7258615", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 950.0, "discounted_cash": 712.5, "setting": "both", "billing_class": "facility"}]}, {"description": "ANTI-GLOMERULAR BSMNT", "code_information": [{"code": "83516", "type": "CPT"}, {"code": "7252322", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 53.0, "discounted_cash": 39.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ANTI-PLA2R", "code_information": [{"code": "83516", "type": "CPT"}, {"code": "7253607", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 318.0, "discounted_cash": 238.5, "setting": "both", "billing_class": "facility"}]}, {"description": "ANTI-RI", "code_information": [{"code": "86255", "type": "CPT"}, {"code": "7256465", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 215.0, "discounted_cash": 161.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ANTI-STREPTOLYSN O TITER", "code_information": [{"code": "86060", "type": "CPT"}, {"code": "4106060", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 142.0, "discounted_cash": 106.5, "setting": "both", "billing_class": "facility"}]}, {"description": "ANTI-STREPTOLYSN O TITER", "code_information": [{"code": "86060", "type": "CPT"}, {"code": "7256060", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 21.0, "discounted_cash": 15.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ANTI-STREPTOLYSN SCREEN", "code_information": [{"code": "86063", "type": "CPT"}, {"code": "7256061", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 48.0, "discounted_cash": 36.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ANTIBDY IDENT RBC EA PNL", "code_information": [{"code": "86870", "type": "CPT"}, {"code": "4106024", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 753.0, "discounted_cash": 564.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ANTIBDY IDENT RBC EA PNL", "code_information": [{"code": "86870", "type": "CPT"}, {"code": "4176024", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 12.84, "discounted_cash": 9.63, "setting": "both", "billing_class": "facility"}]}, {"description": "ANTIBDY IDENT RBC EA PNL", "code_information": [{"code": "86870", "type": "CPT"}, {"code": "7016024", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 510.0, "discounted_cash": 382.5, "setting": "both", "billing_class": "facility"}]}, {"description": "ANTIDPRSSNTS CYCLICAL 1-2/10", "code_information": [{"code": "80335", "type": "CPT"}, {"code": "7253904", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 614.0, "discounted_cash": 460.5, "setting": "both", "billing_class": "facility"}]}, {"description": "ANTIDPRSSNTS CYCLICAL 1-2/5", "code_information": [{"code": "80335", "type": "CPT"}, {"code": "7252138", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 90.0, "discounted_cash": 67.5, "setting": "both", "billing_class": "facility"}]}, {"description": "ANTIDPRSSNTS CYCLICAL 1-2/7", "code_information": [{"code": "80335", "type": "CPT"}, {"code": "7252629", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 670.0, "discounted_cash": 502.5, "setting": "both", "billing_class": "facility"}]}, {"description": "ANTIDPRSSNTS CYCLICAL 1-2/9", "code_information": [{"code": "80335", "type": "CPT"}, {"code": "7253523", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 140.0, "discounted_cash": 105.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ANTIDPRSSNTS CYCLICAL 6+/2", "code_information": [{"code": "80337", "type": "CPT"}, {"code": "7250377", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 65.0, "discounted_cash": 48.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ANTIEPILEPTIC NOS 1-3", "code_information": [{"code": "80339", "type": "CPT"}, {"code": "7250292", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 99.0, "discounted_cash": 74.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ANTIEPILEPTIC NOS 1-3/5", "code_information": [{"code": "80339", "type": "CPT"}, {"code": "7250349", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 269.0, "discounted_cash": 201.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ANTIEPILEPTIC NOS 1-3/8", "code_information": [{"code": "80339", "type": "CPT"}, {"code": "7252538", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 300.0, "discounted_cash": 225.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ANTIEPILEPTIC NOS 1-3/9", "code_information": [{"code": "80339", "type": "CPT"}, {"code": "7252539", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 674.0, "discounted_cash": 505.5, "setting": "both", "billing_class": "facility"}]}, {"description": "ANTINUCLEAR AB(ANA)", "code_information": [{"code": "86038", "type": "CPT"}, {"code": "4106043", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 201.0, "discounted_cash": 150.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ANTINUCLEAR AB(ANA)/2", "code_information": [{"code": "86038", "type": "CPT"}, {"code": "7256043", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 29.0, "discounted_cash": 21.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ANTINUCLEAR AB(ANA)/3", "code_information": [{"code": "86038", "type": "CPT"}, {"code": "7256058", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 121.0, "discounted_cash": 90.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ANTINUCLEAR AB(ANA)TITER", "code_information": [{"code": "86039", "type": "CPT"}, {"code": "4106041", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 734.0, "discounted_cash": 550.5, "setting": "both", "billing_class": "facility"}]}, {"description": "ANTIPHOSPHATIDYLSERINE AB", "code_information": [{"code": "86148", "type": "CPT"}, {"code": "7256142", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 136.0, "discounted_cash": 102.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ANTIPHOSPHATIDYLSERINE AB/2", "code_information": [{"code": "86148", "type": "CPT"}, {"code": "7256143", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 148.0, "discounted_cash": 111.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ANTIPHOSPHATIDYLSERINE AB/3", "code_information": [{"code": "86148", "type": "CPT"}, {"code": "7256144", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 148.0, "discounted_cash": 111.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ANTIPROTEINASE 3 AB/2", "code_information": [{"code": "83520", "type": "CPT"}, {"code": "7258377", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 55.0, "discounted_cash": 41.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ANTITHROMBIN III ACTIVITY", "code_information": [{"code": "85300", "type": "CPT"}, {"code": "4105304", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 389.0, "discounted_cash": 291.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ANTITHROMBIN III ACTIVITY/2", "code_information": [{"code": "85300", "type": "CPT"}, {"code": "7255309", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 316.0, "discounted_cash": 237.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ANTITHROMBIN III ANTIGEN", "code_information": [{"code": "85301", "type": "CPT"}, {"code": "4105301", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 2218.0, "discounted_cash": 1663.5, "setting": "both", "billing_class": "facility"}]}, {"description": "ANTITHROMBIN III ANTIGEN", "code_information": [{"code": "85301", "type": "CPT"}, {"code": "7255301", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 1492.0, "discounted_cash": 1119.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ANTITRYPSIN ALPHA 1 TOTL", "code_information": [{"code": "82103", "type": "CPT"}, {"code": "4106067", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 675.0, "discounted_cash": 506.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ANTITRYPSIN ALPHA 1 TOTL", "code_information": [{"code": "82103", "type": "CPT"}, {"code": "7256067", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 271.0, "discounted_cash": 203.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ANTITRYPSIN ALPHA PHENO", "code_information": [{"code": "82104", "type": "CPT"}, {"code": "7252104", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 100.0, "discounted_cash": 75.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ANTIVEN BLK WIDOW IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5318642", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 1415.0, "discounted_cash": 1061.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ANTIVEN CROTAL IMM FAB 2 EQ IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0841", "type": "HCPCS"}, {"code": "5319635", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 8942.0, "discounted_cash": 6706.5, "setting": "both", "billing_class": "facility"}]}, {"description": "ANTIVEN CROTAL IMM FAB 2 EQ IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0841", "type": "HCPCS"}, {"code": "5319635", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 8942.0, "discounted_cash": 6706.5, "setting": "both", "billing_class": "facility"}]}, {"description": "ANTIVEN CROTAL PER1GM IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0840", "type": "HCPCS"}, {"code": "5319634", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 32560.0, "discounted_cash": 24420.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ANTIVEN CROTAL PER1GM IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0840", "type": "HCPCS"}, {"code": "5319634", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 32560.0, "discounted_cash": 24420.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ANTIVEN SNAKE MICRUS IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5318306", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 17884.0, "discounted_cash": 13413.0, "setting": "both", "billing_class": "facility"}]}, {"description": "AORT/INF/IV/BPG COMP", "code_information": [{"code": "93978", "type": "CPT"}, {"code": "5062020", "type": "CDM"}, {"code": "921", "type": "RC"}], "standard_charges": [{"gross_charge": 4583.0, "discounted_cash": 3437.25, "setting": "both", "billing_class": "facility"}]}, {"description": "AORT/IVC/IV/BPG UNI/LTD", "code_information": [{"code": "93979", "type": "CPT"}, {"code": "5067150", "type": "CDM"}, {"code": "921", "type": "RC"}], "standard_charges": [{"gross_charge": 2904.0, "discounted_cash": 2178.0, "setting": "both", "billing_class": "facility"}]}, {"description": "AORTIC DYSFUNCTION/DILATION", "code_information": [{"code": "81410", "type": "CPT"}, {"code": "7250191", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 4082.0, "discounted_cash": 3061.5, "setting": "both", "billing_class": "facility"}]}, {"description": "AORTIC VALVE #2", "code_information": [{"code": "L8699", "type": "HCPCS"}, {"code": "8141010", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 66708.0, "discounted_cash": 50031.0, "setting": "both", "billing_class": "facility"}]}, {"description": "APAP 120MG SU", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5338016", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 66.0, "discounted_cash": 49.5, "setting": "both", "billing_class": "facility"}]}, {"description": "APAP 120MG SU", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5338016", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 66.0, "discounted_cash": 49.5, "setting": "both", "billing_class": "facility"}]}, {"description": "APAP 160M/5M 20.3ML LQ", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5314016", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 61.0, "discounted_cash": 45.75, "setting": "both", "billing_class": "facility"}]}, {"description": "APAP 160M/5M 20.3ML LQ", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5314016", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 61.0, "discounted_cash": 45.75, "setting": "both", "billing_class": "facility"}]}, {"description": "APAP 160M/5M 5ML LQ", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5314011", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 71.0, "discounted_cash": 53.25, "setting": "both", "billing_class": "facility"}]}, {"description": "APAP 160M/5M 5ML LQ", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5314011", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 71.0, "discounted_cash": 53.25, "setting": "both", "billing_class": "facility"}]}, {"description": "APAP 325MG SU", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5338020", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 61.0, "discounted_cash": 45.75, "setting": "both", "billing_class": "facility"}]}, {"description": "APAP 325MG SU", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5338020", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 61.0, "discounted_cash": 45.75, "setting": "both", "billing_class": "facility"}]}, {"description": "APAP 325MG TB", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5300017", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 85.0, "discounted_cash": 63.75, "setting": "both", "billing_class": "facility"}]}, {"description": "APAP 325MG TB", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5300017", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 85.0, "discounted_cash": 63.75, "setting": "both", "billing_class": "facility"}]}, {"description": "APAP 500MG ES TB", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5300014", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 99.0, "discounted_cash": 74.25, "setting": "both", "billing_class": "facility"}]}, {"description": "APAP 500MG ES TB", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5300014", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 99.0, "discounted_cash": 74.25, "setting": "both", "billing_class": "facility"}]}, {"description": "APAP 650MG SU", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5338024", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 78.0, "discounted_cash": 58.5, "setting": "both", "billing_class": "facility"}]}, {"description": "APAP 650MG SU", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5338024", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 78.0, "discounted_cash": 58.5, "setting": "both", "billing_class": "facility"}]}, {"description": "APAP 80M/.8M 15ML LQ", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5314009", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 118.0, "discounted_cash": 88.5, "setting": "both", "billing_class": "facility"}]}, {"description": "APAP 80M/.8M 15ML LQ", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5314009", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 118.0, "discounted_cash": 88.5, "setting": "both", "billing_class": "facility"}]}, {"description": "APAP NOS PER 10MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0131", "type": "HCPCS"}, {"code": "5318338", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 16.0, "discounted_cash": 12.0, "setting": "both", "billing_class": "facility"}]}, {"description": "APAP NOS PER 10MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0131", "type": "HCPCS"}, {"code": "5318338", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 16.0, "discounted_cash": 12.0, "setting": "both", "billing_class": "facility"}]}, {"description": "APAP/BUTAL/CAF/ TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5327036", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 61.0, "discounted_cash": 45.75, "setting": "both", "billing_class": "facility"}]}, {"description": "APAP/BUTAL/CAF/ TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5327036", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 61.0, "discounted_cash": 45.75, "setting": "both", "billing_class": "facility"}]}, {"description": "APAP/COD 120/12 5ML LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5327011", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 81.0, "discounted_cash": 60.75, "setting": "both", "billing_class": "facility"}]}, {"description": "APAP/COD 120/12 5ML LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5327011", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 81.0, "discounted_cash": 60.75, "setting": "both", "billing_class": "facility"}]}, {"description": "APAP/COD 30MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5327019", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 99.0, "discounted_cash": 74.25, "setting": "both", "billing_class": "facility"}]}, {"description": "APAP/COD 30MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5327019", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 99.0, "discounted_cash": 74.25, "setting": "both", "billing_class": "facility"}]}, {"description": "APIXABAN 2.5MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5300772", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 117.0, "discounted_cash": 87.75, "setting": "both", "billing_class": "facility"}]}, {"description": "APIXABAN 2.5MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5300772", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 117.0, "discounted_cash": 87.75, "setting": "both", "billing_class": "facility"}]}, {"description": "APIXABAN 5MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5300771", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 117.0, "discounted_cash": 87.75, "setting": "both", "billing_class": "facility"}]}, {"description": "APIXABAN 5MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5300771", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 117.0, "discounted_cash": 87.75, "setting": "both", "billing_class": "facility"}]}, {"description": "APLIGRAF PER SQ CM", "code_information": [{"code": "Q4101", "type": "HCPCS"}, {"code": "8240451", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 493.0, "discounted_cash": 369.75, "setting": "both", "billing_class": "facility"}]}, {"description": "APLIGRAF PER SQ CM", "code_information": [{"code": "Q4101", "type": "HCPCS"}, {"code": "8240451", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 493.0, "discounted_cash": 369.75, "setting": "both", "billing_class": "facility"}]}, {"description": "APOLIPOPROTEIN/3", "code_information": [{"code": "82172", "type": "CPT"}, {"code": "7252174", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 249.0, "discounted_cash": 186.75, "setting": "both", "billing_class": "facility"}]}, {"description": "APOLIPOPROTEIN/4", "code_information": [{"code": "82172", "type": "CPT"}, {"code": "7252176", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 18.35, "discounted_cash": 13.76, "setting": "both", "billing_class": "facility"}]}, {"description": "APP LC SKNSB FNHG 1ST 100SC", "code_information": [{"code": "6900016", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 2224.0, "discounted_cash": 1668.0, "setting": "both", "billing_class": "facility"}]}, {"description": "APP LC SKNSB FNHG 1ST 100SC", "code_information": [{"code": "6900016", "type": "CDM"}, {"code": "361", "type": "RC"}], "standard_charges": [{"gross_charge": 2224.0, "discounted_cash": 1668.0, "setting": "both", "billing_class": "facility"}]}, {"description": "APP LC SKNSB FNHG 1ST 25", "code_information": [{"code": "6810536", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 2224.0, "discounted_cash": 1668.0, "setting": "both", "billing_class": "facility"}]}, {"description": "APP LC SKNSB FNHG 1ST 25", "code_information": [{"code": "6810536", "type": "CDM"}, {"code": "361", "type": "RC"}], "standard_charges": [{"gross_charge": 2224.0, "discounted_cash": 1668.0, "setting": "both", "billing_class": "facility"}]}, {"description": "APP LC SKNSB FNHG 1ST 25SC", "code_information": [{"code": "6900018", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 2224.0, "discounted_cash": 1668.0, "setting": "both", "billing_class": "facility"}]}, {"description": "APP LC SKNSB FNHG 1ST 25SC", "code_information": [{"code": "6900018", "type": "CDM"}, {"code": "361", "type": "RC"}], "standard_charges": [{"gross_charge": 2224.0, "discounted_cash": 1668.0, "setting": "both", "billing_class": "facility"}]}, {"description": "APP LC SKNSB FNHG CHILD", "code_information": [{"code": "6810538", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 2224.0, "discounted_cash": 1668.0, "setting": "both", "billing_class": "facility"}]}, {"description": "APP LC SKNSB FNHG CHILD", "code_information": [{"code": "6810538", "type": "CDM"}, {"code": "361", "type": "RC"}], "standard_charges": [{"gross_charge": 2224.0, "discounted_cash": 1668.0, "setting": "both", "billing_class": "facility"}]}, {"description": "APP LC SKNSB FNHG EA ADL 100SC", "code_information": [{"code": "6900015", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 5339.0, "discounted_cash": 4004.25, "setting": "both", "billing_class": "facility"}]}, {"description": "APP LC SKNSB FNHG EA ADL 100SC", "code_information": [{"code": "6900015", "type": "CDM"}, {"code": "361", "type": "RC"}], "standard_charges": [{"gross_charge": 5339.0, "discounted_cash": 4004.25, "setting": "both", "billing_class": "facility"}]}, {"description": "APP LC SKNSB FNHG EA ADL 25SC", "code_information": [{"code": "6900017", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 3236.0, "discounted_cash": 2427.0, "setting": "both", "billing_class": "facility"}]}, {"description": "APP LC SKNSB FNHG EA ADL 25SC", "code_information": [{"code": "6900017", "type": "CDM"}, {"code": "361", "type": "RC"}], "standard_charges": [{"gross_charge": 3236.0, "discounted_cash": 2427.0, "setting": "both", "billing_class": "facility"}]}, {"description": "APP LC SKNSB FNHG EA+25", "code_information": [{"code": "6810537", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 3236.0, "discounted_cash": 2427.0, "setting": "both", "billing_class": "facility"}]}, {"description": "APP LC SKNSB FNHG EA+25", "code_information": [{"code": "6810537", "type": "CDM"}, {"code": "361", "type": "RC"}], "standard_charges": [{"gross_charge": 3236.0, "discounted_cash": 2427.0, "setting": "both", "billing_class": "facility"}]}, {"description": "APP LC SKNSB T/A/L 1ST 100SC", "code_information": [{"code": "6900021", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 6999.0, "discounted_cash": 5249.25, "setting": "both", "billing_class": "facility"}]}, {"description": "APP LC SKNSB T/A/L 1ST 100SC", "code_information": [{"code": "6900021", "type": "CDM"}, {"code": "361", "type": "RC"}], "standard_charges": [{"gross_charge": 6999.0, "discounted_cash": 5249.25, "setting": "both", "billing_class": "facility"}]}, {"description": "APP LC SKNSB T/A/L 1ST 25SC", "code_information": [{"code": "6900023", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 2224.0, "discounted_cash": 1668.0, "setting": "both", "billing_class": "facility"}]}, {"description": "APP LC SKNSB T/A/L 1ST 25SC", "code_information": [{"code": "6900023", "type": "CDM"}, {"code": "361", "type": "RC"}], "standard_charges": [{"gross_charge": 2224.0, "discounted_cash": 1668.0, "setting": "both", "billing_class": "facility"}]}, {"description": "APP LC SKNSB T/A/L 1ST25", "code_information": [{"code": "6810532", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 2224.0, "discounted_cash": 1668.0, "setting": "both", "billing_class": "facility"}]}, {"description": "APP LC SKNSB T/A/L 1ST25", "code_information": [{"code": "6810532", "type": "CDM"}, {"code": "361", "type": "RC"}], "standard_charges": [{"gross_charge": 2224.0, "discounted_cash": 1668.0, "setting": "both", "billing_class": "facility"}]}, {"description": "APP LC SKNSB T/A/L CHILD", "code_information": [{"code": "6810534", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 6999.0, "discounted_cash": 5249.25, "setting": "both", "billing_class": "facility"}]}, {"description": "APP LC SKNSB T/A/L CHILD", "code_information": [{"code": "6810534", "type": "CDM"}, {"code": "361", "type": "RC"}], "standard_charges": [{"gross_charge": 6999.0, "discounted_cash": 5249.25, "setting": "both", "billing_class": "facility"}]}, {"description": "APP LC SKNSB T/A/L EA ADL 25SC", "code_information": [{"code": "6900022", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 2713.0, "discounted_cash": 2034.75, "setting": "both", "billing_class": "facility"}]}, {"description": "APP LC SKNSB T/A/L EA ADL 25SC", "code_information": [{"code": "6900022", "type": "CDM"}, {"code": "361", "type": "RC"}], "standard_charges": [{"gross_charge": 2713.0, "discounted_cash": 2034.75, "setting": "both", "billing_class": "facility"}]}, {"description": "APP LC SKNSB T/A/L EA+25", "code_information": [{"code": "6810533", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 2478.0, "discounted_cash": 1858.5, "setting": "both", "billing_class": "facility"}]}, {"description": "APP LC SKNSB T/A/L EA+25", "code_information": [{"code": "6810533", "type": "CDM"}, {"code": "361", "type": "RC"}], "standard_charges": [{"gross_charge": 2478.0, "discounted_cash": 1858.5, "setting": "both", "billing_class": "facility"}]}, {"description": "APP LC SKNSB TAL CHLDEA+", "code_information": [{"code": "6810535", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 5002.0, "discounted_cash": 3751.5, "setting": "both", "billing_class": "facility"}]}, {"description": "APP LC SKNSB TAL CHLDEA+", "code_information": [{"code": "6810535", "type": "CDM"}, {"code": "361", "type": "RC"}], "standard_charges": [{"gross_charge": 5002.0, "discounted_cash": 3751.5, "setting": "both", "billing_class": "facility"}]}, {"description": "APP LC SKNSB TAL EA ADL 100SC", "code_information": [{"code": "6900019", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 5002.0, "discounted_cash": 3751.5, "setting": "both", "billing_class": "facility"}]}, {"description": "APP LC SKNSB TAL EA ADL 100SC", "code_information": [{"code": "6900019", "type": "CDM"}, {"code": "361", "type": "RC"}], "standard_charges": [{"gross_charge": 5002.0, "discounted_cash": 3751.5, "setting": "both", "billing_class": "facility"}]}, {"description": "APP SKNSUB F/N/H/G 1ST 100SC", "code_information": [{"code": "6900031", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 6999.0, "discounted_cash": 5249.25, "setting": "both", "billing_class": "facility"}]}, {"description": "APP SKNSUB F/N/H/G 1ST 100SC", "code_information": [{"code": "6900031", "type": "CDM"}, {"code": "361", "type": "RC"}], "standard_charges": [{"gross_charge": 6999.0, "discounted_cash": 5249.25, "setting": "both", "billing_class": "facility"}]}, {"description": "APP SKNSUB F/N/H/G 1ST 25SC", "code_information": [{"code": "6900029", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 6420.0, "discounted_cash": 4815.0, "setting": "both", "billing_class": "facility"}]}, {"description": "APP SKNSUB F/N/H/G 1ST 25SC", "code_information": [{"code": "6900029", "type": "CDM"}, {"code": "361", "type": "RC"}], "standard_charges": [{"gross_charge": 6420.0, "discounted_cash": 4815.0, "setting": "both", "billing_class": "facility"}]}, {"description": "APP SKNSUB F/N/H/G ADL 100SC", "code_information": [{"code": "6900024", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 7449.0, "discounted_cash": 5586.75, "setting": "both", "billing_class": "facility"}]}, {"description": "APP SKNSUB F/N/H/G ADL 100SC", "code_information": [{"code": "6900024", "type": "CDM"}, {"code": "361", "type": "RC"}], "standard_charges": [{"gross_charge": 7449.0, "discounted_cash": 5586.75, "setting": "both", "billing_class": "facility"}]}, {"description": "APP SKNSUB F/N/H/G EA ADL 25SC", "code_information": [{"code": "6900030", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 3220.0, "discounted_cash": 2415.0, "setting": "both", "billing_class": "facility"}]}, {"description": "APP SKNSUB F/N/H/G EA ADL 25SC", "code_information": [{"code": "6900030", "type": "CDM"}, {"code": "361", "type": "RC"}], "standard_charges": [{"gross_charge": 3220.0, "discounted_cash": 2415.0, "setting": "both", "billing_class": "facility"}]}, {"description": "APP SKNSUB GRFT T/A/L 1ST100SC", "code_information": [{"code": "6900027", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 12280.0, "discounted_cash": 9210.0, "setting": "both", "billing_class": "facility"}]}, {"description": "APP SKNSUB GRFT T/A/L 1ST100SC", "code_information": [{"code": "6900027", "type": "CDM"}, {"code": "361", "type": "RC"}], "standard_charges": [{"gross_charge": 12280.0, "discounted_cash": 9210.0, "setting": "both", "billing_class": "facility"}]}, {"description": "APP SKNSUB GRFT T/A/L ADL100SC", "code_information": [{"code": "6900028", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 5927.0, "discounted_cash": 4445.25, "setting": "both", "billing_class": "facility"}]}, {"description": "APP SKNSUB GRFT T/A/L ADL100SC", "code_information": [{"code": "6900028", "type": "CDM"}, {"code": "361", "type": "RC"}], "standard_charges": [{"gross_charge": 5927.0, "discounted_cash": 4445.25, "setting": "both", "billing_class": "facility"}]}, {"description": "APP SKNSUB GRFT T/A/L ADL25SC", "code_information": [{"code": "6900026", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 2845.0, "discounted_cash": 2133.75, "setting": "both", "billing_class": "facility"}]}, {"description": "APP SKNSUB GRFT T/A/L ADL25SC", "code_information": [{"code": "6900026", "type": "CDM"}, {"code": "361", "type": "RC"}], "standard_charges": [{"gross_charge": 2845.0, "discounted_cash": 2133.75, "setting": "both", "billing_class": "facility"}]}, {"description": "APP SKNSUB GRFT T/A/L<1ST 25SC", "code_information": [{"code": "6900025", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 6462.0, "discounted_cash": 4846.5, "setting": "both", "billing_class": "facility"}]}, {"description": "APP SKNSUB GRFT T/A/L<1ST 25SC", "code_information": [{"code": "6900025", "type": "CDM"}, {"code": "361", "type": "RC"}], "standard_charges": [{"gross_charge": 6462.0, "discounted_cash": 4846.5, "setting": "both", "billing_class": "facility"}]}, {"description": "APPLY ML COMPRS LWR LEG", "code_information": [{"code": "6810507", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 614.0, "discounted_cash": 460.5, "setting": "both", "billing_class": "facility"}]}, {"description": "APPLY ML COMPRS LWR LEG", "code_information": [{"code": "6810507", "type": "CDM"}, {"code": "361", "type": "RC"}], "standard_charges": [{"gross_charge": 614.0, "discounted_cash": 460.5, "setting": "both", "billing_class": "facility"}]}, {"description": "APPLY ML COMPRS LWR LEG", "code_information": [{"code": "6900091", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 614.0, "discounted_cash": 460.5, "setting": "both", "billing_class": "facility"}]}, {"description": "APPLY ML COMPRS LWR LEG", "code_information": [{"code": "6900091", "type": "CDM"}, {"code": "361", "type": "RC"}], "standard_charges": [{"gross_charge": 614.0, "discounted_cash": 460.5, "setting": "both", "billing_class": "facility"}]}, {"description": "APPLY RIGID LEG CAST", "code_information": [{"code": "6810508", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 1083.0, "discounted_cash": 812.25, "setting": "both", "billing_class": "facility"}]}, {"description": "APPLY RIGID LEG CAST", "code_information": [{"code": "6810508", "type": "CDM"}, {"code": "361", "type": "RC"}], "standard_charges": [{"gross_charge": 1083.0, "discounted_cash": 812.25, "setting": "both", "billing_class": "facility"}]}, {"description": "APPLY RIGID LEG CAST", "code_information": [{"code": "6900090", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 994.0, "discounted_cash": 745.5, "setting": "both", "billing_class": "facility"}]}, {"description": "APPLY RIGID LEG CAST", "code_information": [{"code": "6900090", "type": "CDM"}, {"code": "361", "type": "RC"}], "standard_charges": [{"gross_charge": 994.0, "discounted_cash": 745.5, "setting": "both", "billing_class": "facility"}]}, {"description": "APPLY SKNSB F/N/H/G 1ST", "code_information": [{"code": "6810528", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 6999.0, "discounted_cash": 5249.25, "setting": "both", "billing_class": "facility"}]}, {"description": "APPLY SKNSB F/N/H/G 1ST", "code_information": [{"code": "6810528", "type": "CDM"}, {"code": "361", "type": "RC"}], "standard_charges": [{"gross_charge": 6999.0, "discounted_cash": 5249.25, "setting": "both", "billing_class": "facility"}]}, {"description": "APPLY SKNSB F/N/H/G EA", "code_information": [{"code": "6810529", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 3509.0, "discounted_cash": 2631.75, "setting": "both", "billing_class": "facility"}]}, {"description": "APPLY SKNSB F/N/H/G EA", "code_information": [{"code": "6810529", "type": "CDM"}, {"code": "361", "type": "RC"}], "standard_charges": [{"gross_charge": 3509.0, "discounted_cash": 2631.75, "setting": "both", "billing_class": "facility"}]}, {"description": "APPLY SKNSB FNHG CHILD", "code_information": [{"code": "6810530", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 6999.0, "discounted_cash": 5249.25, "setting": "both", "billing_class": "facility"}]}, {"description": "APPLY SKNSB FNHG CHILD", "code_information": [{"code": "6810530", "type": "CDM"}, {"code": "361", "type": "RC"}], "standard_charges": [{"gross_charge": 6999.0, "discounted_cash": 5249.25, "setting": "both", "billing_class": "facility"}]}, {"description": "APPLY SKNSB FNHG CHLDEA", "code_information": [{"code": "6810531", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 7449.0, "discounted_cash": 5586.75, "setting": "both", "billing_class": "facility"}]}, {"description": "APPLY SKNSB FNHG CHLDEA", "code_information": [{"code": "6810531", "type": "CDM"}, {"code": "361", "type": "RC"}], "standard_charges": [{"gross_charge": 7449.0, "discounted_cash": 5586.75, "setting": "both", "billing_class": "facility"}]}, {"description": "APPLY SKNSB T/A/L 1ST", "code_information": [{"code": "6810524", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 6999.0, "discounted_cash": 5249.25, "setting": "both", "billing_class": "facility"}]}, {"description": "APPLY SKNSB T/A/L 1ST", "code_information": [{"code": "6810524", "type": "CDM"}, {"code": "361", "type": "RC"}], "standard_charges": [{"gross_charge": 6999.0, "discounted_cash": 5249.25, "setting": "both", "billing_class": "facility"}]}, {"description": "APPLY SKNSB T/A/L CHDEA+", "code_information": [{"code": "6810527", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 5927.0, "discounted_cash": 4445.25, "setting": "both", "billing_class": "facility"}]}, {"description": "APPLY SKNSB T/A/L CHDEA+", "code_information": [{"code": "6810527", "type": "CDM"}, {"code": "361", "type": "RC"}], "standard_charges": [{"gross_charge": 5927.0, "discounted_cash": 4445.25, "setting": "both", "billing_class": "facility"}]}, {"description": "APPLY SKNSB T/A/L CHILD", "code_information": [{"code": "6810526", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 12280.0, "discounted_cash": 9210.0, "setting": "both", "billing_class": "facility"}]}, {"description": "APPLY SKNSB T/A/L CHILD", "code_information": [{"code": "6810526", "type": "CDM"}, {"code": "361", "type": "RC"}], "standard_charges": [{"gross_charge": 12280.0, "discounted_cash": 9210.0, "setting": "both", "billing_class": "facility"}]}, {"description": "APPLY SKNSB T/A/L EA+", "code_information": [{"code": "6810525", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 2196.0, "discounted_cash": 1647.0, "setting": "both", "billing_class": "facility"}]}, {"description": "APPLY SKNSB T/A/L EA+", "code_information": [{"code": "6810525", "type": "CDM"}, {"code": "361", "type": "RC"}], "standard_charges": [{"gross_charge": 2196.0, "discounted_cash": 1647.0, "setting": "both", "billing_class": "facility"}]}, {"description": "APRACLONIDINE .5% 5ML OS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5330211", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 376.0, "discounted_cash": 282.0, "setting": "both", "billing_class": "facility"}]}, {"description": "APRACLONIDINE .5% 5ML OS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5330211", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 376.0, "discounted_cash": 282.0, "setting": "both", "billing_class": "facility"}]}, {"description": "AQAPRN-4 ANTB FLO CYTMTRY EA", "code_information": [{"code": "86053", "type": "CPT"}, {"code": "7250286", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 1360.0, "discounted_cash": 1020.0, "setting": "both", "billing_class": "facility"}]}, {"description": "AQUAPORIN-4 AB ELISA", "code_information": [{"code": "86051", "type": "CPT"}, {"code": "7250243", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 558.0, "discounted_cash": 418.5, "setting": "both", "billing_class": "facility"}]}, {"description": "AQUAPORINE 4 AB", "code_information": [{"code": "86052", "type": "CPT"}, {"code": "7253012", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 1090.0, "discounted_cash": 817.5, "setting": "both", "billing_class": "facility"}]}, {"description": "ARCHIV TISSUE EXAM MOLEC", "code_information": [{"code": "88363", "type": "CPT"}, {"code": "4308367", "type": "CDM"}, {"code": "310", "type": "RC"}], "standard_charges": [{"gross_charge": 329.0, "discounted_cash": 246.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ARFORMOTEROL15MCG/2ML IS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5330217", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 190.0, "discounted_cash": 142.5, "setting": "both", "billing_class": "facility"}]}, {"description": "ARFORMOTEROL15MCG/2ML IS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5330217", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 190.0, "discounted_cash": 142.5, "setting": "both", "billing_class": "facility"}]}, {"description": "ARGATROB N/ESRD1MG PMXIJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0883", "type": "HCPCS"}, {"code": "5318346", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 203.0, "discounted_cash": 152.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ARGATROB N/ESRD1MG PMXIJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0883", "type": "HCPCS"}, {"code": "5318346", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 203.0, "discounted_cash": 152.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ARGATROBAN NONESRD 1MGIJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0883", "type": "HCPCS"}, {"code": "5318344", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 23.0, "discounted_cash": 17.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ARGATROBAN NONESRD 1MGIJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0883", "type": "HCPCS"}, {"code": "5318344", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 23.0, "discounted_cash": 17.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ARGININE 10% 300ML IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5318311", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 1373.0, "discounted_cash": 1029.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ARIPIPRAZOLE 10MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5300784", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 322.0, "discounted_cash": 241.5, "setting": "both", "billing_class": "facility"}]}, {"description": "ARIPIPRAZOLE 10MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5300784", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 322.0, "discounted_cash": 241.5, "setting": "both", "billing_class": "facility"}]}, {"description": "ARIPIPRAZOLE 20MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5300785", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 635.0, "discounted_cash": 476.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ARIPIPRAZOLE 20MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5300785", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 635.0, "discounted_cash": 476.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ARIPIPRAZOLE 2MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5300777", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 360.0, "discounted_cash": 270.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ARIPIPRAZOLE 2MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5300777", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 360.0, "discounted_cash": 270.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ARIPIPRAZOLE 30MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5300786", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 569.0, "discounted_cash": 426.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ARIPIPRAZOLE 30MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5300786", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 569.0, "discounted_cash": 426.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ARIPIPRAZOLE 5MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5300783", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 417.0, "discounted_cash": 312.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ARIPIPRAZOLE 5MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5300783", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 417.0, "discounted_cash": 312.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ARIPIPRAZOLE PER.25MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0400", "type": "HCPCS"}, {"code": "5318334", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 1130.0, "discounted_cash": 847.5, "setting": "both", "billing_class": "facility"}]}, {"description": "ARIPIPRAZOLE PER.25MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0400", "type": "HCPCS"}, {"code": "5318334", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 1130.0, "discounted_cash": 847.5, "setting": "both", "billing_class": "facility"}]}, {"description": "ARSENIC", "code_information": [{"code": "82175", "type": "CPT"}, {"code": "7252158", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 997.0, "discounted_cash": 747.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ARSENIC/3", "code_information": [{"code": "82175", "type": "CPT"}, {"code": "7252175", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 60.0, "discounted_cash": 45.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ARSENIC/4", "code_information": [{"code": "82175", "type": "CPT"}, {"code": "7252177", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 43.0, "discounted_cash": 32.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ARTERIOG CAR NKHD SEL", "code_information": [{"code": "4616226", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 20179.0, "discounted_cash": 15134.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ARTERIOG CAR NKHD SEL", "code_information": [{"code": "4916226", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 20179.0, "discounted_cash": 15134.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ARTERIOG EXT CAR SEL", "code_information": [{"code": "4616232", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 20179.0, "discounted_cash": 15134.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ARTERIOG SUBC/INOM", "code_information": [{"code": "4616228", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 20179.0, "discounted_cash": 15134.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ARTERIOG SUBC/INOM", "code_information": [{"code": "4916228", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 20179.0, "discounted_cash": 15134.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ARTERIOG VERT SEL", "code_information": [{"code": "4616230", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 27769.0, "discounted_cash": 20826.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ARTERIOG VERT SEL", "code_information": [{"code": "4916230", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 20179.0, "discounted_cash": 15134.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ARTERIOGR CAR HD SEL", "code_information": [{"code": "4616224", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 26233.0, "discounted_cash": 19674.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ARTERIOGR CAR HD SEL", "code_information": [{"code": "4916224", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 20179.0, "discounted_cash": 15134.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ARTERIOGR CAR NK SEL", "code_information": [{"code": "4616222", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 19269.0, "discounted_cash": 14451.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ARTERIOGR CAR NK SEL", "code_information": [{"code": "4916222", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 20179.0, "discounted_cash": 15134.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ARTEROGRAM ARCH NON SEL", "code_information": [{"code": "4616221", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 21846.0, "discounted_cash": 16384.5, "setting": "both", "billing_class": "facility"}]}, {"description": "ARTEROGRAM ARCH NON SEL", "code_information": [{"code": "4916221", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 20179.0, "discounted_cash": 15134.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ARTHROFLEX PER SQ CM", "code_information": [{"code": "Q4125", "type": "HCPCS"}, {"code": "4020720", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 1964.0, "discounted_cash": 1473.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ARTHROFLEX PER SQ CM", "code_information": [{"code": "Q4125", "type": "HCPCS"}, {"code": "4020720", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 1964.0, "discounted_cash": 1473.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ARTICULAR COMPONENT", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "8131014", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 133017.0, "discounted_cash": 99762.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ASA 300MG SU", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5338095", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 61.0, "discounted_cash": 45.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ASA 300MG SU", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5338095", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 61.0, "discounted_cash": 45.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ASA 325MG EC TB", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5301108", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 66.0, "discounted_cash": 49.5, "setting": "both", "billing_class": "facility"}]}, {"description": "ASA 325MG EC TB", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5301108", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 66.0, "discounted_cash": 49.5, "setting": "both", "billing_class": "facility"}]}, {"description": "ASA 325MG TB", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5301113", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 99.0, "discounted_cash": 74.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ASA 325MG TB", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5301113", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 99.0, "discounted_cash": 74.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ASA 81MG CTB", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5301110", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 85.0, "discounted_cash": 63.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ASA 81MG CTB", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5301110", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 85.0, "discounted_cash": 63.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ASA 81MG EC TB", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5301109", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 77.0, "discounted_cash": 57.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ASA 81MG EC TB", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5301109", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 77.0, "discounted_cash": 57.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ASCORBIC ACID", "code_information": [{"code": "82180", "type": "CPT"}, {"code": "7252180", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 964.0, "discounted_cash": 723.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ASCORBIC ACID 1GM/2ML IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5318315", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 113.0, "discounted_cash": 84.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ASCORBIC ACID 500MG TB", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5301061", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 77.0, "discounted_cash": 57.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ASCORBIC ACID 500MG TB", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5301061", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 77.0, "discounted_cash": 57.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ASCORBIC ACID500MG/1MLIJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5318328", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 113.0, "discounted_cash": 84.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ASENAPINE 5MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5301080", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 313.0, "discounted_cash": 234.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ASENAPINE 5MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5301080", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 313.0, "discounted_cash": 234.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ASIALO GM1 AB", "code_information": [{"code": "83520", "type": "CPT"}, {"code": "7252217", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 610.0, "discounted_cash": 457.5, "setting": "both", "billing_class": "facility"}]}, {"description": "ASIALO GM1 AB/2", "code_information": [{"code": "83520", "type": "CPT"}, {"code": "7253545", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 610.0, "discounted_cash": 457.5, "setting": "both", "billing_class": "facility"}]}, {"description": "ASP ABS/HEMAT/CYST", "code_information": [{"code": "4910160", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 3079.0, "discounted_cash": 2309.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ASP ABS/HEMAT/CYST", "code_information": [{"code": "5050160", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 681.0, "discounted_cash": 510.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ASP ABS/HEMAT/CYST", "code_information": [{"code": "5061160", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 570.0, "discounted_cash": 427.5, "setting": "both", "billing_class": "facility"}]}, {"description": "ASP ABS/HEMAT/CYST", "code_information": [{"code": "6900132", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 681.0, "discounted_cash": 510.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ASP ABS/HEMAT/CYST", "code_information": [{"code": "6900132", "type": "CDM"}, {"code": "361", "type": "RC"}], "standard_charges": [{"gross_charge": 681.0, "discounted_cash": 510.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ASP/INJ INTERM JT WO/US", "code_information": [{"code": "4900608", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 1446.0, "discounted_cash": 1084.5, "setting": "both", "billing_class": "facility"}]}, {"description": "ASP/INJ INTERM JT WO/US", "code_information": [{"code": "4910608", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 1335.0, "discounted_cash": 1001.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ASP/INJ INTERM JT WO/US", "code_information": [{"code": "5060608", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 1446.0, "discounted_cash": 1084.5, "setting": "both", "billing_class": "facility"}]}, {"description": "ASP/INJ RENL CYST/PELVIS", "code_information": [{"code": "5057585", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 18413.0, "discounted_cash": 13809.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ASPERGILLUS AB", "code_information": [{"code": "86606", "type": "CPT"}, {"code": "4106927", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 2109.0, "discounted_cash": 1581.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ASPERGILLUS AB", "code_information": [{"code": "86606", "type": "CPT"}, {"code": "7256606", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 1417.0, "discounted_cash": 1062.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ASPERGILLUS AB/3", "code_information": [{"code": "86606", "type": "CPT"}, {"code": "7256931", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 1417.0, "discounted_cash": 1062.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ASPERGILLUS AB/4", "code_information": [{"code": "86606", "type": "CPT"}, {"code": "7256932", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 95.0, "discounted_cash": 71.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ASPERGILLUS AB/5", "code_information": [{"code": "86606", "type": "CPT"}, {"code": "7256933", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 1417.0, "discounted_cash": 1062.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ASPERGILLUS IA/2", "code_information": [{"code": "87305", "type": "CPT"}, {"code": "7258730", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 227.0, "discounted_cash": 170.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ASPIR BREAST CYST", "code_information": [{"code": "3071004", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 6367.0, "discounted_cash": 4775.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ASPIR BREAST CYST", "code_information": [{"code": "5066650", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 6369.0, "discounted_cash": 4776.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ASPIR BREAST CYST ADD", "code_information": [{"code": "3071009", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 2773.0, "discounted_cash": 2079.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ASPIR BREAST CYST ADD", "code_information": [{"code": "5066652", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 2773.0, "discounted_cash": 2079.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ASPIR/INJ MAJ JT WO/US", "code_information": [{"code": "4900610", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 3777.0, "discounted_cash": 2832.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ASPIR/INJ MAJ JT WO/US", "code_information": [{"code": "4910610", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 3269.0, "discounted_cash": 2451.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ASPIR/INJ MAJ JT WO/US", "code_information": [{"code": "5060610", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 2999.0, "discounted_cash": 2249.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ASPIR/INJ SM JNT WO/US", "code_information": [{"code": "4900600", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 1186.0, "discounted_cash": 889.5, "setting": "both", "billing_class": "facility"}]}, {"description": "ASPIR/INJ SM JNT WO/US", "code_information": [{"code": "4910600", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 1004.0, "discounted_cash": 753.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ASPIR/INJ THYROID CYST", "code_information": [{"code": "5067400", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 3992.0, "discounted_cash": 2994.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ASSAY ORGANIC ACIDS QNT", "code_information": [{"code": "83918", "type": "CPT"}, {"code": "7253918", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 400.0, "discounted_cash": 300.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ASSAY ORGANIC ACIDS QNT/2", "code_information": [{"code": "83918", "type": "CPT"}, {"code": "7253939", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 231.0, "discounted_cash": 173.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ASSAY TOXIN/ANTITOXIN", "code_information": [{"code": "87230", "type": "CPT"}, {"code": "7257077", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 36.0, "discounted_cash": 27.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ASTIGMATISM CORRECT IOL", "code_information": [{"code": "V2787", "type": "HCPCS"}, {"code": "8120100", "type": "CDM"}, {"code": "276", "type": "RC"}], "standard_charges": [{"gross_charge": 8347.0, "discounted_cash": 6260.25, "setting": "both", "billing_class": "facility"}], "modifiers": "GY"}, {"description": "ATENLOL/CHLRTHL 50/25 TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5301140", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 78.0, "discounted_cash": 58.5, "setting": "both", "billing_class": "facility"}]}, {"description": "ATENLOL/CHLRTHL 50/25 TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5301140", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 78.0, "discounted_cash": 58.5, "setting": "both", "billing_class": "facility"}]}, {"description": "ATENOLOL 25MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5301137", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 61.0, "discounted_cash": 45.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ATENOLOL 25MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5301137", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 61.0, "discounted_cash": 45.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ATENOLOL 50MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5301138", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 65.0, "discounted_cash": 48.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ATENOLOL 50MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5301138", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 65.0, "discounted_cash": 48.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ATENOLOL CMPD LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5314312", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 13.0, "discounted_cash": 9.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ATENOLOL CMPD LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5314312", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 13.0, "discounted_cash": 9.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ATHERECT BRACH OPEN PERC", "code_information": [{"code": "4610153", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 40533.0, "discounted_cash": 30399.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ATHERECT ILIAC OPEN PERC", "code_information": [{"code": "4610146", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 32376.0, "discounted_cash": 24282.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ATHERECT RENAL OPEN PERC", "code_information": [{"code": "4610139", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 40533.0, "discounted_cash": 30399.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ATORVASTATIN 10MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5301145", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 95.0, "discounted_cash": 71.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ATORVASTATIN 10MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5301145", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 95.0, "discounted_cash": 71.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ATORVASTATIN 40MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5301147", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 175.0, "discounted_cash": 131.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ATORVASTATIN 40MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5301147", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 175.0, "discounted_cash": 131.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ATOVAQ/PROGUAN250/100 TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5301151", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 84.0, "discounted_cash": 63.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ATOVAQ/PROGUAN250/100 TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5301151", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 84.0, "discounted_cash": 63.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ATROP/HYOS/PB/SCOP10MLLQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5315081", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 78.0, "discounted_cash": 58.5, "setting": "both", "billing_class": "facility"}]}, {"description": "ATROP/HYOS/PB/SCOP10MLLQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5315081", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 78.0, "discounted_cash": 58.5, "setting": "both", "billing_class": "facility"}]}, {"description": "ATROPINE 1% 2ML OS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5330275", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 129.0, "discounted_cash": 96.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ATROPINE 1% 2ML OS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5330275", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 129.0, "discounted_cash": 96.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ATROPINE 1% 3.5GM OO", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5330331", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 59.0, "discounted_cash": 44.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ATROPINE 1% 3.5GM OO", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5330331", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 59.0, "discounted_cash": 44.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ATROPINE 1% 5ML OS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5330282", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 72.0, "discounted_cash": 54.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ATROPINE 1% 5ML OS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5330282", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 72.0, "discounted_cash": 54.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ATROPINE PER 0.01MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0461", "type": "HCPCS"}, {"code": "5318387", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 2.0, "discounted_cash": 1.5, "setting": "both", "billing_class": "facility"}]}, {"description": "ATROPINE PER 0.01MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0461", "type": "HCPCS"}, {"code": "5318387", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 2.0, "discounted_cash": 1.5, "setting": "both", "billing_class": "facility"}]}, {"description": "ATROPINE PER 0.01MGPFSIJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0461", "type": "HCPCS"}, {"code": "5318388", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 1.0, "discounted_cash": 0.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ATROPINE PER 0.01MGPFSIJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0461", "type": "HCPCS"}, {"code": "5318388", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 1.0, "discounted_cash": 0.75, "setting": "both", "billing_class": "facility"}]}, {"description": "AUTOP G&M INFANT W/BRAIN", "code_information": [{"code": "88028", "type": "CPT"}, {"code": "4308028", "type": "CDM"}, {"code": "310", "type": "RC"}], "standard_charges": [{"gross_charge": 595.0, "discounted_cash": 446.25, "setting": "both", "billing_class": "facility"}]}, {"description": "AUTOP G&M SB/NB W/BRN", "code_information": [{"code": "88029", "type": "CPT"}, {"code": "4303422", "type": "CDM"}, {"code": "310", "type": "RC"}], "standard_charges": [{"gross_charge": 595.0, "discounted_cash": 446.25, "setting": "both", "billing_class": "facility"}]}, {"description": "AUTOP G&M W/BRN", "code_information": [{"code": "88025", "type": "CPT"}, {"code": "4308025", "type": "CDM"}, {"code": "310", "type": "RC"}], "standard_charges": [{"gross_charge": 595.0, "discounted_cash": 446.25, "setting": "both", "billing_class": "facility"}]}, {"description": "AUTOP LIMITED REGIONAL", "code_information": [{"code": "88036", "type": "CPT"}, {"code": "4308036", "type": "CDM"}, {"code": "310", "type": "RC"}], "standard_charges": [{"gross_charge": 595.0, "discounted_cash": 446.25, "setting": "both", "billing_class": "facility"}]}, {"description": "AZATHIOPRINE 50MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J7500", "type": "HCPCS"}, {"code": "5301215", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 61.0, "discounted_cash": 45.75, "setting": "both", "billing_class": "facility"}]}, {"description": "AZATHIOPRINE 50MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J7500", "type": "HCPCS"}, {"code": "5301215", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 61.0, "discounted_cash": 45.75, "setting": "both", "billing_class": "facility"}]}, {"description": "AZITHROM PER500MG IVPBIJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0456", "type": "HCPCS"}, {"code": "5318424", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 1481.0, "discounted_cash": 1110.75, "setting": "both", "billing_class": "facility"}]}, {"description": "AZITHROM PER500MG IVPBIJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0456", "type": "HCPCS"}, {"code": "5318424", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 1481.0, "discounted_cash": 1110.75, "setting": "both", "billing_class": "facility"}]}, {"description": "AZITHROMY NEONAT CMPD IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0456", "type": "HCPCS"}, {"code": "5318423", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 4.0, "discounted_cash": 3.0, "setting": "both", "billing_class": "facility"}]}, {"description": "AZITHROMY NEONAT CMPD IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0456", "type": "HCPCS"}, {"code": "5318423", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 4.0, "discounted_cash": 3.0, "setting": "both", "billing_class": "facility"}]}, {"description": "AZITHROMYC 100/5 15ML LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5314300", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 772.0, "discounted_cash": 579.0, "setting": "both", "billing_class": "facility"}]}, {"description": "AZITHROMYC 100/5 15ML LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5314300", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 772.0, "discounted_cash": 579.0, "setting": "both", "billing_class": "facility"}]}, {"description": "AZITHROMYC 200/5 30ML LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5314304", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 772.0, "discounted_cash": 579.0, "setting": "both", "billing_class": "facility"}]}, {"description": "AZITHROMYC 200/5 30ML LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5314304", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 772.0, "discounted_cash": 579.0, "setting": "both", "billing_class": "facility"}]}, {"description": "AZITHROMYC 200/5 5ML LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5314305", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 227.0, "discounted_cash": 170.25, "setting": "both", "billing_class": "facility"}]}, {"description": "AZITHROMYC 200/5 5ML LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5314305", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 227.0, "discounted_cash": 170.25, "setting": "both", "billing_class": "facility"}]}, {"description": "AZITHROMYCIN 250MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5301220", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 72.0, "discounted_cash": 54.0, "setting": "both", "billing_class": "facility"}]}, {"description": "AZITHROMYCIN 250MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5301220", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 72.0, "discounted_cash": 54.0, "setting": "both", "billing_class": "facility"}]}, {"description": "AZITHROMYCIN 600MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5301223", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 306.0, "discounted_cash": 229.5, "setting": "both", "billing_class": "facility"}]}, {"description": "AZITHROMYCIN 600MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5301223", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 306.0, "discounted_cash": 229.5, "setting": "both", "billing_class": "facility"}]}, {"description": "AZITHROMYCIN PER 1ML IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5318426", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 11.0, "discounted_cash": 8.25, "setting": "both", "billing_class": "facility"}]}, {"description": "AZITHROMYCIN PER500MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0456", "type": "HCPCS"}, {"code": "5318414", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 477.0, "discounted_cash": 357.75, "setting": "both", "billing_class": "facility"}]}, {"description": "AZITHROMYCIN PER500MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0456", "type": "HCPCS"}, {"code": "5318414", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 477.0, "discounted_cash": 357.75, "setting": "both", "billing_class": "facility"}]}, {"description": "AZTREONAM PER 100MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0457", "type": "HCPCS"}, {"code": "5318430", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 50.0, "discounted_cash": 37.5, "setting": "both", "billing_class": "facility"}]}, {"description": "AZTREONAM PER 100MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0457", "type": "HCPCS"}, {"code": "5318430", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 50.0, "discounted_cash": 37.5, "setting": "both", "billing_class": "facility"}]}, {"description": "B CELLS TOTAL COUNT", "code_information": [{"code": "86355", "type": "CPT"}, {"code": "4106064", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 355.0, "discounted_cash": 266.25, "setting": "both", "billing_class": "facility"}]}, {"description": "B CELLS TOTAL COUNT", "code_information": [{"code": "86355", "type": "CPT"}, {"code": "7258606", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 258.0, "discounted_cash": 193.5, "setting": "both", "billing_class": "facility"}]}, {"description": "B-TYP NATRIURETC PEPTIDE", "code_information": [{"code": "83880", "type": "CPT"}, {"code": "4103527", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 1455.0, "discounted_cash": 1091.25, "setting": "both", "billing_class": "facility"}]}, {"description": "B-TYP NATRIURETC PEPTIDE", "code_information": [{"code": "83880", "type": "CPT"}, {"code": "4173527", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 32.83, "discounted_cash": 24.62, "setting": "both", "billing_class": "facility"}]}, {"description": "B-TYP NATRIURETC PEPTIDE", "code_information": [{"code": "83880", "type": "CPT"}, {"code": "7253551", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 137.0, "discounted_cash": 102.75, "setting": "both", "billing_class": "facility"}]}, {"description": "B-TYP NATRIURETC PEPTIDE/2", "code_information": [{"code": "83880", "type": "CPT"}, {"code": "4103528", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 1812.0, "discounted_cash": 1359.0, "setting": "both", "billing_class": "facility"}]}, {"description": "BACITRA/POLYMYX 3.5GM OO", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5330353", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 583.0, "discounted_cash": 437.25, "setting": "both", "billing_class": "facility"}]}, {"description": "BACITRA/POLYMYX 3.5GM OO", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5330353", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 583.0, "discounted_cash": 437.25, "setting": "both", "billing_class": "facility"}]}, {"description": "BACITRACIN 30GM OI", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5334293", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 99.0, "discounted_cash": 74.25, "setting": "both", "billing_class": "facility"}]}, {"description": "BACITRACIN 30GM OI", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5334293", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 99.0, "discounted_cash": 74.25, "setting": "both", "billing_class": "facility"}]}, {"description": "BACITRACIN 50000U IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5318453", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 585.0, "discounted_cash": 438.75, "setting": "both", "billing_class": "facility"}]}, {"description": "BACITRACIN/POLYB 10GM PW", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5334304", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 214.0, "discounted_cash": 160.5, "setting": "both", "billing_class": "facility"}]}, {"description": "BACITRACIN/POLYB 10GM PW", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5334304", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 214.0, "discounted_cash": 160.5, "setting": "both", "billing_class": "facility"}]}, {"description": "BACITRACIN/POLYB 15GM OI", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5334301", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 149.0, "discounted_cash": 111.75, "setting": "both", "billing_class": "facility"}]}, {"description": "BACITRACIN/POLYB 15GM OI", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5334301", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 149.0, "discounted_cash": 111.75, "setting": "both", "billing_class": "facility"}]}, {"description": "BACITRACIN/POLYB 30GM OI", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5334303", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 128.0, "discounted_cash": 96.0, "setting": "both", "billing_class": "facility"}]}, {"description": "BACITRACIN/POLYB 30GM OI", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5334303", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 128.0, "discounted_cash": 96.0, "setting": "both", "billing_class": "facility"}]}, {"description": "BACITRACIN500U/GM15GM OI", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5334291", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 90.0, "discounted_cash": 67.5, "setting": "both", "billing_class": "facility"}]}, {"description": "BACITRACIN500U/GM15GM OI", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5334291", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 90.0, "discounted_cash": 67.5, "setting": "both", "billing_class": "facility"}]}, {"description": "BACLOFEN 10MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5301357", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 65.0, "discounted_cash": 48.75, "setting": "both", "billing_class": "facility"}]}, {"description": "BACLOFEN 10MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5301357", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 65.0, "discounted_cash": 48.75, "setting": "both", "billing_class": "facility"}]}, {"description": "BACLOFEN 20MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5301361", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 83.0, "discounted_cash": 62.25, "setting": "both", "billing_class": "facility"}]}, {"description": "BACLOFEN 20MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5301361", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 83.0, "discounted_cash": 62.25, "setting": "both", "billing_class": "facility"}]}, {"description": "BACLOFEN PER 10MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0475", "type": "HCPCS"}, {"code": "5318472", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 1163.0, "discounted_cash": 872.25, "setting": "both", "billing_class": "facility"}]}, {"description": "BACLOFEN PER 10MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0475", "type": "HCPCS"}, {"code": "5318472", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 1163.0, "discounted_cash": 872.25, "setting": "both", "billing_class": "facility"}]}, {"description": "BACTERIUM AB NES", "code_information": [{"code": "86609", "type": "CPT"}, {"code": "7256601", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 108.0, "discounted_cash": 81.0, "setting": "both", "billing_class": "facility"}]}, {"description": "BACTERIUM AB NES/3", "code_information": [{"code": "86609", "type": "CPT"}, {"code": "7256610", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 29.0, "discounted_cash": 21.75, "setting": "both", "billing_class": "facility"}]}, {"description": "BALLN VALVULPLSTY MITRL", "code_information": [{"code": "92987", "type": "CPT"}, {"code": "4612987", "type": "CDM"}, {"code": "480", "type": "RC"}], "standard_charges": [{"gross_charge": 35051.0, "discounted_cash": 26288.25, "setting": "both", "billing_class": "facility"}]}, {"description": "BALOON DILATE URETER", "code_information": [{"code": "4910706", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 6033.0, "discounted_cash": 4524.75, "setting": "both", "billing_class": "facility"}]}, {"description": "BALSAM P/CAST OIL 30GMOI", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5334316", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 299.0, "discounted_cash": 224.25, "setting": "both", "billing_class": "facility"}]}, {"description": "BALSAM P/CAST OIL 30GMOI", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5334316", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 299.0, "discounted_cash": 224.25, "setting": "both", "billing_class": "facility"}]}, {"description": "BALSAM P/CAST OIL 60GMOI", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5334313", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 678.0, "discounted_cash": 508.5, "setting": "both", "billing_class": "facility"}]}, {"description": "BALSAM P/CAST OIL 60GMOI", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5334313", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 678.0, "discounted_cash": 508.5, "setting": "both", "billing_class": "facility"}]}, {"description": "BAND ANNULOPLASTY", "code_information": [{"code": "C1889", "type": "HCPCS"}, {"code": "8141021", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 19527.0, "discounted_cash": 14645.25, "setting": "both", "billing_class": "facility"}]}, {"description": "BAR ORTHO", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8130134", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 3559.0, "discounted_cash": 2669.25, "setting": "both", "billing_class": "facility"}]}, {"description": "BARRIER ADH SEPRA GEL", "code_information": [{"code": "C1765", "type": "HCPCS"}, {"code": "8172007", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 891.0, "discounted_cash": 668.25, "setting": "both", "billing_class": "facility"}]}, {"description": "BARRIER ADHESION", "code_information": [{"code": "C1765", "type": "HCPCS"}, {"code": "8240009", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 5379.0, "discounted_cash": 4034.25, "setting": "both", "billing_class": "facility"}]}, {"description": "BARS ARCH", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8172010", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 591.0, "discounted_cash": 443.25, "setting": "both", "billing_class": "facility"}]}, {"description": "BARTONELLA AB", "code_information": [{"code": "86611", "type": "CPT"}, {"code": "7256608", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 595.0, "discounted_cash": 446.25, "setting": "both", "billing_class": "facility"}]}, {"description": "BARTONELLA AB/3", "code_information": [{"code": "86611", "type": "CPT"}, {"code": "7256611", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 548.0, "discounted_cash": 411.0, "setting": "both", "billing_class": "facility"}]}, {"description": "BARTONELLA AB/4", "code_information": [{"code": "86611", "type": "CPT"}, {"code": "7256612", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 548.0, "discounted_cash": 411.0, "setting": "both", "billing_class": "facility"}]}, {"description": "BARTONELLA AB/5", "code_information": [{"code": "86611", "type": "CPT"}, {"code": "7256613", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 548.0, "discounted_cash": 411.0, "setting": "both", "billing_class": "facility"}]}, {"description": "BARTONELLA AB/6", "code_information": [{"code": "86611", "type": "CPT"}, {"code": "7256614", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 548.0, "discounted_cash": 411.0, "setting": "both", "billing_class": "facility"}]}, {"description": "BARTONELLA AMP PRB", "code_information": [{"code": "87471", "type": "CPT"}, {"code": "7257471", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 463.0, "discounted_cash": 347.25, "setting": "both", "billing_class": "facility"}]}, {"description": "BASE TIB TRIATH TRITN STRY CL", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "4013068", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 21077.0, "discounted_cash": 15807.75, "setting": "both", "billing_class": "facility"}]}, {"description": "BASE TIB UNCOAT TS STRYKER CL", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "4013070", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 18643.0, "discounted_cash": 13982.25, "setting": "both", "billing_class": "facility"}]}, {"description": "BASE TIB UNCT COCR TI DPY CL", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "4012828", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 18567.0, "discounted_cash": 13925.25, "setting": "both", "billing_class": "facility"}]}, {"description": "BASE TIB UNCTD ALL PLY GLOB CL", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "4013245", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 15474.0, "discounted_cash": 11605.5, "setting": "both", "billing_class": "facility"}]}, {"description": "BASE TIB UNCTD ALL POLY DJO CL", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "4013411", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 16469.0, "discounted_cash": 12351.75, "setting": "both", "billing_class": "facility"}]}, {"description": "BASE TIB UNCTD AS AESCULAP CL", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "4013350", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 18813.0, "discounted_cash": 14109.75, "setting": "both", "billing_class": "facility"}]}, {"description": "BASE TIBIAL COATD RP DEPUY CL", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "4012827", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 18567.0, "discounted_cash": 13925.25, "setting": "both", "billing_class": "facility"}]}, {"description": "BASE TIBIAL COATED DEPUY CL", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "4012826", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 22281.0, "discounted_cash": 16710.75, "setting": "both", "billing_class": "facility"}]}, {"description": "BASE TIBIAL COATED DJO CL", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "4013410", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 16469.0, "discounted_cash": 12351.75, "setting": "both", "billing_class": "facility"}]}, {"description": "BASE TIBIAL MODULAR", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "8131249", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 19308.0, "discounted_cash": 14481.0, "setting": "both", "billing_class": "facility"}]}, {"description": "BASEPLATE GLENOID DJO CL", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "4013421", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 24704.0, "discounted_cash": 18528.0, "setting": "both", "billing_class": "facility"}]}, {"description": "BASEPLT TIBIAL", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "4010900", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 16469.0, "discounted_cash": 12351.75, "setting": "both", "billing_class": "facility"}]}, {"description": "BASIC METABOLIC PANEL", "code_information": [{"code": "80048", "type": "CPT"}, {"code": "4100166", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 1121.0, "discounted_cash": 840.75, "setting": "both", "billing_class": "facility"}]}, {"description": "BASIC METABOLIC PANEL", "code_information": [{"code": "80048", "type": "CPT"}, {"code": "4120166", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 5.0, "discounted_cash": 3.75, "setting": "both", "billing_class": "facility"}]}, {"description": "BASIC METABOLIC PANEL", "code_information": [{"code": "80048", "type": "CPT"}, {"code": "4170166", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 4.29, "discounted_cash": 3.22, "setting": "both", "billing_class": "facility"}]}, {"description": "BCR/ABL 1 MINOR BREAKPNT/2", "code_information": [{"code": "81207", "type": "CPT"}, {"code": "7259203", "type": "CDM"}, {"code": "310", "type": "RC"}], "standard_charges": [{"gross_charge": 778.0, "discounted_cash": 583.5, "setting": "both", "billing_class": "facility"}]}, {"description": "BCR/ABL1 MAJOR BREAKPNT/2", "code_information": [{"code": "81206", "type": "CPT"}, {"code": "7259202", "type": "CDM"}, {"code": "310", "type": "RC"}], "standard_charges": [{"gross_charge": 1329.0, "discounted_cash": 996.75, "setting": "both", "billing_class": "facility"}]}, {"description": "BD GAS CAP STICK", "code_information": [{"code": "36416", "type": "CPT"}, {"code": "5506415", "type": "CDM"}, {"code": "460", "type": "RC"}], "standard_charges": [{"gross_charge": 203.0, "discounted_cash": 152.25, "setting": "both", "billing_class": "facility"}]}, {"description": "BECLOMETH AQ NAS 25GM SP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3535", "type": "HCPCS"}, {"code": "5330376", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 2399.0, "discounted_cash": 1799.25, "setting": "both", "billing_class": "facility"}]}, {"description": "BECLOMETH AQ NAS 25GM SP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3535", "type": "HCPCS"}, {"code": "5330376", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 2399.0, "discounted_cash": 1799.25, "setting": "both", "billing_class": "facility"}]}, {"description": "BECLOMETH NAS 25GM SP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3535", "type": "HCPCS"}, {"code": "5330374", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 2221.0, "discounted_cash": 1665.75, "setting": "both", "billing_class": "facility"}]}, {"description": "BECLOMETH NAS 25GM SP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3535", "type": "HCPCS"}, {"code": "5330374", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 2221.0, "discounted_cash": 1665.75, "setting": "both", "billing_class": "facility"}]}, {"description": "BECLOMETHASN40MCG7.3GMIH", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3535", "type": "HCPCS"}, {"code": "5330382", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 847.0, "discounted_cash": 635.25, "setting": "both", "billing_class": "facility"}]}, {"description": "BECLOMETHASN40MCG7.3GMIH", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3535", "type": "HCPCS"}, {"code": "5330382", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 847.0, "discounted_cash": 635.25, "setting": "both", "billing_class": "facility"}]}, {"description": "BECLOMETHASN80MCG7.3GMIH", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3535", "type": "HCPCS"}, {"code": "5330381", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 1065.0, "discounted_cash": 798.75, "setting": "both", "billing_class": "facility"}]}, {"description": "BECLOMETHASN80MCG7.3GMIH", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3535", "type": "HCPCS"}, {"code": "5330381", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 1065.0, "discounted_cash": 798.75, "setting": "both", "billing_class": "facility"}]}, {"description": "BELLADNNA PHENBRB5ML LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5314330", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 85.0, "discounted_cash": 63.75, "setting": "both", "billing_class": "facility"}]}, {"description": "BELLADNNA PHENBRB5ML LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5314330", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 85.0, "discounted_cash": 63.75, "setting": "both", "billing_class": "facility"}]}, {"description": "BELLADONNA OPIUM 30MGSU", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5327802", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 252.0, "discounted_cash": 189.0, "setting": "both", "billing_class": "facility"}]}, {"description": "BELLADONNA OPIUM 60MGSU", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5327806", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 153.0, "discounted_cash": 114.75, "setting": "both", "billing_class": "facility"}]}, {"description": "BENAZEPRIL 10MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5301431", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 66.0, "discounted_cash": 49.5, "setting": "both", "billing_class": "facility"}]}, {"description": "BENAZEPRIL 10MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5301431", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 66.0, "discounted_cash": 49.5, "setting": "both", "billing_class": "facility"}]}, {"description": "BENAZEPRIL 5MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5301430", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 72.0, "discounted_cash": 54.0, "setting": "both", "billing_class": "facility"}]}, {"description": "BENAZEPRIL 5MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5301430", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 72.0, "discounted_cash": 54.0, "setting": "both", "billing_class": "facility"}]}, {"description": "BENZO/BUTA/TETR 56ML SP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5334392", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 728.0, "discounted_cash": 546.0, "setting": "both", "billing_class": "facility"}]}, {"description": "BENZOCAINE 10% 10GM GL", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5334414", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 122.0, "discounted_cash": 91.5, "setting": "both", "billing_class": "facility"}]}, {"description": "BENZOCAINE 10% 10GM GL", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5334414", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 122.0, "discounted_cash": 91.5, "setting": "both", "billing_class": "facility"}]}, {"description": "BENZOCAINE 10% 7GM GL", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5334411", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 76.0, "discounted_cash": 57.0, "setting": "both", "billing_class": "facility"}]}, {"description": "BENZOCAINE 10% 7GM GL", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5334411", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 76.0, "discounted_cash": 57.0, "setting": "both", "billing_class": "facility"}]}, {"description": "BENZOCAINE 20% 30GM R OI", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5338130", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 95.0, "discounted_cash": 71.25, "setting": "both", "billing_class": "facility"}]}, {"description": "BENZOCAINE 20% 30GM R OI", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5338130", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 95.0, "discounted_cash": 71.25, "setting": "both", "billing_class": "facility"}]}, {"description": "BENZOCAINE 20% 9.9GM GL", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5334432", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 100.0, "discounted_cash": 75.0, "setting": "both", "billing_class": "facility"}]}, {"description": "BENZOCAINE 20% 9.9GM GL", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5334432", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 100.0, "discounted_cash": 75.0, "setting": "both", "billing_class": "facility"}]}, {"description": "BENZOCAINE 6MG LZ", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5301478", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 40.0, "discounted_cash": 30.0, "setting": "both", "billing_class": "facility"}]}, {"description": "BENZOCAINE 6MG LZ", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5301478", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 40.0, "discounted_cash": 30.0, "setting": "both", "billing_class": "facility"}]}, {"description": "BENZOCAINE-MENTH EACH LZ", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5301480", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 70.0, "discounted_cash": 52.5, "setting": "both", "billing_class": "facility"}]}, {"description": "BENZOCAINE-MENTH EACH LZ", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5301480", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 70.0, "discounted_cash": 52.5, "setting": "both", "billing_class": "facility"}]}, {"description": "BENZOCAINE/ANTIPYR10MLOT", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5330410", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 247.0, "discounted_cash": 185.25, "setting": "both", "billing_class": "facility"}]}, {"description": "BENZOCAINE/ANTIPYR10MLOT", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5330410", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 247.0, "discounted_cash": 185.25, "setting": "both", "billing_class": "facility"}]}, {"description": "BENZOCAINE/ANTIPYR15MLOT", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5330401", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 90.0, "discounted_cash": 67.5, "setting": "both", "billing_class": "facility"}]}, {"description": "BENZOCAINE/ANTIPYR15MLOT", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5330401", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 90.0, "discounted_cash": 67.5, "setting": "both", "billing_class": "facility"}]}, {"description": "BENZOCAINE20% 60ML SP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5334430", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 458.0, "discounted_cash": 343.5, "setting": "both", "billing_class": "facility"}]}, {"description": "BENZOCAINE20%15MLTS", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5334438", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 111.0, "discounted_cash": 83.25, "setting": "both", "billing_class": "facility"}]}, {"description": "BENZOCAINE20%15MLTS", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5334438", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 111.0, "discounted_cash": 83.25, "setting": "both", "billing_class": "facility"}]}, {"description": "BENZOCAINE20%82.5ML SP", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5334428", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 101.0, "discounted_cash": 75.75, "setting": "both", "billing_class": "facility"}]}, {"description": "BENZOCAINE20%82.5ML SP", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5334428", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 101.0, "discounted_cash": 75.75, "setting": "both", "billing_class": "facility"}]}, {"description": "BENZODIAZEPINES 1-12/2", "code_information": [{"code": "80346", "type": "CPT"}, {"code": "7250154", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 674.0, "discounted_cash": 505.5, "setting": "both", "billing_class": "facility"}]}, {"description": "BENZODIAZEPINES 1-12/5", "code_information": [{"code": "80346", "type": "CPT"}, {"code": "7252183", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 763.0, "discounted_cash": 572.25, "setting": "both", "billing_class": "facility"}]}, {"description": "BENZODIAZEPINES 1-12/6", "code_information": [{"code": "80346", "type": "CPT"}, {"code": "7252185", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 65.0, "discounted_cash": 48.75, "setting": "both", "billing_class": "facility"}]}, {"description": "BENZONATATE 100MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5301499", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 66.0, "discounted_cash": 49.5, "setting": "both", "billing_class": "facility"}]}, {"description": "BENZONATATE 100MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5301499", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 66.0, "discounted_cash": 49.5, "setting": "both", "billing_class": "facility"}]}, {"description": "BENZTROPINE 1MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5301522", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 61.0, "discounted_cash": 45.75, "setting": "both", "billing_class": "facility"}]}, {"description": "BENZTROPINE 1MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5301522", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 61.0, "discounted_cash": 45.75, "setting": "both", "billing_class": "facility"}]}, {"description": "BENZTROPINE 2MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5301526", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 60.0, "discounted_cash": 45.0, "setting": "both", "billing_class": "facility"}]}, {"description": "BENZTROPINE 2MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5301526", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 60.0, "discounted_cash": 45.0, "setting": "both", "billing_class": "facility"}]}, {"description": "BENZTROPINE PER 1MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0515", "type": "HCPCS"}, {"code": "5318538", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 736.0, "discounted_cash": 552.0, "setting": "both", "billing_class": "facility"}]}, {"description": "BENZTROPINE PER 1MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0515", "type": "HCPCS"}, {"code": "5318538", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 736.0, "discounted_cash": 552.0, "setting": "both", "billing_class": "facility"}]}, {"description": "BERACTANT 25MG/ML 4ML IS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3590", "type": "HCPCS"}, {"code": "5331534", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 7737.0, "discounted_cash": 5802.75, "setting": "both", "billing_class": "facility"}]}, {"description": "BERACTANT 25MG/ML 8ML IS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3590", "type": "HCPCS"}, {"code": "5331535", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 7246.0, "discounted_cash": 5434.5, "setting": "both", "billing_class": "facility"}]}, {"description": "BETA 2 GLYCOPROT I AB EA", "code_information": [{"code": "86146", "type": "CPT"}, {"code": "7256115", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 49.0, "discounted_cash": 36.75, "setting": "both", "billing_class": "facility"}]}, {"description": "BETA 2 GLYCOPROT I AB EA/2", "code_information": [{"code": "86146", "type": "CPT"}, {"code": "7256116", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 49.0, "discounted_cash": 36.75, "setting": "both", "billing_class": "facility"}]}, {"description": "BETA 2 GLYCOPROT I AB EA/4", "code_information": [{"code": "86146", "type": "CPT"}, {"code": "7256146", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 49.0, "discounted_cash": 36.75, "setting": "both", "billing_class": "facility"}]}, {"description": "BETA-2-MICROGLOBLN", "code_information": [{"code": "82232", "type": "CPT"}, {"code": "4102232", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 1089.0, "discounted_cash": 816.75, "setting": "both", "billing_class": "facility"}]}, {"description": "BETA-2-MICROGLOBLN/2", "code_information": [{"code": "82232", "type": "CPT"}, {"code": "7252232", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 731.0, "discounted_cash": 548.25, "setting": "both", "billing_class": "facility"}]}, {"description": "BETAMETHASON-D.05%15GMCR", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5334495", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 671.0, "discounted_cash": 503.25, "setting": "both", "billing_class": "facility"}]}, {"description": "BETAMETHASON-D.05%15GMCR", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5334495", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 671.0, "discounted_cash": 503.25, "setting": "both", "billing_class": "facility"}]}, {"description": "BETAMETHASON-D.05%15GOI", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5334505", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 206.0, "discounted_cash": 154.5, "setting": "both", "billing_class": "facility"}]}, {"description": "BETAMETHASON-D.05%15GOI", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5334505", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 206.0, "discounted_cash": 154.5, "setting": "both", "billing_class": "facility"}]}, {"description": "BETAMETHASON-V.1%15GMCR", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5334530", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 184.0, "discounted_cash": 138.0, "setting": "both", "billing_class": "facility"}]}, {"description": "BETAMETHASON-V.1%15GMCR", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5334530", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 184.0, "discounted_cash": 138.0, "setting": "both", "billing_class": "facility"}]}, {"description": "BETAMETHASON-V.1%15GMOI", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5334535", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 474.0, "discounted_cash": 355.5, "setting": "both", "billing_class": "facility"}]}, {"description": "BETAMETHASON-V.1%15GMOI", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5334535", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 474.0, "discounted_cash": 355.5, "setting": "both", "billing_class": "facility"}]}, {"description": "BETAMETHASONE PER 6MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0702", "type": "HCPCS"}, {"code": "5318558", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 329.0, "discounted_cash": 246.75, "setting": "both", "billing_class": "facility"}]}, {"description": "BETAMETHASONE PER 6MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0702", "type": "HCPCS"}, {"code": "5318558", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 329.0, "discounted_cash": 246.75, "setting": "both", "billing_class": "facility"}]}, {"description": "BETAXOLOL .25% 10ML OS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5330406", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 1858.0, "discounted_cash": 1393.5, "setting": "both", "billing_class": "facility"}]}, {"description": "BETAXOLOL .25% 10ML OS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5330406", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 1858.0, "discounted_cash": 1393.5, "setting": "both", "billing_class": "facility"}]}, {"description": "BETAXOLOL .25% 15ML OS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5330402", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 5060.0, "discounted_cash": 3795.0, "setting": "both", "billing_class": "facility"}]}, {"description": "BETAXOLOL .25% 15ML OS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5330402", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 5060.0, "discounted_cash": 3795.0, "setting": "both", "billing_class": "facility"}]}, {"description": "BETAXOLOL .25% 5ML OS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5330407", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 819.0, "discounted_cash": 614.25, "setting": "both", "billing_class": "facility"}]}, {"description": "BETAXOLOL .25% 5ML OS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5330407", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 819.0, "discounted_cash": 614.25, "setting": "both", "billing_class": "facility"}]}, {"description": "BETHANECHOL 10MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5301576", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 85.0, "discounted_cash": 63.75, "setting": "both", "billing_class": "facility"}]}, {"description": "BETHANECHOL 10MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5301576", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 85.0, "discounted_cash": 63.75, "setting": "both", "billing_class": "facility"}]}, {"description": "BETHANECHOL 25MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5301580", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 71.0, "discounted_cash": 53.25, "setting": "both", "billing_class": "facility"}]}, {"description": "BETHANECHOL 25MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5301580", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 71.0, "discounted_cash": 53.25, "setting": "both", "billing_class": "facility"}]}, {"description": "BEVACIZUMAB OPHT PER 1.25MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J7999", "type": "HCPCS"}, {"code": "5318603", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 64.0, "discounted_cash": 48.0, "setting": "both", "billing_class": "facility"}]}, {"description": "BEVACIZUMAB OPHT PER 1.25MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J7999", "type": "HCPCS"}, {"code": "5318603", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 64.0, "discounted_cash": 48.0, "setting": "both", "billing_class": "facility"}]}, {"description": "BEVACIZUMAB PER 10MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J9035", "type": "HCPCS"}, {"code": "5318607", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 786.0, "discounted_cash": 589.5, "setting": "both", "billing_class": "facility"}]}, {"description": "BEVACIZUMAB PER 10MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J9035", "type": "HCPCS"}, {"code": "5318607", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 786.0, "discounted_cash": 589.5, "setting": "both", "billing_class": "facility"}]}, {"description": "BEVACIZUMAB-AWWB PER 10MG IJ", "code_information": [{"code": "Q5107", "type": "HCPCS"}, {"code": "5318608", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 548.0, "discounted_cash": 411.0, "setting": "both", "billing_class": "facility"}]}, {"description": "BEVACIZUMAB-AWWB PER 10MG IJ", "code_information": [{"code": "Q5107", "type": "HCPCS"}, {"code": "5318608", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 548.0, "discounted_cash": 411.0, "setting": "both", "billing_class": "facility"}]}, {"description": "BICALUTAMIDE 50MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5301590", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 468.0, "discounted_cash": 351.0, "setting": "both", "billing_class": "facility"}]}, {"description": "BICALUTAMIDE 50MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5301590", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 468.0, "discounted_cash": 351.0, "setting": "both", "billing_class": "facility"}]}, {"description": "BILE ACIDS TOTAL/2", "code_information": [{"code": "82239", "type": "CPT"}, {"code": "7252241", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 959.0, "discounted_cash": 719.25, "setting": "both", "billing_class": "facility"}]}, {"description": "BILIARY DIL W/WO STENT", "code_information": [{"code": "74363", "type": "CPT"}, {"code": "4914363", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 1971.0, "discounted_cash": 1478.25, "setting": "both", "billing_class": "facility"}]}, {"description": "BILIARY DUCT STONE EXTR", "code_information": [{"code": "4918200", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 8991.0, "discounted_cash": 6743.25, "setting": "both", "billing_class": "facility"}]}, {"description": "BILIARY ENDO DIL WO STNT", "code_information": [{"code": "4918205", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 10970.0, "discounted_cash": 8227.5, "setting": "both", "billing_class": "facility"}]}, {"description": "BILIRUBIN DIRECT", "code_information": [{"code": "82248", "type": "CPT"}, {"code": "4102253", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 652.0, "discounted_cash": 489.0, "setting": "both", "billing_class": "facility"}]}, {"description": "BILIRUBIN DIRECT", "code_information": [{"code": "82248", "type": "CPT"}, {"code": "4172253", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 2.86, "discounted_cash": 2.15, "setting": "both", "billing_class": "facility"}]}, {"description": "BILIRUBIN TOTAL", "code_information": [{"code": "82247", "type": "CPT"}, {"code": "4172250", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 2.86, "discounted_cash": 2.15, "setting": "both", "billing_class": "facility"}]}, {"description": "BILIRUBIN TOTAL", "code_information": [{"code": "82247", "type": "CPT"}, {"code": "7252247", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 306.0, "discounted_cash": 229.5, "setting": "both", "billing_class": "facility"}]}, {"description": "BILIRUBIN TOTAL/2", "code_information": [{"code": "82247", "type": "CPT"}, {"code": "4102250", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 652.0, "discounted_cash": 489.0, "setting": "both", "billing_class": "facility"}]}, {"description": "BIMATOPROST.03% 2.5ML OS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5330419", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 1236.0, "discounted_cash": 927.0, "setting": "both", "billing_class": "facility"}]}, {"description": "BIMATOPROST.03% 2.5ML OS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5330419", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 1236.0, "discounted_cash": 927.0, "setting": "both", "billing_class": "facility"}]}, {"description": "BIOPSY BONE DEEP", "code_information": [{"code": "4917503", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 16850.0, "discounted_cash": 12637.5, "setting": "both", "billing_class": "facility"}]}, {"description": "BIOPSY BONE DEEP", "code_information": [{"code": "5057503", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 11328.0, "discounted_cash": 8496.0, "setting": "both", "billing_class": "facility"}]}, {"description": "BIOPSY BONE SUPERFICIAL", "code_information": [{"code": "4917504", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 10130.0, "discounted_cash": 7597.5, "setting": "both", "billing_class": "facility"}]}, {"description": "BIOPSY BONE SUPERFICIAL", "code_information": [{"code": "5057504", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 10879.0, "discounted_cash": 8159.25, "setting": "both", "billing_class": "facility"}]}, {"description": "BIOPSY BONE SUPERFICIAL", "code_information": [{"code": "5060226", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 8765.0, "discounted_cash": 6573.75, "setting": "both", "billing_class": "facility"}]}, {"description": "BIOTINIDASE EA SPEC", "code_information": [{"code": "82261", "type": "CPT"}, {"code": "7252261", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 377.0, "discounted_cash": 282.75, "setting": "both", "billing_class": "facility"}]}, {"description": "BIPAP MANAGEMENT DLY", "code_information": [{"code": "94660", "type": "CPT"}, {"code": "5504662", "type": "CDM"}, {"code": "410", "type": "RC"}], "standard_charges": [{"gross_charge": 3816.0, "discounted_cash": 2862.0, "setting": "both", "billing_class": "facility"}]}, {"description": "BISACODYL 10MG SU", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5338162", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 71.0, "discounted_cash": 53.25, "setting": "both", "billing_class": "facility"}]}, {"description": "BISACODYL 10MG SU", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5338162", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 71.0, "discounted_cash": 53.25, "setting": "both", "billing_class": "facility"}]}, {"description": "BISACODYL 5MG EC TB", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5301602", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 78.0, "discounted_cash": 58.5, "setting": "both", "billing_class": "facility"}]}, {"description": "BISACODYL 5MG EC TB", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5301602", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 78.0, "discounted_cash": 58.5, "setting": "both", "billing_class": "facility"}]}, {"description": "BISMUTH SUBSALI 30ML LQ", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5316005", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 66.0, "discounted_cash": 49.5, "setting": "both", "billing_class": "facility"}]}, {"description": "BISMUTH SUBSALI 30ML LQ", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5316005", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 66.0, "discounted_cash": 49.5, "setting": "both", "billing_class": "facility"}]}, {"description": "BISMUTH SUBSLCY262MG CTB", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5301616", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 85.0, "discounted_cash": 63.75, "setting": "both", "billing_class": "facility"}]}, {"description": "BISMUTH SUBSLCY262MG CTB", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5301616", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 85.0, "discounted_cash": 63.75, "setting": "both", "billing_class": "facility"}]}, {"description": "BIVALIRUDIN PER 1MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0583", "type": "HCPCS"}, {"code": "5318617", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 37.0, "discounted_cash": 27.75, "setting": "both", "billing_class": "facility"}]}, {"description": "BIVALIRUDIN PER 1MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0583", "type": "HCPCS"}, {"code": "5318617", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 37.0, "discounted_cash": 27.75, "setting": "both", "billing_class": "facility"}]}, {"description": "BLASTOMYCES AB", "code_information": [{"code": "86612", "type": "CPT"}, {"code": "7256198", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 247.0, "discounted_cash": 185.25, "setting": "both", "billing_class": "facility"}]}, {"description": "BLASTOMYCES AB/2", "code_information": [{"code": "86612", "type": "CPT"}, {"code": "7258696", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 271.0, "discounted_cash": 203.25, "setting": "both", "billing_class": "facility"}]}, {"description": "BLD DEGLYCEROLIZED RBC", "code_information": [{"code": "P9039", "type": "HCPCS"}, {"code": "4500027", "type": "CDM"}, {"code": "399", "type": "RC"}], "standard_charges": [{"gross_charge": 2383.0, "discounted_cash": 1787.25, "setting": "both", "billing_class": "facility"}]}, {"description": "BLD PLASMA FROZEN", "code_information": [{"code": "P9017", "type": "HCPCS"}, {"code": "4500018", "type": "CDM"}, {"code": "399", "type": "RC"}], "standard_charges": [{"gross_charge": 241.0, "discounted_cash": 180.75, "setting": "both", "billing_class": "facility"}]}, {"description": "BLD PLATELET PHERESIS", "code_information": [{"code": "P9034", "type": "HCPCS"}, {"code": "4500026", "type": "CDM"}, {"code": "399", "type": "RC"}], "standard_charges": [{"gross_charge": 2725.0, "discounted_cash": 2043.75, "setting": "both", "billing_class": "facility"}]}, {"description": "BLD PLT PHER LEUKO REDUC", "code_information": [{"code": "P9035", "type": "HCPCS"}, {"code": "4500024", "type": "CDM"}, {"code": "399", "type": "RC"}], "standard_charges": [{"gross_charge": 1830.0, "discounted_cash": 1372.5, "setting": "both", "billing_class": "facility"}]}, {"description": "BLD RCELLS WASHED", "code_information": [{"code": "P9022", "type": "HCPCS"}, {"code": "4500011", "type": "CDM"}, {"code": "399", "type": "RC"}], "standard_charges": [{"gross_charge": 1016.0, "discounted_cash": 762.0, "setting": "both", "billing_class": "facility"}]}, {"description": "BLD SMR EXAM W/DIFF", "code_information": [{"code": "85007", "type": "CPT"}, {"code": "4105007", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 356.0, "discounted_cash": 267.0, "setting": "both", "billing_class": "facility"}]}, {"description": "BLD SMR EXAM W/DIFF", "code_information": [{"code": "85007", "type": "CPT"}, {"code": "4125007", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 12.0, "discounted_cash": 9.0, "setting": "both", "billing_class": "facility"}]}, {"description": "BLD SMR EXAM W/DIFF", "code_information": [{"code": "85007", "type": "CPT"}, {"code": "4175007", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 7.14, "discounted_cash": 5.36, "setting": "both", "billing_class": "facility"}]}, {"description": "BLD SMR EXAM W/O DIFF", "code_information": [{"code": "85008", "type": "CPT"}, {"code": "4105008", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 289.0, "discounted_cash": 216.75, "setting": "both", "billing_class": "facility"}]}, {"description": "BLD SMR EXAM W/O DIFF", "code_information": [{"code": "85008", "type": "CPT"}, {"code": "4175008", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 7.14, "discounted_cash": 5.36, "setting": "both", "billing_class": "facility"}]}, {"description": "BLD TYPE ABO", "code_information": [{"code": "86900", "type": "CPT"}, {"code": "4106080", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 626.0, "discounted_cash": 469.5, "setting": "both", "billing_class": "facility"}]}, {"description": "BLD TYPE ABO", "code_information": [{"code": "86900", "type": "CPT"}, {"code": "4176080", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 4.29, "discounted_cash": 3.22, "setting": "both", "billing_class": "facility"}]}, {"description": "BLD TYPE ABO", "code_information": [{"code": "86900", "type": "CPT"}, {"code": "7016080", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 263.0, "discounted_cash": 197.25, "setting": "both", "billing_class": "facility"}]}, {"description": "BLD TYPE ANTIGEN DONOR EA", "code_information": [{"code": "86902", "type": "CPT"}, {"code": "4106901", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 552.0, "discounted_cash": 414.0, "setting": "both", "billing_class": "facility"}]}, {"description": "BLD TYPE ANTIGEN DONOR EA", "code_information": [{"code": "86902", "type": "CPT"}, {"code": "7016904", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 450.0, "discounted_cash": 337.5, "setting": "both", "billing_class": "facility"}]}, {"description": "BLD TYPE ANTIGEN DONOR EA/3", "code_information": [{"code": "86902", "type": "CPT"}, {"code": "7016916", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 450.0, "discounted_cash": 337.5, "setting": "both", "billing_class": "facility"}]}, {"description": "BLD TYPE PAT SERUM SCRN/2", "code_information": [{"code": "86904", "type": "CPT"}, {"code": "4176904", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 18.55, "discounted_cash": 13.91, "setting": "both", "billing_class": "facility"}]}, {"description": "BLD TYPE RH (D)", "code_information": [{"code": "86901", "type": "CPT"}, {"code": "4106100", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 626.0, "discounted_cash": 469.5, "setting": "both", "billing_class": "facility"}]}, {"description": "BLD TYPE RH (D)", "code_information": [{"code": "86901", "type": "CPT"}, {"code": "4176100", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 4.29, "discounted_cash": 3.22, "setting": "both", "billing_class": "facility"}]}, {"description": "BLD TYPE RH (D)", "code_information": [{"code": "86901", "type": "CPT"}, {"code": "7016100", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 117.0, "discounted_cash": 87.75, "setting": "both", "billing_class": "facility"}]}, {"description": "BLD TYPE RH PHENOTYP CMP", "code_information": [{"code": "86906", "type": "CPT"}, {"code": "4106105", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 711.0, "discounted_cash": 533.25, "setting": "both", "billing_class": "facility"}]}, {"description": "BLD TYPE RH PHENOTYP CMP", "code_information": [{"code": "86906", "type": "CPT"}, {"code": "7016105", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 354.0, "discounted_cash": 265.5, "setting": "both", "billing_class": "facility"}]}, {"description": "BLD UREA NITROGEN QUAN", "code_information": [{"code": "84520", "type": "CPT"}, {"code": "4104520", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 441.0, "discounted_cash": 330.75, "setting": "both", "billing_class": "facility"}]}, {"description": "BLD UREA NITROGEN QUAN", "code_information": [{"code": "84520", "type": "CPT"}, {"code": "4174520", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 1.12, "discounted_cash": 0.84, "setting": "both", "billing_class": "facility"}]}, {"description": "BLD UREA NITROGEN QUAN/2", "code_information": [{"code": "84520", "type": "CPT"}, {"code": "4108452", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 473.0, "discounted_cash": 354.75, "setting": "both", "billing_class": "facility"}]}, {"description": "BLD UREA NITROGEN QUAN/2", "code_information": [{"code": "84520", "type": "CPT"}, {"code": "7254521", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 11.0, "discounted_cash": 8.25, "setting": "both", "billing_class": "facility"}]}, {"description": "BLEEDING TIME", "code_information": [{"code": "85002", "type": "CPT"}, {"code": "4105003", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 370.0, "discounted_cash": 277.5, "setting": "both", "billing_class": "facility"}]}, {"description": "BLEEDING TIME", "code_information": [{"code": "85002", "type": "CPT"}, {"code": "4175003", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 8.56, "discounted_cash": 6.42, "setting": "both", "billing_class": "facility"}]}, {"description": "BLISTEX 9.9GM OI", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5334608", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 70.0, "discounted_cash": 52.5, "setting": "both", "billing_class": "facility"}]}, {"description": "BLISTEX 9.9GM OI", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5334608", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 70.0, "discounted_cash": 52.5, "setting": "both", "billing_class": "facility"}]}, {"description": "BLN COLON DILATION", "code_information": [{"code": "C1726", "type": "HCPCS"}, {"code": "8055090", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 2137.0, "discounted_cash": 1602.75, "setting": "both", "billing_class": "facility"}]}, {"description": "BLOOD ADMINISTRATION 1-2 UNITS", "code_information": [{"code": "36430", "type": "CPT"}, {"code": "6290011", "type": "CDM"}, {"code": "391", "type": "RC"}], "standard_charges": [{"gross_charge": 4970.0, "discounted_cash": 3727.5, "setting": "both", "billing_class": "facility"}]}, {"description": "BLOOD ADMINISTRATION 3-4 UNITS", "code_information": [{"code": "36430", "type": "CPT"}, {"code": "6290012", "type": "CDM"}, {"code": "391", "type": "RC"}], "standard_charges": [{"gross_charge": 4970.0, "discounted_cash": 3727.5, "setting": "both", "billing_class": "facility"}]}, {"description": "BLOOD ADMINISTRATION 5-6 UNITS", "code_information": [{"code": "36430", "type": "CPT"}, {"code": "6290013", "type": "CDM"}, {"code": "391", "type": "RC"}], "standard_charges": [{"gross_charge": 4970.0, "discounted_cash": 3727.5, "setting": "both", "billing_class": "facility"}]}, {"description": "BLOOD ADMINISTRATION 7-8 UNITS", "code_information": [{"code": "36430", "type": "CPT"}, {"code": "6290014", "type": "CDM"}, {"code": "391", "type": "RC"}], "standard_charges": [{"gross_charge": 4970.0, "discounted_cash": 3727.5, "setting": "both", "billing_class": "facility"}]}, {"description": "BLOOD ADMINISTRATION 9-10 UNIT", "code_information": [{"code": "36430", "type": "CPT"}, {"code": "6290015", "type": "CDM"}, {"code": "391", "type": "RC"}], "standard_charges": [{"gross_charge": 4970.0, "discounted_cash": 3727.5, "setting": "both", "billing_class": "facility"}]}, {"description": "BLOOD ADMINISTRATION >10 UNITS", "code_information": [{"code": "36430", "type": "CPT"}, {"code": "6290016", "type": "CDM"}, {"code": "391", "type": "RC"}], "standard_charges": [{"gross_charge": 4970.0, "discounted_cash": 3727.5, "setting": "both", "billing_class": "facility"}]}, {"description": "BLOOD CRYOPRECIPITATE", "code_information": [{"code": "P9012", "type": "HCPCS"}, {"code": "4500034", "type": "CDM"}, {"code": "399", "type": "RC"}], "standard_charges": [{"gross_charge": 291.0, "discounted_cash": 218.25, "setting": "both", "billing_class": "facility"}]}, {"description": "BLOOD GAS ARTERIAL STICK", "code_information": [{"code": "36600", "type": "CPT"}, {"code": "5501104", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 566.0, "discounted_cash": 424.5, "setting": "both", "billing_class": "facility"}]}, {"description": "BLOOD GAS O2 SAT ONLY", "code_information": [{"code": "82810", "type": "CPT"}, {"code": "5501108", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 325.0, "discounted_cash": 243.75, "setting": "both", "billing_class": "facility"}]}, {"description": "BLOOD GAS PH ONLY", "code_information": [{"code": "82800", "type": "CPT"}, {"code": "5505025", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 410.0, "discounted_cash": 307.5, "setting": "both", "billing_class": "facility"}]}, {"description": "BLOOD HEMOGLBN", "code_information": [{"code": "85018", "type": "CPT"}, {"code": "4105018", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 254.0, "discounted_cash": 190.5, "setting": "both", "billing_class": "facility"}]}, {"description": "BLOOD HEMOGLBN", "code_information": [{"code": "85018", "type": "CPT"}, {"code": "4175018", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 2.86, "discounted_cash": 2.15, "setting": "both", "billing_class": "facility"}]}, {"description": "BLOOD PRODUCT IRRAND EA", "code_information": [{"code": "86945", "type": "CPT"}, {"code": "4506125", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 372.0, "discounted_cash": 279.0, "setting": "both", "billing_class": "facility"}]}, {"description": "BLOOD RC LEUKOCYTE POOR", "code_information": [{"code": "P9016", "type": "HCPCS"}, {"code": "4500016", "type": "CDM"}, {"code": "399", "type": "RC"}], "standard_charges": [{"gross_charge": 942.0, "discounted_cash": 706.5, "setting": "both", "billing_class": "facility"}]}, {"description": "BLOOD WHOLE", "code_information": [{"code": "P9010", "type": "HCPCS"}, {"code": "4500001", "type": "CDM"}, {"code": "399", "type": "RC"}], "standard_charges": [{"gross_charge": 864.0, "discounted_cash": 648.0, "setting": "both", "billing_class": "facility"}]}, {"description": "BN BLOCKS", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8131260", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 10110.0, "discounted_cash": 7582.5, "setting": "both", "billing_class": "facility"}]}, {"description": "BN CHIPS", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8131275", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 3950.0, "discounted_cash": 2962.5, "setting": "both", "billing_class": "facility"}]}, {"description": "BN EXTN ALLOGRAFT", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "4011203", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 6335.0, "discounted_cash": 4751.25, "setting": "both", "billing_class": "facility"}]}, {"description": "BN FILLER", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8131276", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 13826.0, "discounted_cash": 10369.5, "setting": "both", "billing_class": "facility"}]}, {"description": "BN FILLER 2", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8131277", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 33238.0, "discounted_cash": 24928.5, "setting": "both", "billing_class": "facility"}]}, {"description": "BN GEL/PUTTY 10CC", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8031369", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 25084.0, "discounted_cash": 18813.0, "setting": "both", "billing_class": "facility"}]}, {"description": "BN GEL/PUTTY 2.5CC", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8031359", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 13041.0, "discounted_cash": 9780.75, "setting": "both", "billing_class": "facility"}]}, {"description": "BN GEL/PUTTY 5CC", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8031366", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 15103.0, "discounted_cash": 11327.25, "setting": "both", "billing_class": "facility"}]}, {"description": "BN GRANUELS 10CC", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8131281", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 64760.0, "discounted_cash": 48570.0, "setting": "both", "billing_class": "facility"}]}, {"description": "BN GRANUELS 15CC", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8131282", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 3322.0, "discounted_cash": 2491.5, "setting": "both", "billing_class": "facility"}]}, {"description": "BN GRANUELS 30CC", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8131283", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 5893.0, "discounted_cash": 4419.75, "setting": "both", "billing_class": "facility"}]}, {"description": "BN GRANULES ANY", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8131284", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 2928.0, "discounted_cash": 2196.0, "setting": "both", "billing_class": "facility"}]}, {"description": "BN GRFT", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8131285", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 24703.0, "discounted_cash": 18527.25, "setting": "both", "billing_class": "facility"}]}, {"description": "BN GRFT 2", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8131286", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 34480.0, "discounted_cash": 25860.0, "setting": "both", "billing_class": "facility"}]}, {"description": "BN GRFT 3", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8131287", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 18229.0, "discounted_cash": 13671.75, "setting": "both", "billing_class": "facility"}]}, {"description": "BN GRFT INFS LG", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "4010999", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 72973.0, "discounted_cash": 54729.75, "setting": "both", "billing_class": "facility"}]}, {"description": "BN GRFT INJ 5CC", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8131289", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 17214.0, "discounted_cash": 12910.5, "setting": "both", "billing_class": "facility"}]}, {"description": "BN PASTE 3", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8031374", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 15368.0, "discounted_cash": 11526.0, "setting": "both", "billing_class": "facility"}]}, {"description": "BN PLUGS", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8131290", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 3620.0, "discounted_cash": 2715.0, "setting": "both", "billing_class": "facility"}]}, {"description": "BN STRIP", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "4011050", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 10940.0, "discounted_cash": 8205.0, "setting": "both", "billing_class": "facility"}]}, {"description": "BOLT CNNLTD", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8131315", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 869.0, "discounted_cash": 651.75, "setting": "both", "billing_class": "facility"}]}, {"description": "BONE AGE STUDIES", "code_information": [{"code": "77072", "type": "CPT"}, {"code": "4906020", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 1244.0, "discounted_cash": 933.0, "setting": "both", "billing_class": "facility"}]}, {"description": "BONE AGE STUDIES", "code_information": [{"code": "77072", "type": "CPT"}, {"code": "5116020", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 1777.0, "discounted_cash": 1332.75, "setting": "both", "billing_class": "facility"}]}, {"description": "BONE IMAG 3 PHASE STUDY", "code_information": [{"code": "78315", "type": "CPT"}, {"code": "5208315", "type": "CDM"}, {"code": "341", "type": "RC"}], "standard_charges": [{"gross_charge": 4670.0, "discounted_cash": 3502.5, "setting": "both", "billing_class": "facility"}]}, {"description": "BONE IMAGING LIMITED", "code_information": [{"code": "78300", "type": "CPT"}, {"code": "5208300", "type": "CDM"}, {"code": "341", "type": "RC"}], "standard_charges": [{"gross_charge": 5016.0, "discounted_cash": 3762.0, "setting": "both", "billing_class": "facility"}]}, {"description": "BONE IMAGING MULTIPLE", "code_information": [{"code": "78305", "type": "CPT"}, {"code": "5208305", "type": "CDM"}, {"code": "341", "type": "RC"}], "standard_charges": [{"gross_charge": 5495.0, "discounted_cash": 4121.25, "setting": "both", "billing_class": "facility"}]}, {"description": "BONE IMAGING WHOLE BODY", "code_information": [{"code": "78306", "type": "CPT"}, {"code": "5208307", "type": "CDM"}, {"code": "341", "type": "RC"}], "standard_charges": [{"gross_charge": 5144.0, "discounted_cash": 3858.0, "setting": "both", "billing_class": "facility"}]}, {"description": "BONE LENGTH STUDIES", "code_information": [{"code": "77073", "type": "CPT"}, {"code": "4906040", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 2333.0, "discounted_cash": 1749.75, "setting": "both", "billing_class": "facility"}]}, {"description": "BONE LENGTH STUDIES", "code_information": [{"code": "77073", "type": "CPT"}, {"code": "5057073", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 1990.0, "discounted_cash": 1492.5, "setting": "both", "billing_class": "facility"}]}, {"description": "BONE LENGTH STUDIES", "code_information": [{"code": "77073", "type": "CPT"}, {"code": "5117073", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 2960.0, "discounted_cash": 2220.0, "setting": "both", "billing_class": "facility"}]}, {"description": "BONE MARROW SMEAR INTRP", "code_information": [{"code": "85097", "type": "CPT"}, {"code": "4305097", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 4341.0, "discounted_cash": 3255.75, "setting": "both", "billing_class": "facility"}]}, {"description": "BONE PUTTY", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8031657", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 9631.0, "discounted_cash": 7223.25, "setting": "both", "billing_class": "facility"}]}, {"description": "BONE SURVEY COMPLETE", "code_information": [{"code": "77075", "type": "CPT"}, {"code": "4906063", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 3083.0, "discounted_cash": 2312.25, "setting": "both", "billing_class": "facility"}]}, {"description": "BONE SURVEY COMPLETE", "code_information": [{"code": "77075", "type": "CPT"}, {"code": "5116062", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 3274.0, "discounted_cash": 2455.5, "setting": "both", "billing_class": "facility"}]}, {"description": "BONE SURVEY INFANT", "code_information": [{"code": "77076", "type": "CPT"}, {"code": "4906065", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 1626.0, "discounted_cash": 1219.5, "setting": "both", "billing_class": "facility"}]}, {"description": "BONE SURVEY LIMITED", "code_information": [{"code": "77074", "type": "CPT"}, {"code": "4906060", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 3023.0, "discounted_cash": 2267.25, "setting": "both", "billing_class": "facility"}]}, {"description": "BONE SURVEY LIMITED", "code_information": [{"code": "77074", "type": "CPT"}, {"code": "5117074", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 3804.0, "discounted_cash": 2853.0, "setting": "both", "billing_class": "facility"}]}, {"description": "BORDETELLA AB", "code_information": [{"code": "86615", "type": "CPT"}, {"code": "7256924", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 47.0, "discounted_cash": 35.25, "setting": "both", "billing_class": "facility"}]}, {"description": "BORDETELLA AB/3", "code_information": [{"code": "86615", "type": "CPT"}, {"code": "7256929", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 64.0, "discounted_cash": 48.0, "setting": "both", "billing_class": "facility"}]}, {"description": "BOTULIN TOXN B PER100UIJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0587", "type": "HCPCS"}, {"code": "5318654", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 129.0, "discounted_cash": 96.75, "setting": "both", "billing_class": "facility"}]}, {"description": "BOTULIN TOXN B PER100UIJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0587", "type": "HCPCS"}, {"code": "5318654", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 129.0, "discounted_cash": 96.75, "setting": "both", "billing_class": "facility"}]}, {"description": "BOTULINUM TOXIN A PERUIJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0585", "type": "HCPCS"}, {"code": "5318651", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 7340.0, "discounted_cash": 5505.0, "setting": "both", "billing_class": "facility"}]}, {"description": "BOTULINUM TOXIN A PERUIJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0585", "type": "HCPCS"}, {"code": "5318651", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 7340.0, "discounted_cash": 5505.0, "setting": "both", "billing_class": "facility"}]}, {"description": "BOWEL EVACUANT KIT 4L LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5314384", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 374.0, "discounted_cash": 280.5, "setting": "both", "billing_class": "facility"}]}, {"description": "BOWEL EVACUANT KIT 4L LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5314384", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 374.0, "discounted_cash": 280.5, "setting": "both", "billing_class": "facility"}]}, {"description": "BRAF V600E VARIANT", "code_information": [{"code": "81210", "type": "CPT"}, {"code": "7061210", "type": "CDM"}, {"code": "310", "type": "RC"}], "standard_charges": [{"gross_charge": 254.0, "discounted_cash": 190.5, "setting": "both", "billing_class": "facility"}]}, {"description": "BRAIN IMAG VASC FLO ONLY", "code_information": [{"code": "78610", "type": "CPT"}, {"code": "5208610", "type": "CDM"}, {"code": "341", "type": "RC"}], "standard_charges": [{"gross_charge": 4518.0, "discounted_cash": 3388.5, "setting": "both", "billing_class": "facility"}]}, {"description": "BRAIN MIN 4 VWS VASCFLOW", "code_information": [{"code": "78606", "type": "CPT"}, {"code": "5208606", "type": "CDM"}, {"code": "341", "type": "RC"}], "standard_charges": [{"gross_charge": 4967.0, "discounted_cash": 3725.25, "setting": "both", "billing_class": "facility"}]}, {"description": "BRCA1&2 GEN FULL SEQ DUP/DEL", "code_information": [{"code": "81162", "type": "CPT"}, {"code": "7252280", "type": "CDM"}, {"code": "310", "type": "RC"}], "standard_charges": [{"gross_charge": 4966.0, "discounted_cash": 3724.5, "setting": "both", "billing_class": "facility"}]}, {"description": "BRIMONIDINE .1% 5ML OS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5330427", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 1404.0, "discounted_cash": 1053.0, "setting": "both", "billing_class": "facility"}]}, {"description": "BRIMONIDINE .1% 5ML OS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5330427", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 1404.0, "discounted_cash": 1053.0, "setting": "both", "billing_class": "facility"}]}, {"description": "BRIMONIDINE .15% 5ML OS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5330451", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 590.0, "discounted_cash": 442.5, "setting": "both", "billing_class": "facility"}]}, {"description": "BRIMONIDINE .15% 5ML OS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5330451", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 590.0, "discounted_cash": 442.5, "setting": "both", "billing_class": "facility"}]}, {"description": "BRIMONIDINE .2% 5ML OS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5330437", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 651.0, "discounted_cash": 488.25, "setting": "both", "billing_class": "facility"}]}, {"description": "BRIMONIDINE .2% 5ML OS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5330437", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 651.0, "discounted_cash": 488.25, "setting": "both", "billing_class": "facility"}]}, {"description": "BRINZOLAMIDE 1% 10ML OS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5330444", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 693.0, "discounted_cash": 519.75, "setting": "both", "billing_class": "facility"}]}, {"description": "BRINZOLAMIDE 1% 10ML OS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5330444", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 693.0, "discounted_cash": 519.75, "setting": "both", "billing_class": "facility"}]}, {"description": "BROMOCRIPTINE 2.5MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5301680", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 66.0, "discounted_cash": 49.5, "setting": "both", "billing_class": "facility"}]}, {"description": "BROMOCRIPTINE 2.5MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5301680", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 66.0, "discounted_cash": 49.5, "setting": "both", "billing_class": "facility"}]}, {"description": "BRONCHOSCOPE DIAGN PULMONARY", "code_information": [{"code": "C1601", "type": "HCPCS"}, {"code": "8031438", "type": "CDM"}, {"code": "272", "type": "RC"}], "standard_charges": [{"gross_charge": 1762.0, "discounted_cash": 1321.5, "setting": "both", "billing_class": "facility"}]}, {"description": "BRONCHOSPASM EVAL PRE/PS", "code_information": [{"code": "94060", "type": "CPT"}, {"code": "5501201", "type": "CDM"}, {"code": "460", "type": "RC"}], "standard_charges": [{"gross_charge": 2285.0, "discounted_cash": 1713.75, "setting": "both", "billing_class": "facility"}]}, {"description": "BRUCELLA AB/2", "code_information": [{"code": "86622", "type": "CPT"}, {"code": "7256628", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 51.0, "discounted_cash": 38.25, "setting": "both", "billing_class": "facility"}]}, {"description": "BRUCELLA AB/3", "code_information": [{"code": "86622", "type": "CPT"}, {"code": "7256635", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 51.0, "discounted_cash": 38.25, "setting": "both", "billing_class": "facility"}]}, {"description": "BSE TB JRNY CTDUNCTD PLY SN CL", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "4012920", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 17020.0, "discounted_cash": 12765.0, "setting": "both", "billing_class": "facility"}]}, {"description": "BSE TIB KNE UNI PLY AESCULP CL", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "4013354", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 23124.0, "discounted_cash": 17343.0, "setting": "both", "billing_class": "facility"}]}, {"description": "BSE TIB UNCTD RPPLY AESCULP CL", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "4013351", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 16305.0, "discounted_cash": 12228.75, "setting": "both", "billing_class": "facility"}]}, {"description": "BSS IRR 15ML OS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5332452", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 128.0, "discounted_cash": 96.0, "setting": "both", "billing_class": "facility"}]}, {"description": "BSS IRR 500ML OS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5332454", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 511.0, "discounted_cash": 383.25, "setting": "both", "billing_class": "facility"}]}, {"description": "BSS PLUS IRR 500ML OS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5332457", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 610.0, "discounted_cash": 457.5, "setting": "both", "billing_class": "facility"}]}, {"description": "BUDE/FORMOT160/4.5 6GMIH", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3535", "type": "HCPCS"}, {"code": "5330463", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 1869.0, "discounted_cash": 1401.75, "setting": "both", "billing_class": "facility"}]}, {"description": "BUDE/FORMOT160/4.5 6GMIH", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3535", "type": "HCPCS"}, {"code": "5330463", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 1869.0, "discounted_cash": 1401.75, "setting": "both", "billing_class": "facility"}]}, {"description": "BUDES/FORMOT80/4.5 6GMIH", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3535", "type": "HCPCS"}, {"code": "5330462", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 1656.0, "discounted_cash": 1242.0, "setting": "both", "billing_class": "facility"}]}, {"description": "BUDES/FORMOT80/4.5 6GMIH", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3535", "type": "HCPCS"}, {"code": "5330462", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 1656.0, "discounted_cash": 1242.0, "setting": "both", "billing_class": "facility"}]}, {"description": "BUDESONIDE .25MG/2ML IS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5330430", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 171.0, "discounted_cash": 128.25, "setting": "both", "billing_class": "facility"}]}, {"description": "BUDESONIDE .25MG/2ML IS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5330430", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 171.0, "discounted_cash": 128.25, "setting": "both", "billing_class": "facility"}]}, {"description": "BUDESONIDE .5MG/2ML IS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5330448", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 159.0, "discounted_cash": 119.25, "setting": "both", "billing_class": "facility"}]}, {"description": "BUDESONIDE .5MG/2ML IS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5330448", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 159.0, "discounted_cash": 119.25, "setting": "both", "billing_class": "facility"}]}, {"description": "BUMETANIDE 1MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5301742", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 85.0, "discounted_cash": 63.75, "setting": "both", "billing_class": "facility"}]}, {"description": "BUMETANIDE 1MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5301742", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 85.0, "discounted_cash": 63.75, "setting": "both", "billing_class": "facility"}]}, {"description": "BUMETANIDE PER .5MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J1939", "type": "HCPCS"}, {"code": "5318684", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 39.0, "discounted_cash": 29.25, "setting": "both", "billing_class": "facility"}]}, {"description": "BUMETANIDE PER .5MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J1939", "type": "HCPCS"}, {"code": "5318684", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 39.0, "discounted_cash": 29.25, "setting": "both", "billing_class": "facility"}]}, {"description": "BUPIV/MELOX PER 1MG/0.03MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0668", "type": "HCPCS"}, {"code": "5318678", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 5.0, "discounted_cash": 3.75, "setting": "both", "billing_class": "facility"}]}, {"description": "BUPIV/MELOX PER 1MG/0.03MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0668", "type": "HCPCS"}, {"code": "5318678", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 5.0, "discounted_cash": 3.75, "setting": "both", "billing_class": "facility"}]}, {"description": "BUPIVAC .125% NS 100MLIJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5318712", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 549.0, "discounted_cash": 411.75, "setting": "both", "billing_class": "facility"}]}, {"description": "BUPIVAC EPIDURAL IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J7999", "type": "HCPCS"}, {"code": "5318730", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 1070.0, "discounted_cash": 802.5, "setting": "both", "billing_class": "facility"}]}, {"description": "BUPIVAC EPIDURAL IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J7999", "type": "HCPCS"}, {"code": "5318730", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 1070.0, "discounted_cash": 802.5, "setting": "both", "billing_class": "facility"}]}, {"description": "BUPIVAC.0625% NS250ML IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J7999", "type": "HCPCS"}, {"code": "5318719", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 1472.0, "discounted_cash": 1104.0, "setting": "both", "billing_class": "facility"}]}, {"description": "BUPIVAC.0625% NS250ML IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J7999", "type": "HCPCS"}, {"code": "5318719", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 1472.0, "discounted_cash": 1104.0, "setting": "both", "billing_class": "facility"}]}, {"description": "BUPIVACAI/DEX NOS PER 0.5MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0665", "type": "HCPCS"}, {"code": "5318776", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 2.0, "discounted_cash": 1.5, "setting": "both", "billing_class": "facility"}]}, {"description": "BUPIVACAI/DEX NOS PER 0.5MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0665", "type": "HCPCS"}, {"code": "5318776", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 2.0, "discounted_cash": 1.5, "setting": "both", "billing_class": "facility"}]}, {"description": "BUPIVACAI/EPI NOS PER 0.5MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0665", "type": "HCPCS"}, {"code": "5318769", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 1.0, "discounted_cash": 0.75, "setting": "both", "billing_class": "facility"}]}, {"description": "BUPIVACAI/EPI NOS PER 0.5MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0665", "type": "HCPCS"}, {"code": "5318769", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 1.0, "discounted_cash": 0.75, "setting": "both", "billing_class": "facility"}]}, {"description": "BUPIVACAIN LIPO PER1MGIJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0666", "type": "HCPCS"}, {"code": "5318692", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 20.0, "discounted_cash": 15.0, "setting": "both", "billing_class": "facility"}]}, {"description": "BUPIVACAIN LIPO PER1MGIJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0666", "type": "HCPCS"}, {"code": "5318692", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 20.0, "discounted_cash": 15.0, "setting": "both", "billing_class": "facility"}]}, {"description": "BUPIVACAIN PF NOS PER 0.5MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0665", "type": "HCPCS"}, {"code": "5318772", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 4.0, "discounted_cash": 3.0, "setting": "both", "billing_class": "facility"}]}, {"description": "BUPIVACAIN PF NOS PER 0.5MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0665", "type": "HCPCS"}, {"code": "5318772", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 4.0, "discounted_cash": 3.0, "setting": "both", "billing_class": "facility"}]}, {"description": "BUPIVACAINE NOS PER 0.5MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0665", "type": "HCPCS"}, {"code": "5318768", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 0.98, "discounted_cash": 0.74, "setting": "both", "billing_class": "facility"}]}, {"description": "BUPIVACAINE NOS PER 0.5MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0665", "type": "HCPCS"}, {"code": "5318768", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 0.98, "discounted_cash": 0.74, "setting": "both", "billing_class": "facility"}]}, {"description": "BUPRENORPHINE 2MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5301754", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 111.0, "discounted_cash": 83.25, "setting": "both", "billing_class": "facility"}]}, {"description": "BUPRENORPHINE 2MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5301754", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 111.0, "discounted_cash": 83.25, "setting": "both", "billing_class": "facility"}]}, {"description": "BUPRENRPH/NALOX 8/2MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5301757", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 197.0, "discounted_cash": 147.75, "setting": "both", "billing_class": "facility"}]}, {"description": "BUPRENRPH/NALOX 8/2MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5301757", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 197.0, "discounted_cash": 147.75, "setting": "both", "billing_class": "facility"}]}, {"description": "BUPRENRPH/NALX 2/.5MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5301756", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 189.0, "discounted_cash": 141.75, "setting": "both", "billing_class": "facility"}]}, {"description": "BUPRENRPH/NALX 2/.5MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5301756", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 189.0, "discounted_cash": 141.75, "setting": "both", "billing_class": "facility"}]}, {"description": "BUPROPION 100MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5301746", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 78.0, "discounted_cash": 58.5, "setting": "both", "billing_class": "facility"}]}, {"description": "BUPROPION 100MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5301746", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 78.0, "discounted_cash": 58.5, "setting": "both", "billing_class": "facility"}]}, {"description": "BUPROPION 100MG XR TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5301748", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 61.0, "discounted_cash": 45.75, "setting": "both", "billing_class": "facility"}]}, {"description": "BUPROPION 100MG XR TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5301748", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 61.0, "discounted_cash": 45.75, "setting": "both", "billing_class": "facility"}]}, {"description": "BUPROPION 150MG XR TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5301749", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 66.0, "discounted_cash": 49.5, "setting": "both", "billing_class": "facility"}]}, {"description": "BUPROPION 150MG XR TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5301749", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 66.0, "discounted_cash": 49.5, "setting": "both", "billing_class": "facility"}]}, {"description": "BUPROPION 150MG XR24 TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5301753", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 147.0, "discounted_cash": 110.25, "setting": "both", "billing_class": "facility"}]}, {"description": "BUPROPION 150MG XR24 TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5301753", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 147.0, "discounted_cash": 110.25, "setting": "both", "billing_class": "facility"}]}, {"description": "BUPROPION 75MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5301745", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 64.0, "discounted_cash": 48.0, "setting": "both", "billing_class": "facility"}]}, {"description": "BUPROPION 75MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5301745", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 64.0, "discounted_cash": 48.0, "setting": "both", "billing_class": "facility"}]}, {"description": "BURR HOLE COVER II", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8172867", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 2338.0, "discounted_cash": 1753.5, "setting": "both", "billing_class": "facility"}]}, {"description": "BUSPIRONE 5MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5301760", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 66.0, "discounted_cash": 49.5, "setting": "both", "billing_class": "facility"}]}, {"description": "BUSPIRONE 5MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5301760", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 66.0, "discounted_cash": 49.5, "setting": "both", "billing_class": "facility"}]}, {"description": "BUTORPHANOL PER 1MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0595", "type": "HCPCS"}, {"code": "5318752", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 83.0, "discounted_cash": 62.25, "setting": "both", "billing_class": "facility"}]}, {"description": "BUTORPHANOL PER 1MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0595", "type": "HCPCS"}, {"code": "5318752", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 83.0, "discounted_cash": 62.25, "setting": "both", "billing_class": "facility"}]}, {"description": "BUTTON TIGHTRP ABS RND CONCAVE", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "4011056", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 5399.0, "discounted_cash": 4049.25, "setting": "both", "billing_class": "facility"}]}, {"description": "BX ABD/RETROPER PERC NDL", "code_information": [{"code": "4917502", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 11775.0, "discounted_cash": 8831.25, "setting": "both", "billing_class": "facility"}]}, {"description": "BX ABD/RETROPER PERC NDL", "code_information": [{"code": "5057502", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 10213.0, "discounted_cash": 7659.75, "setting": "both", "billing_class": "facility"}]}, {"description": "BX ADRENAL GLAND", "code_information": [{"code": "5056069", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 18314.0, "discounted_cash": 13735.5, "setting": "both", "billing_class": "facility"}]}, {"description": "BX BRST 1ST LESION STRTC", "code_information": [{"code": "3079081", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 5243.0, "discounted_cash": 3932.25, "setting": "both", "billing_class": "facility"}]}, {"description": "BX BRST 1ST LESION US", "code_information": [{"code": "3079183", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 8769.0, "discounted_cash": 6576.75, "setting": "both", "billing_class": "facility"}]}, {"description": "BX BRST ADD LESION STRTC", "code_information": [{"code": "3079182", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 3435.0, "discounted_cash": 2576.25, "setting": "both", "billing_class": "facility"}]}, {"description": "BX BRST ADD LESION US", "code_information": [{"code": "3079184", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 4324.0, "discounted_cash": 3243.0, "setting": "both", "billing_class": "facility"}]}, {"description": "BX LIVER PERC NDL", "code_information": [{"code": "4918215", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 14162.0, "discounted_cash": 10621.5, "setting": "both", "billing_class": "facility"}]}, {"description": "BX LIVER PERC NDL", "code_information": [{"code": "5058215", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 12654.0, "discounted_cash": 9490.5, "setting": "both", "billing_class": "facility"}]}, {"description": "BX LIVER PERC NDL", "code_information": [{"code": "5067520", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 10213.0, "discounted_cash": 7659.75, "setting": "both", "billing_class": "facility"}]}, {"description": "BX LUNG/MEDIAST PERC NDL", "code_information": [{"code": "4917510", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 18300.0, "discounted_cash": 13725.0, "setting": "both", "billing_class": "facility"}]}, {"description": "BX LUNG/MEDIAST PERC NDL", "code_information": [{"code": "5057510", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 10213.0, "discounted_cash": 7659.75, "setting": "both", "billing_class": "facility"}]}, {"description": "BX MUSCLE PERC NDL", "code_information": [{"code": "4917511", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 6191.0, "discounted_cash": 4643.25, "setting": "both", "billing_class": "facility"}]}, {"description": "BX MUSCLE PERC NDL", "code_information": [{"code": "5057511", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 8134.0, "discounted_cash": 6100.5, "setting": "both", "billing_class": "facility"}]}, {"description": "BX MUSCLE PERC NDL", "code_information": [{"code": "5067515", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 8791.0, "discounted_cash": 6593.25, "setting": "both", "billing_class": "facility"}]}, {"description": "BX PANCREAS PERC NDL", "code_information": [{"code": "4917512", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 17290.0, "discounted_cash": 12967.5, "setting": "both", "billing_class": "facility"}]}, {"description": "BX PANCREAS PERC NDL", "code_information": [{"code": "5057512", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 14024.0, "discounted_cash": 10518.0, "setting": "both", "billing_class": "facility"}]}, {"description": "BX PLEURA PERC NDL", "code_information": [{"code": "5057505", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 9033.0, "discounted_cash": 6774.75, "setting": "both", "billing_class": "facility"}]}, {"description": "BX PROSTATE NEEDLE/PUNCH", "code_information": [{"code": "5057540", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 5740.0, "discounted_cash": 4305.0, "setting": "both", "billing_class": "facility"}]}, {"description": "BX RENAL PERC NDL", "code_information": [{"code": "4917514", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 13681.0, "discounted_cash": 10260.75, "setting": "both", "billing_class": "facility"}]}, {"description": "BX RENAL PERC NDL", "code_information": [{"code": "5057514", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 12654.0, "discounted_cash": 9490.5, "setting": "both", "billing_class": "facility"}]}, {"description": "BX RENAL PERC NDL", "code_information": [{"code": "5067535", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 12137.0, "discounted_cash": 9102.75, "setting": "both", "billing_class": "facility"}]}, {"description": "BX SALIVARY GLAND NDL", "code_information": [{"code": "5062400", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 3870.0, "discounted_cash": 2902.5, "setting": "both", "billing_class": "facility"}]}, {"description": "BX SOFT TISSUE NECK/THOR", "code_information": [{"code": "4911550", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 9814.0, "discounted_cash": 7360.5, "setting": "both", "billing_class": "facility"}]}, {"description": "BX THYROID PERC NDL", "code_information": [{"code": "4917509", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 5995.0, "discounted_cash": 4496.25, "setting": "both", "billing_class": "facility"}]}, {"description": "BX THYROID PERC NDL", "code_information": [{"code": "5057509", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 3520.0, "discounted_cash": 2640.0, "setting": "both", "billing_class": "facility"}]}, {"description": "BX THYROID PERC NDL", "code_information": [{"code": "5067545", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 2777.0, "discounted_cash": 2082.75, "setting": "both", "billing_class": "facility"}]}, {"description": "C DIFF TOXIN AMP PROBE", "code_information": [{"code": "87493", "type": "CPT"}, {"code": "4108751", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 538.0, "discounted_cash": 403.5, "setting": "both", "billing_class": "facility"}]}, {"description": "C DIFF TOXIN AMP PROBE", "code_information": [{"code": "87493", "type": "CPT"}, {"code": "4177493", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 64.23, "discounted_cash": 48.17, "setting": "both", "billing_class": "facility"}]}, {"description": "C DIFF TOXIN AMP PROBE", "code_information": [{"code": "87493", "type": "CPT"}, {"code": "7258754", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 174.0, "discounted_cash": 130.5, "setting": "both", "billing_class": "facility"}]}, {"description": "C FUNGI SKIN HAIR NAIL", "code_information": [{"code": "87101", "type": "CPT"}, {"code": "4107101", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 1080.0, "discounted_cash": 810.0, "setting": "both", "billing_class": "facility"}]}, {"description": "C FUNGI SKIN HAIR NAIL", "code_information": [{"code": "87101", "type": "CPT"}, {"code": "4177101", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 5.71, "discounted_cash": 4.28, "setting": "both", "billing_class": "facility"}]}, {"description": "C FUNGI SKIN HAIR NAIL", "code_information": [{"code": "87101", "type": "CPT"}, {"code": "7257101", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 90.0, "discounted_cash": 67.5, "setting": "both", "billing_class": "facility"}]}, {"description": "C-PEPTIDE", "code_information": [{"code": "84681", "type": "CPT"}, {"code": "4103976", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 1105.0, "discounted_cash": 828.75, "setting": "both", "billing_class": "facility"}]}, {"description": "C-PEPTIDE", "code_information": [{"code": "84681", "type": "CPT"}, {"code": "7253976", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 742.0, "discounted_cash": 556.5, "setting": "both", "billing_class": "facility"}]}, {"description": "C-REACTIVE PROTEIN", "code_information": [{"code": "86140", "type": "CPT"}, {"code": "4106021", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 1149.0, "discounted_cash": 861.75, "setting": "both", "billing_class": "facility"}]}, {"description": "C-REACTIVE PROTEIN", "code_information": [{"code": "86140", "type": "CPT"}, {"code": "4176021", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 14.27, "discounted_cash": 10.7, "setting": "both", "billing_class": "facility"}]}, {"description": "C-REACTIVE PROTEIN", "code_information": [{"code": "86140", "type": "CPT"}, {"code": "7256021", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 11.0, "discounted_cash": 8.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CA CARB VITD 250/125TB", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5301833", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 85.0, "discounted_cash": 63.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CA CARB VITD 250/125TB", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5301833", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 85.0, "discounted_cash": 63.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CA CARB VITD 500/200TB", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5301834", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 71.0, "discounted_cash": 53.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CA CARB VITD 500/200TB", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5301834", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 71.0, "discounted_cash": 53.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CA CARB1.25GM/5ML 5ML LQ", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5314450", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 61.0, "discounted_cash": 45.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CA CARB1.25GM/5ML 5ML LQ", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5314450", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 61.0, "discounted_cash": 45.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CA GLUC 1GM NS 50ML IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5318824", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 610.0, "discounted_cash": 457.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CA GLUC 1ML LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5314469", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 85.0, "discounted_cash": 63.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CA GLUC 1ML LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5314469", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 85.0, "discounted_cash": 63.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CA GLUC 2GM NS 100ML IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5318827", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 775.0, "discounted_cash": 581.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CA GLUC NEO DOSE LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5314467", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 14.0, "discounted_cash": 10.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CA GLUC NEO DOSE LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5314467", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 14.0, "discounted_cash": 10.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CA GLUC(FRESENIUS) 1ML NEO IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5318829", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 72.0, "discounted_cash": 54.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CA GLUC(WG CRITICAL) PER10MGIJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0613", "type": "HCPCS"}, {"code": "5318821", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 4.0, "discounted_cash": 3.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CA GLUC(WG CRITICAL) PER10MGIJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0613", "type": "HCPCS"}, {"code": "5318821", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 4.0, "discounted_cash": 3.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CA GLUCONATE NOS PER 10MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0612", "type": "HCPCS"}, {"code": "5318819", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 2.0, "discounted_cash": 1.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CA GLUCONATE NOS PER 10MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0612", "type": "HCPCS"}, {"code": "5318819", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 2.0, "discounted_cash": 1.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CABLE DALL MILE", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8173000", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 6184.0, "discounted_cash": 4638.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CABLE FX SPINE", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8131500", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 6089.0, "discounted_cash": 4566.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CACL PER 2MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0618", "type": "HCPCS"}, {"code": "5318803", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 3.0, "discounted_cash": 2.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CACL PER 2MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0618", "type": "HCPCS"}, {"code": "5318803", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 3.0, "discounted_cash": 2.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CACL PER 2MG PFS IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0618", "type": "HCPCS"}, {"code": "5318804", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 0.33, "discounted_cash": 0.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CACL PER 2MG PFS IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0618", "type": "HCPCS"}, {"code": "5318804", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 0.33, "discounted_cash": 0.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CAFFEINE CIT 60MG/3ML LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5314439", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 752.0, "discounted_cash": 564.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CAFFEINE CIT 60MG/3ML LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5314439", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 752.0, "discounted_cash": 564.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CAFFEINE CIT PER 1ML LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5314437", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 530.0, "discounted_cash": 397.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CAFFEINE CIT PER 1ML LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5314437", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 530.0, "discounted_cash": 397.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CAFFEINE CIT PER 5MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0706", "type": "HCPCS"}, {"code": "5318762", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 111.0, "discounted_cash": 83.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CAFFEINE CIT PER 5MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0706", "type": "HCPCS"}, {"code": "5318762", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 111.0, "discounted_cash": 83.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CAFFEINE QUANT", "code_information": [{"code": "80155", "type": "CPT"}, {"code": "4100299", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 835.0, "discounted_cash": 626.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CAFFEINE QUANT", "code_information": [{"code": "80155", "type": "CPT"}, {"code": "4170300", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 34.25, "discounted_cash": 25.69, "setting": "both", "billing_class": "facility"}]}, {"description": "CAFFEINE/NA BENZ 500MGIJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5318767", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 715.0, "discounted_cash": 536.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CALAMINE 120ML LT", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5334659", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 85.0, "discounted_cash": 63.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CALAMINE 120ML LT", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5334659", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 85.0, "discounted_cash": 63.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CALAMINE 180ML LT", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5334655", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 61.0, "discounted_cash": 45.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CALAMINE 180ML LT", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5334655", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 61.0, "discounted_cash": 45.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CALAMINE/PRAMOX 180ML LT", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5335280", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 258.0, "discounted_cash": 193.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CALAMINE/PRAMOX 180ML LT", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5335280", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 258.0, "discounted_cash": 193.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CALCIPOTRIENE 60GM CR", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5334666", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 2244.0, "discounted_cash": 1683.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CALCIPOTRIENE 60GM CR", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5334666", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 2244.0, "discounted_cash": 1683.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CALCITONIN", "code_information": [{"code": "82308", "type": "CPT"}, {"code": "7252308", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 1227.0, "discounted_cash": 920.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CALCITONIN NS200U/2ML SP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3590", "type": "HCPCS"}, {"code": "5330445", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 1600.0, "discounted_cash": 1200.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CALCITONIN NS200U/2ML SP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3590", "type": "HCPCS"}, {"code": "5330445", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 1600.0, "discounted_cash": 1200.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CALCITONIN UPTO 400U IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0630", "type": "HCPCS"}, {"code": "5318788", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 2488.0, "discounted_cash": 1866.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CALCITONIN UPTO 400U IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0630", "type": "HCPCS"}, {"code": "5318788", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 2488.0, "discounted_cash": 1866.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CALCITONINNS200U/3.7MLSP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3590", "type": "HCPCS"}, {"code": "5330454", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 928.0, "discounted_cash": 696.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CALCITONINNS200U/3.7MLSP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3590", "type": "HCPCS"}, {"code": "5330454", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 928.0, "discounted_cash": 696.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CALCITRIOL .25MCG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5301791", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 61.0, "discounted_cash": 45.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CALCITRIOL .25MCG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5301791", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 61.0, "discounted_cash": 45.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CALCIUM", "code_information": [{"code": "82310", "type": "CPT"}, {"code": "4102310", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 487.0, "discounted_cash": 365.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CALCIUM", "code_information": [{"code": "82310", "type": "CPT"}, {"code": "4172310", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 1.12, "discounted_cash": 0.84, "setting": "both", "billing_class": "facility"}]}, {"description": "CALCIUM ACETATE 667MG TB", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5301810", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 61.0, "discounted_cash": 45.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CALCIUM ACETATE 667MG TB", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5301810", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 61.0, "discounted_cash": 45.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CALCIUM CARB 1.25GM TB", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5301813", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 85.0, "discounted_cash": 63.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CALCIUM CARB 1.25GM TB", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5301813", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 85.0, "discounted_cash": 63.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CALCIUM CARB 500MG TB", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5301815", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 85.0, "discounted_cash": 63.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CALCIUM CARB 500MG TB", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5301815", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 85.0, "discounted_cash": 63.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CALCIUM CARBONATE CTB", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5301819", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 61.0, "discounted_cash": 45.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CALCIUM CARBONATE CTB", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5301819", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 61.0, "discounted_cash": 45.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CALCIUM IONIZED", "code_information": [{"code": "82330", "type": "CPT"}, {"code": "4102330", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 1618.0, "discounted_cash": 1213.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CALCIUM IONIZED", "code_information": [{"code": "82330", "type": "CPT"}, {"code": "4172330", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 8.56, "discounted_cash": 6.42, "setting": "both", "billing_class": "facility"}]}, {"description": "CALCIUM URINE QUAN", "code_information": [{"code": "82340", "type": "CPT"}, {"code": "4102340", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 664.0, "discounted_cash": 498.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CALCIUM URINE QUAN", "code_information": [{"code": "82340", "type": "CPT"}, {"code": "4172340", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 1.12, "discounted_cash": 0.84, "setting": "both", "billing_class": "facility"}]}, {"description": "CALCIUM URINE QUAN/2", "code_information": [{"code": "82340", "type": "CPT"}, {"code": "4102341", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 482.0, "discounted_cash": 361.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CALCIUM/2", "code_information": [{"code": "82310", "type": "CPT"}, {"code": "7252310", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 500.0, "discounted_cash": 375.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CALCULUS INFRARED SPCTRO", "code_information": [{"code": "82365", "type": "CPT"}, {"code": "7252365", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 412.0, "discounted_cash": 309.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CALCULUS QUAL", "code_information": [{"code": "82355", "type": "CPT"}, {"code": "7252355", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 52.0, "discounted_cash": 39.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CALCULUS QUAN", "code_information": [{"code": "82360", "type": "CPT"}, {"code": "7252360", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 377.0, "discounted_cash": 282.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CALFACTANT35MG/ML 3ML IS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3590", "type": "HCPCS"}, {"code": "5330455", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 3616.0, "discounted_cash": 2712.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CALFACTANT35MG/ML 6ML IS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3590", "type": "HCPCS"}, {"code": "5330447", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 6398.0, "discounted_cash": 4798.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CALPROTECTIN FECAL", "code_information": [{"code": "83993", "type": "CPT"}, {"code": "7254001", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 626.0, "discounted_cash": 469.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CAMPYLOBACTER AB", "code_information": [{"code": "86625", "type": "CPT"}, {"code": "7256625", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 403.0, "discounted_cash": 302.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CANDESARTAN 16MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5301914", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 85.0, "discounted_cash": 63.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CANDESARTAN 16MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5301914", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 85.0, "discounted_cash": 63.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CANDIDA AB", "code_information": [{"code": "86628", "type": "CPT"}, {"code": "7256049", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 177.0, "discounted_cash": 132.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CANDIDA SKIN TEST PER IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3590", "type": "HCPCS"}, {"code": "5318851", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 532.0, "discounted_cash": 399.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CANNABINOID GC/MS QUANT", "code_information": [{"code": "80349", "type": "CPT"}, {"code": "7258316", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 143.0, "discounted_cash": 107.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CAP BLD COLL", "code_information": [{"code": "36416", "type": "CPT"}, {"code": "4206417", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 178.0, "discounted_cash": 133.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CAP BLD COLL/2", "code_information": [{"code": "36416", "type": "CPT"}, {"code": "4203641", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 210.0, "discounted_cash": 157.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CAP LOCKING SCREW NCB", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8131507", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 2999.0, "discounted_cash": 2249.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CAP ULNAR TOTAL ELBOW", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "8131506", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 28348.0, "discounted_cash": 21261.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CAPSAICIN .025%42.5GM CR", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5334730", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 375.0, "discounted_cash": 281.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CAPSAICIN .025%42.5GM CR", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5334730", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 375.0, "discounted_cash": 281.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CAPSAICIN .075% 60GM CR", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5334732", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 485.0, "discounted_cash": 363.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CAPSAICIN .075% 60GM CR", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5334732", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 485.0, "discounted_cash": 363.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CAPTOPRIL 12.5MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5301922", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 61.0, "discounted_cash": 45.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CAPTOPRIL 12.5MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5301922", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 61.0, "discounted_cash": 45.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CAPTOPRIL 25MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5301923", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 71.0, "discounted_cash": 53.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CAPTOPRIL 25MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5301923", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 71.0, "discounted_cash": 53.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CAPTOPRIL CMPD LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5314477", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 4.0, "discounted_cash": 3.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CAPTOPRIL CMPD LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5314477", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 4.0, "discounted_cash": 3.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CAR SEAT/BED TEST 60MIN", "code_information": [{"code": "94780", "type": "CPT"}, {"code": "3114780", "type": "CDM"}, {"code": "920", "type": "RC"}], "standard_charges": [{"gross_charge": 450.0, "discounted_cash": 337.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CAR/BED TEST EA ADD 30", "code_information": [{"code": "94781", "type": "CPT"}, {"code": "3114781", "type": "CDM"}, {"code": "920", "type": "RC"}], "standard_charges": [{"gross_charge": 213.0, "discounted_cash": 159.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CARBACHOL .01% 1.5ML OS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5330449", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 518.0, "discounted_cash": 388.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CARBAMAZAPINE", "code_information": [{"code": "80156", "type": "CPT"}, {"code": "4102372", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 990.0, "discounted_cash": 742.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CARBAMAZAPINE", "code_information": [{"code": "80156", "type": "CPT"}, {"code": "4172372", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 8.56, "discounted_cash": 6.42, "setting": "both", "billing_class": "facility"}]}, {"description": "CARBAMAZEPIN200/10 10MLQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5314483", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 130.0, "discounted_cash": 97.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CARBAMAZEPIN200/10 10MLQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5314483", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 130.0, "discounted_cash": 97.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CARBAMAZEPINE 100MG CTB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5301975", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 61.0, "discounted_cash": 45.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CARBAMAZEPINE 100MG CTB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5301975", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 61.0, "discounted_cash": 45.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CARBAMAZEPINE 200MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5301981", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 65.0, "discounted_cash": 48.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CARBAMAZEPINE 200MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5301981", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 65.0, "discounted_cash": 48.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CARBAMAZEPINE 200MG XRCP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5301979", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 85.0, "discounted_cash": 63.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CARBAMAZEPINE 200MG XRCP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5301979", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 85.0, "discounted_cash": 63.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CARBAMAZEPINE 200MG XRTB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5301977", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 85.0, "discounted_cash": 63.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CARBAMAZEPINE 200MG XRTB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5301977", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 85.0, "discounted_cash": 63.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CARBAMAZEPINE FREE", "code_information": [{"code": "80157", "type": "CPT"}, {"code": "7250157", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 197.0, "discounted_cash": 147.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CARBAMAZEPINE PER 1ML LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5314474", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 85.0, "discounted_cash": 63.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CARBAMAZEPINE PER 1ML LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5314474", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 85.0, "discounted_cash": 63.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CARBAMIDE PEROXID15ML LQ", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5314484", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 183.0, "discounted_cash": 137.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CARBAMIDE PEROXID15ML LQ", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5314484", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 183.0, "discounted_cash": 137.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CARBAMIDE PERX6.5%15MLOT", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5330492", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 61.0, "discounted_cash": 45.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CARBAMIDE PERX6.5%15MLOT", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5330492", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 61.0, "discounted_cash": 45.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CARBHYDRT DEFC TRNSFRRN", "code_information": [{"code": "82373", "type": "CPT"}, {"code": "7252373", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 579.0, "discounted_cash": 434.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CARBIDOPA/LEVD 10/100 TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5302027", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 61.0, "discounted_cash": 45.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CARBIDOPA/LEVD 10/100 TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5302027", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 61.0, "discounted_cash": 45.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CARBIDOPA/LEVD 25/100 TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5302031", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 61.0, "discounted_cash": 45.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CARBIDOPA/LEVD 25/100 TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5302031", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 61.0, "discounted_cash": 45.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CARBIDOPA/LEVD 25/250 TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5302035", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 61.0, "discounted_cash": 45.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CARBIDOPA/LEVD 25/250 TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5302035", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 61.0, "discounted_cash": 45.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CARBIDOPA/LEVD50/200XRTB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5302036", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 66.0, "discounted_cash": 49.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CARBIDOPA/LEVD50/200XRTB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5302036", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 66.0, "discounted_cash": 49.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CARBON DIOXIDE", "code_information": [{"code": "82374", "type": "CPT"}, {"code": "4102374", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 391.0, "discounted_cash": 293.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CARBON DIOXIDE", "code_information": [{"code": "82374", "type": "CPT"}, {"code": "4172374", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 8.56, "discounted_cash": 6.42, "setting": "both", "billing_class": "facility"}]}, {"description": "CARBON MONOXIDE QUAN", "code_information": [{"code": "82375", "type": "CPT"}, {"code": "4102375", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 1469.0, "discounted_cash": 1101.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CARBON MONOXIDE QUAN", "code_information": [{"code": "82375", "type": "CPT"}, {"code": "4172375", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 8.56, "discounted_cash": 6.42, "setting": "both", "billing_class": "facility"}]}, {"description": "CARBOPROST PER 0.1MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0675", "type": "HCPCS"}, {"code": "5318908", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 120.84, "discounted_cash": 90.63, "setting": "both", "billing_class": "facility"}]}, {"description": "CARBOPROST PER 0.1MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0675", "type": "HCPCS"}, {"code": "5318908", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 120.84, "discounted_cash": 90.63, "setting": "both", "billing_class": "facility"}]}, {"description": "CARCINO-EMBRYONIC AG", "code_information": [{"code": "82378", "type": "CPT"}, {"code": "4106151", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 771.0, "discounted_cash": 578.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CARCINO-EMBRYONIC AG", "code_information": [{"code": "82378", "type": "CPT"}, {"code": "4176151", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 17.13, "discounted_cash": 12.85, "setting": "both", "billing_class": "facility"}]}, {"description": "CARCINO-EMBRYONIC AG", "code_information": [{"code": "82378", "type": "CPT"}, {"code": "7252378", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 635.0, "discounted_cash": 476.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CARCINO-EMBRYONIC AG/2", "code_information": [{"code": "82378", "type": "CPT"}, {"code": "7256151", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 14.0, "discounted_cash": 10.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CARD BLD POOL MULT STUDY", "code_information": [{"code": "78483", "type": "CPT"}, {"code": "5208483", "type": "CDM"}, {"code": "341", "type": "RC"}], "standard_charges": [{"gross_charge": 23624.0, "discounted_cash": 17718.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CARD GATED 1ST PASS PROC", "code_information": [{"code": "78496", "type": "CPT"}, {"code": "5208413", "type": "CDM"}, {"code": "341", "type": "RC"}], "standard_charges": [{"gross_charge": 788.0, "discounted_cash": 591.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CARD GATED 1ST PASS REST", "code_information": [{"code": "78481", "type": "CPT"}, {"code": "5208431", "type": "CDM"}, {"code": "341", "type": "RC"}], "standard_charges": [{"gross_charge": 2553.0, "discounted_cash": 1914.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CARDIO STRESS TEST", "code_information": [{"code": "93015", "type": "CPT"}, {"code": "5113015", "type": "CDM"}, {"code": "480", "type": "RC"}], "standard_charges": [{"gross_charge": 1272.0, "discounted_cash": 954.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CARDIO STRESS TRACE ONLY", "code_information": [{"code": "93017", "type": "CPT"}, {"code": "4603017", "type": "CDM"}, {"code": "482", "type": "RC"}], "standard_charges": [{"gross_charge": 5163.0, "discounted_cash": 3872.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CARDIO STRESS TRACE ONLY", "code_information": [{"code": "93017", "type": "CPT"}, {"code": "5203017", "type": "CDM"}, {"code": "482", "type": "RC"}], "standard_charges": [{"gross_charge": 7089.0, "discounted_cash": 5316.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CARDIOLIPIN AB EA IG", "code_information": [{"code": "86147", "type": "CPT"}, {"code": "4106381", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 159.0, "discounted_cash": 119.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CARDIOLIPIN AB EA IG/2", "code_information": [{"code": "86147", "type": "CPT"}, {"code": "7256382", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 109.0, "discounted_cash": 81.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CARDIOLIPIN AB EA IG/3", "code_information": [{"code": "86147", "type": "CPT"}, {"code": "7256385", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 109.0, "discounted_cash": 81.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CARDIOLIPIN AB EA IG/4", "code_information": [{"code": "86147", "type": "CPT"}, {"code": "7256386", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 109.0, "discounted_cash": 81.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CARDIOPLEG SOL 1000ML IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5318915", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 950.0, "discounted_cash": 712.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CARDIOVERSION ELEC", "code_information": [{"code": "92960", "type": "CPT"}, {"code": "4611110", "type": "CDM"}, {"code": "480", "type": "RC"}], "standard_charges": [{"gross_charge": 5934.0, "discounted_cash": 4450.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CARDIOVERSION ELEC/SCHED", "code_information": [{"code": "92960", "type": "CPT"}, {"code": "6102960", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 5931.0, "discounted_cash": 4448.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CARNITINE", "code_information": [{"code": "82379", "type": "CPT"}, {"code": "7252379", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 1219.0, "discounted_cash": 914.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CAROTENE", "code_information": [{"code": "82380", "type": "CPT"}, {"code": "7252380", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 468.0, "discounted_cash": 351.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CARPEL HEAD", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "8130128", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 16038.0, "discounted_cash": 12028.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CARVEDILOL 12.5MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5302079", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 90.0, "discounted_cash": 67.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CARVEDILOL 12.5MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5302079", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 90.0, "discounted_cash": 67.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CARVEDILOL 25MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5302080", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 83.0, "discounted_cash": 62.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CARVEDILOL 25MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5302080", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 83.0, "discounted_cash": 62.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CARVEDILOL 3.125MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5302077", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 65.0, "discounted_cash": 48.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CARVEDILOL 3.125MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5302077", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 65.0, "discounted_cash": 48.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CARVEDILOL 6.25MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5302078", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 84.0, "discounted_cash": 63.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CARVEDILOL 6.25MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5302078", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 84.0, "discounted_cash": 63.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CASPR2 AB", "code_information": [{"code": "86255", "type": "CPT"}, {"code": "7250403", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 630.0, "discounted_cash": 472.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CASTOR OIL 60ML LQ", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5314522", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 85.0, "discounted_cash": 63.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CASTOR OIL 60ML LQ", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5314522", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 85.0, "discounted_cash": 63.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CASTOR OIL EMUL 60ML LQ", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5314524", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 141.0, "discounted_cash": 105.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CASTOR OIL EMUL 60ML LQ", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5314524", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 141.0, "discounted_cash": 105.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CATECHOLAMINES FRAC", "code_information": [{"code": "82384", "type": "CPT"}, {"code": "7252384", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 147.0, "discounted_cash": 110.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CATECHOLAMINES FRAC/2", "code_information": [{"code": "82384", "type": "CPT"}, {"code": "7252385", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 241.0, "discounted_cash": 180.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CATECHOLAMINES FRAC/3", "code_information": [{"code": "82384", "type": "CPT"}, {"code": "7252386", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 262.0, "discounted_cash": 196.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CATECHOLAMINES(TOT)URINE", "code_information": [{"code": "82382", "type": "CPT"}, {"code": "7252387", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 262.0, "discounted_cash": 196.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH ABL BIDRCT THRMCOOL", "code_information": [{"code": "C1732", "type": "HCPCS"}, {"code": "8055003", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 62556.0, "discounted_cash": 46917.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH ABL ESOP HALO90D", "code_information": [{"code": "C1726", "type": "HCPCS"}, {"code": "8056047", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 2258.0, "discounted_cash": 1693.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH ABL RF CONDUCTR MC", "code_information": [{"code": "C1733", "type": "HCPCS"}, {"code": "8240100", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 4225.0, "discounted_cash": 3168.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH ABLATN 3D MAPPNG", "code_information": [{"code": "C1732", "type": "HCPCS"}, {"code": "8056146", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 68082.0, "discounted_cash": 51061.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH ANGIO OMNI FLUSH", "code_information": [{"code": "C1887", "type": "HCPCS"}, {"code": "8056013", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 283.0, "discounted_cash": 212.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH ANGIOJET RHEO THROM", "code_information": [{"code": "C1757", "type": "HCPCS"}, {"code": "8240026", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 4521.0, "discounted_cash": 3390.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH ASH SPLIT MEDCOMP", "code_information": [{"code": "C1750", "type": "HCPCS"}, {"code": "8245820", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 7207.0, "discounted_cash": 5405.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH ASPIRATION EXPORTAP", "code_information": [{"code": "C1757", "type": "HCPCS"}, {"code": "8056052", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 8474.0, "discounted_cash": 6355.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH ASPIRATION HTORQ INDIGO", "code_information": [{"code": "C1757", "type": "HCPCS"}, {"code": "8050017", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 191962.0, "discounted_cash": 143971.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH ASPIRATION XTORQ INDIGO", "code_information": [{"code": "C1757", "type": "HCPCS"}, {"code": "8177027", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 53444.0, "discounted_cash": 40083.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH ATHER SILVERHAWK", "code_information": [{"code": "C1714", "type": "HCPCS"}, {"code": "8240739", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 26043.0, "discounted_cash": 19532.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH ATHER STEALTH 360", "code_information": [{"code": "C1724", "type": "HCPCS"}, {"code": "8056043", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 34944.0, "discounted_cash": 26208.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH ATHERECTOMY DIRECT", "code_information": [{"code": "C1714", "type": "HCPCS"}, {"code": "8056045", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 46493.0, "discounted_cash": 34869.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH BAL DIL SINUS", "code_information": [{"code": "C1726", "type": "HCPCS"}, {"code": "8056054", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 5216.0, "discounted_cash": 3912.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH BARD NIAGARA DL", "code_information": [{"code": "C1752", "type": "HCPCS"}, {"code": "8245080", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 1154.0, "discounted_cash": 865.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH BLLN AGNT PACLITAXEL NTAP", "code_information": [{"code": "C9610", "type": "HCPCS"}, {"code": "8058510", "type": "CDM"}, {"code": "272", "type": "RC"}], "standard_charges": [{"gross_charge": 29146.0, "discounted_cash": 21859.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH BLN CUTTING WOLVERINE", "code_information": [{"code": "C1725", "type": "HCPCS"}, {"code": "8056066", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 11525.0, "discounted_cash": 8643.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH BLN DIL CRE", "code_information": [{"code": "C1726", "type": "HCPCS"}, {"code": "8240030", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 3793.0, "discounted_cash": 2844.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH BLN DIL METACROSS RX", "code_information": [{"code": "C1725", "type": "HCPCS"}, {"code": "8056074", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 4915.0, "discounted_cash": 3686.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH BLN DIL MINI TREK", "code_information": [{"code": "C1725", "type": "HCPCS"}, {"code": "8051726", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 1569.0, "discounted_cash": 1176.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH BLN DIL NEPHROMAX", "code_information": [{"code": "C1726", "type": "HCPCS"}, {"code": "4031250", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 3775.0, "discounted_cash": 2831.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH BLN DIL NONVASCULAR", "code_information": [{"code": "C1726", "type": "HCPCS"}, {"code": "8240074", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 1711.0, "discounted_cash": 1283.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH BLN DIL RX NC TREK", "code_information": [{"code": "C1725", "type": "HCPCS"}, {"code": "8051725", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 1950.0, "discounted_cash": 1462.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH BLN DIL STERLNG OTW", "code_information": [{"code": "C1725", "type": "HCPCS"}, {"code": "8240035", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 3011.0, "discounted_cash": 2258.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH BLN DIL SV SYMMETRY", "code_information": [{"code": "C1725", "type": "HCPCS"}, {"code": "8245165", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 4563.0, "discounted_cash": 3422.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH BLN DIL ULTRATHIN", "code_information": [{"code": "C1725", "type": "HCPCS"}, {"code": "8245190", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 2678.0, "discounted_cash": 2008.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH BLN DIL UROMAX UHP", "code_information": [{"code": "C1726", "type": "HCPCS"}, {"code": "8240761", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 2114.0, "discounted_cash": 1585.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH BLN PERIPH CUTTING", "code_information": [{"code": "C1725", "type": "HCPCS"}, {"code": "4031269", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 5039.0, "discounted_cash": 3779.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH BLN RELIANT STN GRF", "code_information": [{"code": "C1725", "type": "HCPCS"}, {"code": "4031275", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 7811.0, "discounted_cash": 5858.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH BLN TIS DISSCT NVAS", "code_information": [{"code": "C1727", "type": "HCPCS"}, {"code": "8240076", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 3614.0, "discounted_cash": 2710.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH BLN ULTRATHIN SDS", "code_information": [{"code": "C1725", "type": "HCPCS"}, {"code": "4031290", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 1743.0, "discounted_cash": 1307.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH BLN URIN TRCT OCCLU", "code_information": [{"code": "C2628", "type": "HCPCS"}, {"code": "8056098", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 1547.0, "discounted_cash": 1160.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH BLN URO SP COOK", "code_information": [{"code": "C2627", "type": "HCPCS"}, {"code": "8245270", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 849.0, "discounted_cash": 636.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH BROVIAC", "code_information": [{"code": "C1751", "type": "HCPCS"}, {"code": "8173300", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 1418.0, "discounted_cash": 1063.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH CERVICAL RIPENING", "code_information": [{"code": "C1726", "type": "HCPCS"}, {"code": "8031589", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 832.0, "discounted_cash": 624.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH CLOTTRIEVER", "code_information": [{"code": "C1757", "type": "HCPCS"}, {"code": "8056324", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 78970.0, "discounted_cash": 59227.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH CNTRL VEIN", "code_information": [{"code": "C1751", "type": "HCPCS"}, {"code": "8056365", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 1099.0, "discounted_cash": 824.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH COR ART/GRFT S&I", "code_information": [{"code": "93455", "type": "CPT"}, {"code": "4613455", "type": "CDM"}, {"code": "480", "type": "RC"}], "standard_charges": [{"gross_charge": 18241.0, "discounted_cash": 13680.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH COR ART/GRFT S&I", "code_information": [{"code": "93455", "type": "CPT"}, {"code": "4613455", "type": "CDM"}, {"code": "481", "type": "RC"}], "standard_charges": [{"gross_charge": 18241.0, "discounted_cash": 13680.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH COR DIAG OPTITORQUE", "code_information": [{"code": "C1887", "type": "HCPCS"}, {"code": "8058045", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 537.0, "discounted_cash": 402.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH CORONARY ARTERY S&I", "code_information": [{"code": "93454", "type": "CPT"}, {"code": "4613454", "type": "CDM"}, {"code": "480", "type": "RC"}], "standard_charges": [{"gross_charge": 38706.0, "discounted_cash": 29029.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH CORONARY ARTERY S&I", "code_information": [{"code": "93454", "type": "CPT"}, {"code": "4613454", "type": "CDM"}, {"code": "481", "type": "RC"}], "standard_charges": [{"gross_charge": 38706.0, "discounted_cash": 29029.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH CORONARY DIL TREK", "code_information": [{"code": "C1725", "type": "HCPCS"}, {"code": "8056359", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 1271.0, "discounted_cash": 953.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH CORONARY IMAGING", "code_information": [{"code": "C1753", "type": "HCPCS"}, {"code": "8058046", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 9764.0, "discounted_cash": 7323.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH DELIVERY LONG SHTH", "code_information": [{"code": "C1887", "type": "HCPCS"}, {"code": "8056911", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 6852.0, "discounted_cash": 5139.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH DIAG MULTI ELCT MAP", "code_information": [{"code": "C1732", "type": "HCPCS"}, {"code": "8056384", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 19790.0, "discounted_cash": 14842.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH DIAL HEMOSPLIT", "code_information": [{"code": "C1750", "type": "HCPCS"}, {"code": "4020901", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 5881.0, "discounted_cash": 4410.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH DIAL VAXCEL CHRON", "code_information": [{"code": "C1750", "type": "HCPCS"}, {"code": "8240050", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 6613.0, "discounted_cash": 4959.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH DIALYSIS HEMOGLIDE", "code_information": [{"code": "C1750", "type": "HCPCS"}, {"code": "8245504", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 2488.0, "discounted_cash": 1866.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH DIAMONDBACK 360", "code_information": [{"code": "C1724", "type": "HCPCS"}, {"code": "4031310", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 3820.0, "discounted_cash": 2865.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH DIL PTA ATLAS", "code_information": [{"code": "C1725", "type": "HCPCS"}, {"code": "8240793", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 4070.0, "discounted_cash": 3052.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH DRAINAGE", "code_information": [{"code": "C1729", "type": "HCPCS"}, {"code": "8240082", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 619.0, "discounted_cash": 464.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH DRAINAGE 2", "code_information": [{"code": "C1729", "type": "HCPCS"}, {"code": "8240083", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 3028.0, "discounted_cash": 2271.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH DRAINAGE ALL PURP", "code_information": [{"code": "C1729", "type": "HCPCS"}, {"code": "4031340", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 1185.0, "discounted_cash": 888.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH DRAINAGE BILIARY", "code_information": [{"code": "C1729", "type": "HCPCS"}, {"code": "8240081", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 1453.0, "discounted_cash": 1089.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH DRAINAGE MALECOT", "code_information": [{"code": "C1729", "type": "HCPCS"}, {"code": "8245531", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 532.0, "discounted_cash": 399.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH DRN GASTR/JEJ", "code_information": [{"code": "C1729", "type": "HCPCS"}, {"code": "8245532", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 1328.0, "discounted_cash": 996.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH DRN PARA/THORA", "code_information": [{"code": "C1729", "type": "HCPCS"}, {"code": "8245534", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 762.0, "discounted_cash": 571.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH DRN PLEURAL", "code_information": [{"code": "C1729", "type": "HCPCS"}, {"code": "8245533", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 2063.0, "discounted_cash": 1547.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH DRNG", "code_information": [{"code": "C1729", "type": "HCPCS"}, {"code": "8041115", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 1959.0, "discounted_cash": 1469.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH ELECTROPHSLGY DIAGN", "code_information": [{"code": "C1730", "type": "HCPCS"}, {"code": "8056033", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 5104.0, "discounted_cash": 3828.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH EMBOLECTOMY", "code_information": [{"code": "C1757", "type": "HCPCS"}, {"code": "8056318", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 1089.0, "discounted_cash": 816.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH EP DFLECT TP BS WEB", "code_information": [{"code": "C1730", "type": "HCPCS"}, {"code": "8245550", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 2123.0, "discounted_cash": 1592.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH EP DIAG NOT3D 19OR<", "code_information": [{"code": "C1730", "type": "HCPCS"}, {"code": "8240084", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 5379.0, "discounted_cash": 4034.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH EP LASSO 2515 ECO", "code_information": [{"code": "C1732", "type": "HCPCS"}, {"code": "8056339", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 31574.0, "discounted_cash": 23680.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH EP LVWR STEERABLE", "code_information": [{"code": "C1730", "type": "HCPCS"}, {"code": "8240818", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 14587.0, "discounted_cash": 10940.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH FGRTY EMBLA", "code_information": [{"code": "C1757", "type": "HCPCS"}, {"code": "8056373", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 8328.0, "discounted_cash": 6246.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH GLIDE", "code_information": [{"code": "C1887", "type": "HCPCS"}, {"code": "8056439", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 714.0, "discounted_cash": 535.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH GROSHONG", "code_information": [{"code": "C1751", "type": "HCPCS"}, {"code": "8141250", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 1899.0, "discounted_cash": 1424.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH GROSHONG SM", "code_information": [{"code": "C1751", "type": "HCPCS"}, {"code": "8056455", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 2058.0, "discounted_cash": 1543.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH GUIDELNR NAVIAGT RX", "code_information": [{"code": "C1887", "type": "HCPCS"}, {"code": "8056456", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 5391.0, "discounted_cash": 4043.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH GUIDEWIRE SUPPRT", "code_information": [{"code": "C1887", "type": "HCPCS"}, {"code": "8056041", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 3709.0, "discounted_cash": 2781.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH GUIDING", "code_information": [{"code": "C1887", "type": "HCPCS"}, {"code": "8056037", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 1355.0, "discounted_cash": 1016.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH GUIDING", "code_information": [{"code": "C1887", "type": "HCPCS"}, {"code": "8240096", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 2514.0, "discounted_cash": 1885.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH GUIDING LAUNCHER", "code_information": [{"code": "C1887", "type": "HCPCS"}, {"code": "8241084", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 728.0, "discounted_cash": 546.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH HEMOCATH MEDCOMP LT", "code_information": [{"code": "C1750", "type": "HCPCS"}, {"code": "8245720", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 3563.0, "discounted_cash": 2672.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH HEMODIAL LONG TERM", "code_information": [{"code": "C1750", "type": "HCPCS"}, {"code": "8240098", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 4840.0, "discounted_cash": 3630.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH HEMODIAL LONG TERM2", "code_information": [{"code": "C1750", "type": "HCPCS"}, {"code": "8240095", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 6206.0, "discounted_cash": 4654.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH HEMODIAL SHORT TRM2", "code_information": [{"code": "C1752", "type": "HCPCS"}, {"code": "8245721", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 2258.0, "discounted_cash": 1693.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH HICKMAN", "code_information": [{"code": "C1751", "type": "HCPCS"}, {"code": "8056470", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 1656.0, "discounted_cash": 1242.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH INF PERPH/CNTRL/ML3", "code_information": [{"code": "C1751", "type": "HCPCS"}, {"code": "8245756", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 962.0, "discounted_cash": 721.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH INF PERPH/CNTRL/ML4", "code_information": [{"code": "C1751", "type": "HCPCS"}, {"code": "8245757", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 2744.0, "discounted_cash": 2058.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH INF PICC", "code_information": [{"code": "C1751", "type": "HCPCS"}, {"code": "8245755", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 803.0, "discounted_cash": 602.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH INF PICC DL PWR", "code_information": [{"code": "C1751", "type": "HCPCS"}, {"code": "8245753", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 3406.0, "discounted_cash": 2554.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH INF PICC TL PWR", "code_information": [{"code": "C1751", "type": "HCPCS"}, {"code": "8240043", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 3284.0, "discounted_cash": 2463.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH INF UNIFUS ANGIODYN", "code_information": [{"code": "C1757", "type": "HCPCS"}, {"code": "8245780", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 1873.0, "discounted_cash": 1404.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH INTRATHECAL 1 PIECE", "code_information": [{"code": "C1755", "type": "HCPCS"}, {"code": "8173328", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 9761.0, "discounted_cash": 7320.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH INTRATHECAL ASCENDA", "code_information": [{"code": "C1755", "type": "HCPCS"}, {"code": "8056424", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 13993.0, "discounted_cash": 10494.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH L HRT ART/GRFT", "code_information": [{"code": "93459", "type": "CPT"}, {"code": "4613459", "type": "CDM"}, {"code": "480", "type": "RC"}], "standard_charges": [{"gross_charge": 36004.0, "discounted_cash": 27003.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH L HRT ART/GRFT", "code_information": [{"code": "93459", "type": "CPT"}, {"code": "4613459", "type": "CDM"}, {"code": "481", "type": "RC"}], "standard_charges": [{"gross_charge": 36004.0, "discounted_cash": 27003.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH L HRT ARTERY/VENTR", "code_information": [{"code": "93458", "type": "CPT"}, {"code": "4613458", "type": "CDM"}, {"code": "480", "type": "RC"}], "standard_charges": [{"gross_charge": 43970.0, "discounted_cash": 32977.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH L HRT ARTERY/VENTR", "code_information": [{"code": "93458", "type": "CPT"}, {"code": "4613458", "type": "CDM"}, {"code": "481", "type": "RC"}], "standard_charges": [{"gross_charge": 43970.0, "discounted_cash": 32977.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH LSR TURBO BOOSTER", "code_information": [{"code": "C1885", "type": "HCPCS"}, {"code": "4031450", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 28278.0, "discounted_cash": 21208.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH MULT LUM CV", "code_information": [{"code": "C1751", "type": "HCPCS"}, {"code": "8056590", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 859.0, "discounted_cash": 644.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH MUSHROOM MALECOT", "code_information": [{"code": "C1729", "type": "HCPCS"}, {"code": "8056596", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 380.0, "discounted_cash": 285.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH NEPHROSTOMY", "code_information": [{"code": "C1729", "type": "HCPCS"}, {"code": "8056615", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 1179.0, "discounted_cash": 884.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH PERIPH IVL SHOCKWAVE S4", "code_information": [{"code": "C1725", "type": "HCPCS"}, {"code": "8056883", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 48268.0, "discounted_cash": 36201.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH PERIPHL CTO CROSSER", "code_information": [{"code": "C1714", "type": "HCPCS"}, {"code": "4031482", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 28118.0, "discounted_cash": 21088.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH PERIT DIAL LNG TRM", "code_information": [{"code": "C1750", "type": "HCPCS"}, {"code": "4031483", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 2298.0, "discounted_cash": 1723.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH PICC BS VAXCEL", "code_information": [{"code": "C1751", "type": "HCPCS"}, {"code": "8245870", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 959.0, "discounted_cash": 719.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH PICC DL NEONATAL", "code_information": [{"code": "C1751", "type": "HCPCS"}, {"code": "8245905", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 588.0, "discounted_cash": 441.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH PORTACATH", "code_information": [{"code": "C1788", "type": "HCPCS"}, {"code": "8056660", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 2274.0, "discounted_cash": 1705.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH PRPH DIL POLARCATH", "code_information": [{"code": "C1725", "type": "HCPCS"}, {"code": "8240045", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 3900.0, "discounted_cash": 2925.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH PT DEV ARRW TREROTL", "code_information": [{"code": "C1757", "type": "HCPCS"}, {"code": "8240044", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 1130.0, "discounted_cash": 847.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH PTA ADMIRAL XTREME", "code_information": [{"code": "C1725", "type": "HCPCS"}, {"code": "4031335", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 15156.0, "discounted_cash": 11367.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH PTA ADVANC35LP BLN", "code_information": [{"code": "C1725", "type": "HCPCS"}, {"code": "8056669", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 4895.0, "discounted_cash": 3671.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH PTA AMPHIRION DEEP", "code_information": [{"code": "C1725", "type": "HCPCS"}, {"code": "8245964", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 5088.0, "discounted_cash": 3816.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH PTA ARMADA14 BLN", "code_information": [{"code": "C1725", "type": "HCPCS"}, {"code": "8058258", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 3632.0, "discounted_cash": 2724.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH PTA BLN DIL OTW JADE", "code_information": [{"code": "C1725", "type": "HCPCS"}, {"code": "8058230", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 3653.0, "discounted_cash": 2739.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH PTA BLN FF ULTRASCORE", "code_information": [{"code": "C1725", "type": "HCPCS"}, {"code": "8056882", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 10708.0, "discounted_cash": 8031.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH PTA CHOCOLATE BLN", "code_information": [{"code": "C1725", "type": "HCPCS"}, {"code": "8056671", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 12976.0, "discounted_cash": 9732.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH PTA CORDIS MAXI LD", "code_information": [{"code": "C1725", "type": "HCPCS"}, {"code": "8240046", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 3011.0, "discounted_cash": 2258.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH PTA DIL CONQUEST", "code_information": [{"code": "C1725", "type": "HCPCS"}, {"code": "8240059", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 3173.0, "discounted_cash": 2379.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH PTA DORADO", "code_information": [{"code": "C1725", "type": "HCPCS"}, {"code": "4020970", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 1770.0, "discounted_cash": 1327.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH PTA DRUG COATED BLN", "code_information": [{"code": "C2623", "type": "HCPCS"}, {"code": "8056891", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 26812.0, "discounted_cash": 20109.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH PTA EVERCROSS BLN", "code_information": [{"code": "C1725", "type": "HCPCS"}, {"code": "8056663", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 2327.0, "discounted_cash": 1745.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH PTA IN.PACT ADMIRAL", "code_information": [{"code": "C2623", "type": "HCPCS"}, {"code": "8058260", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 13547.0, "discounted_cash": 10160.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH PTA NANOCROSS 014", "code_information": [{"code": "C1725", "type": "HCPCS"}, {"code": "8056672", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 5246.0, "discounted_cash": 3934.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH PTCA APEX OTW BLN", "code_information": [{"code": "C1725", "type": "HCPCS"}, {"code": "8056666", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 9358.0, "discounted_cash": 7018.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH PTCA APEX RX BLN", "code_information": [{"code": "C1725", "type": "HCPCS"}, {"code": "8056667", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 3401.0, "discounted_cash": 2550.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH PTCA MAVERCK MONORL", "code_information": [{"code": "C1725", "type": "HCPCS"}, {"code": "8240845", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 3583.0, "discounted_cash": 2687.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH PTCA MAVERICK OTW", "code_information": [{"code": "C1725", "type": "HCPCS"}, {"code": "8240846", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 3583.0, "discounted_cash": 2687.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH PWR PICC SOLO DL", "code_information": [{"code": "C1751", "type": "HCPCS"}, {"code": "4031501", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 5053.0, "discounted_cash": 3789.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH PWR PICC SOLO SL", "code_information": [{"code": "C1751", "type": "HCPCS"}, {"code": "4031502", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 4373.0, "discounted_cash": 3279.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH PWR PICC SOLO TL", "code_information": [{"code": "C1751", "type": "HCPCS"}, {"code": "4031503", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 4079.0, "discounted_cash": 3059.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH QUANTUM MAVERICK", "code_information": [{"code": "C1725", "type": "HCPCS"}, {"code": "8056682", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 2233.0, "discounted_cash": 1674.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH R&L HRT AR/VNT BPGF", "code_information": [{"code": "93461", "type": "CPT"}, {"code": "4613461", "type": "CDM"}, {"code": "480", "type": "RC"}], "standard_charges": [{"gross_charge": 33494.0, "discounted_cash": 25120.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH R&L HRT AR/VNT BPGF", "code_information": [{"code": "93461", "type": "CPT"}, {"code": "4613461", "type": "CDM"}, {"code": "481", "type": "RC"}], "standard_charges": [{"gross_charge": 33494.0, "discounted_cash": 25120.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH R&L HRT ART/VENT", "code_information": [{"code": "93460", "type": "CPT"}, {"code": "4613460", "type": "CDM"}, {"code": "480", "type": "RC"}], "standard_charges": [{"gross_charge": 30728.0, "discounted_cash": 23046.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH R&L HRT ART/VENT", "code_information": [{"code": "93460", "type": "CPT"}, {"code": "4613460", "type": "CDM"}, {"code": "481", "type": "RC"}], "standard_charges": [{"gross_charge": 30728.0, "discounted_cash": 23046.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH RE-ENTRY ENTEER BLN", "code_information": [{"code": "C1887", "type": "HCPCS"}, {"code": "8056691", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 13564.0, "discounted_cash": 10173.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH REPERFUS ASPIRATION", "code_information": [{"code": "C1887", "type": "HCPCS"}, {"code": "8056689", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 22892.0, "discounted_cash": 17169.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH REPERFUS INTRACRAN", "code_information": [{"code": "C1887", "type": "HCPCS"}, {"code": "4031510", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 28167.0, "discounted_cash": 21125.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH RIGHT HEART", "code_information": [{"code": "93451", "type": "CPT"}, {"code": "4613451", "type": "CDM"}, {"code": "480", "type": "RC"}], "standard_charges": [{"gross_charge": 23570.0, "discounted_cash": 17677.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH RIGHT HEART", "code_information": [{"code": "93451", "type": "CPT"}, {"code": "4613451", "type": "CDM"}, {"code": "481", "type": "RC"}], "standard_charges": [{"gross_charge": 23570.0, "discounted_cash": 17677.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH SHOCKWAVE C2", "code_information": [{"code": "C1761", "type": "HCPCS"}, {"code": "8056916", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 82496.0, "discounted_cash": 61872.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH SHOCKWAVE E8", "code_information": [{"code": "C1725", "type": "HCPCS"}, {"code": "8056919", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 73899.37, "discounted_cash": 55424.53, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH SHOCKWAVE M5 +IVL", "code_information": [{"code": "C1761", "type": "HCPCS"}, {"code": "8056917", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 60555.0, "discounted_cash": 45416.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH SINUS GUIDE", "code_information": [{"code": "C1887", "type": "HCPCS"}, {"code": "8056701", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 3839.0, "discounted_cash": 2879.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH STENT GRAFT BLLN", "code_information": [{"code": "C1725", "type": "HCPCS"}, {"code": "8056716", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 5750.0, "discounted_cash": 4312.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH SUPPORT INTRCRNL SOFIA EX", "code_information": [{"code": "C1887", "type": "HCPCS"}, {"code": "8056728", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 24638.0, "discounted_cash": 18478.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH SUPPORT TRAILBLAZER", "code_information": [{"code": "C1887", "type": "HCPCS"}, {"code": "8056738", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 2667.0, "discounted_cash": 2000.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH SUPPORT USHER", "code_information": [{"code": "C1887", "type": "HCPCS"}, {"code": "8056736", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 5086.0, "discounted_cash": 3814.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH SUPRA", "code_information": [{"code": "C2627", "type": "HCPCS"}, {"code": "8041215", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 849.0, "discounted_cash": 636.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH SUPRAPUBIC", "code_information": [{"code": "C2627", "type": "HCPCS"}, {"code": "8031650", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 1255.0, "discounted_cash": 941.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH TESIO MEDCMP BIOFLX", "code_information": [{"code": "C1750", "type": "HCPCS"}, {"code": "8240851", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 5173.0, "discounted_cash": 3879.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH THORACIC", "code_information": [{"code": "C1729", "type": "HCPCS"}, {"code": "8056780", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 722.0, "discounted_cash": 541.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH THORACIC ANY 2", "code_information": [{"code": "C1729", "type": "HCPCS"}, {"code": "8056779", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 329.0, "discounted_cash": 246.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH THROMB/EMBOLECT 4", "code_information": [{"code": "C1757", "type": "HCPCS"}, {"code": "8240109", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 13426.0, "discounted_cash": 10069.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH THROMB/EMBOLECTOMY", "code_information": [{"code": "C1757", "type": "HCPCS"}, {"code": "8240121", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 7772.0, "discounted_cash": 5829.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH THROMBECTOMY", "code_information": [{"code": "C1757", "type": "HCPCS"}, {"code": "8056687", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 58597.0, "discounted_cash": 43947.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH TRAY DIALYSIS", "code_information": [{"code": "C1752", "type": "HCPCS"}, {"code": "8081016", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 2402.0, "discounted_cash": 1801.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH TRIP-LUMEN", "code_information": [{"code": "C1751", "type": "HCPCS"}, {"code": "8056805", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 2529.0, "discounted_cash": 1896.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH URET FLEXT", "code_information": [{"code": "C1758", "type": "HCPCS"}, {"code": "8041245", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 165.0, "discounted_cash": 123.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH URETERAL", "code_information": [{"code": "C1758", "type": "HCPCS"}, {"code": "8161100", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 536.0, "discounted_cash": 402.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH URETERAL DL", "code_information": [{"code": "C1758", "type": "HCPCS"}, {"code": "8246027", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 1379.0, "discounted_cash": 1034.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH URETERAL WV", "code_information": [{"code": "C1758", "type": "HCPCS"}, {"code": "8041252", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 997.0, "discounted_cash": 747.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH URETHRAL BALLOON", "code_information": [{"code": "C1889", "type": "HCPCS"}, {"code": "8056828", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 45008.0, "discounted_cash": 33756.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH URTRL FLEXIMA", "code_information": [{"code": "C1758", "type": "HCPCS"}, {"code": "8246050", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 1044.0, "discounted_cash": 783.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH US INTRAVASCULAR", "code_information": [{"code": "C1753", "type": "HCPCS"}, {"code": "8240113", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 5328.0, "discounted_cash": 3996.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH US SOUNDSTAR ECO", "code_information": [{"code": "C1759", "type": "HCPCS"}, {"code": "8058288", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 52356.0, "discounted_cash": 39267.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH VAS MIDLN BASIC KIT", "code_information": [{"code": "C1751", "type": "HCPCS"}, {"code": "8056821", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 3732.0, "discounted_cash": 2799.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH VENTR", "code_information": [{"code": "C1729", "type": "HCPCS"}, {"code": "8141275", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 1720.0, "discounted_cash": 1290.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH VENTRICULAR STNDRD", "code_information": [{"code": "C1729", "type": "HCPCS"}, {"code": "8141274", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 2005.0, "discounted_cash": 1503.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CATHETER IVUS", "code_information": [{"code": "C1753", "type": "HCPCS"}, {"code": "8056542", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 10600.0, "discounted_cash": 7950.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CBC AUTO W/O DIFF", "code_information": [{"code": "85027", "type": "CPT"}, {"code": "4100056", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 816.0, "discounted_cash": 612.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CBC AUTO W/O DIFF", "code_information": [{"code": "85027", "type": "CPT"}, {"code": "4170056", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 5.71, "discounted_cash": 4.28, "setting": "both", "billing_class": "facility"}]}, {"description": "CBC WITH AUTO DIFF", "code_information": [{"code": "85025", "type": "CPT"}, {"code": "4105028", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 1044.0, "discounted_cash": 783.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CBC WITH AUTO DIFF", "code_information": [{"code": "85025", "type": "CPT"}, {"code": "4125028", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 12.0, "discounted_cash": 9.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CBC WITH AUTO DIFF", "code_information": [{"code": "85025", "type": "CPT"}, {"code": "4175028", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 5.71, "discounted_cash": 4.28, "setting": "both", "billing_class": "facility"}]}, {"description": "CBC WITH AUTO DIFF", "code_information": [{"code": "85025", "type": "CPT"}, {"code": "7255028", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 27.0, "discounted_cash": 20.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CBL ORTHO W CRIMP", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8131515", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 5109.0, "discounted_cash": 3831.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CBLE FIX BN", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8131513", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 17743.0, "discounted_cash": 13307.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CBLE FIX BN SLEVE", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8131514", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 7411.0, "discounted_cash": 5558.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CEFAZOLIN 500MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0690", "type": "HCPCS"}, {"code": "5318976", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 118.0, "discounted_cash": 88.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CEFAZOLIN 500MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0690", "type": "HCPCS"}, {"code": "5318976", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 118.0, "discounted_cash": 88.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CEFAZOLIN 500MG IVPB IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0690", "type": "HCPCS"}, {"code": "5318973", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 160.0, "discounted_cash": 120.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CEFAZOLIN 500MG IVPB IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0690", "type": "HCPCS"}, {"code": "5318973", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 160.0, "discounted_cash": 120.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CEFAZOLIN 500MG PMX IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0690", "type": "HCPCS"}, {"code": "5318977", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 353.0, "discounted_cash": 264.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CEFAZOLIN 500MG PMX IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0690", "type": "HCPCS"}, {"code": "5318977", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 353.0, "discounted_cash": 264.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CEFAZOLIN NEO PER 1ML IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5318980", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 97.0, "discounted_cash": 72.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CEFDINIR 125/5 5ML PWLQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5314579", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 193.0, "discounted_cash": 144.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CEFDINIR 125/5 5ML PWLQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5314579", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 193.0, "discounted_cash": 144.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CEFDINIR 250/5 5ML PWLQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5314578", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 130.0, "discounted_cash": 97.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CEFDINIR 250/5 5ML PWLQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5314578", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 130.0, "discounted_cash": 97.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CEFDINIR 250/5 60ML PWLQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5314581", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 85.0, "discounted_cash": 63.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CEFDINIR 250/5 60ML PWLQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5314581", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 85.0, "discounted_cash": 63.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CEFDINIR 300MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5302100", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 124.0, "discounted_cash": 93.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CEFDINIR 300MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5302100", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 124.0, "discounted_cash": 93.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CEFEPIME PED PER 1ML IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5318994", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 97.0, "discounted_cash": 72.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CEFEPIME PER 500MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0692", "type": "HCPCS"}, {"code": "5318985", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 372.0, "discounted_cash": 279.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CEFEPIME PER 500MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0692", "type": "HCPCS"}, {"code": "5318985", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 372.0, "discounted_cash": 279.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CEFEPIME PER500MG IVPBIJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0692", "type": "HCPCS"}, {"code": "5318988", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 473.0, "discounted_cash": 354.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CEFEPIME PER500MG IVPBIJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0692", "type": "HCPCS"}, {"code": "5318988", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 473.0, "discounted_cash": 354.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CEFOTAXIME PER 1GM IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0698", "type": "HCPCS"}, {"code": "5319023", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 322.0, "discounted_cash": 241.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CEFOTAXIME PER 1GM IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0698", "type": "HCPCS"}, {"code": "5319023", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 322.0, "discounted_cash": 241.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CEFOTAXIME PER 1ML IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5319027", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 90.0, "discounted_cash": 67.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CEFOTAXIME PER1GM IVPBIJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0698", "type": "HCPCS"}, {"code": "5319022", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 256.0, "discounted_cash": 192.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CEFOTAXIME PER1GM IVPBIJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0698", "type": "HCPCS"}, {"code": "5319022", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 256.0, "discounted_cash": 192.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CEFOXITIN 100MG PEDI IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0694", "type": "HCPCS"}, {"code": "5319055", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 113.0, "discounted_cash": 84.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CEFOXITIN 100MG PEDI IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0694", "type": "HCPCS"}, {"code": "5319055", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 113.0, "discounted_cash": 84.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CEFOXITIN PER 1GM IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0694", "type": "HCPCS"}, {"code": "5319049", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 438.0, "discounted_cash": 328.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CEFOXITIN PER 1GM IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0694", "type": "HCPCS"}, {"code": "5319049", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 438.0, "discounted_cash": 328.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CEFPROZIL 250MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5302119", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 110.0, "discounted_cash": 82.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CEFPROZIL 250MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5302119", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 110.0, "discounted_cash": 82.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CEFPROZIL 250MG/5 5ML LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5314554", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 108.0, "discounted_cash": 81.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CEFPROZIL 250MG/5 5ML LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5314554", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 108.0, "discounted_cash": 81.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CEFTAROLINE PER 10MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0712", "type": "HCPCS"}, {"code": "5319052", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 39.0, "discounted_cash": 29.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CEFTAROLINE PER 10MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0712", "type": "HCPCS"}, {"code": "5319052", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 39.0, "discounted_cash": 29.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CEFTAZ/AVIBAC.5/.125G IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0714", "type": "HCPCS"}, {"code": "5319071", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 1384.0, "discounted_cash": 1038.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CEFTAZ/AVIBAC.5/.125G IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0714", "type": "HCPCS"}, {"code": "5319071", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 1384.0, "discounted_cash": 1038.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CEFTAZIDIME NEO IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J7999", "type": "HCPCS"}, {"code": "5319065", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 90.0, "discounted_cash": 67.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CEFTAZIDIME NEO IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J7999", "type": "HCPCS"}, {"code": "5319065", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 90.0, "discounted_cash": 67.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CEFTAZIDIME PER 1ML IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5319067", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 77.0, "discounted_cash": 57.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CEFTAZIDIME PER 500MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0713", "type": "HCPCS"}, {"code": "5319060", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 242.0, "discounted_cash": 181.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CEFTAZIDIME PER 500MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0713", "type": "HCPCS"}, {"code": "5319060", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 242.0, "discounted_cash": 181.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CEFTOLOZ/TAZOBACT 75MGIJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0695", "type": "HCPCS"}, {"code": "5319074", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 95.0, "discounted_cash": 71.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CEFTOLOZ/TAZOBACT 75MGIJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0695", "type": "HCPCS"}, {"code": "5319074", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 95.0, "discounted_cash": 71.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CEFTRIAX PER250MG IVPBIJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0696", "type": "HCPCS"}, {"code": "5319091", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 339.0, "discounted_cash": 254.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CEFTRIAX PER250MG IVPBIJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0696", "type": "HCPCS"}, {"code": "5319091", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 339.0, "discounted_cash": 254.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CEFTRIAXONE NEO IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0696", "type": "HCPCS"}, {"code": "5319090", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 113.0, "discounted_cash": 84.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CEFTRIAXONE NEO IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0696", "type": "HCPCS"}, {"code": "5319090", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 113.0, "discounted_cash": 84.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CEFTRIAXONE PER 1ML IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5319094", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 113.0, "discounted_cash": 84.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CEFTRIAXONE PER 250MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0696", "type": "HCPCS"}, {"code": "5319082", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 423.0, "discounted_cash": 317.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CEFTRIAXONE PER 250MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0696", "type": "HCPCS"}, {"code": "5319082", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 423.0, "discounted_cash": 317.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CEFUROX PER 750MG IVPBIJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0697", "type": "HCPCS"}, {"code": "5319100", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 211.0, "discounted_cash": 158.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CEFUROX PER 750MG IVPBIJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0697", "type": "HCPCS"}, {"code": "5319100", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 211.0, "discounted_cash": 158.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CEFUROXIME 125/5 100PWLQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5314590", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 828.0, "discounted_cash": 621.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CEFUROXIME 125/5 100PWLQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5314590", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 828.0, "discounted_cash": 621.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CEFUROXIME 250/5 50PWLQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5314593", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 189.0, "discounted_cash": 141.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CEFUROXIME 250/5 50PWLQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5314593", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 189.0, "discounted_cash": 141.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CEFUROXIME 250MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5302121", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 136.0, "discounted_cash": 102.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CEFUROXIME 250MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5302121", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 136.0, "discounted_cash": 102.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CEFUROXIME 500MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5302122", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 130.0, "discounted_cash": 97.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CEFUROXIME 500MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5302122", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 130.0, "discounted_cash": 97.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CEFUROXIME PED PER1ML IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5319108", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 113.0, "discounted_cash": 84.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CEFUROXIME PEDI DOSE IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0697", "type": "HCPCS"}, {"code": "5319107", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 113.0, "discounted_cash": 84.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CEFUROXIME PEDI DOSE IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0697", "type": "HCPCS"}, {"code": "5319107", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 113.0, "discounted_cash": 84.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CEFUROXIME PER 750MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0697", "type": "HCPCS"}, {"code": "5319101", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 287.0, "discounted_cash": 215.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CEFUROXIME PER 750MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0697", "type": "HCPCS"}, {"code": "5319101", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 287.0, "discounted_cash": 215.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CELECOXIB 100MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5302129", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 92.0, "discounted_cash": 69.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CELECOXIB 100MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5302129", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 92.0, "discounted_cash": 69.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CELECOXIB 200MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5302130", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 113.0, "discounted_cash": 84.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CELECOXIB 200MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5302130", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 113.0, "discounted_cash": 84.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CELL COUNT MISC BODY FLD", "code_information": [{"code": "89050", "type": "CPT"}, {"code": "4109050", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 547.0, "discounted_cash": 410.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CELL COUNT MISC BODY FLD", "code_information": [{"code": "89050", "type": "CPT"}, {"code": "4179050", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 8.56, "discounted_cash": 6.42, "setting": "both", "billing_class": "facility"}]}, {"description": "CELL COUNT MISC W/DIFF", "code_information": [{"code": "89051", "type": "CPT"}, {"code": "4109051", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 463.0, "discounted_cash": 347.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CELL COUNT MISC W/DIFF", "code_information": [{"code": "89051", "type": "CPT"}, {"code": "4179051", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 9.98, "discounted_cash": 7.49, "setting": "both", "billing_class": "facility"}]}, {"description": "CELLULAR FUNCTION ASSAY/2", "code_information": [{"code": "86352", "type": "CPT"}, {"code": "7256352", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 246.0, "discounted_cash": 184.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CELLULOSE OXIDIZ 2X14 EA", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3590", "type": "HCPCS"}, {"code": "5337362", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 875.0, "discounted_cash": 656.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CEMT BN", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8131520", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 11506.0, "discounted_cash": 8629.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CEMT BN 2", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8131521", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 1080.0, "discounted_cash": 810.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CEMT BN ANTIFUL BMT CAP", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "4011888", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 5539.0, "discounted_cash": 4154.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CEMT BN CEMEX FAST 70G", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "4011996", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 4774.0, "discounted_cash": 3580.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CEMT BN PL FUL BIOMT CAP", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "4011886", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 954.0, "discounted_cash": 715.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CEMT BN W/ANTIBIOTIC", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8131522", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 4044.0, "discounted_cash": 3033.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CEMT BON", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8173505", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 1130.0, "discounted_cash": 847.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CEPHALEXIN 250MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5302204", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 78.0, "discounted_cash": 58.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CEPHALEXIN 250MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5302204", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 78.0, "discounted_cash": 58.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CEPHALEXIN 500MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5302208", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 72.0, "discounted_cash": 54.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CEPHALEXIN 500MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5302208", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 72.0, "discounted_cash": 54.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CEPHALEXIN250/5 100 PWLQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5314568", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 429.0, "discounted_cash": 321.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CEPHALEXIN250/5 100 PWLQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5314568", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 429.0, "discounted_cash": 321.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CEPHALEXIN250/5 5ML PWLQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5314566", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 61.0, "discounted_cash": 45.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CEPHALEXIN250/5 5ML PWLQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5314566", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 61.0, "discounted_cash": 45.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CERULOPLASMIN", "code_information": [{"code": "82390", "type": "CPT"}, {"code": "4102390", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 576.0, "discounted_cash": 432.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CERULOPLASMIN", "code_information": [{"code": "82390", "type": "CPT"}, {"code": "7252390", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 422.0, "discounted_cash": 316.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CERVICAL MYELO LUMB INJ", "code_information": [{"code": "4902301", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 2884.0, "discounted_cash": 2163.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CERVICAL MYELO LUMB INJ", "code_information": [{"code": "4912301", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 4591.0, "discounted_cash": 3443.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CETIRIZINE 10MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5302246", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 86.0, "discounted_cash": 64.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CETIRIZINE 10MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5302246", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 86.0, "discounted_cash": 64.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CETIRIZINE 1MG/ML 5ML LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5314594", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 66.0, "discounted_cash": 49.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CETIRIZINE 1MG/ML 5ML LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5314594", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 66.0, "discounted_cash": 49.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CETIRIZINE 5MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5302245", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 86.0, "discounted_cash": 64.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CETIRIZINE 5MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5302245", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 86.0, "discounted_cash": 64.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CETYLPYRDN/BENZO 9PK LZ", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5312252", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 85.0, "discounted_cash": 63.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CETYLPYRDN/BENZO 9PK LZ", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5312252", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 85.0, "discounted_cash": 63.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CFTR COMMON VARIANTS/2", "code_information": [{"code": "81220", "type": "CPT"}, {"code": "7259204", "type": "CDM"}, {"code": "310", "type": "RC"}], "standard_charges": [{"gross_charge": 361.0, "discounted_cash": 270.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CH GTUBE TO GJTUBE W/FLU", "code_information": [{"code": "4919446", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 3519.0, "discounted_cash": 2639.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CHANGE BILIARY DRAIN CTH", "code_information": [{"code": "4917515", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 4857.0, "discounted_cash": 3642.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CHANGE NEPHROSTOMY TUBE", "code_information": [{"code": "4917520", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 4737.0, "discounted_cash": 3552.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CHANGE PERC DRAIN CATH", "code_information": [{"code": "75984", "type": "CPT"}, {"code": "4915985", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 1004.0, "discounted_cash": 753.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CHANGE URETER STENT PERC", "code_information": [{"code": "4917526", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 12808.0, "discounted_cash": 9606.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CHANGE URETER STENT TRAN", "code_information": [{"code": "4910387", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 7379.0, "discounted_cash": 5534.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CHANGE URETEROSTOMY TUBE", "code_information": [{"code": "4917525", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 4472.0, "discounted_cash": 3354.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CHAR/SORB25GM/120ML LQ", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5314033", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 255.0, "discounted_cash": 191.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CHAR/SORB25GM/120ML LQ", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5314033", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 255.0, "discounted_cash": 191.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CHAR/SORB50GM/240ML LQ", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5314034", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 352.0, "discounted_cash": 264.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CHAR/SORB50GM/240ML LQ", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5314034", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 352.0, "discounted_cash": 264.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CHEM CAUTERY OF TISSUE", "code_information": [{"code": "6904010", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 853.0, "discounted_cash": 639.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CHEM CAUTERY OF TISSUE", "code_information": [{"code": "6904010", "type": "CDM"}, {"code": "361", "type": "RC"}], "standard_charges": [{"gross_charge": 853.0, "discounted_cash": 639.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CHEMILUMINESCENT ASY/2", "code_information": [{"code": "82397", "type": "CPT"}, {"code": "7252397", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 1232.0, "discounted_cash": 924.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CHEMILUMINESCENT ASY/3", "code_information": [{"code": "82397", "type": "CPT"}, {"code": "7252398", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 476.0, "discounted_cash": 357.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CHEMILUMINESCENT ASY/6", "code_information": [{"code": "82397", "type": "CPT"}, {"code": "7253558", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 178.0, "discounted_cash": 133.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CHEMILUMNESCENT ASY", "code_information": [{"code": "82397", "type": "CPT"}, {"code": "7252396", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 482.0, "discounted_cash": 361.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CHEST 1 VIEW", "code_information": [{"code": "71045", "type": "CPT"}, {"code": "4901045", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 2558.0, "discounted_cash": 1918.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CHEST 1 VIEW", "code_information": [{"code": "71045", "type": "CPT"}, {"code": "5111045", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 1608.0, "discounted_cash": 1206.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CHEST 2 VIEWS", "code_information": [{"code": "71046", "type": "CPT"}, {"code": "4901046", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 2638.0, "discounted_cash": 1978.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CHEST 2 VIEWS", "code_information": [{"code": "71046", "type": "CPT"}, {"code": "5111046", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 2302.0, "discounted_cash": 1726.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CHEST 3 VIEWS", "code_information": [{"code": "71047", "type": "CPT"}, {"code": "4901047", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 461.0, "discounted_cash": 345.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CHEST 3 VIEWS", "code_information": [{"code": "71047", "type": "CPT"}, {"code": "5111047", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 461.0, "discounted_cash": 345.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CHIKUNGUNYA AB", "code_information": [{"code": "86790", "type": "CPT"}, {"code": "7256799", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 208.0, "discounted_cash": 156.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CHIKUNGUNYA AB/2", "code_information": [{"code": "86790", "type": "CPT"}, {"code": "7256801", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 208.0, "discounted_cash": 156.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CHLAMYDIA AB/5", "code_information": [{"code": "86631", "type": "CPT"}, {"code": "7256903", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 726.0, "discounted_cash": 544.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CHLAMYDIA AMP PROBE", "code_information": [{"code": "87491", "type": "CPT"}, {"code": "4107492", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 213.0, "discounted_cash": 159.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CHLAMYDIA AMP PROBE/2", "code_information": [{"code": "87491", "type": "CPT"}, {"code": "7257492", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 65.0, "discounted_cash": 48.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CHLAMYDIA DIRECT PRB", "code_information": [{"code": "87490", "type": "CPT"}, {"code": "4107170", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 331.0, "discounted_cash": 248.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CHLAMYDIA IGM/2", "code_information": [{"code": "86632", "type": "CPT"}, {"code": "7256632", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 33.0, "discounted_cash": 24.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CHLAMYDIA PNEUM AMP PRB", "code_information": [{"code": "87486", "type": "CPT"}, {"code": "4106321", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 85.0, "discounted_cash": 63.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CHLAMYDIA PNEUM AMP PRB", "code_information": [{"code": "87486", "type": "CPT"}, {"code": "7257488", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 315.0, "discounted_cash": 236.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CHLORAL HYD500/5 5ML LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5314615", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 83.0, "discounted_cash": 62.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CHLORAL HYD500/5 5ML LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5314615", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 83.0, "discounted_cash": 62.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CHLORAMPHENIC UPTO1GM IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0720", "type": "HCPCS"}, {"code": "5319193", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 1026.0, "discounted_cash": 769.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CHLORAMPHENIC UPTO1GM IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0720", "type": "HCPCS"}, {"code": "5319193", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 1026.0, "discounted_cash": 769.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CHLORDIAZEPOXIDE 25MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5302393", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 61.0, "discounted_cash": 45.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CHLORDIAZEPOXIDE 25MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5302393", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 61.0, "discounted_cash": 45.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CHLORDIAZEPOXIDE 5MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5302385", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 61.0, "discounted_cash": 45.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CHLORDIAZEPOXIDE 5MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5302385", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 61.0, "discounted_cash": 45.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CHLORHEXID ORAL CARE KT", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5334777", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 85.0, "discounted_cash": 63.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CHLORHEXID ORAL CARE KT", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5334777", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 85.0, "discounted_cash": 63.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CHLORHEXIDINE 15ML LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5314638", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 71.0, "discounted_cash": 53.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CHLORHEXIDINE 15ML LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5314638", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 71.0, "discounted_cash": 53.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CHLORIDE", "code_information": [{"code": "82435", "type": "CPT"}, {"code": "4102439", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 417.0, "discounted_cash": 312.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CHLORIDE", "code_information": [{"code": "82435", "type": "CPT"}, {"code": "4172439", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 1.12, "discounted_cash": 0.84, "setting": "both", "billing_class": "facility"}]}, {"description": "CHLORIDE OTHER SOURCE", "code_information": [{"code": "82438", "type": "CPT"}, {"code": "4172438", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 1.32, "discounted_cash": 0.99, "setting": "both", "billing_class": "facility"}]}, {"description": "CHLORIDE OTHER SOURCE", "code_information": [{"code": "82438", "type": "CPT"}, {"code": "7252438", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 474.0, "discounted_cash": 355.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CHLORIDE OTHER SOURCE/2", "code_information": [{"code": "82438", "type": "CPT"}, {"code": "4102438", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 485.0, "discounted_cash": 363.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CHLORIDE URINE", "code_information": [{"code": "82436", "type": "CPT"}, {"code": "4102435", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 414.0, "discounted_cash": 310.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CHLORIDE URINE", "code_information": [{"code": "82436", "type": "CPT"}, {"code": "4172435", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 1.32, "discounted_cash": 0.99, "setting": "both", "billing_class": "facility"}]}, {"description": "CHLORIDE URINE/2", "code_information": [{"code": "82436", "type": "CPT"}, {"code": "4102436", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 380.0, "discounted_cash": 285.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CHLORIDE URINE/2", "code_information": [{"code": "82436", "type": "CPT"}, {"code": "4172436", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 1.12, "discounted_cash": 0.84, "setting": "both", "billing_class": "facility"}]}, {"description": "CHLOROTHIAZIDE PER1ML LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5314669", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 84.0, "discounted_cash": 63.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CHLOROTHIAZIDE PER1ML LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5314669", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 84.0, "discounted_cash": 63.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CHLORPROMAZ UPTO 50MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3230", "type": "HCPCS"}, {"code": "5319309", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 711.0, "discounted_cash": 533.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CHLORPROMAZ UPTO 50MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3230", "type": "HCPCS"}, {"code": "5319309", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 711.0, "discounted_cash": 533.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CHLORPROMAZINE 100MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5302600", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 66.0, "discounted_cash": 49.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CHLORPROMAZINE 100MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5302600", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 66.0, "discounted_cash": 49.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CHLORPROMAZINE 10MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5302590", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 61.0, "discounted_cash": 45.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CHLORPROMAZINE 10MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5302590", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 61.0, "discounted_cash": 45.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CHLORPROMAZINE 25MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5302594", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 61.0, "discounted_cash": 45.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CHLORPROMAZINE 25MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5302594", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 61.0, "discounted_cash": 45.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CHLORTHIAZIDE250 5ML LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5314671", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 66.0, "discounted_cash": 49.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CHLORTHIAZIDE250 5ML LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5314671", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 66.0, "discounted_cash": 49.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CHOLANGIO INTRAOP S&I INIT", "code_information": [{"code": "74300", "type": "CPT"}, {"code": "4904300", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 2716.0, "discounted_cash": 2037.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CHOLANGIO+INJ EXIST CTH", "code_information": [{"code": "4907531", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 1952.0, "discounted_cash": 1464.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CHOLANGIO+INJ EXIST CTH", "code_information": [{"code": "4917531", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 1315.0, "discounted_cash": 986.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CHOLANGIO+INJ NEW", "code_information": [{"code": "4917532", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 9394.0, "discounted_cash": 7045.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CHOLESTEROL", "code_information": [{"code": "84311", "type": "CPT"}, {"code": "4104311", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 626.0, "discounted_cash": 469.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CHOLESTEROL", "code_information": [{"code": "84311", "type": "CPT"}, {"code": "4176366", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 7.14, "discounted_cash": 5.36, "setting": "both", "billing_class": "facility"}]}, {"description": "CHOLESTEROL", "code_information": [{"code": "84311", "type": "CPT"}, {"code": "7258432", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 92.0, "discounted_cash": 69.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CHOLESTEROL HDL", "code_information": [{"code": "83718", "type": "CPT"}, {"code": "4102477", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 761.0, "discounted_cash": 570.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CHOLESTEROL HDL", "code_information": [{"code": "83718", "type": "CPT"}, {"code": "4172477", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 5.71, "discounted_cash": 4.28, "setting": "both", "billing_class": "facility"}]}, {"description": "CHOLESTEROL TOTAL", "code_information": [{"code": "82465", "type": "CPT"}, {"code": "4102465", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 352.0, "discounted_cash": 264.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CHOLESTEROL TOTAL", "code_information": [{"code": "82465", "type": "CPT"}, {"code": "4172465", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 1.12, "discounted_cash": 0.84, "setting": "both", "billing_class": "facility"}]}, {"description": "CHOLESTYRAMINE 4GM PWLQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5314680", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 61.0, "discounted_cash": 45.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CHOLESTYRAMINE 4GM PWLQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5314680", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 61.0, "discounted_cash": 45.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CHOLINESTERASE PSEUDO/3", "code_information": [{"code": "82480", "type": "CPT"}, {"code": "7252483", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 585.0, "discounted_cash": 438.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CHOLINESTERASE RBC", "code_information": [{"code": "82482", "type": "CPT"}, {"code": "7252482", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 585.0, "discounted_cash": 438.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CHRM ANAL 15-20 CELL W/BND", "code_information": [{"code": "88262", "type": "CPT"}, {"code": "7068255", "type": "CDM"}, {"code": "310", "type": "RC"}], "standard_charges": [{"gross_charge": 1437.0, "discounted_cash": 1077.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CHRM ANAL 15-20 CELL W/BND", "code_information": [{"code": "88262", "type": "CPT"}, {"code": "7258256", "type": "CDM"}, {"code": "310", "type": "RC"}], "standard_charges": [{"gross_charge": 1777.0, "discounted_cash": 1332.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CHRM ANAL 20-25 CELLS", "code_information": [{"code": "88264", "type": "CPT"}, {"code": "7038264", "type": "CDM"}, {"code": "310", "type": "RC"}], "standard_charges": [{"gross_charge": 533.0, "discounted_cash": 399.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CHRM ANAL 20-25 CELLS", "code_information": [{"code": "88264", "type": "CPT"}, {"code": "7258242", "type": "CDM"}, {"code": "310", "type": "RC"}], "standard_charges": [{"gross_charge": 457.0, "discounted_cash": 342.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CHRM ANAL 5 CELL W/BND", "code_information": [{"code": "88261", "type": "CPT"}, {"code": "7258247", "type": "CDM"}, {"code": "310", "type": "RC"}], "standard_charges": [{"gross_charge": 5078.0, "discounted_cash": 3808.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CHRMSM BRKG 50-100 CELLS", "code_information": [{"code": "88248", "type": "CPT"}, {"code": "7258263", "type": "CDM"}, {"code": "310", "type": "RC"}], "standard_charges": [{"gross_charge": 2990.0, "discounted_cash": 2242.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CHROM/MASS SPEC NES QL/10", "code_information": [{"code": "82542", "type": "CPT"}, {"code": "7252551", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 1031.0, "discounted_cash": 773.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CHROM/MASS SPEC NES QL/13", "code_information": [{"code": "82542", "type": "CPT"}, {"code": "7252566", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 66.0, "discounted_cash": 49.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CHROM/MASS SPEC NES QL/14", "code_information": [{"code": "82542", "type": "CPT"}, {"code": "7252567", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 569.0, "discounted_cash": 426.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CHROM/MASS SPEC NES QL/15", "code_information": [{"code": "82542", "type": "CPT"}, {"code": "7252568", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 83.0, "discounted_cash": 62.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CHROM/MASS SPEC NES QL/21", "code_information": [{"code": "82542", "type": "CPT"}, {"code": "7254124", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 583.0, "discounted_cash": 437.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CHROM/MASS SPEC NES QL/22", "code_information": [{"code": "82542", "type": "CPT"}, {"code": "7255428", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 780.0, "discounted_cash": 585.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CHROM/MASS SPEC NES QL/28", "code_information": [{"code": "82542", "type": "CPT"}, {"code": "7258333", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 853.0, "discounted_cash": 639.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CHROM/MASS SPEC NES QL/4", "code_information": [{"code": "82542", "type": "CPT"}, {"code": "7252491", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 2324.0, "discounted_cash": 1743.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CHROMIUM/2", "code_information": [{"code": "82495", "type": "CPT"}, {"code": "7252495", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 53.0, "discounted_cash": 39.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CHROMO ADD KARYOTYPES EA/2", "code_information": [{"code": "88280", "type": "CPT"}, {"code": "7038280", "type": "CDM"}, {"code": "310", "type": "RC"}], "standard_charges": [{"gross_charge": 113.0, "discounted_cash": 84.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CHROMO ADD KARYOTYPES EA/2", "code_information": [{"code": "88280", "type": "CPT"}, {"code": "7258280", "type": "CDM"}, {"code": "310", "type": "RC"}], "standard_charges": [{"gross_charge": 501.0, "discounted_cash": 375.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CHST WALL MANIPULATN INI", "code_information": [{"code": "94667", "type": "CPT"}, {"code": "5504667", "type": "CDM"}, {"code": "410", "type": "RC"}], "standard_charges": [{"gross_charge": 896.0, "discounted_cash": 672.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CHST WALL MANIPULATN SUB", "code_information": [{"code": "94668", "type": "CPT"}, {"code": "5504668", "type": "CDM"}, {"code": "410", "type": "RC"}], "standard_charges": [{"gross_charge": 780.0, "discounted_cash": 585.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CICLOPIROX .77% 15GM CR", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5334848", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 561.0, "discounted_cash": 420.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CICLOPIROX .77% 15GM CR", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5334848", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 561.0, "discounted_cash": 420.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CILOSTAZOL 100MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5302731", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 85.0, "discounted_cash": 63.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CILOSTAZOL 100MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5302731", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 85.0, "discounted_cash": 63.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CILOSTAZOL 50MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5302730", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 61.0, "discounted_cash": 45.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CILOSTAZOL 50MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5302730", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 61.0, "discounted_cash": 45.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CINACALCET 30MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5302762", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 284.0, "discounted_cash": 213.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CINACALCET 30MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5302762", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 284.0, "discounted_cash": 213.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CIPROFLOX PER200MG PMXIJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0744", "type": "HCPCS"}, {"code": "5319388", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 689.0, "discounted_cash": 516.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CIPROFLOX PER200MG PMXIJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0744", "type": "HCPCS"}, {"code": "5319388", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 689.0, "discounted_cash": 516.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CIPROFLOX/DEXM 7.5ML OT", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5330543", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 1565.0, "discounted_cash": 1173.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CIPROFLOX/DEXM 7.5ML OT", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5330543", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 1565.0, "discounted_cash": 1173.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CIPROFLOXACIN .3% 5ML OS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5330547", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 776.0, "discounted_cash": 582.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CIPROFLOXACIN .3% 5ML OS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5330547", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 776.0, "discounted_cash": 582.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CIPROFLOXACIN 250MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5302775", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 100.0, "discounted_cash": 75.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CIPROFLOXACIN 250MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5302775", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 100.0, "discounted_cash": 75.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CIPROFLOXACIN 500MGTB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5302776", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 162.0, "discounted_cash": 121.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CIPROFLOXACIN 500MGTB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5302776", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 162.0, "discounted_cash": 121.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CIPROFLOXACIN 750MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5302777", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 147.0, "discounted_cash": 110.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CIPROFLOXACIN 750MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5302777", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 147.0, "discounted_cash": 110.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CIPROFLOXACIN.3%2.5MLOS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5330546", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 380.0, "discounted_cash": 285.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CIPROFLOXACIN.3%2.5MLOS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5330546", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 380.0, "discounted_cash": 285.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CIPROFLOXACIN.3%3.5GM OO", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5330549", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 1206.0, "discounted_cash": 904.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CIPROFLOXACIN.3%3.5GM OO", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5330549", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 1206.0, "discounted_cash": 904.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CIPROFLOXACIN/HCTS10MLOT", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5334855", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 997.0, "discounted_cash": 747.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CIPROFLOXACIN/HCTS10MLOT", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5334855", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 997.0, "discounted_cash": 747.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CIPROFLOXACN PER 200MGIJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0744", "type": "HCPCS"}, {"code": "5319385", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 616.0, "discounted_cash": 462.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CIPROFLOXACN PER 200MGIJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0744", "type": "HCPCS"}, {"code": "5319385", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 616.0, "discounted_cash": 462.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CIRCUMCISION", "code_information": [{"code": "3110150", "type": "CDM"}, {"code": "723", "type": "RC"}], "standard_charges": [{"gross_charge": 2262.0, "discounted_cash": 1696.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CISATRACURIM 10MG/1ML IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5319393", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 592.0, "discounted_cash": 444.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CISATRACURM 2MG/ML 5MLIJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5319391", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 543.0, "discounted_cash": 407.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CISATRACURM 2MG/ML10MLIJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5319392", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 1323.0, "discounted_cash": 992.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CISATRACURM10MG/ML20MLIJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5319390", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 4231.0, "discounted_cash": 3173.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CISTERNOGRAM", "code_information": [{"code": "78630", "type": "CPT"}, {"code": "5208630", "type": "CDM"}, {"code": "341", "type": "RC"}], "standard_charges": [{"gross_charge": 5382.0, "discounted_cash": 4036.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CITALOPRAM 20MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5302773", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 108.0, "discounted_cash": 81.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CITALOPRAM 20MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5302773", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 108.0, "discounted_cash": 81.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CITRATE MG 300ML LQ", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5314754", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 99.0, "discounted_cash": 74.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CITRATE MG 300ML LQ", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5314754", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 99.0, "discounted_cash": 74.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CITRATE/2", "code_information": [{"code": "82507", "type": "CPT"}, {"code": "7252509", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 1171.0, "discounted_cash": 878.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CK MB FRACTION", "code_information": [{"code": "82553", "type": "CPT"}, {"code": "4102553", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 1001.0, "discounted_cash": 750.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CK MB FRACTION", "code_information": [{"code": "82553", "type": "CPT"}, {"code": "4172553", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 4.29, "discounted_cash": 3.22, "setting": "both", "billing_class": "facility"}]}, {"description": "CK MB FRACTION", "code_information": [{"code": "82553", "type": "CPT"}, {"code": "7252553", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 98.0, "discounted_cash": 73.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CLARITHROMY125/5 50 PWLQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5314753", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 592.0, "discounted_cash": 444.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CLARITHROMY125/5 50 PWLQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5314753", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 592.0, "discounted_cash": 444.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CLARITHROMY250/5 100PWLQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5314757", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 916.3, "discounted_cash": 687.23, "setting": "both", "billing_class": "facility"}]}, {"description": "CLARITHROMY250/5 100PWLQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5314757", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 916.3, "discounted_cash": 687.23, "setting": "both", "billing_class": "facility"}]}, {"description": "CLARITHROMY250/5 50 PWLQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5314759", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 598.0, "discounted_cash": 448.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CLARITHROMY250/5 50 PWLQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5314759", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 598.0, "discounted_cash": 448.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CLARITHROMYCIN 250MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5302780", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 147.0, "discounted_cash": 110.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CLARITHROMYCIN 250MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5302780", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 147.0, "discounted_cash": 110.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CLAVICLE COMPLETE", "code_information": [{"code": "73000", "type": "CPT"}, {"code": "4903000", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 1372.0, "discounted_cash": 1029.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CLAVICLE COMPLETE", "code_information": [{"code": "73000", "type": "CPT"}, {"code": "5113000", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 1301.0, "discounted_cash": 975.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CLINDAMYC PER1ML CMPD LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5314772", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 85.0, "discounted_cash": 63.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CLINDAMYC PER1ML CMPD LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5314772", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 85.0, "discounted_cash": 63.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CLINDAMYCIN 1% 30ML TS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5334866", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 787.0, "discounted_cash": 590.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CLINDAMYCIN 1% 30ML TS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5334866", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 787.0, "discounted_cash": 590.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CLINDAMYCIN 1% 60ML TS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5334867", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 856.0, "discounted_cash": 642.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CLINDAMYCIN 1% 60ML TS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5334867", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 856.0, "discounted_cash": 642.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CLINDAMYCIN 150MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5302814", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 61.0, "discounted_cash": 45.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CLINDAMYCIN 150MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5302814", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 61.0, "discounted_cash": 45.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CLINDAMYCIN 300MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5302818", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 174.0, "discounted_cash": 130.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CLINDAMYCIN 300MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5302818", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 174.0, "discounted_cash": 130.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CLINDAMYCIN 75/5 100PWLQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5314770", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 694.0, "discounted_cash": 520.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CLINDAMYCIN 75/5 100PWLQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5314770", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 694.0, "discounted_cash": 520.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CLINDAMYCIN 75/5 5MLPWLQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5314769", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 26.0, "discounted_cash": 19.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CLINDAMYCIN 75/5 5MLPWLQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5314769", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 26.0, "discounted_cash": 19.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CLINDAMYCIN PED IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0736", "type": "HCPCS"}, {"code": "5319435", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 16.0, "discounted_cash": 12.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CLINDAMYCIN PED IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0736", "type": "HCPCS"}, {"code": "5319435", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 16.0, "discounted_cash": 12.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CLINDAMYCIN PER 1ML IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5319428", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 113.0, "discounted_cash": 84.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CLINDAMYCIN PER 300MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0736", "type": "HCPCS"}, {"code": "5319424", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 124.0, "discounted_cash": 93.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CLINDAMYCIN PER 300MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0736", "type": "HCPCS"}, {"code": "5319424", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 124.0, "discounted_cash": 93.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CLINDAMYCIN PER 300MG PMX IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0736", "type": "HCPCS"}, {"code": "5319425", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 588.0, "discounted_cash": 441.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CLINDAMYCIN PER 300MG PMX IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0736", "type": "HCPCS"}, {"code": "5319425", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 588.0, "discounted_cash": 441.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CLIP ANEURANEUR", "code_information": [{"code": "C1889", "type": "HCPCS"}, {"code": "8141285", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 2761.0, "discounted_cash": 2070.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CLIP ANEURP", "code_information": [{"code": "C1889", "type": "HCPCS"}, {"code": "8141290", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 3815.0, "discounted_cash": 2861.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CLIP ANUERSYM", "code_information": [{"code": "C1889", "type": "HCPCS"}, {"code": "8151210", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 3011.0, "discounted_cash": 2258.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CLLAR CERV ADJ BR TH EX", "code_information": [{"code": "L0200", "type": "HCPCS"}, {"code": "8131542", "type": "CDM"}, {"code": "274", "type": "RC"}], "standard_charges": [{"gross_charge": 11135.0, "discounted_cash": 8351.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CLMP CRANIAL TITANIUM", "code_information": [{"code": "L8699", "type": "HCPCS"}, {"code": "8192009", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 3114.0, "discounted_cash": 2335.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CLOBAZAM 10MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5302851", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 1366.0, "discounted_cash": 1024.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CLOBAZAM 10MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5302851", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 1366.0, "discounted_cash": 1024.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CLOBAZAM 2.5MG/ML 1ML LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5314775", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 159.0, "discounted_cash": 119.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CLOBAZAM 2.5MG/ML 1ML LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5314775", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 159.0, "discounted_cash": 119.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CLOBAZAM 5MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5302850", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 681.0, "discounted_cash": 510.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CLOBAZAM 5MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5302850", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 681.0, "discounted_cash": 510.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CLOBETASOL .05% 15GM CR", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5334868", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 549.0, "discounted_cash": 411.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CLOBETASOL .05% 15GM CR", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5334868", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 549.0, "discounted_cash": 411.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CLOBETASOL .05% 15GM OI", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5334924", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 960.0, "discounted_cash": 720.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CLOBETASOL .05% 15GM OI", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5334924", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 960.0, "discounted_cash": 720.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CLOBETASOL .05% 25ML TS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5334861", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 467.0, "discounted_cash": 350.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CLOBETASOL .05% 25ML TS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5334861", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 467.0, "discounted_cash": 350.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CLONAZEPAM .5MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5302910", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 72.0, "discounted_cash": 54.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CLONAZEPAM .5MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5302910", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 72.0, "discounted_cash": 54.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CLONAZEPAM 1ML CMPD LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5314778", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 13.0, "discounted_cash": 9.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CLONAZEPAM 1ML CMPD LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5314778", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 13.0, "discounted_cash": 9.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CLONAZEPAM 2MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5302918", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 47.0, "discounted_cash": 35.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CLONAZEPAM 2MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5302918", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 47.0, "discounted_cash": 35.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CLONIDINE .1MG XR TD", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5334897", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 305.0, "discounted_cash": 228.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CLONIDINE .1MG XR TD", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5334897", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 305.0, "discounted_cash": 228.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CLONIDINE .2MG XR TD", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5334899", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 519.0, "discounted_cash": 389.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CLONIDINE .2MG XR TD", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5334899", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 519.0, "discounted_cash": 389.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CLONIDINE .3MG XR TD", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5334901", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 608.0, "discounted_cash": 456.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CLONIDINE .3MG XR TD", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5334901", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 608.0, "discounted_cash": 456.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CLONIDINE 0.1MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5302941", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 85.0, "discounted_cash": 63.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CLONIDINE 0.1MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5302941", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 85.0, "discounted_cash": 63.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CLONIDINE 0.2MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5302945", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 85.0, "discounted_cash": 63.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CLONIDINE 0.2MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5302945", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 85.0, "discounted_cash": 63.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CLONIDINE 0.3MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5302949", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 61.0, "discounted_cash": 45.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CLONIDINE 0.3MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5302949", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 61.0, "discounted_cash": 45.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CLOPIDOGREL 300MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5302970", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 500.0, "discounted_cash": 375.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CLOPIDOGREL 300MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5302970", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 500.0, "discounted_cash": 375.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CLOPIDOGREL 75MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5302965", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 156.0, "discounted_cash": 117.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CLOPIDOGREL 75MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5302965", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 156.0, "discounted_cash": 117.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CLORAZEPATE 3.75MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5302976", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 85.0, "discounted_cash": 63.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CLORAZEPATE 3.75MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5302976", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 85.0, "discounted_cash": 63.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CLOSTRIDIUM IA", "code_information": [{"code": "87324", "type": "CPT"}, {"code": "4105006", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 244.0, "discounted_cash": 183.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CLOSTRIDIUM IA", "code_information": [{"code": "87324", "type": "CPT"}, {"code": "4175006", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 32.83, "discounted_cash": 24.62, "setting": "both", "billing_class": "facility"}]}, {"description": "CLOSTRIDIUM IA", "code_information": [{"code": "87324", "type": "CPT"}, {"code": "7255006", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 28.0, "discounted_cash": 21.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CLOSTRIDIUM IA/2", "code_information": [{"code": "87324", "type": "CPT"}, {"code": "4107324", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 22.0, "discounted_cash": 16.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CLOSURE OF SPLIT WOUND", "code_information": [{"code": "6902020", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 7373.0, "discounted_cash": 5529.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CLOSURE OF SPLIT WOUND", "code_information": [{"code": "6902020", "type": "CDM"}, {"code": "361", "type": "RC"}], "standard_charges": [{"gross_charge": 7373.0, "discounted_cash": 5529.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CLOT FACTOR II PRTHRMBN", "code_information": [{"code": "85210", "type": "CPT"}, {"code": "7255210", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 164.0, "discounted_cash": 123.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CLOT FACTOR V (LABILE)", "code_information": [{"code": "85220", "type": "CPT"}, {"code": "4105220", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 2384.0, "discounted_cash": 1788.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CLOT FACTOR VII(STABLE)", "code_information": [{"code": "85230", "type": "CPT"}, {"code": "4105230", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 2384.0, "discounted_cash": 1788.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CLOT FACTOR VII(STABLE)", "code_information": [{"code": "85230", "type": "CPT"}, {"code": "7255230", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 156.0, "discounted_cash": 117.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CLOT FCTR IX(PTC/XMAS)", "code_information": [{"code": "85250", "type": "CPT"}, {"code": "4105250", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 2182.0, "discounted_cash": 1636.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CLOT FCTR IX(PTC/XMAS)", "code_information": [{"code": "85250", "type": "CPT"}, {"code": "7255250", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 356.0, "discounted_cash": 267.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CLOT FCTR VIII RELATE AG", "code_information": [{"code": "85244", "type": "CPT"}, {"code": "7258524", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 1182.0, "discounted_cash": 886.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CLOT FCTR VIII(AHG)1 STG", "code_information": [{"code": "85240", "type": "CPT"}, {"code": "4105240", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 1481.0, "discounted_cash": 1110.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CLOT FCTR VIII(AHG)1 STG", "code_information": [{"code": "85240", "type": "CPT"}, {"code": "7255240", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 996.0, "discounted_cash": 747.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CLOT FCTR X(STUART-PRWR)", "code_information": [{"code": "85260", "type": "CPT"}, {"code": "4105260", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 389.0, "discounted_cash": 291.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CLOT FCTR X(STUART-PRWR)", "code_information": [{"code": "85260", "type": "CPT"}, {"code": "7255260", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 284.0, "discounted_cash": 213.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CLOT FCTR XI(PTA)", "code_information": [{"code": "85270", "type": "CPT"}, {"code": "4105270", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 751.0, "discounted_cash": 563.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CLOT FCTR XI(PTA)", "code_information": [{"code": "85270", "type": "CPT"}, {"code": "7255270", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 550.0, "discounted_cash": 412.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CLOT FCTR XII(HAGEMANN)", "code_information": [{"code": "85280", "type": "CPT"}, {"code": "4105280", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 1056.0, "discounted_cash": 792.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CLOT FCTR XII(HAGEMANN)", "code_information": [{"code": "85280", "type": "CPT"}, {"code": "7255280", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 772.0, "discounted_cash": 579.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CLOT FCTR XIII SCREEN", "code_information": [{"code": "85291", "type": "CPT"}, {"code": "7258529", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 39.0, "discounted_cash": 29.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CLOT FCTR XIII(FBRN STB)", "code_information": [{"code": "85290", "type": "CPT"}, {"code": "7255290", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 488.0, "discounted_cash": 366.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CLOTRIMAZ/BETAMET 15GMCR", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5334893", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 657.0, "discounted_cash": 492.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CLOTRIMAZ/BETAMET 15GMCR", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5334893", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 657.0, "discounted_cash": 492.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CLOTRIMAZOL 2% 21GM V CR", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5338261", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 160.0, "discounted_cash": 120.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CLOTRIMAZOL 2% 21GM V CR", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5338261", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 160.0, "discounted_cash": 120.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CLOTRIMAZOLE 1% 30GM CR", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5334874", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 152.0, "discounted_cash": 114.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CLOTRIMAZOLE 1% 30GM CR", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5334874", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 152.0, "discounted_cash": 114.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CLOTRIMAZOLE 1%45GM VCR", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5334884", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 181.0, "discounted_cash": 135.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CLOTRIMAZOLE 1%45GM VCR", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5334884", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 181.0, "discounted_cash": 135.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CLOTRIMAZOLE 10MG LZ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5302894", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 85.0, "discounted_cash": 63.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CLOTRIMAZOLE 10MG LZ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5302894", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 85.0, "discounted_cash": 63.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CLOZAPINE", "code_information": [{"code": "80159", "type": "CPT"}, {"code": "7250062", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 83.0, "discounted_cash": 62.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CLOZAPINE 100MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5303017", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 93.0, "discounted_cash": 69.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CLOZAPINE 100MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5303017", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 93.0, "discounted_cash": 69.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CLOZAPINE 25MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5303016", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 66.0, "discounted_cash": 49.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CLOZAPINE 25MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5303016", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 66.0, "discounted_cash": 49.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CMP EP ABL INTRA AFIB PVI EP3D", "code_information": [{"code": "93656", "type": "CPT"}, {"code": "4613663", "type": "CDM"}, {"code": "480", "type": "RC"}], "standard_charges": [{"gross_charge": 56826.0, "discounted_cash": 42619.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CMP EP ABL INTRA AFIB PVI EP3D", "code_information": [{"code": "93656", "type": "CPT"}, {"code": "4613663", "type": "CDM"}, {"code": "481", "type": "RC"}], "standard_charges": [{"gross_charge": 56826.0, "discounted_cash": 42619.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CMP FEM UNCTD PATLL AESCULP CL", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "4013343", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 25084.0, "discounted_cash": 18813.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CMP FM UNCT 3D UNCT PTL DJO CL", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "4013407", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 27999.0, "discounted_cash": 20999.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CMP FM UNCTD PATLL FM GLOB CL", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "4013238", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 23208.0, "discounted_cash": 17406.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CMPLMNT FIXATION TEST EA AG/2", "code_information": [{"code": "86171", "type": "CPT"}, {"code": "7258618", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 3910.0, "discounted_cash": 2932.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CMV QUANT/2", "code_information": [{"code": "87497", "type": "CPT"}, {"code": "7257497", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 809.0, "discounted_cash": 606.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CNS PATHOGENS 12-25", "code_information": [{"code": "87483", "type": "CPT"}, {"code": "4107483", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 2273.0, "discounted_cash": 1704.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CNS PATHOGENS 12-25", "code_information": [{"code": "87483", "type": "CPT"}, {"code": "7257483", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 1202.0, "discounted_cash": 901.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CNSLT/RPT REFRD MATERIAL", "code_information": [{"code": "88323", "type": "CPT"}, {"code": "4308323", "type": "CDM"}, {"code": "310", "type": "RC"}], "standard_charges": [{"gross_charge": 960.0, "discounted_cash": 720.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CNSLT/RPT REFRD SLIDES", "code_information": [{"code": "88321", "type": "CPT"}, {"code": "4308321", "type": "CDM"}, {"code": "310", "type": "RC"}], "standard_charges": [{"gross_charge": 960.0, "discounted_cash": 720.0, "setting": "both", "billing_class": "facility"}]}, {"description": "COAGULATION TIME ACTIVTD", "code_information": [{"code": "85347", "type": "CPT"}, {"code": "4105347", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 416.0, "discounted_cash": 312.0, "setting": "both", "billing_class": "facility"}]}, {"description": "COAGULATION TIME ACTIVTD", "code_information": [{"code": "85347", "type": "CPT"}, {"code": "4175347", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 54.23, "discounted_cash": 40.67, "setting": "both", "billing_class": "facility"}]}, {"description": "COAL TAR SHMP3%240ML SH", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5334922", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 142.0, "discounted_cash": 106.5, "setting": "both", "billing_class": "facility"}]}, {"description": "COAL TAR SHMP3%240ML SH", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5334922", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 142.0, "discounted_cash": 106.5, "setting": "both", "billing_class": "facility"}]}, {"description": "COCAINE 4% 4ML TS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5327318", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 520.0, "discounted_cash": 390.0, "setting": "both", "billing_class": "facility"}]}, {"description": "COCCIDIOIDES ANTIBODY", "code_information": [{"code": "86635", "type": "CPT"}, {"code": "4106172", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 1223.0, "discounted_cash": 917.25, "setting": "both", "billing_class": "facility"}]}, {"description": "COCCIDIOIDES ANTIBODY/2", "code_information": [{"code": "86635", "type": "CPT"}, {"code": "7256172", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 34.0, "discounted_cash": 25.5, "setting": "both", "billing_class": "facility"}]}, {"description": "COCCIDIOIDES ANTIBODY/4", "code_information": [{"code": "86635", "type": "CPT"}, {"code": "7256721", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 86.0, "discounted_cash": 64.5, "setting": "both", "billing_class": "facility"}]}, {"description": "COCCIDIOIDES ANTIBODY/5", "code_information": [{"code": "86635", "type": "CPT"}, {"code": "7256722", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 86.0, "discounted_cash": 64.5, "setting": "both", "billing_class": "facility"}]}, {"description": "COCCIDIOIDES ANTIBODY/6", "code_information": [{"code": "86635", "type": "CPT"}, {"code": "7257453", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 122.0, "discounted_cash": 91.5, "setting": "both", "billing_class": "facility"}]}, {"description": "COCCIDIOIDES ANTIBODY/9", "code_information": [{"code": "86635", "type": "CPT"}, {"code": "7258682", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 97.0, "discounted_cash": 72.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CODEINE 15MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5327364", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 63.0, "discounted_cash": 47.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CODEINE 15MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5327364", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 63.0, "discounted_cash": 47.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CODEINE PER 30MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0745", "type": "HCPCS"}, {"code": "5327339", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 147.0, "discounted_cash": 110.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CODEINE PER 30MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0745", "type": "HCPCS"}, {"code": "5327339", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 147.0, "discounted_cash": 110.25, "setting": "both", "billing_class": "facility"}]}, {"description": "COIL EMB PERIPH COMPLEX", "code_information": [{"code": "C1889", "type": "HCPCS"}, {"code": "8187026", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 21941.0, "discounted_cash": 16455.75, "setting": "both", "billing_class": "facility"}]}, {"description": "COIL EMB POD PACKNG J-SFT RUBY", "code_information": [{"code": "C1889", "type": "HCPCS"}, {"code": "8173718", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 21941.0, "discounted_cash": 16455.75, "setting": "both", "billing_class": "facility"}]}, {"description": "COIL EMBOLIC", "code_information": [{"code": "C1889", "type": "HCPCS"}, {"code": "8031745", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 832.0, "discounted_cash": 624.0, "setting": "both", "billing_class": "facility"}]}, {"description": "COIL EMBOLIC DETACH", "code_information": [{"code": "C1889", "type": "HCPCS"}, {"code": "8060300", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 29663.0, "discounted_cash": 22247.25, "setting": "both", "billing_class": "facility"}]}, {"description": "COIL PV PLATINUM", "code_information": [{"code": "C1889", "type": "HCPCS"}, {"code": "4021019", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 1453.0, "discounted_cash": 1089.75, "setting": "both", "billing_class": "facility"}]}, {"description": "COLCHICINE .6MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5303042", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 61.0, "discounted_cash": 45.75, "setting": "both", "billing_class": "facility"}]}, {"description": "COLCHICINE .6MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5303042", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 61.0, "discounted_cash": 45.75, "setting": "both", "billing_class": "facility"}]}, {"description": "COLD AGGLUTINATN TITER", "code_information": [{"code": "86157", "type": "CPT"}, {"code": "4106015", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 1186.0, "discounted_cash": 889.5, "setting": "both", "billing_class": "facility"}]}, {"description": "COLD AGGLUTINATN TITER", "code_information": [{"code": "86157", "type": "CPT"}, {"code": "7016015", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 561.0, "discounted_cash": 420.75, "setting": "both", "billing_class": "facility"}]}, {"description": "COLD AGGLUTINATN TITER", "code_information": [{"code": "86157", "type": "CPT"}, {"code": "7256015", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 796.0, "discounted_cash": 597.0, "setting": "both", "billing_class": "facility"}]}, {"description": "COLD AGGLUTININ SCREEN", "code_information": [{"code": "86156", "type": "CPT"}, {"code": "7016050", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 315.0, "discounted_cash": 236.25, "setting": "both", "billing_class": "facility"}]}, {"description": "COLESTIPOL 1GM TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5303044", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 85.0, "discounted_cash": 63.75, "setting": "both", "billing_class": "facility"}]}, {"description": "COLESTIPOL 1GM TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5303044", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 85.0, "discounted_cash": 63.75, "setting": "both", "billing_class": "facility"}]}, {"description": "COLISTIMETHA UPTO150MGIJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0770", "type": "HCPCS"}, {"code": "5319491", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 1467.0, "discounted_cash": 1100.25, "setting": "both", "billing_class": "facility"}]}, {"description": "COLISTIMETHA UPTO150MGIJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0770", "type": "HCPCS"}, {"code": "5319491", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 1467.0, "discounted_cash": 1100.25, "setting": "both", "billing_class": "facility"}]}, {"description": "COLLAGEN CROSS LINKS", "code_information": [{"code": "82523", "type": "CPT"}, {"code": "7252523", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 173.0, "discounted_cash": 129.75, "setting": "both", "billing_class": "facility"}]}, {"description": "COLLAGEN CROSS LINKS/5", "code_information": [{"code": "82523", "type": "CPT"}, {"code": "7253950", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 640.0, "discounted_cash": 480.0, "setting": "both", "billing_class": "facility"}]}, {"description": "COLLAGEN CROSS LINKS/6", "code_information": [{"code": "82523", "type": "CPT"}, {"code": "7258252", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 214.0, "discounted_cash": 160.5, "setting": "both", "billing_class": "facility"}]}, {"description": "COLLAGEN MIC SHT70X35 EA", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3590", "type": "HCPCS"}, {"code": "5336612", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 2273.0, "discounted_cash": 1704.75, "setting": "both", "billing_class": "facility"}]}, {"description": "COLLAGEN MIC1GM PFS EA", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3590", "type": "HCPCS"}, {"code": "5336622", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 1882.0, "discounted_cash": 1411.5, "setting": "both", "billing_class": "facility"}]}, {"description": "COLLAGEN MICROFIB 1GM PW", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3590", "type": "HCPCS"}, {"code": "5336610", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 1804.0, "discounted_cash": 1353.0, "setting": "both", "billing_class": "facility"}]}, {"description": "COLLAGEN MICROFIB 5GM PW", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3590", "type": "HCPCS"}, {"code": "5336620", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 11537.0, "discounted_cash": 8652.75, "setting": "both", "billing_class": "facility"}]}, {"description": "COLLAGENASE250U/GM15GMOI", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5334957", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 2528.0, "discounted_cash": 1896.0, "setting": "both", "billing_class": "facility"}]}, {"description": "COLLAGENASE250U/GM15GMOI", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5334957", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 2528.0, "discounted_cash": 1896.0, "setting": "both", "billing_class": "facility"}]}, {"description": "COLLAGENASE250U/GM30GMOI", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5334958", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 1810.0, "discounted_cash": 1357.5, "setting": "both", "billing_class": "facility"}]}, {"description": "COLLAGENASE250U/GM30GMOI", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5334958", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 1810.0, "discounted_cash": 1357.5, "setting": "both", "billing_class": "facility"}]}, {"description": "COLON DBL CM STUDY INCLD GLUC", "code_information": [{"code": "74280", "type": "CPT"}, {"code": "4904280", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 3423.0, "discounted_cash": 2567.25, "setting": "both", "billing_class": "facility"}]}, {"description": "COLON SNGL CM STUDY", "code_information": [{"code": "74270", "type": "CPT"}, {"code": "4904270", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 1885.0, "discounted_cash": 1413.75, "setting": "both", "billing_class": "facility"}]}, {"description": "COLONIC LAVAGE 4L PWLQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5314381", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 375.0, "discounted_cash": 281.25, "setting": "both", "billing_class": "facility"}]}, {"description": "COLONIC LAVAGE 4L PWLQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5314381", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 375.0, "discounted_cash": 281.25, "setting": "both", "billing_class": "facility"}]}, {"description": "COMP EP ABL AFIB ADTNL", "code_information": [{"code": "93657", "type": "CPT"}, {"code": "4613664", "type": "CDM"}, {"code": "480", "type": "RC"}], "standard_charges": [{"gross_charge": 42620.0, "discounted_cash": 31965.0, "setting": "both", "billing_class": "facility"}]}, {"description": "COMP EP IND/ABLA INTR EP3D SVT", "code_information": [{"code": "93653", "type": "CPT"}, {"code": "4613653", "type": "CDM"}, {"code": "480", "type": "RC"}], "standard_charges": [{"gross_charge": 56826.0, "discounted_cash": 42619.5, "setting": "both", "billing_class": "facility"}]}, {"description": "COMP EP/ABLAT INTRA V-TACH 3D", "code_information": [{"code": "93654", "type": "CPT"}, {"code": "4613654", "type": "CDM"}, {"code": "480", "type": "RC"}], "standard_charges": [{"gross_charge": 56826.0, "discounted_cash": 42619.5, "setting": "both", "billing_class": "facility"}]}, {"description": "COMP FEM COATD ATTUNE DEPUY CL", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "4012818", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 34349.0, "discounted_cash": 25761.75, "setting": "both", "billing_class": "facility"}]}, {"description": "COMP FEM CTD TRIATH STRYKR CL", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "4013047", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 29184.0, "discounted_cash": 21888.0, "setting": "both", "billing_class": "facility"}]}, {"description": "COMP FEM UNCT FLX ATT DPY CL", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "4012810", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 30634.0, "discounted_cash": 22975.5, "setting": "both", "billing_class": "facility"}]}, {"description": "COMP FEMOR COATED AESCULAP CL", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "4013341", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 25084.0, "discounted_cash": 18813.0, "setting": "both", "billing_class": "facility"}]}, {"description": "COMP FEMOR UNCTD AS AESCULP CL", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "4013342", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 29003.0, "discounted_cash": 21752.25, "setting": "both", "billing_class": "facility"}]}, {"description": "COMP FEMORAL CTD 3D CTD DJO CL", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "4013406", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 29646.0, "discounted_cash": 22234.5, "setting": "both", "billing_class": "facility"}]}, {"description": "COMP METABOLIC PANEL", "code_information": [{"code": "80053", "type": "CPT"}, {"code": "4100111", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 2081.0, "discounted_cash": 1560.75, "setting": "both", "billing_class": "facility"}]}, {"description": "COMP METABOLIC PANEL", "code_information": [{"code": "80053", "type": "CPT"}, {"code": "4120111", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 12.0, "discounted_cash": 9.0, "setting": "both", "billing_class": "facility"}]}, {"description": "COMP METABOLIC PANEL", "code_information": [{"code": "80053", "type": "CPT"}, {"code": "4170111", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 8.56, "discounted_cash": 6.42, "setting": "both", "billing_class": "facility"}]}, {"description": "COMP TST EA ELECTRONIC", "code_information": [{"code": "86923", "type": "CPT"}, {"code": "4106923", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 215.0, "discounted_cash": 161.25, "setting": "both", "billing_class": "facility"}]}, {"description": "COMP TST EA ELECTRONIC", "code_information": [{"code": "86923", "type": "CPT"}, {"code": "4176923", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 8.85, "discounted_cash": 6.64, "setting": "both", "billing_class": "facility"}]}, {"description": "COMP TST EA UT AHG TECH", "code_information": [{"code": "86922", "type": "CPT"}, {"code": "4106212", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 655.0, "discounted_cash": 491.25, "setting": "both", "billing_class": "facility"}]}, {"description": "COMP TST EA UT AHG TECH", "code_information": [{"code": "86922", "type": "CPT"}, {"code": "4176212", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 5.71, "discounted_cash": 4.28, "setting": "both", "billing_class": "facility"}]}, {"description": "COMP TST EA UT INCUB TCH", "code_information": [{"code": "86921", "type": "CPT"}, {"code": "4106211", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 414.0, "discounted_cash": 310.5, "setting": "both", "billing_class": "facility"}]}, {"description": "COMP TST EA UT INCUB TCH", "code_information": [{"code": "86921", "type": "CPT"}, {"code": "4176211", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 7.14, "discounted_cash": 5.36, "setting": "both", "billing_class": "facility"}]}, {"description": "COMP TST EA UT SPIN TECH", "code_information": [{"code": "86920", "type": "CPT"}, {"code": "4106210", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 388.0, "discounted_cash": 291.0, "setting": "both", "billing_class": "facility"}]}, {"description": "COMP TST EA UT SPIN TECH", "code_information": [{"code": "86920", "type": "CPT"}, {"code": "4176210", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 7.14, "discounted_cash": 5.36, "setting": "both", "billing_class": "facility"}]}, {"description": "COMPLEMENT AG EA", "code_information": [{"code": "86160", "type": "CPT"}, {"code": "4106159", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 992.0, "discounted_cash": 744.0, "setting": "both", "billing_class": "facility"}]}, {"description": "COMPLEMENT AG EA", "code_information": [{"code": "86160", "type": "CPT"}, {"code": "7256136", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 12.0, "discounted_cash": 9.0, "setting": "both", "billing_class": "facility"}]}, {"description": "COMPLEMENT AG EA/10", "code_information": [{"code": "86160", "type": "CPT"}, {"code": "7256332", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 12.0, "discounted_cash": 9.0, "setting": "both", "billing_class": "facility"}]}, {"description": "COMPLEMENT AG EA/11", "code_information": [{"code": "86160", "type": "CPT"}, {"code": "7256333", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 12.0, "discounted_cash": 9.0, "setting": "both", "billing_class": "facility"}]}, {"description": "COMPLEMENT AG EA/2", "code_information": [{"code": "86160", "type": "CPT"}, {"code": "4106332", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 706.0, "discounted_cash": 529.5, "setting": "both", "billing_class": "facility"}]}, {"description": "COMPLEMENT AG EA/2", "code_information": [{"code": "86160", "type": "CPT"}, {"code": "4176332", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 18.55, "discounted_cash": 13.91, "setting": "both", "billing_class": "facility"}]}, {"description": "COMPLEMENT AG EA/3", "code_information": [{"code": "86160", "type": "CPT"}, {"code": "4106333", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 768.0, "discounted_cash": 576.0, "setting": "both", "billing_class": "facility"}]}, {"description": "COMPLEMENT AG EA/3", "code_information": [{"code": "86160", "type": "CPT"}, {"code": "4176333", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 18.55, "discounted_cash": 13.91, "setting": "both", "billing_class": "facility"}]}, {"description": "COMPLEMENT AG EA/3", "code_information": [{"code": "86160", "type": "CPT"}, {"code": "7256157", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 64.0, "discounted_cash": 48.0, "setting": "both", "billing_class": "facility"}]}, {"description": "COMPLEMENT AG EA/5", "code_information": [{"code": "86160", "type": "CPT"}, {"code": "7256161", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 807.0, "discounted_cash": 605.25, "setting": "both", "billing_class": "facility"}]}, {"description": "COMPLEMENT AG EA/6", "code_information": [{"code": "86160", "type": "CPT"}, {"code": "7256163", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 144.0, "discounted_cash": 108.0, "setting": "both", "billing_class": "facility"}]}, {"description": "COMPLEMENT TOTAL CH50", "code_information": [{"code": "86162", "type": "CPT"}, {"code": "7256162", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 843.0, "discounted_cash": 632.25, "setting": "both", "billing_class": "facility"}]}, {"description": "COMPLEMNT FUNCT ACTIV EA", "code_information": [{"code": "86161", "type": "CPT"}, {"code": "7258308", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 135.0, "discounted_cash": 101.25, "setting": "both", "billing_class": "facility"}]}, {"description": "COMPONENT ART GRFT HERO", "code_information": [{"code": "C1768", "type": "HCPCS"}, {"code": "8174122", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 13010.0, "discounted_cash": 9757.5, "setting": "both", "billing_class": "facility"}]}, {"description": "COMPONENT ARTICULAR CAPITATE", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "8131548", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 92278.0, "discounted_cash": 69208.5, "setting": "both", "billing_class": "facility"}]}, {"description": "COMPONENT FEM COAT DEPUY CL", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "4012808", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 30634.0, "discounted_cash": 22975.5, "setting": "both", "billing_class": "facility"}]}, {"description": "COMPONENT FX PHALANGEAL", "code_information": [{"code": "L8642", "type": "HCPCS"}, {"code": "8131549", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 13622.0, "discounted_cash": 10216.5, "setting": "both", "billing_class": "facility"}]}, {"description": "COMPR REV MATERIAL", "code_information": [{"code": "88325", "type": "CPT"}, {"code": "4308325", "type": "CDM"}, {"code": "310", "type": "RC"}], "standard_charges": [{"gross_charge": 2147.0, "discounted_cash": 1610.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CONCENTRATION INF AGENT/2", "code_information": [{"code": "87015", "type": "CPT"}, {"code": "4107016", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 271.0, "discounted_cash": 203.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CONCENTRATION INF AGENT/4", "code_information": [{"code": "87015", "type": "CPT"}, {"code": "7257017", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 180.0, "discounted_cash": 135.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CONCENTRATION INF AGENT/7", "code_information": [{"code": "87015", "type": "CPT"}, {"code": "7257212", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 197.0, "discounted_cash": 147.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CONJ ESTROGEN .3MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5303065", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 135.0, "discounted_cash": 101.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CONJ ESTROGEN .3MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5303065", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 135.0, "discounted_cash": 101.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CONJ ESTROGEN .625MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5303069", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 61.0, "discounted_cash": 45.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CONJ ESTROGEN .625MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5303069", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 61.0, "discounted_cash": 45.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CONJUGAT ESTRGN 30GM VCR", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3590", "type": "HCPCS"}, {"code": "5334998", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 2994.0, "discounted_cash": 2245.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CONJUGAT ESTRGN 30GM VCR", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3590", "type": "HCPCS"}, {"code": "5334998", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 2994.0, "discounted_cash": 2245.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CONJUGAT ESTRGN42.5GMVCR", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3590", "type": "HCPCS"}, {"code": "5334999", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 2387.0, "discounted_cash": 1790.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CONJUGAT ESTRGN42.5GMVCR", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3590", "type": "HCPCS"}, {"code": "5334999", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 2387.0, "discounted_cash": 1790.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CONSULT/FROZEN ADD", "code_information": [{"code": "88332", "type": "CPT"}, {"code": "4308332", "type": "CDM"}, {"code": "310", "type": "RC"}], "standard_charges": [{"gross_charge": 292.0, "discounted_cash": 219.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CONSULT/FROZEN SEC", "code_information": [{"code": "88331", "type": "CPT"}, {"code": "4308331", "type": "CDM"}, {"code": "310", "type": "RC"}], "standard_charges": [{"gross_charge": 734.0, "discounted_cash": 550.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CONSULT/SURGERY", "code_information": [{"code": "88329", "type": "CPT"}, {"code": "4308329", "type": "CDM"}, {"code": "310", "type": "RC"}], "standard_charges": [{"gross_charge": 400.0, "discounted_cash": 300.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CONTRST EVAL EXISTNG CVD", "code_information": [{"code": "4916598", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 405.0, "discounted_cash": 303.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CONVERT EXT BILI DRAIN", "code_information": [{"code": "4917986", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 8707.0, "discounted_cash": 6530.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CONVRT NEPHOST TO URETER", "code_information": [{"code": "4910434", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 2914.0, "discounted_cash": 2185.5, "setting": "both", "billing_class": "facility"}]}, {"description": "COOMBS DIRECT EA", "code_information": [{"code": "86880", "type": "CPT"}, {"code": "4106031", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 576.0, "discounted_cash": 432.0, "setting": "both", "billing_class": "facility"}]}, {"description": "COOMBS DIRECT EA", "code_information": [{"code": "86880", "type": "CPT"}, {"code": "4176031", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 8.56, "discounted_cash": 6.42, "setting": "both", "billing_class": "facility"}]}, {"description": "COOMBS DIRECT EA", "code_information": [{"code": "86880", "type": "CPT"}, {"code": "7016031", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 197.0, "discounted_cash": 147.75, "setting": "both", "billing_class": "facility"}]}, {"description": "COOMBS DIRECT EA/2", "code_information": [{"code": "86880", "type": "CPT"}, {"code": "4106033", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 532.0, "discounted_cash": 399.0, "setting": "both", "billing_class": "facility"}]}, {"description": "COOMBS DIRECT EA/2", "code_information": [{"code": "86880", "type": "CPT"}, {"code": "7016033", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 197.0, "discounted_cash": 147.75, "setting": "both", "billing_class": "facility"}]}, {"description": "COOMBS DIRECT EA/3", "code_information": [{"code": "86880", "type": "CPT"}, {"code": "4106036", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 413.0, "discounted_cash": 309.75, "setting": "both", "billing_class": "facility"}]}, {"description": "COOMBS DIRECT EA/3", "code_information": [{"code": "86880", "type": "CPT"}, {"code": "7016880", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 197.0, "discounted_cash": 147.75, "setting": "both", "billing_class": "facility"}]}, {"description": "COOMBS DIRECT EA/4", "code_information": [{"code": "86880", "type": "CPT"}, {"code": "4106037", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 413.0, "discounted_cash": 309.75, "setting": "both", "billing_class": "facility"}]}, {"description": "COOMBS INDIRECT EA", "code_information": [{"code": "86885", "type": "CPT"}, {"code": "4106885", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 532.0, "discounted_cash": 399.0, "setting": "both", "billing_class": "facility"}]}, {"description": "COOMBS INDIRECT EA", "code_information": [{"code": "86885", "type": "CPT"}, {"code": "4176885", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 8.56, "discounted_cash": 6.42, "setting": "both", "billing_class": "facility"}]}, {"description": "COOMBS INDIRECT EA AB TITR", "code_information": [{"code": "86886", "type": "CPT"}, {"code": "4106032", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 405.0, "discounted_cash": 303.75, "setting": "both", "billing_class": "facility"}]}, {"description": "COOMBS INDIRECT EA AB TITR", "code_information": [{"code": "86886", "type": "CPT"}, {"code": "4176027", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 27.11, "discounted_cash": 20.33, "setting": "both", "billing_class": "facility"}]}, {"description": "COPPER/3", "code_information": [{"code": "82525", "type": "CPT"}, {"code": "7252525", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 429.0, "discounted_cash": 321.75, "setting": "both", "billing_class": "facility"}]}, {"description": "COR ANGPLSTY ADD", "code_information": [{"code": "92921", "type": "CPT"}, {"code": "4612921", "type": "CDM"}, {"code": "480", "type": "RC"}], "standard_charges": [{"gross_charge": 18672.0, "discounted_cash": 14004.0, "setting": "both", "billing_class": "facility"}]}, {"description": "COR ANGPLSTY INIT", "code_information": [{"code": "92920", "type": "CPT"}, {"code": "4612919", "type": "CDM"}, {"code": "480", "type": "RC"}], "standard_charges": [{"gross_charge": 23612.0, "discounted_cash": 17709.0, "setting": "both", "billing_class": "facility"}]}, {"description": "COR ATHER STNT APLST ADD", "code_information": [{"code": "92934", "type": "CPT"}, {"code": "4612934", "type": "CDM"}, {"code": "480", "type": "RC"}], "standard_charges": [{"gross_charge": 88183.0, "discounted_cash": 66137.25, "setting": "both", "billing_class": "facility"}]}, {"description": "COR ATHER STNT APLST INI", "code_information": [{"code": "92933", "type": "CPT"}, {"code": "4612933", "type": "CDM"}, {"code": "480", "type": "RC"}], "standard_charges": [{"gross_charge": 80318.0, "discounted_cash": 60238.5, "setting": "both", "billing_class": "facility"}]}, {"description": "COR ATHERECT APLAS ADD", "code_information": [{"code": "92925", "type": "CPT"}, {"code": "4612925", "type": "CDM"}, {"code": "480", "type": "RC"}], "standard_charges": [{"gross_charge": 47708.0, "discounted_cash": 35781.0, "setting": "both", "billing_class": "facility"}]}, {"description": "COR ATHERECT APLAS INIT", "code_information": [{"code": "92924", "type": "CPT"}, {"code": "4612924", "type": "CDM"}, {"code": "480", "type": "RC"}], "standard_charges": [{"gross_charge": 26193.0, "discounted_cash": 19644.75, "setting": "both", "billing_class": "facility"}]}, {"description": "COR STNT ANGIO ADD", "code_information": [{"code": "92929", "type": "CPT"}, {"code": "4612929", "type": "CDM"}, {"code": "480", "type": "RC"}], "standard_charges": [{"gross_charge": 75758.0, "discounted_cash": 56818.5, "setting": "both", "billing_class": "facility"}]}, {"description": "COR STNT ANGIO INIT", "code_information": [{"code": "92928", "type": "CPT"}, {"code": "4612928", "type": "CDM"}, {"code": "480", "type": "RC"}], "standard_charges": [{"gross_charge": 63763.0, "discounted_cash": 47822.25, "setting": "both", "billing_class": "facility"}]}, {"description": "COR THROMBLYS-INTRA COR", "code_information": [{"code": "92975", "type": "CPT"}, {"code": "4612975", "type": "CDM"}, {"code": "480", "type": "RC"}], "standard_charges": [{"gross_charge": 4216.0, "discounted_cash": 3162.0, "setting": "both", "billing_class": "facility"}]}, {"description": "COR THROMBLYS-VEN INFSN", "code_information": [{"code": "92977", "type": "CPT"}, {"code": "4612977", "type": "CDM"}, {"code": "480", "type": "RC"}], "standard_charges": [{"gross_charge": 1492.0, "discounted_cash": 1119.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CORTISOL FREE/2", "code_information": [{"code": "82530", "type": "CPT"}, {"code": "7252534", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 337.0, "discounted_cash": 252.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CORTISOL FREE/3", "code_information": [{"code": "82530", "type": "CPT"}, {"code": "7252535", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 367.0, "discounted_cash": 275.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CORTISOL TOTAL", "code_information": [{"code": "82533", "type": "CPT"}, {"code": "4102533", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 704.0, "discounted_cash": 528.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CORTISOL TOTAL", "code_information": [{"code": "82533", "type": "CPT"}, {"code": "4172533", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 12.84, "discounted_cash": 9.63, "setting": "both", "billing_class": "facility"}]}, {"description": "CORTISOL TOTAL/2", "code_information": [{"code": "82533", "type": "CPT"}, {"code": "4102534", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 607.0, "discounted_cash": 455.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CORTISOL TOTAL/3", "code_information": [{"code": "82533", "type": "CPT"}, {"code": "4102537", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 607.0, "discounted_cash": 455.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CORTISOL TOTAL/4", "code_information": [{"code": "82533", "type": "CPT"}, {"code": "7252533", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 52.0, "discounted_cash": 39.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CORTISOL TOTAL/5", "code_information": [{"code": "82533", "type": "CPT"}, {"code": "7252536", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 117.0, "discounted_cash": 87.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CORTISONE 25MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5303089", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 85.0, "discounted_cash": 63.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CORTISONE 25MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5303089", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 85.0, "discounted_cash": 63.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CORTROSYN PER.25MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0834", "type": "HCPCS"}, {"code": "5319575", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 3012.0, "discounted_cash": 2259.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CORTROSYN PER.25MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0834", "type": "HCPCS"}, {"code": "5319575", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 3012.0, "discounted_cash": 2259.0, "setting": "both", "billing_class": "facility"}]}, {"description": "COSYNTROPIN PER.25MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0834", "type": "HCPCS"}, {"code": "5319589", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 1584.0, "discounted_cash": 1188.0, "setting": "both", "billing_class": "facility"}]}, {"description": "COSYNTROPIN PER.25MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0834", "type": "HCPCS"}, {"code": "5319589", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 1584.0, "discounted_cash": 1188.0, "setting": "both", "billing_class": "facility"}]}, {"description": "COVID 19", "code_information": [{"code": "U0002", "type": "HCPCS"}, {"code": "4105386", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 135.0, "discounted_cash": 101.25, "setting": "both", "billing_class": "facility"}]}, {"description": "COVID 19", "code_information": [{"code": "U0002", "type": "HCPCS"}, {"code": "4170001", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 47.6, "discounted_cash": 35.7, "setting": "both", "billing_class": "facility"}]}, {"description": "COVID 19", "code_information": [{"code": "U0002", "type": "HCPCS"}, {"code": "7037635", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 196.0, "discounted_cash": 147.0, "setting": "both", "billing_class": "facility"}]}, {"description": "COVID 19", "code_information": [{"code": "U0002", "type": "HCPCS"}, {"code": "7250043", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 196.0, "discounted_cash": 147.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CP ACE CTD DUAL MOB MEDACTA CL", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "4013436", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 16428.0, "discounted_cash": 12321.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CPR", "code_information": [{"code": "92950", "type": "CPT"}, {"code": "5500200", "type": "CDM"}, {"code": "480", "type": "RC"}], "standard_charges": [{"gross_charge": 5097.0, "discounted_cash": 3822.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CPR CARDIOPULM RESUSC", "code_information": [{"code": "92950", "type": "CPT"}, {"code": "6100535", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 4204.0, "discounted_cash": 3153.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CREATINE KINASE ISONZ", "code_information": [{"code": "82552", "type": "CPT"}, {"code": "4102552", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 614.0, "discounted_cash": 460.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CREATINE KINASE ISONZ", "code_information": [{"code": "82552", "type": "CPT"}, {"code": "7252552", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 47.0, "discounted_cash": 35.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CREATINE KINASE TOTAL", "code_information": [{"code": "82550", "type": "CPT"}, {"code": "4102550", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 680.0, "discounted_cash": 510.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CREATINE KINASE TOTAL", "code_information": [{"code": "82550", "type": "CPT"}, {"code": "4172550", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 1.12, "discounted_cash": 0.84, "setting": "both", "billing_class": "facility"}]}, {"description": "CREATINE KINASE TOTAL", "code_information": [{"code": "82550", "type": "CPT"}, {"code": "7252550", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 47.0, "discounted_cash": 35.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CREATININE BLOOD", "code_information": [{"code": "82565", "type": "CPT"}, {"code": "4172565", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 1.12, "discounted_cash": 0.84, "setting": "both", "billing_class": "facility"}]}, {"description": "CREATININE BLOOD/2", "code_information": [{"code": "82565", "type": "CPT"}, {"code": "4102565", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 177.0, "discounted_cash": 132.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CREATININE CLEARANCE", "code_information": [{"code": "82575", "type": "CPT"}, {"code": "4102575", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 994.0, "discounted_cash": 745.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CREATININE CLEARANCE", "code_information": [{"code": "82575", "type": "CPT"}, {"code": "4172575", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 8.56, "discounted_cash": 6.42, "setting": "both", "billing_class": "facility"}]}, {"description": "CREATININE OTHR SRCE", "code_information": [{"code": "82570", "type": "CPT"}, {"code": "4102570", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 640.0, "discounted_cash": 480.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CREATININE OTHR SRCE", "code_information": [{"code": "82570", "type": "CPT"}, {"code": "4172570", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 7.14, "discounted_cash": 5.36, "setting": "both", "billing_class": "facility"}]}, {"description": "CREATININE OTHR SRCE/2", "code_information": [{"code": "82570", "type": "CPT"}, {"code": "4102571", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 516.0, "discounted_cash": 387.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CREATININE OTHR SRCE/2", "code_information": [{"code": "82570", "type": "CPT"}, {"code": "4172571", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 1.12, "discounted_cash": 0.84, "setting": "both", "billing_class": "facility"}]}, {"description": "CREATININE OTHR SRCE/2", "code_information": [{"code": "82570", "type": "CPT"}, {"code": "7252570", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 5.0, "discounted_cash": 3.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CREATININE OTHR SRCE/3", "code_information": [{"code": "82570", "type": "CPT"}, {"code": "4102573", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 516.0, "discounted_cash": 387.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CREATININE OTHR SRCE/3", "code_information": [{"code": "82570", "type": "CPT"}, {"code": "4172573", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 1.12, "discounted_cash": 0.84, "setting": "both", "billing_class": "facility"}]}, {"description": "CREATININE OTHR SRCE/3", "code_information": [{"code": "82570", "type": "CPT"}, {"code": "7252571", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 916.0, "discounted_cash": 687.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CREATININE OTHR SRCE/4", "code_information": [{"code": "82570", "type": "CPT"}, {"code": "7252573", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 28.0, "discounted_cash": 21.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CREATININE OTHR SRCE/5", "code_information": [{"code": "82570", "type": "CPT"}, {"code": "7252574", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 501.0, "discounted_cash": 375.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CREATININE OTHR SRCE/6", "code_information": [{"code": "82570", "type": "CPT"}, {"code": "7258294", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 501.0, "discounted_cash": 375.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CRIT CARE E&M 30-74 MIN", "code_information": [{"code": "99291", "type": "CPT"}, {"code": "6100514", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 5964.0, "discounted_cash": 4473.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CRIT CARE E&M 30-74 MIN", "code_information": [{"code": "99291", "type": "CPT"}, {"code": "6169291", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 5964.0, "discounted_cash": 4473.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CRITICAL CR E&M ADDL 30", "code_information": [{"code": "99292", "type": "CPT"}, {"code": "6103055", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 2420.0, "discounted_cash": 1815.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CRITICAL CR E&M ADDL 30", "code_information": [{"code": "99292", "type": "CPT"}, {"code": "6169292", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 2420.0, "discounted_cash": 1815.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CRM MOISTURE BARRIER", "code_information": [{"code": "A6250", "type": "HCPCS"}, {"code": "8031901", "type": "CDM"}, {"code": "271", "type": "RC"}], "standard_charges": [{"gross_charge": 2484.0, "discounted_cash": 1863.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CRP HI SENSITIVITY", "code_information": [{"code": "86141", "type": "CPT"}, {"code": "4106140", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 175.0, "discounted_cash": 131.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CRP HI SENSITIVITY", "code_information": [{"code": "86141", "type": "CPT"}, {"code": "4176141", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 14.27, "discounted_cash": 10.7, "setting": "both", "billing_class": "facility"}]}, {"description": "CRYOABLATE SGL PULM TUMOR UNI", "code_information": [{"code": "4912994", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 35107.0, "discounted_cash": 26330.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CRYOCRIT QUAL/SEMI QNT/2", "code_information": [{"code": "82595", "type": "CPT"}, {"code": "4102596", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 280.0, "discounted_cash": 210.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CRYOCRIT QUAL/SEMI QNT/2", "code_information": [{"code": "82595", "type": "CPT"}, {"code": "7252596", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 208.0, "discounted_cash": 156.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CRYPTOCOCCIS AB", "code_information": [{"code": "86641", "type": "CPT"}, {"code": "7256173", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 724.0, "discounted_cash": 543.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CRYPTOCOCCUS NEO IA", "code_information": [{"code": "87327", "type": "CPT"}, {"code": "4106420", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 109.0, "discounted_cash": 81.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CRYPTOSPORIDIUM IA", "code_information": [{"code": "87328", "type": "CPT"}, {"code": "4107329", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 868.0, "discounted_cash": 651.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CRYPTOSPORIDIUM IA", "code_information": [{"code": "87328", "type": "CPT"}, {"code": "4177329", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 4.29, "discounted_cash": 3.22, "setting": "both", "billing_class": "facility"}]}, {"description": "CRYPTOSPORIDIUM IA", "code_information": [{"code": "87328", "type": "CPT"}, {"code": "7257330", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 228.0, "discounted_cash": 171.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CRYST ID BODY FLD EX URN", "code_information": [{"code": "89060", "type": "CPT"}, {"code": "4109363", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 218.0, "discounted_cash": 163.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CRYST ID BODY FLD EX URN", "code_information": [{"code": "89060", "type": "CPT"}, {"code": "4179363", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 4.29, "discounted_cash": 3.22, "setting": "both", "billing_class": "facility"}]}, {"description": "CRYST ID BODY FLD EX URN", "code_information": [{"code": "89060", "type": "CPT"}, {"code": "7259367", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 31.0, "discounted_cash": 23.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CSF LEAK DETECTION", "code_information": [{"code": "78650", "type": "CPT"}, {"code": "5208650", "type": "CDM"}, {"code": "341", "type": "RC"}], "standard_charges": [{"gross_charge": 2659.0, "discounted_cash": 1994.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CT ABD & PELVIS W/CM", "code_information": [{"code": "74177", "type": "CPT"}, {"code": "5054177", "type": "CDM"}, {"code": "350", "type": "RC"}], "standard_charges": [{"gross_charge": 21764.0, "discounted_cash": 16323.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CT ABD & PELVIS W/CM", "code_information": [{"code": "74177", "type": "CPT"}, {"code": "5114177", "type": "CDM"}, {"code": "350", "type": "RC"}], "standard_charges": [{"gross_charge": 16759.0, "discounted_cash": 12569.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CT ABD & PELVIS W/O CM", "code_information": [{"code": "74176", "type": "CPT"}, {"code": "5054179", "type": "CDM"}, {"code": "350", "type": "RC"}], "standard_charges": [{"gross_charge": 17942.0, "discounted_cash": 13456.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CT ABD & PELVIS W/O CM", "code_information": [{"code": "74176", "type": "CPT"}, {"code": "5114176", "type": "CDM"}, {"code": "350", "type": "RC"}], "standard_charges": [{"gross_charge": 15340.0, "discounted_cash": 11505.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CT ABD & PELVIS WO/W CM", "code_information": [{"code": "74178", "type": "CPT"}, {"code": "5054178", "type": "CDM"}, {"code": "350", "type": "RC"}], "standard_charges": [{"gross_charge": 22415.0, "discounted_cash": 16811.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CT ABD & PELVIS WO/W CM", "code_information": [{"code": "74178", "type": "CPT"}, {"code": "5114178", "type": "CDM"}, {"code": "350", "type": "RC"}], "standard_charges": [{"gross_charge": 19221.0, "discounted_cash": 14415.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CT ABDOMEN W/ CM", "code_information": [{"code": "74160", "type": "CPT"}, {"code": "5054160", "type": "CDM"}, {"code": "350", "type": "RC"}], "standard_charges": [{"gross_charge": 7928.0, "discounted_cash": 5946.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CT ABDOMEN W/ CM", "code_information": [{"code": "74160", "type": "CPT"}, {"code": "5114160", "type": "CDM"}, {"code": "350", "type": "RC"}], "standard_charges": [{"gross_charge": 7928.0, "discounted_cash": 5946.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CT ABDOMEN W/O CM", "code_information": [{"code": "74150", "type": "CPT"}, {"code": "5054150", "type": "CDM"}, {"code": "350", "type": "RC"}], "standard_charges": [{"gross_charge": 7501.0, "discounted_cash": 5625.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CT ABDOMEN W/O CM", "code_information": [{"code": "74150", "type": "CPT"}, {"code": "5114150", "type": "CDM"}, {"code": "350", "type": "RC"}], "standard_charges": [{"gross_charge": 7501.0, "discounted_cash": 5625.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CT ABDOMEN WO/W CM", "code_information": [{"code": "74170", "type": "CPT"}, {"code": "5054170", "type": "CDM"}, {"code": "350", "type": "RC"}], "standard_charges": [{"gross_charge": 12014.0, "discounted_cash": 9010.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CT ABDOMEN WO/W CM", "code_information": [{"code": "74170", "type": "CPT"}, {"code": "5114170", "type": "CDM"}, {"code": "350", "type": "RC"}], "standard_charges": [{"gross_charge": 9609.0, "discounted_cash": 7206.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CT CARD SCORING WO CONT", "code_information": [{"code": "75571", "type": "CPT"}, {"code": "5056500", "type": "CDM"}, {"code": "350", "type": "RC"}], "standard_charges": [{"gross_charge": 908.0, "discounted_cash": 681.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CT CARD SCORING WO CONT", "code_information": [{"code": "75571", "type": "CPT"}, {"code": "5117557", "type": "CDM"}, {"code": "350", "type": "RC"}], "standard_charges": [{"gross_charge": 908.0, "discounted_cash": 681.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CT CEREBRAL PERF W CONT", "code_information": [{"code": "42T", "type": "CPT"}, {"code": "5050042", "type": "CDM"}, {"code": "350", "type": "RC"}], "standard_charges": [{"gross_charge": 5828.0, "discounted_cash": 4371.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CT GDE PARENCHYM ABLAT", "code_information": [{"code": "77013", "type": "CPT"}, {"code": "5057013", "type": "CDM"}, {"code": "350", "type": "RC"}], "standard_charges": [{"gross_charge": 2088.0, "discounted_cash": 1566.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CT GUIDANCE NDL PLACEMNT", "code_information": [{"code": "77012", "type": "CPT"}, {"code": "5056361", "type": "CDM"}, {"code": "350", "type": "RC"}], "standard_charges": [{"gross_charge": 6155.0, "discounted_cash": 4616.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CT GUIDE RAD THERAPY FL", "code_information": [{"code": "77014", "type": "CPT"}, {"code": "5056370", "type": "CDM"}, {"code": "350", "type": "RC"}], "standard_charges": [{"gross_charge": 2647.0, "discounted_cash": 1985.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CT HEAD/BRAIN W CONTRAST", "code_information": [{"code": "70460", "type": "CPT"}, {"code": "5050460", "type": "CDM"}, {"code": "350", "type": "RC"}], "standard_charges": [{"gross_charge": 7856.0, "discounted_cash": 5892.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CT HEAD/BRAIN WO CONTRST", "code_information": [{"code": "70450", "type": "CPT"}, {"code": "5050450", "type": "CDM"}, {"code": "350", "type": "RC"}], "standard_charges": [{"gross_charge": 9151.0, "discounted_cash": 6863.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CT HEAD/BRAIN WO CONTRST", "code_information": [{"code": "70450", "type": "CPT"}, {"code": "5110450", "type": "CDM"}, {"code": "350", "type": "RC"}], "standard_charges": [{"gross_charge": 6613.0, "discounted_cash": 4959.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CT HEAD/BRAIN WO/W CONTR", "code_information": [{"code": "70470", "type": "CPT"}, {"code": "5050470", "type": "CDM"}, {"code": "350", "type": "RC"}], "standard_charges": [{"gross_charge": 9842.0, "discounted_cash": 7381.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CT HEAD/BRAIN WO/W CONTR", "code_information": [{"code": "70470", "type": "CPT"}, {"code": "5110470", "type": "CDM"}, {"code": "350", "type": "RC"}], "standard_charges": [{"gross_charge": 11931.0, "discounted_cash": 8948.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CT HRT STRUCT MORPH W CM", "code_information": [{"code": "75572", "type": "CPT"}, {"code": "5050213", "type": "CDM"}, {"code": "350", "type": "RC"}], "standard_charges": [{"gross_charge": 4639.0, "discounted_cash": 3479.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CT LOWER EXTRMTY W/ CM", "code_information": [{"code": "73701", "type": "CPT"}, {"code": "5053701", "type": "CDM"}, {"code": "350", "type": "RC"}], "standard_charges": [{"gross_charge": 6174.0, "discounted_cash": 4630.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CT LOWER EXTRMTY W/O CM", "code_information": [{"code": "73700", "type": "CPT"}, {"code": "5053700", "type": "CDM"}, {"code": "350", "type": "RC"}], "standard_charges": [{"gross_charge": 7668.0, "discounted_cash": 5751.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CT LOWER EXTRMTY W/O CM", "code_information": [{"code": "73700", "type": "CPT"}, {"code": "5113700", "type": "CDM"}, {"code": "350", "type": "RC"}], "standard_charges": [{"gross_charge": 5401.0, "discounted_cash": 4050.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CT LOWER EXTRMTY WO/W CM", "code_information": [{"code": "73702", "type": "CPT"}, {"code": "5053702", "type": "CDM"}, {"code": "350", "type": "RC"}], "standard_charges": [{"gross_charge": 7981.0, "discounted_cash": 5985.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CT LOWER EXTRMTY WO/W CM", "code_information": [{"code": "73702", "type": "CPT"}, {"code": "5113702", "type": "CDM"}, {"code": "350", "type": "RC"}], "standard_charges": [{"gross_charge": 10891.0, "discounted_cash": 8168.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CT LTD OR LOC F/U STUDY", "code_information": [{"code": "76380", "type": "CPT"}, {"code": "5056505", "type": "CDM"}, {"code": "350", "type": "RC"}], "standard_charges": [{"gross_charge": 3175.0, "discounted_cash": 2381.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CT MAXILLOFACIAL W/CM", "code_information": [{"code": "70487", "type": "CPT"}, {"code": "5050487", "type": "CDM"}, {"code": "350", "type": "RC"}], "standard_charges": [{"gross_charge": 7856.0, "discounted_cash": 5892.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CT MAXILLOFACIAL W/CM", "code_information": [{"code": "70487", "type": "CPT"}, {"code": "5110587", "type": "CDM"}, {"code": "350", "type": "RC"}], "standard_charges": [{"gross_charge": 11022.0, "discounted_cash": 8266.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CT MAXILLOFACIAL W/O CM", "code_information": [{"code": "70486", "type": "CPT"}, {"code": "5050486", "type": "CDM"}, {"code": "350", "type": "RC"}], "standard_charges": [{"gross_charge": 8526.0, "discounted_cash": 6394.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CT MAXILLOFACIAL W/O CM", "code_information": [{"code": "70486", "type": "CPT"}, {"code": "5110586", "type": "CDM"}, {"code": "350", "type": "RC"}], "standard_charges": [{"gross_charge": 6850.0, "discounted_cash": 5137.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CT MAXILLOFACIAL WO/W CM", "code_information": [{"code": "70488", "type": "CPT"}, {"code": "5050488", "type": "CDM"}, {"code": "350", "type": "RC"}], "standard_charges": [{"gross_charge": 10153.0, "discounted_cash": 7614.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CT MAXILLOFACIAL WO/W CM", "code_information": [{"code": "70488", "type": "CPT"}, {"code": "5110588", "type": "CDM"}, {"code": "350", "type": "RC"}], "standard_charges": [{"gross_charge": 12065.0, "discounted_cash": 9048.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CT ORB/EAR/FOSSA W/CM", "code_information": [{"code": "70481", "type": "CPT"}, {"code": "5050524", "type": "CDM"}, {"code": "350", "type": "RC"}], "standard_charges": [{"gross_charge": 7856.0, "discounted_cash": 5892.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CT ORB/EAR/FOSSA W/O CM", "code_information": [{"code": "70480", "type": "CPT"}, {"code": "5050520", "type": "CDM"}, {"code": "350", "type": "RC"}], "standard_charges": [{"gross_charge": 6930.0, "discounted_cash": 5197.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CT ORB/EAR/FOSSA W/O CM", "code_information": [{"code": "70480", "type": "CPT"}, {"code": "5110480", "type": "CDM"}, {"code": "350", "type": "RC"}], "standard_charges": [{"gross_charge": 6058.0, "discounted_cash": 4543.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CT ORB/EAR/FOSSA WO/W CM", "code_information": [{"code": "70482", "type": "CPT"}, {"code": "5050528", "type": "CDM"}, {"code": "350", "type": "RC"}], "standard_charges": [{"gross_charge": 9521.0, "discounted_cash": 7140.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CT ORB/EAR/FOSSA WO/W CM", "code_information": [{"code": "70482", "type": "CPT"}, {"code": "5110482", "type": "CDM"}, {"code": "350", "type": "RC"}], "standard_charges": [{"gross_charge": 13070.0, "discounted_cash": 9802.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CT PELVIS W/O CONTRAST", "code_information": [{"code": "72192", "type": "CPT"}, {"code": "5052192", "type": "CDM"}, {"code": "350", "type": "RC"}], "standard_charges": [{"gross_charge": 10757.0, "discounted_cash": 8067.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CT PELVIS W/O CONTRAST", "code_information": [{"code": "72192", "type": "CPT"}, {"code": "5112192", "type": "CDM"}, {"code": "350", "type": "RC"}], "standard_charges": [{"gross_charge": 5940.0, "discounted_cash": 4455.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CT PELVIS WITH CONTRAST", "code_information": [{"code": "72193", "type": "CPT"}, {"code": "5052193", "type": "CDM"}, {"code": "350", "type": "RC"}], "standard_charges": [{"gross_charge": 13119.0, "discounted_cash": 9839.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CT PELVIS WITH CONTRAST", "code_information": [{"code": "72193", "type": "CPT"}, {"code": "5112193", "type": "CDM"}, {"code": "350", "type": "RC"}], "standard_charges": [{"gross_charge": 11672.0, "discounted_cash": 8754.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CT PELVIS WO/W CM", "code_information": [{"code": "72194", "type": "CPT"}, {"code": "5052194", "type": "CDM"}, {"code": "350", "type": "RC"}], "standard_charges": [{"gross_charge": 9304.0, "discounted_cash": 6978.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CT PELVIS WO/W CM", "code_information": [{"code": "72194", "type": "CPT"}, {"code": "5112194", "type": "CDM"}, {"code": "350", "type": "RC"}], "standard_charges": [{"gross_charge": 11054.0, "discounted_cash": 8290.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CT SFT TISS NECK WO/W CM", "code_information": [{"code": "70492", "type": "CPT"}, {"code": "5050492", "type": "CDM"}, {"code": "350", "type": "RC"}], "standard_charges": [{"gross_charge": 9352.0, "discounted_cash": 7014.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CT SFT TISS NECK WO/W CM", "code_information": [{"code": "70492", "type": "CPT"}, {"code": "5110492", "type": "CDM"}, {"code": "350", "type": "RC"}], "standard_charges": [{"gross_charge": 9352.0, "discounted_cash": 7014.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CT SINUS W/O CONTRAST", "code_information": [{"code": "70486", "type": "CPT"}, {"code": "5050202", "type": "CDM"}, {"code": "350", "type": "RC"}], "standard_charges": [{"gross_charge": 8094.0, "discounted_cash": 6070.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CT SINUS WITH CONTRAST", "code_information": [{"code": "70487", "type": "CPT"}, {"code": "5050200", "type": "CDM"}, {"code": "350", "type": "RC"}], "standard_charges": [{"gross_charge": 8807.0, "discounted_cash": 6605.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CT SINUS WO/W CONTRAST", "code_information": [{"code": "70488", "type": "CPT"}, {"code": "5050204", "type": "CDM"}, {"code": "350", "type": "RC"}], "standard_charges": [{"gross_charge": 12065.0, "discounted_cash": 9048.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CT SOFT TISS NECK W CM", "code_information": [{"code": "70491", "type": "CPT"}, {"code": "5050491", "type": "CDM"}, {"code": "350", "type": "RC"}], "standard_charges": [{"gross_charge": 14289.0, "discounted_cash": 10716.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CT SOFT TISS NECK W CM", "code_information": [{"code": "70491", "type": "CPT"}, {"code": "5110491", "type": "CDM"}, {"code": "350", "type": "RC"}], "standard_charges": [{"gross_charge": 11734.0, "discounted_cash": 8800.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CT SOFT TISS NECK WO CM", "code_information": [{"code": "70490", "type": "CPT"}, {"code": "5050490", "type": "CDM"}, {"code": "350", "type": "RC"}], "standard_charges": [{"gross_charge": 11516.0, "discounted_cash": 8637.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CT SOFT TISS NECK WO CM", "code_information": [{"code": "70490", "type": "CPT"}, {"code": "5110490", "type": "CDM"}, {"code": "350", "type": "RC"}], "standard_charges": [{"gross_charge": 6509.0, "discounted_cash": 4881.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CT SPINE CERVICAL W/CM", "code_information": [{"code": "72126", "type": "CPT"}, {"code": "5052126", "type": "CDM"}, {"code": "350", "type": "RC"}], "standard_charges": [{"gross_charge": 12886.0, "discounted_cash": 9664.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CT SPINE CERVICAL W/O CM", "code_information": [{"code": "72125", "type": "CPT"}, {"code": "5052125", "type": "CDM"}, {"code": "350", "type": "RC"}], "standard_charges": [{"gross_charge": 17631.0, "discounted_cash": 13223.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CT SPINE CERVICAL W/O CM", "code_information": [{"code": "72125", "type": "CPT"}, {"code": "5112125", "type": "CDM"}, {"code": "350", "type": "RC"}], "standard_charges": [{"gross_charge": 8440.0, "discounted_cash": 6330.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CT SPINE CERVICL WO/W CM", "code_information": [{"code": "72127", "type": "CPT"}, {"code": "5052127", "type": "CDM"}, {"code": "350", "type": "RC"}], "standard_charges": [{"gross_charge": 13900.0, "discounted_cash": 10425.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CT SPINE CERVICL WO/W CM", "code_information": [{"code": "72127", "type": "CPT"}, {"code": "5112127", "type": "CDM"}, {"code": "350", "type": "RC"}], "standard_charges": [{"gross_charge": 16061.0, "discounted_cash": 12045.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CT SPINE LUMBAR W/CM", "code_information": [{"code": "72132", "type": "CPT"}, {"code": "5052132", "type": "CDM"}, {"code": "350", "type": "RC"}], "standard_charges": [{"gross_charge": 10492.0, "discounted_cash": 7869.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CT SPINE LUMBAR W/O CM", "code_information": [{"code": "72131", "type": "CPT"}, {"code": "5052131", "type": "CDM"}, {"code": "350", "type": "RC"}], "standard_charges": [{"gross_charge": 11916.0, "discounted_cash": 8937.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CT SPINE LUMBAR W/O CM", "code_information": [{"code": "72131", "type": "CPT"}, {"code": "5112131", "type": "CDM"}, {"code": "350", "type": "RC"}], "standard_charges": [{"gross_charge": 10582.0, "discounted_cash": 7936.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CT SPINE LUMBAR WO/W CM", "code_information": [{"code": "72133", "type": "CPT"}, {"code": "5052133", "type": "CDM"}, {"code": "350", "type": "RC"}], "standard_charges": [{"gross_charge": 13473.0, "discounted_cash": 10104.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CT SPINE LUMBAR WO/W CM", "code_information": [{"code": "72133", "type": "CPT"}, {"code": "5112133", "type": "CDM"}, {"code": "350", "type": "RC"}], "standard_charges": [{"gross_charge": 16971.0, "discounted_cash": 12728.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CT SPINE THORACIC W/CM", "code_information": [{"code": "72129", "type": "CPT"}, {"code": "5052129", "type": "CDM"}, {"code": "350", "type": "RC"}], "standard_charges": [{"gross_charge": 12266.0, "discounted_cash": 9199.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CT SPINE THORACIC W/O CM", "code_information": [{"code": "72128", "type": "CPT"}, {"code": "5052128", "type": "CDM"}, {"code": "350", "type": "RC"}], "standard_charges": [{"gross_charge": 13217.0, "discounted_cash": 9912.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CT SPINE THORACIC W/O CM", "code_information": [{"code": "72128", "type": "CPT"}, {"code": "5112128", "type": "CDM"}, {"code": "350", "type": "RC"}], "standard_charges": [{"gross_charge": 13217.0, "discounted_cash": 9912.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CT SPINE THORACIC WO/W", "code_information": [{"code": "72130", "type": "CPT"}, {"code": "5052130", "type": "CDM"}, {"code": "350", "type": "RC"}], "standard_charges": [{"gross_charge": 14546.0, "discounted_cash": 10909.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CT SPINE THORACIC WO/W", "code_information": [{"code": "72130", "type": "CPT"}, {"code": "5112130", "type": "CDM"}, {"code": "350", "type": "RC"}], "standard_charges": [{"gross_charge": 19847.0, "discounted_cash": 14885.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CT THORAX W/O CONTRAST", "code_information": [{"code": "71250", "type": "CPT"}, {"code": "5051250", "type": "CDM"}, {"code": "350", "type": "RC"}], "standard_charges": [{"gross_charge": 7969.0, "discounted_cash": 5976.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CT THORAX W/O CONTRAST", "code_information": [{"code": "71250", "type": "CPT"}, {"code": "5111250", "type": "CDM"}, {"code": "350", "type": "RC"}], "standard_charges": [{"gross_charge": 7643.0, "discounted_cash": 5732.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CT THORAX WITH CONTRAST", "code_information": [{"code": "71260", "type": "CPT"}, {"code": "5051260", "type": "CDM"}, {"code": "350", "type": "RC"}], "standard_charges": [{"gross_charge": 12719.0, "discounted_cash": 9539.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CT THORAX WITH CONTRAST", "code_information": [{"code": "71260", "type": "CPT"}, {"code": "5111260", "type": "CDM"}, {"code": "350", "type": "RC"}], "standard_charges": [{"gross_charge": 10099.0, "discounted_cash": 7574.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CT THORAX WO/W CONTRAST", "code_information": [{"code": "71270", "type": "CPT"}, {"code": "5051270", "type": "CDM"}, {"code": "350", "type": "RC"}], "standard_charges": [{"gross_charge": 11970.0, "discounted_cash": 8977.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CT THORAX WO/W CONTRAST", "code_information": [{"code": "71270", "type": "CPT"}, {"code": "5111270", "type": "CDM"}, {"code": "350", "type": "RC"}], "standard_charges": [{"gross_charge": 13835.0, "discounted_cash": 10376.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CT UPPER EXTRMTY W/ CM", "code_information": [{"code": "73201", "type": "CPT"}, {"code": "5053201", "type": "CDM"}, {"code": "350", "type": "RC"}], "standard_charges": [{"gross_charge": 7856.0, "discounted_cash": 5892.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CT UPPER EXTRMTY W/O CM", "code_information": [{"code": "73200", "type": "CPT"}, {"code": "5053200", "type": "CDM"}, {"code": "350", "type": "RC"}], "standard_charges": [{"gross_charge": 6370.0, "discounted_cash": 4777.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CT UPPER EXTRMTY W/O CM", "code_information": [{"code": "73200", "type": "CPT"}, {"code": "5113200", "type": "CDM"}, {"code": "350", "type": "RC"}], "standard_charges": [{"gross_charge": 6370.0, "discounted_cash": 4777.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CT UPPER EXTRMTY WO/W CM", "code_information": [{"code": "73202", "type": "CPT"}, {"code": "5053202", "type": "CDM"}, {"code": "350", "type": "RC"}], "standard_charges": [{"gross_charge": 10518.0, "discounted_cash": 7888.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CT UPPER EXTRMTY WO/W CM", "code_information": [{"code": "73202", "type": "CPT"}, {"code": "5113202", "type": "CDM"}, {"code": "350", "type": "RC"}], "standard_charges": [{"gross_charge": 12154.0, "discounted_cash": 9115.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CTA ABD LE RO WO/W CONT", "code_information": [{"code": "75635", "type": "CPT"}, {"code": "5050496", "type": "CDM"}, {"code": "350", "type": "RC"}], "standard_charges": [{"gross_charge": 10505.0, "discounted_cash": 7878.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CTA ABD/PEL WO/W CM", "code_information": [{"code": "74174", "type": "CPT"}, {"code": "5054174", "type": "CDM"}, {"code": "350", "type": "RC"}], "standard_charges": [{"gross_charge": 17006.0, "discounted_cash": 12754.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CTA ABD/PEL WO/W CM", "code_information": [{"code": "74174", "type": "CPT"}, {"code": "5114174", "type": "CDM"}, {"code": "350", "type": "RC"}], "standard_charges": [{"gross_charge": 17006.0, "discounted_cash": 12754.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CTA ABDOMEN WO/W CM", "code_information": [{"code": "74175", "type": "CPT"}, {"code": "5050498", "type": "CDM"}, {"code": "350", "type": "RC"}], "standard_charges": [{"gross_charge": 8899.0, "discounted_cash": 6674.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CTA ABDOMEN WO/W CM", "code_information": [{"code": "74175", "type": "CPT"}, {"code": "5110498", "type": "CDM"}, {"code": "350", "type": "RC"}], "standard_charges": [{"gross_charge": 8899.0, "discounted_cash": 6674.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CTA CHEST (NONCOR) WO/W", "code_information": [{"code": "71275", "type": "CPT"}, {"code": "5050461", "type": "CDM"}, {"code": "350", "type": "RC"}], "standard_charges": [{"gross_charge": 16486.0, "discounted_cash": 12364.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CTA CHEST (NONCOR) WO/W", "code_information": [{"code": "71275", "type": "CPT"}, {"code": "5110461", "type": "CDM"}, {"code": "350", "type": "RC"}], "standard_charges": [{"gross_charge": 16486.0, "discounted_cash": 12364.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CTA HEAD WO/W CONTRAST", "code_information": [{"code": "70496", "type": "CPT"}, {"code": "5050500", "type": "CDM"}, {"code": "350", "type": "RC"}], "standard_charges": [{"gross_charge": 11324.0, "discounted_cash": 8493.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CTA HEAD WO/W CONTRAST", "code_information": [{"code": "70496", "type": "CPT"}, {"code": "5110500", "type": "CDM"}, {"code": "350", "type": "RC"}], "standard_charges": [{"gross_charge": 11324.0, "discounted_cash": 8493.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CTA LOWR EXTRMTY WO/W CM", "code_information": [{"code": "73706", "type": "CPT"}, {"code": "5050510", "type": "CDM"}, {"code": "350", "type": "RC"}], "standard_charges": [{"gross_charge": 8672.0, "discounted_cash": 6504.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CTA LOWR EXTRMTY WO/W CM", "code_information": [{"code": "73706", "type": "CPT"}, {"code": "5110510", "type": "CDM"}, {"code": "350", "type": "RC"}], "standard_charges": [{"gross_charge": 10925.0, "discounted_cash": 8193.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CTA NECK WO/W CONTRAST", "code_information": [{"code": "70498", "type": "CPT"}, {"code": "5050502", "type": "CDM"}, {"code": "350", "type": "RC"}], "standard_charges": [{"gross_charge": 11324.0, "discounted_cash": 8493.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CTA NECK WO/W CONTRAST", "code_information": [{"code": "70498", "type": "CPT"}, {"code": "5110502", "type": "CDM"}, {"code": "350", "type": "RC"}], "standard_charges": [{"gross_charge": 11324.0, "discounted_cash": 8493.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CTA PELVIS WO/W CONTRAST", "code_information": [{"code": "72191", "type": "CPT"}, {"code": "5050504", "type": "CDM"}, {"code": "350", "type": "RC"}], "standard_charges": [{"gross_charge": 16059.0, "discounted_cash": 12044.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CTA UP EXTREMITY WO/W CM", "code_information": [{"code": "73206", "type": "CPT"}, {"code": "5050508", "type": "CDM"}, {"code": "350", "type": "RC"}], "standard_charges": [{"gross_charge": 8936.0, "discounted_cash": 6702.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CTA UP EXTREMITY WO/W CM", "code_information": [{"code": "73206", "type": "CPT"}, {"code": "5110508", "type": "CDM"}, {"code": "350", "type": "RC"}], "standard_charges": [{"gross_charge": 8936.0, "discounted_cash": 6702.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CULT AMPLIFIED PROBE EA", "code_information": [{"code": "87150", "type": "CPT"}, {"code": "7257150", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 60.0, "discounted_cash": 45.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CULT ANAEROBIC ANY EX BLD", "code_information": [{"code": "87075", "type": "CPT"}, {"code": "4177075", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 7.14, "discounted_cash": 5.36, "setting": "both", "billing_class": "facility"}]}, {"description": "CULT ANAEROBIC ANY EX BLD/2", "code_information": [{"code": "87075", "type": "CPT"}, {"code": "4107075", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 834.0, "discounted_cash": 625.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CULT DIR PRB EA ORGANISM", "code_information": [{"code": "87149", "type": "CPT"}, {"code": "4107149", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 313.0, "discounted_cash": 234.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CULT DIR PRB EA ORGANISM/3", "code_information": [{"code": "87149", "type": "CPT"}, {"code": "7258715", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 196.0, "discounted_cash": 147.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CULT FUNGI ID MOLD EA", "code_information": [{"code": "87107", "type": "CPT"}, {"code": "4107111", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 247.0, "discounted_cash": 185.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CULT FUNGI ID MOLD EA", "code_information": [{"code": "87107", "type": "CPT"}, {"code": "4177107", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 14.27, "discounted_cash": 10.7, "setting": "both", "billing_class": "facility"}]}, {"description": "CULT FUNGI ID YEAST EA", "code_information": [{"code": "87106", "type": "CPT"}, {"code": "4107106", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 306.0, "discounted_cash": 229.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CULT FUNGI ID YEAST EA", "code_information": [{"code": "87106", "type": "CPT"}, {"code": "4177106", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 11.42, "discounted_cash": 8.57, "setting": "both", "billing_class": "facility"}]}, {"description": "CULT ID SEQUENCING EA/2", "code_information": [{"code": "87153", "type": "CPT"}, {"code": "7258716", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 258.0, "discounted_cash": 193.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CULT MYCOBACTERIAL EA ISOL", "code_information": [{"code": "87118", "type": "CPT"}, {"code": "7257119", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 246.0, "discounted_cash": 184.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CULT STOOL ADD PATH EA", "code_information": [{"code": "87046", "type": "CPT"}, {"code": "4107048", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 512.0, "discounted_cash": 384.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CULT STOOL ADD PATH EA", "code_information": [{"code": "87046", "type": "CPT"}, {"code": "4177048", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 11.42, "discounted_cash": 8.57, "setting": "both", "billing_class": "facility"}]}, {"description": "CULT STOOL ADD PATH EA/2", "code_information": [{"code": "87046", "type": "CPT"}, {"code": "7257047", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 64.0, "discounted_cash": 48.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CULT STOOL ADD PATH EA/3", "code_information": [{"code": "87046", "type": "CPT"}, {"code": "4177047", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 18.55, "discounted_cash": 13.91, "setting": "both", "billing_class": "facility"}]}, {"description": "CULT STOOL ADD PATH EA/3", "code_information": [{"code": "87046", "type": "CPT"}, {"code": "7257057", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 36.0, "discounted_cash": 27.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CULT STOOL ADD PATH EA/5", "code_information": [{"code": "87046", "type": "CPT"}, {"code": "4107080", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 403.0, "discounted_cash": 302.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CULT STOOL ADD PATH EA/5", "code_information": [{"code": "87046", "type": "CPT"}, {"code": "4177080", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 18.55, "discounted_cash": 13.91, "setting": "both", "billing_class": "facility"}]}, {"description": "CULTURE AEROBIC DEF ID", "code_information": [{"code": "87077", "type": "CPT"}, {"code": "4108707", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 313.0, "discounted_cash": 234.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CULTURE AEROBIC DEF ID", "code_information": [{"code": "87077", "type": "CPT"}, {"code": "4178707", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 11.42, "discounted_cash": 8.57, "setting": "both", "billing_class": "facility"}]}, {"description": "CULTURE AEROBIC DEF ID/2", "code_information": [{"code": "87077", "type": "CPT"}, {"code": "7257074", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 246.0, "discounted_cash": 184.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CULTURE AEROBIC DEF ID/3", "code_information": [{"code": "87077", "type": "CPT"}, {"code": "7258707", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 77.0, "discounted_cash": 57.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CULTURE AEROBIC QUANT OTH", "code_information": [{"code": "87071", "type": "CPT"}, {"code": "4107021", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 639.0, "discounted_cash": 479.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CULTURE AEROBIC QUANT OTH", "code_information": [{"code": "87071", "type": "CPT"}, {"code": "4176911", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 7.14, "discounted_cash": 5.36, "setting": "both", "billing_class": "facility"}]}, {"description": "CULTURE AFB", "code_information": [{"code": "87116", "type": "CPT"}, {"code": "4107116", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 635.0, "discounted_cash": 476.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CULTURE AFB", "code_information": [{"code": "87116", "type": "CPT"}, {"code": "7257116", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 425.0, "discounted_cash": 318.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CULTURE ANAEROBIC DEF ID/2", "code_information": [{"code": "87076", "type": "CPT"}, {"code": "4107076", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 380.0, "discounted_cash": 285.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CULTURE ANAEROBIC DEF ID/2", "code_information": [{"code": "87076", "type": "CPT"}, {"code": "4177076", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 11.42, "discounted_cash": 8.57, "setting": "both", "billing_class": "facility"}]}, {"description": "CULTURE ANAEROBIC DEF ID/3", "code_information": [{"code": "87076", "type": "CPT"}, {"code": "4107097", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 210.0, "discounted_cash": 157.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CULTURE BACT OTH SOURCE", "code_information": [{"code": "87070", "type": "CPT"}, {"code": "4177022", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 7.14, "discounted_cash": 5.36, "setting": "both", "billing_class": "facility"}]}, {"description": "CULTURE BACT OTH SOURCE/10", "code_information": [{"code": "87070", "type": "CPT"}, {"code": "4107064", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 606.0, "discounted_cash": 454.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CULTURE BACT OTH SOURCE/10", "code_information": [{"code": "87070", "type": "CPT"}, {"code": "4177068", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 2.86, "discounted_cash": 2.15, "setting": "both", "billing_class": "facility"}]}, {"description": "CULTURE BACT OTH SOURCE/11", "code_information": [{"code": "87070", "type": "CPT"}, {"code": "4107065", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 553.0, "discounted_cash": 414.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CULTURE BACT OTH SOURCE/11", "code_information": [{"code": "87070", "type": "CPT"}, {"code": "4177069", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 7.14, "discounted_cash": 5.36, "setting": "both", "billing_class": "facility"}]}, {"description": "CULTURE BACT OTH SOURCE/13", "code_information": [{"code": "87070", "type": "CPT"}, {"code": "4107067", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 586.0, "discounted_cash": 439.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CULTURE BACT OTH SOURCE/14", "code_information": [{"code": "87070", "type": "CPT"}, {"code": "4107068", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 553.0, "discounted_cash": 414.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CULTURE BACT OTH SOURCE/14", "code_information": [{"code": "87070", "type": "CPT"}, {"code": "4177073", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 8.56, "discounted_cash": 6.42, "setting": "both", "billing_class": "facility"}]}, {"description": "CULTURE BACT OTH SOURCE/15", "code_information": [{"code": "87070", "type": "CPT"}, {"code": "4107069", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 553.0, "discounted_cash": 414.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CULTURE BACT OTH SOURCE/15", "code_information": [{"code": "87070", "type": "CPT"}, {"code": "4177074", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 7.14, "discounted_cash": 5.36, "setting": "both", "billing_class": "facility"}]}, {"description": "CULTURE BACT OTH SOURCE/16", "code_information": [{"code": "87070", "type": "CPT"}, {"code": "4107070", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 638.0, "discounted_cash": 478.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CULTURE BACT OTH SOURCE/16", "code_information": [{"code": "87070", "type": "CPT"}, {"code": "4177078", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 7.14, "discounted_cash": 5.36, "setting": "both", "billing_class": "facility"}]}, {"description": "CULTURE BACT OTH SOURCE/18", "code_information": [{"code": "87070", "type": "CPT"}, {"code": "4107073", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 734.0, "discounted_cash": 550.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CULTURE BACT OTH SOURCE/19", "code_information": [{"code": "87070", "type": "CPT"}, {"code": "4107074", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 734.0, "discounted_cash": 550.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CULTURE BACT OTH SOURCE/19", "code_information": [{"code": "87070", "type": "CPT"}, {"code": "4177083", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 2.86, "discounted_cash": 2.15, "setting": "both", "billing_class": "facility"}]}, {"description": "CULTURE BACT OTH SOURCE/2", "code_information": [{"code": "87070", "type": "CPT"}, {"code": "4107022", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 616.0, "discounted_cash": 462.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CULTURE BACT OTH SOURCE/2", "code_information": [{"code": "87070", "type": "CPT"}, {"code": "4177024", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 7.14, "discounted_cash": 5.36, "setting": "both", "billing_class": "facility"}]}, {"description": "CULTURE BACT OTH SOURCE/20", "code_information": [{"code": "87070", "type": "CPT"}, {"code": "4107078", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 675.0, "discounted_cash": 506.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CULTURE BACT OTH SOURCE/20", "code_information": [{"code": "87070", "type": "CPT"}, {"code": "4177085", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 4.29, "discounted_cash": 3.22, "setting": "both", "billing_class": "facility"}]}, {"description": "CULTURE BACT OTH SOURCE/21", "code_information": [{"code": "87070", "type": "CPT"}, {"code": "4177133", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 7.14, "discounted_cash": 5.36, "setting": "both", "billing_class": "facility"}]}, {"description": "CULTURE BACT OTH SOURCE/23", "code_information": [{"code": "87070", "type": "CPT"}, {"code": "4107085", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 616.0, "discounted_cash": 462.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CULTURE BACT OTH SOURCE/25", "code_information": [{"code": "87070", "type": "CPT"}, {"code": "4107133", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 593.0, "discounted_cash": 444.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CULTURE BACT OTH SOURCE/3", "code_information": [{"code": "87070", "type": "CPT"}, {"code": "4107024", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 553.0, "discounted_cash": 414.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CULTURE BACT OTH SOURCE/3", "code_information": [{"code": "87070", "type": "CPT"}, {"code": "4177043", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 7.14, "discounted_cash": 5.36, "setting": "both", "billing_class": "facility"}]}, {"description": "CULTURE BACT OTH SOURCE/4", "code_information": [{"code": "87070", "type": "CPT"}, {"code": "4177054", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 7.14, "discounted_cash": 5.36, "setting": "both", "billing_class": "facility"}]}, {"description": "CULTURE BACT OTH SOURCE/5", "code_information": [{"code": "87070", "type": "CPT"}, {"code": "4107033", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 734.0, "discounted_cash": 550.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CULTURE BACT OTH SOURCE/5", "code_information": [{"code": "87070", "type": "CPT"}, {"code": "4177056", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 0.97, "discounted_cash": 0.73, "setting": "both", "billing_class": "facility"}]}, {"description": "CULTURE BACT OTH SOURCE/6", "code_information": [{"code": "87070", "type": "CPT"}, {"code": "4107043", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 553.0, "discounted_cash": 414.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CULTURE BACT OTH SOURCE/6", "code_information": [{"code": "87070", "type": "CPT"}, {"code": "4177064", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 7.14, "discounted_cash": 5.36, "setting": "both", "billing_class": "facility"}]}, {"description": "CULTURE BACT OTH SOURCE/7", "code_information": [{"code": "87070", "type": "CPT"}, {"code": "4177065", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 7.14, "discounted_cash": 5.36, "setting": "both", "billing_class": "facility"}]}, {"description": "CULTURE BACT OTH SOURCE/8", "code_information": [{"code": "87070", "type": "CPT"}, {"code": "7257162", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 131.0, "discounted_cash": 98.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CULTURE BACT OTH SOURCE/9", "code_information": [{"code": "87070", "type": "CPT"}, {"code": "4177067", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 5.71, "discounted_cash": 4.28, "setting": "both", "billing_class": "facility"}]}, {"description": "CULTURE BACTERIAL SCREEN", "code_information": [{"code": "87081", "type": "CPT"}, {"code": "4107039", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 493.0, "discounted_cash": 369.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CULTURE BACTERIAL SCREEN", "code_information": [{"code": "87081", "type": "CPT"}, {"code": "4177039", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 7.14, "discounted_cash": 5.36, "setting": "both", "billing_class": "facility"}]}, {"description": "CULTURE BACTERIAL SCREEN/2", "code_information": [{"code": "87081", "type": "CPT"}, {"code": "4107044", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 377.0, "discounted_cash": 282.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CULTURE BACTERIAL SCREEN/2", "code_information": [{"code": "87081", "type": "CPT"}, {"code": "4177044", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 11.42, "discounted_cash": 8.57, "setting": "both", "billing_class": "facility"}]}, {"description": "CULTURE BACTERIAL SCREEN/3", "code_information": [{"code": "87081", "type": "CPT"}, {"code": "4107053", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 517.0, "discounted_cash": 387.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CULTURE BACTERIAL SCREEN/4", "code_information": [{"code": "87081", "type": "CPT"}, {"code": "4177081", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 4.29, "discounted_cash": 3.22, "setting": "both", "billing_class": "facility"}]}, {"description": "CULTURE BACTERIAL SCREEN/5", "code_information": [{"code": "87081", "type": "CPT"}, {"code": "4107081", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 644.0, "discounted_cash": 483.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CULTURE BACTERIAL SCREEN/5", "code_information": [{"code": "87081", "type": "CPT"}, {"code": "4177099", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 11.42, "discounted_cash": 8.57, "setting": "both", "billing_class": "facility"}]}, {"description": "CULTURE BACTERIAL SCREEN/6", "code_information": [{"code": "87081", "type": "CPT"}, {"code": "4107099", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 511.0, "discounted_cash": 383.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CULTURE BACTERIAL SCREEN/6", "code_information": [{"code": "87081", "type": "CPT"}, {"code": "4177160", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 11.42, "discounted_cash": 8.57, "setting": "both", "billing_class": "facility"}]}, {"description": "CULTURE BACTERIAL SCREEN/7", "code_information": [{"code": "87081", "type": "CPT"}, {"code": "4107160", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 377.0, "discounted_cash": 282.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CULTURE BACTERIAL SCREEN/9", "code_information": [{"code": "87081", "type": "CPT"}, {"code": "4108701", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 564.0, "discounted_cash": 423.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CULTURE BLOOD", "code_information": [{"code": "87040", "type": "CPT"}, {"code": "4107040", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 982.0, "discounted_cash": 736.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CULTURE BLOOD", "code_information": [{"code": "87040", "type": "CPT"}, {"code": "4177040", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 14.27, "discounted_cash": 10.7, "setting": "both", "billing_class": "facility"}]}, {"description": "CULTURE CHLAMYDIA", "code_information": [{"code": "87110", "type": "CPT"}, {"code": "4107110", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 794.0, "discounted_cash": 595.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CULTURE CHLAMYDIA", "code_information": [{"code": "87110", "type": "CPT"}, {"code": "7257110", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 65.0, "discounted_cash": 48.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CULTURE FUNGI BLOOD", "code_information": [{"code": "87103", "type": "CPT"}, {"code": "4107103", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 467.0, "discounted_cash": 350.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CULTURE FUNGI BLOOD", "code_information": [{"code": "87103", "type": "CPT"}, {"code": "4177103", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 14.27, "discounted_cash": 10.7, "setting": "both", "billing_class": "facility"}]}, {"description": "CULTURE FUNGI OTHER", "code_information": [{"code": "87102", "type": "CPT"}, {"code": "4107102", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 694.0, "discounted_cash": 520.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CULTURE FUNGI OTHER", "code_information": [{"code": "87102", "type": "CPT"}, {"code": "4177102", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 7.14, "discounted_cash": 5.36, "setting": "both", "billing_class": "facility"}]}, {"description": "CULTURE MYCOPLASMA ANY", "code_information": [{"code": "87109", "type": "CPT"}, {"code": "7257109", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 401.0, "discounted_cash": 300.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CULTURE STOOL", "code_information": [{"code": "87045", "type": "CPT"}, {"code": "4107055", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 885.0, "discounted_cash": 663.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CULTURE STOOL", "code_information": [{"code": "87045", "type": "CPT"}, {"code": "4177055", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 14.27, "discounted_cash": 10.7, "setting": "both", "billing_class": "facility"}]}, {"description": "CULTURE TYPNG FLUORO EA", "code_information": [{"code": "87140", "type": "CPT"}, {"code": "7257140", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 65.0, "discounted_cash": 48.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CULTURE TYPNG SEROLOGIC/2", "code_information": [{"code": "87147", "type": "CPT"}, {"code": "4177147", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 28.55, "discounted_cash": 21.41, "setting": "both", "billing_class": "facility"}]}, {"description": "CULTURE TYPNG SEROLOGIC/3", "code_information": [{"code": "87147", "type": "CPT"}, {"code": "4107147", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 440.0, "discounted_cash": 330.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CULTURE URINE COLONY CT", "code_information": [{"code": "87086", "type": "CPT"}, {"code": "4107086", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 1293.0, "discounted_cash": 969.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CULTURE URINE IDENT", "code_information": [{"code": "87088", "type": "CPT"}, {"code": "4107088", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 1348.0, "discounted_cash": 1011.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CULTURE URINE IDENT", "code_information": [{"code": "87088", "type": "CPT"}, {"code": "4177088", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 5.71, "discounted_cash": 4.28, "setting": "both", "billing_class": "facility"}]}, {"description": "CUP ACE BMNTM PRSFT PLS DPY CL", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "4012803", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 20424.0, "discounted_cash": 15318.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CUP ACETAB CTD CTD P2 DJO CL", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "4013392", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 14823.0, "discounted_cash": 11117.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CUP ACETAB GRIPTN COAT DPY CL", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "4012801", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 16711.0, "discounted_cash": 12533.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CUP ACETABULR TRITAN STRYK CL", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "4013115", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 16213.0, "discounted_cash": 12159.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CUP ACETABULR UNCOAT DEPUY CL", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "4012802", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 16711.0, "discounted_cash": 12533.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CV CATH OH IABP", "code_information": [{"code": "C1725", "type": "HCPCS"}, {"code": "8056936", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 14982.0, "discounted_cash": 11236.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CV2 AB", "code_information": [{"code": "83516", "type": "CPT"}, {"code": "7253486", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 1000.0, "discounted_cash": 750.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CYANIDE", "code_information": [{"code": "82600", "type": "CPT"}, {"code": "7252600", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 1107.0, "discounted_cash": 830.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CYANOCOBALAMN UPTO1MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3420", "type": "HCPCS"}, {"code": "5319674", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 171.0, "discounted_cash": 128.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CYANOCOBALAMN UPTO1MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3420", "type": "HCPCS"}, {"code": "5319674", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 171.0, "discounted_cash": 128.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CYANOCOBLMN(VIT B12)", "code_information": [{"code": "82607", "type": "CPT"}, {"code": "4102611", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 353.0, "discounted_cash": 264.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CYANOCOBLMN(VIT B12)", "code_information": [{"code": "82607", "type": "CPT"}, {"code": "4172611", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 9.98, "discounted_cash": 7.49, "setting": "both", "billing_class": "facility"}]}, {"description": "CYANOCOBLMN(VIT B12)", "code_information": [{"code": "82607", "type": "CPT"}, {"code": "7252611", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 12.0, "discounted_cash": 9.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CYC CITRULLINATED PEP AB", "code_information": [{"code": "86200", "type": "CPT"}, {"code": "4103596", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 201.0, "discounted_cash": 150.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CYC CITRULLINATED PEP AB", "code_information": [{"code": "86200", "type": "CPT"}, {"code": "7253596", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 136.0, "discounted_cash": 102.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CYCLOBENZAPRINE 10MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5303254", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 85.0, "discounted_cash": 63.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CYCLOBENZAPRINE 10MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5303254", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 85.0, "discounted_cash": 63.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CYCLOPENTOLATE 1% 2ML OS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5330590", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 284.0, "discounted_cash": 213.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CYCLOPENTOLATE 1%15ML OS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5330598", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 469.0, "discounted_cash": 351.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CYCLOPENTOLATE 1%5ML OS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5330597", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 532.0, "discounted_cash": 399.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CYCLOPENTOLATE 2%2ML OS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5330601", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 435.0, "discounted_cash": 326.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CYCLOPENTOLATE 2%5ML OS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5330603", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 441.0, "discounted_cash": 330.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CYCLOPHOSPHAMIDE 25MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8530", "type": "HCPCS"}, {"code": "5303278", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 78.0, "discounted_cash": 58.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CYCLOPHOSPHAMIDE 25MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8530", "type": "HCPCS"}, {"code": "5303278", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 78.0, "discounted_cash": 58.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CYCLOPHOSPHAMIDE 50MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8530", "type": "HCPCS"}, {"code": "5303281", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 126.0, "discounted_cash": 94.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CYCLOPHOSPHAMIDE 50MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8530", "type": "HCPCS"}, {"code": "5303281", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 126.0, "discounted_cash": 94.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CYCLOSPORIN 100MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J7502", "type": "HCPCS"}, {"code": "5303292", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 160.0, "discounted_cash": 120.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CYCLOSPORIN 100MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J7502", "type": "HCPCS"}, {"code": "5303292", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 160.0, "discounted_cash": 120.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CYCLOSPORIN 25MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J7515", "type": "HCPCS"}, {"code": "5303286", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 61.0, "discounted_cash": 45.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CYCLOSPORIN 25MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J7515", "type": "HCPCS"}, {"code": "5303286", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 61.0, "discounted_cash": 45.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CYCLOSPORINE", "code_information": [{"code": "80158", "type": "CPT"}, {"code": "4102613", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 1739.0, "discounted_cash": 1304.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CYCLOSPORINE 100MG MODIFIED CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J7502", "type": "HCPCS"}, {"code": "5303293", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 100.0, "discounted_cash": 75.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CYCLOSPORINE 100MG MODIFIED CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J7502", "type": "HCPCS"}, {"code": "5303293", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 100.0, "discounted_cash": 75.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CYCLOSPORINE 25MG GEL CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J7515", "type": "HCPCS"}, {"code": "5303289", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 61.0, "discounted_cash": 45.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CYCLOSPORINE 25MG GEL CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J7515", "type": "HCPCS"}, {"code": "5303289", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 61.0, "discounted_cash": 45.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CYCLOSPORINE.05% .4ML OS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5330610", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 120.0, "discounted_cash": 90.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CYCLOSPORINE.05% .4ML OS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5330610", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 120.0, "discounted_cash": 90.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CYCLOSPORINE/2", "code_information": [{"code": "80158", "type": "CPT"}, {"code": "7252613", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 92.0, "discounted_cash": 69.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CYCLOSPORINE100MG/1ML LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J7502", "type": "HCPCS"}, {"code": "5314875", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 35.0, "discounted_cash": 26.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CYCLOSPORINE100MG/1ML LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J7502", "type": "HCPCS"}, {"code": "5314875", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 35.0, "discounted_cash": 26.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CYP2C19 COMMON VARIANTS/2", "code_information": [{"code": "81225", "type": "CPT"}, {"code": "7251231", "type": "CDM"}, {"code": "310", "type": "RC"}], "standard_charges": [{"gross_charge": 457.0, "discounted_cash": 342.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CYPROHEPTADINE 4MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5303304", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 61.0, "discounted_cash": 45.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CYPROHEPTADINE 4MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5303304", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 61.0, "discounted_cash": 45.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CYSTATIN C", "code_information": [{"code": "82610", "type": "CPT"}, {"code": "7255607", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 60.0, "discounted_cash": 45.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CYSTATIN C", "code_information": [{"code": "82610", "type": "CPT"}, {"code": "7258261", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 201.0, "discounted_cash": 150.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CYSTOGRAPHY 3VW MIN", "code_information": [{"code": "74430", "type": "CPT"}, {"code": "4904434", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 4054.0, "discounted_cash": 3040.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CYSTOSCOPY BLUE LIGHT PROC", "code_information": [{"code": "3219738", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 1659.0, "discounted_cash": 1244.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CYTAL 6-LAYER PER SQ CM", "code_information": [{"code": "Q4166", "type": "HCPCS"}, {"code": "4028004", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 361.0, "discounted_cash": 270.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CYTAL 6-LAYER PER SQ CM", "code_information": [{"code": "Q4166", "type": "HCPCS"}, {"code": "4028004", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 361.0, "discounted_cash": 270.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CYTAL WND 1-LYR 3CMX3.5CM SQCM", "code_information": [{"code": "Q4166", "type": "HCPCS"}, {"code": "4027992", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 53.0, "discounted_cash": 39.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CYTAL WND 1-LYR 3CMX3.5CM SQCM", "code_information": [{"code": "Q4166", "type": "HCPCS"}, {"code": "4027992", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 53.0, "discounted_cash": 39.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CYTAL WND 1-LYR 3CMX7CM SQ CM", "code_information": [{"code": "Q4166", "type": "HCPCS"}, {"code": "4027993", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 52.0, "discounted_cash": 39.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CYTAL WND 1-LYR 3CMX7CM SQ CM", "code_information": [{"code": "Q4166", "type": "HCPCS"}, {"code": "4027993", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 52.0, "discounted_cash": 39.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CYTAL WND 1-LYR 7CMX10CM SQ CM", "code_information": [{"code": "Q4166", "type": "HCPCS"}, {"code": "4027994", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 34.0, "discounted_cash": 25.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CYTAL WND 1-LYR 7CMX10CM SQ CM", "code_information": [{"code": "Q4166", "type": "HCPCS"}, {"code": "4027994", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 34.0, "discounted_cash": 25.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CYTAL WND 2-LYR 5CMX5CM SQ CM", "code_information": [{"code": "Q4166", "type": "HCPCS"}, {"code": "4027988", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 253.0, "discounted_cash": 189.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CYTAL WND 2-LYR 5CMX5CM SQ CM", "code_information": [{"code": "Q4166", "type": "HCPCS"}, {"code": "4027988", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 253.0, "discounted_cash": 189.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CYTAL WND 2-LYR 7CMX10CM SQ CM", "code_information": [{"code": "Q4166", "type": "HCPCS"}, {"code": "4027989", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 164.0, "discounted_cash": 123.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CYTAL WND 2-LYR 7CMX10CM SQ CM", "code_information": [{"code": "Q4166", "type": "HCPCS"}, {"code": "4027989", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 164.0, "discounted_cash": 123.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CYTAL WND 3-LYR 10CMX15CM SQCM", "code_information": [{"code": "Q4166", "type": "HCPCS"}, {"code": "4027986", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 201.0, "discounted_cash": 150.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CYTAL WND 3-LYR 10CMX15CM SQCM", "code_information": [{"code": "Q4166", "type": "HCPCS"}, {"code": "4027986", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 201.0, "discounted_cash": 150.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CYTAL WND 3-LYR 5CMX5CM SQ CM", "code_information": [{"code": "Q4166", "type": "HCPCS"}, {"code": "4027998", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 253.0, "discounted_cash": 189.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CYTAL WND 3-LYR 5CMX5CM SQ CM", "code_information": [{"code": "Q4166", "type": "HCPCS"}, {"code": "4027998", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 253.0, "discounted_cash": 189.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CYTAL WND 3-LYR 7CMX10CM SQ CM", "code_information": [{"code": "Q4166", "type": "HCPCS"}, {"code": "4027997", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 275.0, "discounted_cash": 206.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CYTAL WND 3-LYR 7CMX10CM SQ CM", "code_information": [{"code": "Q4166", "type": "HCPCS"}, {"code": "4027997", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 275.0, "discounted_cash": 206.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CYTO C/V BETHESDA", "code_information": [{"code": "88164", "type": "CPT"}, {"code": "7258164", "type": "CDM"}, {"code": "310", "type": "RC"}], "standard_charges": [{"gross_charge": 72.0, "discounted_cash": 54.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CYTO C/V PHYS INTRP", "code_information": [{"code": "88141", "type": "CPT"}, {"code": "4308141", "type": "CDM"}, {"code": "310", "type": "RC"}], "standard_charges": [{"gross_charge": 385.0, "discounted_cash": 288.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CYTO C/V PREP SCREEN", "code_information": [{"code": "88142", "type": "CPT"}, {"code": "7258142", "type": "CDM"}, {"code": "310", "type": "RC"}], "standard_charges": [{"gross_charge": 131.0, "discounted_cash": 98.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CYTO FNA 1ST EVAL", "code_information": [{"code": "88172", "type": "CPT"}, {"code": "4308175", "type": "CDM"}, {"code": "310", "type": "RC"}], "standard_charges": [{"gross_charge": 752.0, "discounted_cash": 564.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CYTO FNA ADD EVAL", "code_information": [{"code": "88177", "type": "CPT"}, {"code": "4308177", "type": "CDM"}, {"code": "310", "type": "RC"}], "standard_charges": [{"gross_charge": 433.0, "discounted_cash": 324.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CYTO SMEAR PREP", "code_information": [{"code": "88161", "type": "CPT"}, {"code": "4308140", "type": "CDM"}, {"code": "310", "type": "RC"}], "standard_charges": [{"gross_charge": 344.0, "discounted_cash": 258.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CYTO SMR GYN TECH SCRN", "code_information": [{"code": "P3000", "type": "HCPCS"}, {"code": "4303462", "type": "CDM"}, {"code": "310", "type": "RC"}], "standard_charges": [{"gross_charge": 159.0, "discounted_cash": 119.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CYTOGEN VARIANT CHROME", "code_information": [{"code": "81229", "type": "CPT"}, {"code": "7251229", "type": "CDM"}, {"code": "310", "type": "RC"}], "standard_charges": [{"gross_charge": 4685.0, "discounted_cash": 3513.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CYTOMEGALOVIRUS AB", "code_information": [{"code": "86644", "type": "CPT"}, {"code": "4106910", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 243.0, "discounted_cash": 182.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CYTOMEGALOVIRUS AB IGM", "code_information": [{"code": "86645", "type": "CPT"}, {"code": "7256645", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 48.0, "discounted_cash": 36.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CYTOMEGALOVIRUS AB IGM/2", "code_information": [{"code": "86645", "type": "CPT"}, {"code": "7256646", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 156.0, "discounted_cash": 117.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CYTOMEGALOVIRUS AB/4", "code_information": [{"code": "86644", "type": "CPT"}, {"code": "7259425", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 48.0, "discounted_cash": 36.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CYTOMEGALOVIRUS AMP PRB", "code_information": [{"code": "87496", "type": "CPT"}, {"code": "7257500", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 852.0, "discounted_cash": 639.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CYTOMEGALOVIRUS AMPL PRB/3", "code_information": [{"code": "87496", "type": "CPT"}, {"code": "7258756", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 445.0, "discounted_cash": 333.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CYTOPATH CONL SMR W/INT", "code_information": [{"code": "88108", "type": "CPT"}, {"code": "4308108", "type": "CDM"}, {"code": "310", "type": "RC"}], "standard_charges": [{"gross_charge": 519.0, "discounted_cash": 389.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CYTOPATH CONL SMR W/INT", "code_information": [{"code": "88108", "type": "CPT"}, {"code": "7258001", "type": "CDM"}, {"code": "310", "type": "RC"}], "standard_charges": [{"gross_charge": 110.0, "discounted_cash": 82.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CYTOPATH FILTER W/INT", "code_information": [{"code": "88106", "type": "CPT"}, {"code": "4308106", "type": "CDM"}, {"code": "310", "type": "RC"}], "standard_charges": [{"gross_charge": 576.0, "discounted_cash": 432.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CYTOPATH OTHER SOURCE", "code_information": [{"code": "88160", "type": "CPT"}, {"code": "4308160", "type": "CDM"}, {"code": "310", "type": "RC"}], "standard_charges": [{"gross_charge": 258.0, "discounted_cash": 193.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CYTOPATH WASH/BRUSH/SM", "code_information": [{"code": "88104", "type": "CPT"}, {"code": "4308104", "type": "CDM"}, {"code": "310", "type": "RC"}], "standard_charges": [{"gross_charge": 313.0, "discounted_cash": 234.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CYTOPATH WASH/BRUSH/SM", "code_information": [{"code": "88104", "type": "CPT"}, {"code": "7258104", "type": "CDM"}, {"code": "310", "type": "RC"}], "standard_charges": [{"gross_charge": 229.0, "discounted_cash": 171.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CYTOPTH CELL ENHANCE TEC", "code_information": [{"code": "88112", "type": "CPT"}, {"code": "4308112", "type": "CDM"}, {"code": "310", "type": "RC"}], "standard_charges": [{"gross_charge": 819.0, "discounted_cash": 614.25, "setting": "both", "billing_class": "facility"}]}, {"description": "D10 NACL 0.225 250ML IVF", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5412412", "type": "CDM"}, {"code": "258", "type": "RC"}], "standard_charges": [{"gross_charge": 477.0, "discounted_cash": 357.75, "setting": "both", "billing_class": "facility"}]}, {"description": "D10 NACL 0.45 1000ML IVF", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5412415", "type": "CDM"}, {"code": "258", "type": "RC"}], "standard_charges": [{"gross_charge": 438.0, "discounted_cash": 328.5, "setting": "both", "billing_class": "facility"}]}, {"description": "D10 NACL 0.9 1000ML IVF", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5412425", "type": "CDM"}, {"code": "258", "type": "RC"}], "standard_charges": [{"gross_charge": 601.0, "discounted_cash": 450.75, "setting": "both", "billing_class": "facility"}]}, {"description": "D10W 1000ML TPN", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5412440", "type": "CDM"}, {"code": "258", "type": "RC"}], "standard_charges": [{"gross_charge": 569.0, "discounted_cash": 426.75, "setting": "both", "billing_class": "facility"}]}, {"description": "D10W 250ML TPN", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5412430", "type": "CDM"}, {"code": "258", "type": "RC"}], "standard_charges": [{"gross_charge": 511.0, "discounted_cash": 383.25, "setting": "both", "billing_class": "facility"}]}, {"description": "D10W 500ML TPN", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5412435", "type": "CDM"}, {"code": "258", "type": "RC"}], "standard_charges": [{"gross_charge": 511.0, "discounted_cash": 383.25, "setting": "both", "billing_class": "facility"}]}, {"description": "D12.5W 250ML IVF", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5412087", "type": "CDM"}, {"code": "258", "type": "RC"}], "standard_charges": [{"gross_charge": 505.0, "discounted_cash": 378.75, "setting": "both", "billing_class": "facility"}]}, {"description": "D5 100ML IVF", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J7060", "type": "HCPCS"}, {"code": "5412360", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 1058.0, "discounted_cash": 793.5, "setting": "both", "billing_class": "facility"}]}, {"description": "D5 100ML IVF", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J7060", "type": "HCPCS"}, {"code": "5412360", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 1058.0, "discounted_cash": 793.5, "setting": "both", "billing_class": "facility"}]}, {"description": "D5 150ML IVF", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J7060", "type": "HCPCS"}, {"code": "5412365", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 605.0, "discounted_cash": 453.75, "setting": "both", "billing_class": "facility"}]}, {"description": "D5 150ML IVF", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J7060", "type": "HCPCS"}, {"code": "5412365", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 605.0, "discounted_cash": 453.75, "setting": "both", "billing_class": "facility"}]}, {"description": "D5 250ML IVF", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J7060", "type": "HCPCS"}, {"code": "5412370", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 629.0, "discounted_cash": 471.75, "setting": "both", "billing_class": "facility"}]}, {"description": "D5 250ML IVF", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J7060", "type": "HCPCS"}, {"code": "5412370", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 629.0, "discounted_cash": 471.75, "setting": "both", "billing_class": "facility"}]}, {"description": "D5 25ML IVF", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5412350", "type": "CDM"}, {"code": "258", "type": "RC"}], "standard_charges": [{"gross_charge": 487.0, "discounted_cash": 365.25, "setting": "both", "billing_class": "facility"}]}, {"description": "D5 500ML IVF", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J7060", "type": "HCPCS"}, {"code": "5412375", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 610.0, "discounted_cash": 457.5, "setting": "both", "billing_class": "facility"}]}, {"description": "D5 500ML IVF", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J7060", "type": "HCPCS"}, {"code": "5412375", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 610.0, "discounted_cash": 457.5, "setting": "both", "billing_class": "facility"}]}, {"description": "D5 50ML IVF", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J7060", "type": "HCPCS"}, {"code": "5412355", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 682.0, "discounted_cash": 511.5, "setting": "both", "billing_class": "facility"}]}, {"description": "D5 50ML IVF", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J7060", "type": "HCPCS"}, {"code": "5412355", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 682.0, "discounted_cash": 511.5, "setting": "both", "billing_class": "facility"}]}, {"description": "D5 L RINGER KCL20 1L IVF", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5412175", "type": "CDM"}, {"code": "258", "type": "RC"}], "standard_charges": [{"gross_charge": 677.0, "discounted_cash": 507.75, "setting": "both", "billing_class": "facility"}]}, {"description": "D5 L RINGERS 1000ML IVF", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J7121", "type": "HCPCS"}, {"code": "5412170", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 608.0, "discounted_cash": 456.0, "setting": "both", "billing_class": "facility"}]}, {"description": "D5 L RINGERS 1000ML IVF", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J7121", "type": "HCPCS"}, {"code": "5412170", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 608.0, "discounted_cash": 456.0, "setting": "both", "billing_class": "facility"}]}, {"description": "D5 L RINGERS 500ML IVF", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J7121", "type": "HCPCS"}, {"code": "5412165", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 530.0, "discounted_cash": 397.5, "setting": "both", "billing_class": "facility"}]}, {"description": "D5 L RINGERS 500ML IVF", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J7121", "type": "HCPCS"}, {"code": "5412165", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 530.0, "discounted_cash": 397.5, "setting": "both", "billing_class": "facility"}]}, {"description": "D5 NACL 0.2 1000ML IVF", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5412215", "type": "CDM"}, {"code": "258", "type": "RC"}], "standard_charges": [{"gross_charge": 445.0, "discounted_cash": 333.75, "setting": "both", "billing_class": "facility"}]}, {"description": "D5 NACL 0.2 500ML IVF", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5412210", "type": "CDM"}, {"code": "258", "type": "RC"}], "standard_charges": [{"gross_charge": 713.0, "discounted_cash": 534.75, "setting": "both", "billing_class": "facility"}]}, {"description": "D5 NACL 0.33 1000ML IVF", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5412255", "type": "CDM"}, {"code": "258", "type": "RC"}], "standard_charges": [{"gross_charge": 532.0, "discounted_cash": 399.0, "setting": "both", "billing_class": "facility"}]}, {"description": "D5 NACL 0.33 500ML IVF", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5412250", "type": "CDM"}, {"code": "258", "type": "RC"}], "standard_charges": [{"gross_charge": 585.0, "discounted_cash": 438.75, "setting": "both", "billing_class": "facility"}]}, {"description": "D5 NACL 0.45 1000ML IVF", "code_information": [{"code": "S5010", "type": "HCPCS"}, {"code": "5412290", "type": "CDM"}, {"code": "258", "type": "RC"}], "standard_charges": [{"gross_charge": 699.0, "discounted_cash": 524.25, "setting": "both", "billing_class": "facility"}]}, {"description": "D5 NACL 0.45 500ML IVF", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5412285", "type": "CDM"}, {"code": "258", "type": "RC"}], "standard_charges": [{"gross_charge": 483.0, "discounted_cash": 362.25, "setting": "both", "billing_class": "facility"}]}, {"description": "D5 NACL 0.9 1000ML IVF", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J7042", "type": "HCPCS"}, {"code": "5412335", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 531.0, "discounted_cash": 398.25, "setting": "both", "billing_class": "facility"}]}, {"description": "D5 NACL 0.9 1000ML IVF", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J7042", "type": "HCPCS"}, {"code": "5412335", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 531.0, "discounted_cash": 398.25, "setting": "both", "billing_class": "facility"}]}, {"description": "D5 NACL 0.9 500ML IVF", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J7042", "type": "HCPCS"}, {"code": "5412330", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 537.0, "discounted_cash": 402.75, "setting": "both", "billing_class": "facility"}]}, {"description": "D5 NACL 0.9 500ML IVF", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J7042", "type": "HCPCS"}, {"code": "5412330", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 537.0, "discounted_cash": 402.75, "setting": "both", "billing_class": "facility"}]}, {"description": "D5 NACL.2 KCL10 0.5L IVF", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5412220", "type": "CDM"}, {"code": "258", "type": "RC"}], "standard_charges": [{"gross_charge": 557.0, "discounted_cash": 417.75, "setting": "both", "billing_class": "facility"}]}, {"description": "D5 NACL.2 KCL10 1L IVF", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5412225", "type": "CDM"}, {"code": "258", "type": "RC"}], "standard_charges": [{"gross_charge": 731.0, "discounted_cash": 548.25, "setting": "both", "billing_class": "facility"}]}, {"description": "D5 NACL.2 KCL20 1L IVF", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5412230", "type": "CDM"}, {"code": "258", "type": "RC"}], "standard_charges": [{"gross_charge": 494.0, "discounted_cash": 370.5, "setting": "both", "billing_class": "facility"}]}, {"description": "D5 NACL.2 KCL40 1L IVF", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5412240", "type": "CDM"}, {"code": "258", "type": "RC"}], "standard_charges": [{"gross_charge": 731.0, "discounted_cash": 548.25, "setting": "both", "billing_class": "facility"}]}, {"description": "D5 NACL.33 KCL20 1L IVF", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5412265", "type": "CDM"}, {"code": "258", "type": "RC"}], "standard_charges": [{"gross_charge": 731.0, "discounted_cash": 548.25, "setting": "both", "billing_class": "facility"}]}, {"description": "D5 NACL.45 KCL10 1L IVF", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5412300", "type": "CDM"}, {"code": "258", "type": "RC"}], "standard_charges": [{"gross_charge": 577.0, "discounted_cash": 432.75, "setting": "both", "billing_class": "facility"}]}, {"description": "D5 NACL.45 KCL20 1L IVF", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5412310", "type": "CDM"}, {"code": "258", "type": "RC"}], "standard_charges": [{"gross_charge": 646.0, "discounted_cash": 484.5, "setting": "both", "billing_class": "facility"}]}, {"description": "D5 NACL.45 KCL30 1L IVF", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5412315", "type": "CDM"}, {"code": "258", "type": "RC"}], "standard_charges": [{"gross_charge": 582.0, "discounted_cash": 436.5, "setting": "both", "billing_class": "facility"}]}, {"description": "D5 NACL.45 KCL40 1L IVF", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5412320", "type": "CDM"}, {"code": "258", "type": "RC"}], "standard_charges": [{"gross_charge": 639.0, "discounted_cash": 479.25, "setting": "both", "billing_class": "facility"}]}, {"description": "D5 NACL.45KCL10 0.5L IVF", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5412295", "type": "CDM"}, {"code": "258", "type": "RC"}], "standard_charges": [{"gross_charge": 630.0, "discounted_cash": 472.5, "setting": "both", "billing_class": "facility"}]}, {"description": "D5 NACL.9 KCL20 1L IVF", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5412340", "type": "CDM"}, {"code": "258", "type": "RC"}], "standard_charges": [{"gross_charge": 577.0, "discounted_cash": 432.75, "setting": "both", "billing_class": "facility"}]}, {"description": "D5 RINGERS 1000ML IVF", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5412190", "type": "CDM"}, {"code": "258", "type": "RC"}], "standard_charges": [{"gross_charge": 646.0, "discounted_cash": 484.5, "setting": "both", "billing_class": "facility"}]}, {"description": "D5W 1000ML IVF", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J7070", "type": "HCPCS"}, {"code": "5412380", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 538.0, "discounted_cash": 403.5, "setting": "both", "billing_class": "facility"}]}, {"description": "D5W 1000ML IVF", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J7070", "type": "HCPCS"}, {"code": "5412380", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 538.0, "discounted_cash": 403.5, "setting": "both", "billing_class": "facility"}]}, {"description": "D5W KCL 20 1000ML IVF", "code_information": [{"code": "S5012", "type": "HCPCS"}, {"code": "5412395", "type": "CDM"}, {"code": "258", "type": "RC"}], "standard_charges": [{"gross_charge": 674.0, "discounted_cash": 505.5, "setting": "both", "billing_class": "facility"}]}, {"description": "D7.5W 250ML IVF", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5412086", "type": "CDM"}, {"code": "258", "type": "RC"}], "standard_charges": [{"gross_charge": 652.0, "discounted_cash": 489.0, "setting": "both", "billing_class": "facility"}]}, {"description": "D70W 500ML IN 1L TPN", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5413415", "type": "CDM"}, {"code": "258", "type": "RC"}], "standard_charges": [{"gross_charge": 2838.0, "discounted_cash": 2128.5, "setting": "both", "billing_class": "facility"}]}, {"description": "D70W PER1 ML TPN", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5413421", "type": "CDM"}, {"code": "258", "type": "RC"}], "standard_charges": [{"gross_charge": 85.0, "discounted_cash": 63.75, "setting": "both", "billing_class": "facility"}]}, {"description": "DABIGATRAN 150MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5303320", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 140.0, "discounted_cash": 105.0, "setting": "both", "billing_class": "facility"}]}, {"description": "DABIGATRAN 150MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5303320", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 140.0, "discounted_cash": 105.0, "setting": "both", "billing_class": "facility"}]}, {"description": "DABIGATRAN 75MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5303319", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 140.0, "discounted_cash": 105.0, "setting": "both", "billing_class": "facility"}]}, {"description": "DABIGATRAN 75MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5303319", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 140.0, "discounted_cash": 105.0, "setting": "both", "billing_class": "facility"}]}, {"description": "DANAZOL 100MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5303350", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 97.0, "discounted_cash": 72.75, "setting": "both", "billing_class": "facility"}]}, {"description": "DANAZOL 100MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5303350", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 97.0, "discounted_cash": 72.75, "setting": "both", "billing_class": "facility"}]}, {"description": "DANTROLENE 20MG/70ML IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5319752", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 1673.0, "discounted_cash": 1254.75, "setting": "both", "billing_class": "facility"}]}, {"description": "DANTROLENE 25MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5303419", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 72.0, "discounted_cash": 54.0, "setting": "both", "billing_class": "facility"}]}, {"description": "DANTROLENE 25MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5303419", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 72.0, "discounted_cash": 54.0, "setting": "both", "billing_class": "facility"}]}, {"description": "DAPAGLIFLOZIN 10MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5303431", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 222.0, "discounted_cash": 166.5, "setting": "both", "billing_class": "facility"}]}, {"description": "DAPAGLIFLOZIN 10MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5303431", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 222.0, "discounted_cash": 166.5, "setting": "both", "billing_class": "facility"}]}, {"description": "DAPAGLIFLOZIN 5MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5303430", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 222.0, "discounted_cash": 166.5, "setting": "both", "billing_class": "facility"}]}, {"description": "DAPAGLIFLOZIN 5MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5303430", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 222.0, "discounted_cash": 166.5, "setting": "both", "billing_class": "facility"}]}, {"description": "DAPSONE 100MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5303443", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 85.0, "discounted_cash": 63.75, "setting": "both", "billing_class": "facility"}]}, {"description": "DAPSONE 100MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5303443", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 85.0, "discounted_cash": 63.75, "setting": "both", "billing_class": "facility"}]}, {"description": "DAPSONE 25MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5303442", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 85.0, "discounted_cash": 63.75, "setting": "both", "billing_class": "facility"}]}, {"description": "DAPSONE 25MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5303442", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 85.0, "discounted_cash": 63.75, "setting": "both", "billing_class": "facility"}]}, {"description": "DAPTOMYCIN PER 1MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0878", "type": "HCPCS"}, {"code": "5319759", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 11.0, "discounted_cash": 8.25, "setting": "both", "billing_class": "facility"}]}, {"description": "DAPTOMYCIN PER 1MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0878", "type": "HCPCS"}, {"code": "5319759", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 11.0, "discounted_cash": 8.25, "setting": "both", "billing_class": "facility"}]}, {"description": "DARUNAVIR 800MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5303463", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 799.0, "discounted_cash": 599.25, "setting": "both", "billing_class": "facility"}]}, {"description": "DARUNAVIR 800MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5303463", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 799.0, "discounted_cash": 599.25, "setting": "both", "billing_class": "facility"}]}, {"description": "DCLOT CVAD THROMBL AGNT", "code_information": [{"code": "4906593", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 1110.0, "discounted_cash": 832.5, "setting": "both", "billing_class": "facility"}]}, {"description": "DCLOT CVAD THROMBL AGNT", "code_information": [{"code": "4916593", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 885.0, "discounted_cash": 663.75, "setting": "both", "billing_class": "facility"}]}, {"description": "DEBRID SUBQ 1ST 20 SQ CM OR <", "code_information": [{"code": "6810517", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 1478.0, "discounted_cash": 1108.5, "setting": "both", "billing_class": "facility"}]}, {"description": "DEBRID SUBQ 1ST 20 SQ CM OR <", "code_information": [{"code": "6810517", "type": "CDM"}, {"code": "361", "type": "RC"}], "standard_charges": [{"gross_charge": 1478.0, "discounted_cash": 1108.5, "setting": "both", "billing_class": "facility"}]}, {"description": "DEBRID SUBQ 1ST 20 SQ CM OR <", "code_information": [{"code": "6900040", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 1420.0, "discounted_cash": 1065.0, "setting": "both", "billing_class": "facility"}]}, {"description": "DEBRID SUBQ 1ST 20 SQ CM OR <", "code_information": [{"code": "6900040", "type": "CDM"}, {"code": "361", "type": "RC"}], "standard_charges": [{"gross_charge": 1420.0, "discounted_cash": 1065.0, "setting": "both", "billing_class": "facility"}]}, {"description": "DEBRIDE BONE 20SQ CM/<", "code_information": [{"code": "6810514", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 6246.0, "discounted_cash": 4684.5, "setting": "both", "billing_class": "facility"}]}, {"description": "DEBRIDE BONE 20SQ CM/<", "code_information": [{"code": "6810514", "type": "CDM"}, {"code": "361", "type": "RC"}], "standard_charges": [{"gross_charge": 6246.0, "discounted_cash": 4684.5, "setting": "both", "billing_class": "facility"}]}, {"description": "DEBRIDE BONE 20SQ CM/<", "code_information": [{"code": "6900044", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 6004.0, "discounted_cash": 4503.0, "setting": "both", "billing_class": "facility"}]}, {"description": "DEBRIDE BONE 20SQ CM/<", "code_information": [{"code": "6900044", "type": "CDM"}, {"code": "361", "type": "RC"}], "standard_charges": [{"gross_charge": 6004.0, "discounted_cash": 4503.0, "setting": "both", "billing_class": "facility"}]}, {"description": "DEBRIDE BONE EA ADD 20SQ", "code_information": [{"code": "6810513", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 5289.0, "discounted_cash": 3966.75, "setting": "both", "billing_class": "facility"}]}, {"description": "DEBRIDE BONE EA ADD 20SQ", "code_information": [{"code": "6810513", "type": "CDM"}, {"code": "361", "type": "RC"}], "standard_charges": [{"gross_charge": 5289.0, "discounted_cash": 3966.75, "setting": "both", "billing_class": "facility"}]}, {"description": "DEBRIDE BONE EA ADD 20SQ", "code_information": [{"code": "6900045", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 5540.0, "discounted_cash": 4155.0, "setting": "both", "billing_class": "facility"}]}, {"description": "DEBRIDE BONE EA ADD 20SQ", "code_information": [{"code": "6900045", "type": "CDM"}, {"code": "361", "type": "RC"}], "standard_charges": [{"gross_charge": 5540.0, "discounted_cash": 4155.0, "setting": "both", "billing_class": "facility"}]}, {"description": "DEBRIDE MSCL/FSCA 20SQCM", "code_information": [{"code": "6810516", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 2289.0, "discounted_cash": 1716.75, "setting": "both", "billing_class": "facility"}]}, {"description": "DEBRIDE MSCL/FSCA 20SQCM", "code_information": [{"code": "6810516", "type": "CDM"}, {"code": "361", "type": "RC"}], "standard_charges": [{"gross_charge": 2289.0, "discounted_cash": 1716.75, "setting": "both", "billing_class": "facility"}]}, {"description": "DEBRIDE MSCL/FSCA 20SQCM", "code_information": [{"code": "6900042", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 2399.0, "discounted_cash": 1799.25, "setting": "both", "billing_class": "facility"}]}, {"description": "DEBRIDE MSCL/FSCA 20SQCM", "code_information": [{"code": "6900042", "type": "CDM"}, {"code": "361", "type": "RC"}], "standard_charges": [{"gross_charge": 2399.0, "discounted_cash": 1799.25, "setting": "both", "billing_class": "facility"}]}, {"description": "DEBRIDE MSCL/FSCA EA ADD", "code_information": [{"code": "6810515", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 2887.0, "discounted_cash": 2165.25, "setting": "both", "billing_class": "facility"}]}, {"description": "DEBRIDE MSCL/FSCA EA ADD", "code_information": [{"code": "6810515", "type": "CDM"}, {"code": "361", "type": "RC"}], "standard_charges": [{"gross_charge": 2887.0, "discounted_cash": 2165.25, "setting": "both", "billing_class": "facility"}]}, {"description": "DEBRIDE MSCL/FSCA EA ADD", "code_information": [{"code": "6900043", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 3027.0, "discounted_cash": 2270.25, "setting": "both", "billing_class": "facility"}]}, {"description": "DEBRIDE MSCL/FSCA EA ADD", "code_information": [{"code": "6900043", "type": "CDM"}, {"code": "361", "type": "RC"}], "standard_charges": [{"gross_charge": 3027.0, "discounted_cash": 2270.25, "setting": "both", "billing_class": "facility"}]}, {"description": "DEBRIDE NAIL 1-5", "code_information": [{"code": "6810519", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 267.0, "discounted_cash": 200.25, "setting": "both", "billing_class": "facility"}]}, {"description": "DEBRIDE NAIL 1-5", "code_information": [{"code": "6810519", "type": "CDM"}, {"code": "361", "type": "RC"}], "standard_charges": [{"gross_charge": 267.0, "discounted_cash": 200.25, "setting": "both", "billing_class": "facility"}]}, {"description": "DEBRIDE NAIL 1-5", "code_information": [{"code": "6900036", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 256.0, "discounted_cash": 192.0, "setting": "both", "billing_class": "facility"}]}, {"description": "DEBRIDE NAIL 1-5", "code_information": [{"code": "6900036", "type": "CDM"}, {"code": "361", "type": "RC"}], "standard_charges": [{"gross_charge": 256.0, "discounted_cash": 192.0, "setting": "both", "billing_class": "facility"}]}, {"description": "DEBRIDE NAIL 6 OR MORE", "code_information": [{"code": "6810520", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 267.0, "discounted_cash": 200.25, "setting": "both", "billing_class": "facility"}]}, {"description": "DEBRIDE NAIL 6 OR MORE", "code_information": [{"code": "6810520", "type": "CDM"}, {"code": "361", "type": "RC"}], "standard_charges": [{"gross_charge": 267.0, "discounted_cash": 200.25, "setting": "both", "billing_class": "facility"}]}, {"description": "DEBRIDE NAIL 6 OR MORE", "code_information": [{"code": "6900037", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 280.0, "discounted_cash": 210.0, "setting": "both", "billing_class": "facility"}]}, {"description": "DEBRIDE NAIL 6 OR MORE", "code_information": [{"code": "6900037", "type": "CDM"}, {"code": "361", "type": "RC"}], "standard_charges": [{"gross_charge": 280.0, "discounted_cash": 210.0, "setting": "both", "billing_class": "facility"}]}, {"description": "DEBRIDE SUBQ EA ADD 20SQ", "code_information": [{"code": "6900041", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 2351.0, "discounted_cash": 1763.25, "setting": "both", "billing_class": "facility"}]}, {"description": "DEBRIDE SUBQ EA ADD 20SQ", "code_information": [{"code": "6900041", "type": "CDM"}, {"code": "361", "type": "RC"}], "standard_charges": [{"gross_charge": 2351.0, "discounted_cash": 1763.25, "setting": "both", "billing_class": "facility"}]}, {"description": "DEBRIFE SUBQ EA ADD 20SQ", "code_information": [{"code": "6810518", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 2446.0, "discounted_cash": 1834.5, "setting": "both", "billing_class": "facility"}]}, {"description": "DEBRIFE SUBQ EA ADD 20SQ", "code_information": [{"code": "6810518", "type": "CDM"}, {"code": "361", "type": "RC"}], "standard_charges": [{"gross_charge": 2446.0, "discounted_cash": 1834.5, "setting": "both", "billing_class": "facility"}]}, {"description": "DECALCIFICATION", "code_information": [{"code": "88311", "type": "CPT"}, {"code": "4308311", "type": "CDM"}, {"code": "310", "type": "RC"}], "standard_charges": [{"gross_charge": 344.0, "discounted_cash": 258.0, "setting": "both", "billing_class": "facility"}]}, {"description": "DEFEROXAMINE PER500MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0895", "type": "HCPCS"}, {"code": "5319794", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 449.0, "discounted_cash": 336.75, "setting": "both", "billing_class": "facility"}]}, {"description": "DEFEROXAMINE PER500MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0895", "type": "HCPCS"}, {"code": "5319794", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 449.0, "discounted_cash": 336.75, "setting": "both", "billing_class": "facility"}]}, {"description": "DEFIB LUMAX 540HF-T MOBL", "code_information": [{"code": "C1882", "type": "HCPCS"}, {"code": "4008398", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 224451.0, "discounted_cash": 168338.25, "setting": "both", "billing_class": "facility"}]}, {"description": "DEHYDROEPIANDRST SULFATE", "code_information": [{"code": "82627", "type": "CPT"}, {"code": "7252631", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 916.0, "discounted_cash": 687.0, "setting": "both", "billing_class": "facility"}]}, {"description": "DEHYDROEPIANDRSTRONE", "code_information": [{"code": "82626", "type": "CPT"}, {"code": "7252632", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 974.0, "discounted_cash": 730.5, "setting": "both", "billing_class": "facility"}]}, {"description": "DELAY PLC PROX ANEU INIT+S&I", "code_information": [{"code": "4614710", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 36090.0, "discounted_cash": 27067.5, "setting": "both", "billing_class": "facility"}]}, {"description": "DELIVERY COMPLEX", "code_information": [{"code": "3101212", "type": "CDM"}, {"code": "722", "type": "RC"}], "standard_charges": [{"gross_charge": 10151.0, "discounted_cash": 7613.25, "setting": "both", "billing_class": "facility"}]}, {"description": "DELIVERY SIMPLE", "code_information": [{"code": "3101210", "type": "CDM"}, {"code": "722", "type": "RC"}], "standard_charges": [{"gross_charge": 11336.0, "discounted_cash": 8502.0, "setting": "both", "billing_class": "facility"}]}, {"description": "DEMECLOCYCLINE 150MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5303515", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 241.0, "discounted_cash": 180.75, "setting": "both", "billing_class": "facility"}]}, {"description": "DEMECLOCYCLINE 150MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5303515", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 241.0, "discounted_cash": 180.75, "setting": "both", "billing_class": "facility"}]}, {"description": "DENGUE FEVER AB", "code_information": [{"code": "86790", "type": "CPT"}, {"code": "7256717", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 158.0, "discounted_cash": 118.5, "setting": "both", "billing_class": "facility"}]}, {"description": "DENGUE FEVER AB/2", "code_information": [{"code": "86790", "type": "CPT"}, {"code": "7256720", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 135.0, "discounted_cash": 101.25, "setting": "both", "billing_class": "facility"}]}, {"description": "DENGUE FEVER AB/5", "code_information": [{"code": "86790", "type": "CPT"}, {"code": "7257478", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 158.0, "discounted_cash": 118.5, "setting": "both", "billing_class": "facility"}]}, {"description": "DERMACELL PER SQ CM", "code_information": [{"code": "Q4122", "type": "HCPCS"}, {"code": "4028008", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 471.0, "discounted_cash": 353.25, "setting": "both", "billing_class": "facility"}]}, {"description": "DERMACELL PER SQ CM", "code_information": [{"code": "Q4122", "type": "HCPCS"}, {"code": "4028008", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 471.0, "discounted_cash": 353.25, "setting": "both", "billing_class": "facility"}]}, {"description": "DERMAGRAFT PER SQ CM", "code_information": [{"code": "Q4106", "type": "HCPCS"}, {"code": "8246126", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 595.0, "discounted_cash": 446.25, "setting": "both", "billing_class": "facility"}]}, {"description": "DERMAGRAFT PER SQ CM", "code_information": [{"code": "Q4106", "type": "HCPCS"}, {"code": "8246126", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 595.0, "discounted_cash": 446.25, "setting": "both", "billing_class": "facility"}]}, {"description": "DERMAPURE 3CMX4CM PER SQ CM", "code_information": [{"code": "Q4152", "type": "HCPCS"}, {"code": "4028040", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 985.0, "discounted_cash": 738.75, "setting": "both", "billing_class": "facility"}]}, {"description": "DERMAPURE 3CMX4CM PER SQ CM", "code_information": [{"code": "Q4152", "type": "HCPCS"}, {"code": "4028040", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 985.0, "discounted_cash": 738.75, "setting": "both", "billing_class": "facility"}]}, {"description": "DERMAPURE 4CMX6CM PER SQ CM", "code_information": [{"code": "Q4152", "type": "HCPCS"}, {"code": "4028041", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 772.0, "discounted_cash": 579.0, "setting": "both", "billing_class": "facility"}]}, {"description": "DERMAPURE 4CMX6CM PER SQ CM", "code_information": [{"code": "Q4152", "type": "HCPCS"}, {"code": "4028041", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 772.0, "discounted_cash": 579.0, "setting": "both", "billing_class": "facility"}]}, {"description": "DERMAPURE 7CMX10CM PER SQ CM", "code_information": [{"code": "Q4152", "type": "HCPCS"}, {"code": "4028042", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 375.0, "discounted_cash": 281.25, "setting": "both", "billing_class": "facility"}]}, {"description": "DERMAPURE 7CMX10CM PER SQ CM", "code_information": [{"code": "Q4152", "type": "HCPCS"}, {"code": "4028042", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 375.0, "discounted_cash": 281.25, "setting": "both", "billing_class": "facility"}]}, {"description": "DESIPRAMINE 25MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5303569", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 78.0, "discounted_cash": 58.5, "setting": "both", "billing_class": "facility"}]}, {"description": "DESIPRAMINE 25MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5303569", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 78.0, "discounted_cash": 58.5, "setting": "both", "billing_class": "facility"}]}, {"description": "DESMOPRESSIN .01%2.5MLSP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5330639", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 2209.0, "discounted_cash": 1656.75, "setting": "both", "billing_class": "facility"}]}, {"description": "DESMOPRESSIN .01%2.5MLSP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5330639", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 2209.0, "discounted_cash": 1656.75, "setting": "both", "billing_class": "facility"}]}, {"description": "DESMOPRESSIN .01%5ML SP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5330641", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 1979.0, "discounted_cash": 1484.25, "setting": "both", "billing_class": "facility"}]}, {"description": "DESMOPRESSIN .01%5ML SP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5330641", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 1979.0, "discounted_cash": 1484.25, "setting": "both", "billing_class": "facility"}]}, {"description": "DESMOPRESSIN .1MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5303585", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 102.0, "discounted_cash": 76.5, "setting": "both", "billing_class": "facility"}]}, {"description": "DESMOPRESSIN .1MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5303585", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 102.0, "discounted_cash": 76.5, "setting": "both", "billing_class": "facility"}]}, {"description": "DESMOPRESSIN PER 1MCG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J2597", "type": "HCPCS"}, {"code": "5319819", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 315.0, "discounted_cash": 236.25, "setting": "both", "billing_class": "facility"}]}, {"description": "DESMOPRESSIN PER 1MCG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J2597", "type": "HCPCS"}, {"code": "5319819", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 315.0, "discounted_cash": 236.25, "setting": "both", "billing_class": "facility"}]}, {"description": "DESOXIMETASONE.25%15GMCR", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5335093", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 586.0, "discounted_cash": 439.5, "setting": "both", "billing_class": "facility"}]}, {"description": "DESOXIMETASONE.25%15GMCR", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5335093", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 586.0, "discounted_cash": 439.5, "setting": "both", "billing_class": "facility"}]}, {"description": "DESOXYCORTICSTRNE 11", "code_information": [{"code": "82633", "type": "CPT"}, {"code": "7252633", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 1019.0, "discounted_cash": 764.25, "setting": "both", "billing_class": "facility"}]}, {"description": "DESTRUCT PREMLG LES 1ST", "code_information": [{"code": "6810540", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 752.0, "discounted_cash": 564.0, "setting": "both", "billing_class": "facility"}]}, {"description": "DESTRUCT PREMLG LES 1ST", "code_information": [{"code": "6810540", "type": "CDM"}, {"code": "361", "type": "RC"}], "standard_charges": [{"gross_charge": 752.0, "discounted_cash": 564.0, "setting": "both", "billing_class": "facility"}]}, {"description": "DESVENLAFAXINE 50MG XRTB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5303590", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 146.0, "discounted_cash": 109.5, "setting": "both", "billing_class": "facility"}]}, {"description": "DESVENLAFAXINE 50MG XRTB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5303590", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 146.0, "discounted_cash": 109.5, "setting": "both", "billing_class": "facility"}]}, {"description": "DEV LDLOCK SPECTRA518062", "code_information": [{"code": "C1773", "type": "HCPCS"}, {"code": "8240937", "type": "CDM"}, {"code": "272", "type": "RC"}], "standard_charges": [{"gross_charge": 4779.0, "discounted_cash": 3584.25, "setting": "both", "billing_class": "facility"}]}, {"description": "DEV REP URINARY W/SLING", "code_information": [{"code": "C1771", "type": "HCPCS"}, {"code": "8240135", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 18511.0, "discounted_cash": 13883.25, "setting": "both", "billing_class": "facility"}]}, {"description": "DEV VAG TP TENSN FR SNGL", "code_information": [{"code": "C1771", "type": "HCPCS"}, {"code": "8240944", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 17243.0, "discounted_cash": 12932.25, "setting": "both", "billing_class": "facility"}]}, {"description": "DEXAMETH/NEO/POLY 5ML OS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5330722", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 122.0, "discounted_cash": 91.5, "setting": "both", "billing_class": "facility"}]}, {"description": "DEXAMETH/NEO/POLY 5ML OS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5330722", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 122.0, "discounted_cash": 91.5, "setting": "both", "billing_class": "facility"}]}, {"description": "DEXAMETH/NEO/POLY3.5GMOO", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5330751", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 734.0, "discounted_cash": 550.5, "setting": "both", "billing_class": "facility"}]}, {"description": "DEXAMETH/NEO/POLY3.5GMOO", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5330751", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 734.0, "discounted_cash": 550.5, "setting": "both", "billing_class": "facility"}]}, {"description": "DEXAMETHASONE .5/5ML LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5314908", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 70.0, "discounted_cash": 52.5, "setting": "both", "billing_class": "facility"}]}, {"description": "DEXAMETHASONE .5/5ML LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5314908", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 70.0, "discounted_cash": 52.5, "setting": "both", "billing_class": "facility"}]}, {"description": "DEXAMETHASONE .5MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5303596", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 61.0, "discounted_cash": 45.75, "setting": "both", "billing_class": "facility"}]}, {"description": "DEXAMETHASONE .5MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5303596", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 61.0, "discounted_cash": 45.75, "setting": "both", "billing_class": "facility"}]}, {"description": "DEXAMETHASONE 4MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5303604", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 61.0, "discounted_cash": 45.75, "setting": "both", "billing_class": "facility"}]}, {"description": "DEXAMETHASONE 4MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5303604", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 61.0, "discounted_cash": 45.75, "setting": "both", "billing_class": "facility"}]}, {"description": "DEXAMETHASONE PER 1ML IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5319865", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 99.0, "discounted_cash": 74.25, "setting": "both", "billing_class": "facility"}]}, {"description": "DEXAMETHASONE-S PER1MGIJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J1100", "type": "HCPCS"}, {"code": "5319864", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 22.0, "discounted_cash": 16.5, "setting": "both", "billing_class": "facility"}]}, {"description": "DEXAMETHASONE-S PER1MGIJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J1100", "type": "HCPCS"}, {"code": "5319864", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 22.0, "discounted_cash": 16.5, "setting": "both", "billing_class": "facility"}]}, {"description": "DEXMEDETM400MCG/100PMXIJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5319882", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 843.0, "discounted_cash": 632.25, "setting": "both", "billing_class": "facility"}]}, {"description": "DEXMEDETOMIDINE200MCGIJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5319880", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 1999.0, "discounted_cash": 1499.25, "setting": "both", "billing_class": "facility"}]}, {"description": "DEXTRAN40NACL.9 500MLIVF", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J7100", "type": "HCPCS"}, {"code": "5412075", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 1680.0, "discounted_cash": 1260.0, "setting": "both", "billing_class": "facility"}]}, {"description": "DEXTRAN40NACL.9 500MLIVF", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J7100", "type": "HCPCS"}, {"code": "5412075", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 1680.0, "discounted_cash": 1260.0, "setting": "both", "billing_class": "facility"}]}, {"description": "DEXTROSE 50% 50ML IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5319901", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 469.0, "discounted_cash": 351.75, "setting": "both", "billing_class": "facility"}]}, {"description": "DEXTROSE 50% 50ML PFS IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5319913", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 355.0, "discounted_cash": 266.25, "setting": "both", "billing_class": "facility"}]}, {"description": "DFB CLARIA MRI DTMA1D1", "code_information": [{"code": "C1882", "type": "HCPCS"}, {"code": "4008495", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 310863.0, "discounted_cash": 233147.25, "setting": "both", "billing_class": "facility"}]}, {"description": "DFB ELLIPS DR DF1 231136", "code_information": [{"code": "C1721", "type": "HCPCS"}, {"code": "4008426", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 211670.0, "discounted_cash": 158752.5, "setting": "both", "billing_class": "facility"}]}, {"description": "DFB FORTFY ASSR DR DFIS1", "code_information": [{"code": "C1721", "type": "HCPCS"}, {"code": "4008316", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 211670.0, "discounted_cash": 158752.5, "setting": "both", "billing_class": "facility"}]}, {"description": "DFB ILESTO7 VRTDX 383594", "code_information": [{"code": "C1722", "type": "HCPCS"}, {"code": "4008346", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 179823.0, "discounted_cash": 134867.25, "setting": "both", "billing_class": "facility"}]}, {"description": "DFB IPERIA PROMRI 393007", "code_information": [{"code": "C1882", "type": "HCPCS"}, {"code": "4008383", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 81010.0, "discounted_cash": 60757.5, "setting": "both", "billing_class": "facility"}]}, {"description": "DFB LUMAX 740DR-T MOBL", "code_information": [{"code": "C1721", "type": "HCPCS"}, {"code": "4008393", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 198887.0, "discounted_cash": 149165.25, "setting": "both", "billing_class": "facility"}]}, {"description": "DFB LUMAX 740DRT HM MNTR", "code_information": [{"code": "C1721", "type": "HCPCS"}, {"code": "4008391", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 192652.0, "discounted_cash": 144489.0, "setting": "both", "billing_class": "facility"}]}, {"description": "DFB LUMAX 740HFT BIV MOB", "code_information": [{"code": "C1882", "type": "HCPCS"}, {"code": "4008392", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 230685.0, "discounted_cash": 173013.75, "setting": "both", "billing_class": "facility"}]}, {"description": "DFB LUMAX 740HFT HM MNTR", "code_information": [{"code": "C1882", "type": "HCPCS"}, {"code": "4008389", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 224451.0, "discounted_cash": 168338.25, "setting": "both", "billing_class": "facility"}]}, {"description": "DFB LUMAX 740VRT HM MNTR", "code_information": [{"code": "C1722", "type": "HCPCS"}, {"code": "4008390", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 174572.0, "discounted_cash": 130929.0, "setting": "both", "billing_class": "facility"}]}, {"description": "DFB LUMAX SC 740 VRT MOB", "code_information": [{"code": "C1722", "type": "HCPCS"}, {"code": "4008394", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 180807.0, "discounted_cash": 135605.25, "setting": "both", "billing_class": "facility"}]}, {"description": "DFB QUADRA ASSUR 336540Q", "code_information": [{"code": "C1882", "type": "HCPCS"}, {"code": "4008439", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 205124.0, "discounted_cash": 153843.0, "setting": "both", "billing_class": "facility"}]}, {"description": "DFB UNIFY ASSURA DF4/DF4", "code_information": [{"code": "C1882", "type": "HCPCS"}, {"code": "4008422", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 254252.0, "discounted_cash": 190689.0, "setting": "both", "billing_class": "facility"}]}, {"description": "DFB VIVA XT CRTD DTBA1D1", "code_information": [{"code": "C1882", "type": "HCPCS"}, {"code": "4008482", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 283034.0, "discounted_cash": 212275.5, "setting": "both", "billing_class": "facility"}]}, {"description": "DFB VIVA XT CRTD DTBA1D4", "code_information": [{"code": "C1882", "type": "HCPCS"}, {"code": "4008483", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 283034.0, "discounted_cash": 212275.5, "setting": "both", "billing_class": "facility"}]}, {"description": "DFIB DC ATLAS DR V242", "code_information": [{"code": "C1721", "type": "HCPCS"}, {"code": "4000108", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 28728.0, "discounted_cash": 21546.0, "setting": "both", "billing_class": "facility"}]}, {"description": "DFIB DC EPIC+ DR V239", "code_information": [{"code": "C1721", "type": "HCPCS"}, {"code": "4000117", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 26913.0, "discounted_cash": 20184.75, "setting": "both", "billing_class": "facility"}]}, {"description": "DFIB EVERA S DR DDBC3D1", "code_information": [{"code": "C1721", "type": "HCPCS"}, {"code": "4008325", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 225696.0, "discounted_cash": 169272.0, "setting": "both", "billing_class": "facility"}]}, {"description": "DFIB EVERA S DR DDBC3D4", "code_information": [{"code": "C1721", "type": "HCPCS"}, {"code": "4008321", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 225696.0, "discounted_cash": 169272.0, "setting": "both", "billing_class": "facility"}]}, {"description": "DFIB EVERA S VR DVBC3D1", "code_information": [{"code": "C1722", "type": "HCPCS"}, {"code": "4008324", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 197779.0, "discounted_cash": 148334.25, "setting": "both", "billing_class": "facility"}]}, {"description": "DFIB EVERA S VR DVBC3D4", "code_information": [{"code": "C1722", "type": "HCPCS"}, {"code": "4008322", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 197779.0, "discounted_cash": 148334.25, "setting": "both", "billing_class": "facility"}]}, {"description": "DFIB EVERA XT DR DDBB1D1", "code_information": [{"code": "C1721", "type": "HCPCS"}, {"code": "4008327", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 230685.0, "discounted_cash": 173013.75, "setting": "both", "billing_class": "facility"}]}, {"description": "DFIB EVERA XT DR DDBB1D4", "code_information": [{"code": "C1721", "type": "HCPCS"}, {"code": "4008326", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 230685.0, "discounted_cash": 173013.75, "setting": "both", "billing_class": "facility"}]}, {"description": "DFIB EVERA XT VR DVBB1D1", "code_information": [{"code": "C1722", "type": "HCPCS"}, {"code": "4008328", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 220711.0, "discounted_cash": 165533.25, "setting": "both", "billing_class": "facility"}]}, {"description": "DFIB EVERA XT VR DVBB1D4", "code_information": [{"code": "C1722", "type": "HCPCS"}, {"code": "4008323", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 202766.0, "discounted_cash": 152074.5, "setting": "both", "billing_class": "facility"}]}, {"description": "DFIB ILESTO 7 HFT 383547", "code_information": [{"code": "C1882", "type": "HCPCS"}, {"code": "4008348", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 189411.0, "discounted_cash": 142058.25, "setting": "both", "billing_class": "facility"}]}, {"description": "DFIB ILESTO 7 VRT 383578", "code_information": [{"code": "C1722", "type": "HCPCS"}, {"code": "4008347", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 131366.0, "discounted_cash": 98524.5, "setting": "both", "billing_class": "facility"}]}, {"description": "DFIB LUMAX 540 DR-T", "code_information": [{"code": "C1721", "type": "HCPCS"}, {"code": "4000208", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 177691.0, "discounted_cash": 133268.25, "setting": "both", "billing_class": "facility"}]}, {"description": "DFIB LUMAX 540 DR-T MOBL", "code_information": [{"code": "C1721", "type": "HCPCS"}, {"code": "4008400", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 183924.0, "discounted_cash": 137943.0, "setting": "both", "billing_class": "facility"}]}, {"description": "DFIB LUMAX 540 HF-T", "code_information": [{"code": "C1882", "type": "HCPCS"}, {"code": "4000206", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 218217.0, "discounted_cash": 163662.75, "setting": "both", "billing_class": "facility"}]}, {"description": "DFIB LUMAX 540 VR-T", "code_information": [{"code": "C1722", "type": "HCPCS"}, {"code": "4000207", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 165221.0, "discounted_cash": 123915.75, "setting": "both", "billing_class": "facility"}]}, {"description": "DFIB LUMAX 540 VR-T MOBL", "code_information": [{"code": "C1722", "type": "HCPCS"}, {"code": "4008399", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 171455.0, "discounted_cash": 128591.25, "setting": "both", "billing_class": "facility"}]}, {"description": "DFIB SC ATLAS+ VR V193", "code_information": [{"code": "C1722", "type": "HCPCS"}, {"code": "4000299", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 177189.0, "discounted_cash": 132891.75, "setting": "both", "billing_class": "facility"}]}, {"description": "DFIB SUBCUTAN SQ-RX 1010", "code_information": [{"code": "C1722", "type": "HCPCS"}, {"code": "4008441", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 10202.0, "discounted_cash": 7651.5, "setting": "both", "billing_class": "facility"}]}, {"description": "DFIB VIVA S CRTD DTBB1D1", "code_information": [{"code": "C1882", "type": "HCPCS"}, {"code": "4008480", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 274929.0, "discounted_cash": 206196.75, "setting": "both", "billing_class": "facility"}]}, {"description": "DFIB VIVA S CRTD DTBB1D4", "code_information": [{"code": "C1882", "type": "HCPCS"}, {"code": "4008481", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 274929.0, "discounted_cash": 206196.75, "setting": "both", "billing_class": "facility"}]}, {"description": "DIA-CIR THRO+IMG+S&I", "code_information": [{"code": "4916904", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 21085.0, "discounted_cash": 15813.75, "setting": "both", "billing_class": "facility"}]}, {"description": "DIA-CIR THRO+PLST+IMG+S&I", "code_information": [{"code": "4916905", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 39341.0, "discounted_cash": 29505.75, "setting": "both", "billing_class": "facility"}]}, {"description": "DIA-CIR THRO+STN+IMG+S&I", "code_information": [{"code": "4916906", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 64596.0, "discounted_cash": 48447.0, "setting": "both", "billing_class": "facility"}]}, {"description": "DIAB SLFMGMT GRP 30 MIN", "code_information": [{"code": "G0109", "type": "HCPCS"}, {"code": "3530109", "type": "CDM"}, {"code": "942", "type": "RC"}], "standard_charges": [{"gross_charge": 136.0, "discounted_cash": 102.0, "setting": "both", "billing_class": "facility"}]}, {"description": "DIAB SLFMGMT IND 30 MIN", "code_information": [{"code": "G0108", "type": "HCPCS"}, {"code": "3530108", "type": "CDM"}, {"code": "942", "type": "RC"}], "standard_charges": [{"gross_charge": 267.0, "discounted_cash": 200.25, "setting": "both", "billing_class": "facility"}]}, {"description": "DIAL-CIRC BAL-PLASTY+S&I", "code_information": [{"code": "4916902", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 17856.0, "discounted_cash": 13392.0, "setting": "both", "billing_class": "facility"}]}, {"description": "DIAL-CIRC STNT+PLSTY+S&I", "code_information": [{"code": "4916903", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 45461.0, "discounted_cash": 34095.75, "setting": "both", "billing_class": "facility"}]}, {"description": "DIALYSATE 2000-2999ML PD", "code_information": [{"code": "A4722", "type": "HCPCS"}, {"code": "5412078", "type": "CDM"}, {"code": "270", "type": "RC"}], "standard_charges": [{"gross_charge": 895.0, "discounted_cash": 671.25, "setting": "both", "billing_class": "facility"}]}, {"description": "DIAZEPAM 2MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5303708", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 66.0, "discounted_cash": 49.5, "setting": "both", "billing_class": "facility"}]}, {"description": "DIAZEPAM 2MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5303708", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 66.0, "discounted_cash": 49.5, "setting": "both", "billing_class": "facility"}]}, {"description": "DIAZEPAM 5MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5303712", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 66.0, "discounted_cash": 49.5, "setting": "both", "billing_class": "facility"}]}, {"description": "DIAZEPAM 5MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5303712", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 66.0, "discounted_cash": 49.5, "setting": "both", "billing_class": "facility"}]}, {"description": "DIAZEPAM UPTO 5MG SG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3360", "type": "HCPCS"}, {"code": "5319938", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 190.0, "discounted_cash": 142.5, "setting": "both", "billing_class": "facility"}]}, {"description": "DIAZEPAM UPTO 5MG SG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3360", "type": "HCPCS"}, {"code": "5319938", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 190.0, "discounted_cash": 142.5, "setting": "both", "billing_class": "facility"}]}, {"description": "DIAZOXIDE50MG/ML 1ML LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5314933", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 184.0, "discounted_cash": 138.0, "setting": "both", "billing_class": "facility"}]}, {"description": "DIAZOXIDE50MG/ML 1ML LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5314933", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 184.0, "discounted_cash": 138.0, "setting": "both", "billing_class": "facility"}]}, {"description": "DIBUCAINE NUMBER", "code_information": [{"code": "82638", "type": "CPT"}, {"code": "7252638", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 1054.0, "discounted_cash": 790.5, "setting": "both", "billing_class": "facility"}]}, {"description": "DICLOFEN/MISPR75/.200 TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5303752", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 183.0, "discounted_cash": 137.25, "setting": "both", "billing_class": "facility"}]}, {"description": "DICLOFEN/MISPR75/.200 TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5303752", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 183.0, "discounted_cash": 137.25, "setting": "both", "billing_class": "facility"}]}, {"description": "DICLOFENAC .1% 2.5ML OS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5330761", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 476.0, "discounted_cash": 357.0, "setting": "both", "billing_class": "facility"}]}, {"description": "DICLOFENAC .1% 2.5ML OS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5330761", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 476.0, "discounted_cash": 357.0, "setting": "both", "billing_class": "facility"}]}, {"description": "DICLOFENAC .1% 5ML OS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5330760", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 520.0, "discounted_cash": 390.0, "setting": "both", "billing_class": "facility"}]}, {"description": "DICLOFENAC .1% 5ML OS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5330760", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 520.0, "discounted_cash": 390.0, "setting": "both", "billing_class": "facility"}]}, {"description": "DICYCLOMINE 10MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5303820", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 85.0, "discounted_cash": 63.75, "setting": "both", "billing_class": "facility"}]}, {"description": "DICYCLOMINE 10MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5303820", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 85.0, "discounted_cash": 63.75, "setting": "both", "billing_class": "facility"}]}, {"description": "DICYCLOMINE UPTO 20MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0500", "type": "HCPCS"}, {"code": "5319981", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 1814.0, "discounted_cash": 1360.5, "setting": "both", "billing_class": "facility"}]}, {"description": "DICYCLOMINE UPTO 20MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0500", "type": "HCPCS"}, {"code": "5319981", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 1814.0, "discounted_cash": 1360.5, "setting": "both", "billing_class": "facility"}]}, {"description": "DIFFUSING CAPACITY", "code_information": [{"code": "94729", "type": "CPT"}, {"code": "5504729", "type": "CDM"}, {"code": "460", "type": "RC"}], "standard_charges": [{"gross_charge": 2363.0, "discounted_cash": 1772.25, "setting": "both", "billing_class": "facility"}]}, {"description": "DIG BREAST TOMO BILAT", "code_information": [{"code": "77062", "type": "CPT"}, {"code": "3077062", "type": "CDM"}, {"code": "401", "type": "RC"}], "standard_charges": [{"gross_charge": 372.0, "discounted_cash": 279.0, "setting": "both", "billing_class": "facility"}]}, {"description": "DIG BREAST TOMO BILAT", "code_information": [{"code": "77062", "type": "CPT"}, {"code": "4907062", "type": "CDM"}, {"code": "401", "type": "RC"}], "standard_charges": [{"gross_charge": 390.0, "discounted_cash": 292.5, "setting": "both", "billing_class": "facility"}]}, {"description": "DIG BREAST TOMO BILAT", "code_information": [{"code": "77062", "type": "CPT"}, {"code": "5117062", "type": "CDM"}, {"code": "401", "type": "RC"}], "standard_charges": [{"gross_charge": 372.0, "discounted_cash": 279.0, "setting": "both", "billing_class": "facility"}]}, {"description": "DIG BREAST TOMO UNI", "code_information": [{"code": "77061", "type": "CPT"}, {"code": "3077061", "type": "CDM"}, {"code": "401", "type": "RC"}], "standard_charges": [{"gross_charge": 375.0, "discounted_cash": 281.25, "setting": "both", "billing_class": "facility"}]}, {"description": "DIG BREAST TOMO UNI", "code_information": [{"code": "77061", "type": "CPT"}, {"code": "5117061", "type": "CDM"}, {"code": "401", "type": "RC"}], "standard_charges": [{"gross_charge": 375.0, "discounted_cash": 281.25, "setting": "both", "billing_class": "facility"}]}, {"description": "DIGOXIN .05MG/ML 5ML LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5314964", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 85.0, "discounted_cash": 63.75, "setting": "both", "billing_class": "facility"}]}, {"description": "DIGOXIN .05MG/ML 5ML LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5314964", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 85.0, "discounted_cash": 63.75, "setting": "both", "billing_class": "facility"}]}, {"description": "DIGOXIN .05MG/ML 60ML LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5314969", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 804.0, "discounted_cash": 603.0, "setting": "both", "billing_class": "facility"}]}, {"description": "DIGOXIN .05MG/ML 60ML LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5314969", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 804.0, "discounted_cash": 603.0, "setting": "both", "billing_class": "facility"}]}, {"description": "DIGOXIN .1MG/ML PEDI IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5320025", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 85.0, "discounted_cash": 63.75, "setting": "both", "billing_class": "facility"}]}, {"description": "DIGOXIN 0.125MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5303944", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 66.0, "discounted_cash": 49.5, "setting": "both", "billing_class": "facility"}]}, {"description": "DIGOXIN 0.125MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5303944", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 66.0, "discounted_cash": 49.5, "setting": "both", "billing_class": "facility"}]}, {"description": "DIGOXIN 0.25MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5303952", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 66.0, "discounted_cash": 49.5, "setting": "both", "billing_class": "facility"}]}, {"description": "DIGOXIN 0.25MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5303952", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 66.0, "discounted_cash": 49.5, "setting": "both", "billing_class": "facility"}]}, {"description": "DIGOXIN IMM FB PER VL IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J1162", "type": "HCPCS"}, {"code": "5320031", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 13395.0, "discounted_cash": 10046.25, "setting": "both", "billing_class": "facility"}]}, {"description": "DIGOXIN IMM FB PER VL IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J1162", "type": "HCPCS"}, {"code": "5320031", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 13395.0, "discounted_cash": 10046.25, "setting": "both", "billing_class": "facility"}]}, {"description": "DIGOXIN TOTAL", "code_information": [{"code": "80162", "type": "CPT"}, {"code": "4102643", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 1186.0, "discounted_cash": 889.5, "setting": "both", "billing_class": "facility"}]}, {"description": "DIGOXIN TOTAL", "code_information": [{"code": "80162", "type": "CPT"}, {"code": "4172643", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 8.56, "discounted_cash": 6.42, "setting": "both", "billing_class": "facility"}]}, {"description": "DIGOXIN UPTO .5MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J1160", "type": "HCPCS"}, {"code": "5320028", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 142.0, "discounted_cash": 106.5, "setting": "both", "billing_class": "facility"}]}, {"description": "DIGOXIN UPTO .5MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J1160", "type": "HCPCS"}, {"code": "5320028", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 142.0, "discounted_cash": 106.5, "setting": "both", "billing_class": "facility"}]}, {"description": "DIHYDROERGOTAM PER1MGIJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J1110", "type": "HCPCS"}, {"code": "5320049", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 891.0, "discounted_cash": 668.25, "setting": "both", "billing_class": "facility"}]}, {"description": "DIHYDROERGOTAM PER1MGIJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J1110", "type": "HCPCS"}, {"code": "5320049", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 891.0, "discounted_cash": 668.25, "setting": "both", "billing_class": "facility"}]}, {"description": "DIHYDROTESTOSTERONE", "code_information": [{"code": "82642", "type": "CPT"}, {"code": "7252641", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 84.0, "discounted_cash": 63.0, "setting": "both", "billing_class": "facility"}]}, {"description": "DIL BLN ESOPH/PYLORIC", "code_information": [{"code": "C1726", "type": "HCPCS"}, {"code": "8246180", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 2847.0, "discounted_cash": 2135.25, "setting": "both", "billing_class": "facility"}]}, {"description": "DIL BLN QUANTUM TTC", "code_information": [{"code": "C1726", "type": "HCPCS"}, {"code": "8246181", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 2298.0, "discounted_cash": 1723.5, "setting": "both", "billing_class": "facility"}]}, {"description": "DILAT BILE DUCT EA", "code_information": [{"code": "4917542", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 6033.0, "discounted_cash": 4524.75, "setting": "both", "billing_class": "facility"}]}, {"description": "DILAT NEPHRO/URETR/URETH", "code_information": [{"code": "74485", "type": "CPT"}, {"code": "4914486", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 4986.0, "discounted_cash": 3739.5, "setting": "both", "billing_class": "facility"}]}, {"description": "DILTIAZEM 120MG XR24 CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5304043", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 61.0, "discounted_cash": 45.75, "setting": "both", "billing_class": "facility"}]}, {"description": "DILTIAZEM 120MG XR24 CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5304043", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 61.0, "discounted_cash": 45.75, "setting": "both", "billing_class": "facility"}]}, {"description": "DILTIAZEM 180MG XR24 CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5304044", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 61.0, "discounted_cash": 45.75, "setting": "both", "billing_class": "facility"}]}, {"description": "DILTIAZEM 180MG XR24 CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5304044", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 61.0, "discounted_cash": 45.75, "setting": "both", "billing_class": "facility"}]}, {"description": "DILTIAZEM 240MG XR24 CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5304045", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 68.0, "discounted_cash": 51.0, "setting": "both", "billing_class": "facility"}]}, {"description": "DILTIAZEM 240MG XR24 CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5304045", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 68.0, "discounted_cash": 51.0, "setting": "both", "billing_class": "facility"}]}, {"description": "DILTIAZEM 300MG XR24 CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5304046", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 66.0, "discounted_cash": 49.5, "setting": "both", "billing_class": "facility"}]}, {"description": "DILTIAZEM 300MG XR24 CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5304046", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 66.0, "discounted_cash": 49.5, "setting": "both", "billing_class": "facility"}]}, {"description": "DILTIAZEM 30MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5304033", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 65.0, "discounted_cash": 48.75, "setting": "both", "billing_class": "facility"}]}, {"description": "DILTIAZEM 30MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5304033", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 65.0, "discounted_cash": 48.75, "setting": "both", "billing_class": "facility"}]}, {"description": "DILTIAZEM 60MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5304037", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 61.0, "discounted_cash": 45.75, "setting": "both", "billing_class": "facility"}]}, {"description": "DILTIAZEM 60MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5304037", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 61.0, "discounted_cash": 45.75, "setting": "both", "billing_class": "facility"}]}, {"description": "DILTIAZEM PER 0.5MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J1163", "type": "HCPCS"}, {"code": "5320057", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 3.0, "discounted_cash": 2.25, "setting": "both", "billing_class": "facility"}]}, {"description": "DILTIAZEM PER 0.5MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J1163", "type": "HCPCS"}, {"code": "5320057", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 3.0, "discounted_cash": 2.25, "setting": "both", "billing_class": "facility"}]}, {"description": "DILTIAZEM PER 0.5MG PMX IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J1163", "type": "HCPCS"}, {"code": "5320069", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 3.0, "discounted_cash": 2.25, "setting": "both", "billing_class": "facility"}]}, {"description": "DILTIAZEM PER 0.5MG PMX IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J1163", "type": "HCPCS"}, {"code": "5320069", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 3.0, "discounted_cash": 2.25, "setting": "both", "billing_class": "facility"}]}, {"description": "DIMETHYL SULFOX 50% 50ML", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J1212", "type": "HCPCS"}, {"code": "5339049", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 4995.0, "discounted_cash": 3746.25, "setting": "both", "billing_class": "facility"}]}, {"description": "DIMETHYL SULFOX 50% 50ML", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J1212", "type": "HCPCS"}, {"code": "5339049", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 4995.0, "discounted_cash": 3746.25, "setting": "both", "billing_class": "facility"}]}, {"description": "DINOPROSTONE 10MG SU", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5338320", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 3435.0, "discounted_cash": 2576.25, "setting": "both", "billing_class": "facility"}]}, {"description": "DINOPROSTONE 10MG SU", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5338320", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 3435.0, "discounted_cash": 2576.25, "setting": "both", "billing_class": "facility"}]}, {"description": "DINOPROSTONE 20MG SU", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5338321", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 15534.0, "discounted_cash": 11650.5, "setting": "both", "billing_class": "facility"}]}, {"description": "DIPHENHYD-ZINC 2% 30GMCR", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5335269", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 110.0, "discounted_cash": 82.5, "setting": "both", "billing_class": "facility"}]}, {"description": "DIPHENHYD-ZINC 2% 30GMCR", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5335269", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 110.0, "discounted_cash": 82.5, "setting": "both", "billing_class": "facility"}]}, {"description": "DIPHENHYDR UPTO 50MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J1200", "type": "HCPCS"}, {"code": "5320117", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 113.0, "discounted_cash": 84.75, "setting": "both", "billing_class": "facility"}]}, {"description": "DIPHENHYDR UPTO 50MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J1200", "type": "HCPCS"}, {"code": "5320117", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 113.0, "discounted_cash": 84.75, "setting": "both", "billing_class": "facility"}]}, {"description": "DIPHENHYDRA12.5MG/5ML LQ", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5314998", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 85.0, "discounted_cash": 63.75, "setting": "both", "billing_class": "facility"}]}, {"description": "DIPHENHYDRA12.5MG/5ML LQ", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5314998", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 85.0, "discounted_cash": 63.75, "setting": "both", "billing_class": "facility"}]}, {"description": "DIPHENHYDRAMINE 25MG CP", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5304087", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 85.0, "discounted_cash": 63.75, "setting": "both", "billing_class": "facility"}]}, {"description": "DIPHENHYDRAMINE 25MG CP", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5304087", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 85.0, "discounted_cash": 63.75, "setting": "both", "billing_class": "facility"}]}, {"description": "DIPHENOX/ATROP 2.5 TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5304098", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 66.0, "discounted_cash": 49.5, "setting": "both", "billing_class": "facility"}]}, {"description": "DIPHENOX/ATROP 2.5 TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5304098", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 66.0, "discounted_cash": 49.5, "setting": "both", "billing_class": "facility"}]}, {"description": "DIPHTHER TET <7YR IJ", "code_information": [{"code": "90702", "type": "CPT"}, {"code": "5320139", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 1517.0, "discounted_cash": 1137.75, "setting": "both", "billing_class": "facility"}]}, {"description": "DIPHTHER TET <7YR IJ", "code_information": [{"code": "90702", "type": "CPT"}, {"code": "5320139", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 1517.0, "discounted_cash": 1137.75, "setting": "both", "billing_class": "facility"}]}, {"description": "DIPHTHER TET >7YR PF IJ", "code_information": [{"code": "90714", "type": "CPT"}, {"code": "5320137", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 997.0, "discounted_cash": 747.75, "setting": "both", "billing_class": "facility"}]}, {"description": "DIPHTHER TET >7YR PF IJ", "code_information": [{"code": "90714", "type": "CPT"}, {"code": "5320137", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 997.0, "discounted_cash": 747.75, "setting": "both", "billing_class": "facility"}]}, {"description": "DIPYRDAML/ASA200/25 XRCP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5304123", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 160.0, "discounted_cash": 120.0, "setting": "both", "billing_class": "facility"}]}, {"description": "DIPYRDAML/ASA200/25 XRCP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5304123", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 160.0, "discounted_cash": 120.0, "setting": "both", "billing_class": "facility"}]}, {"description": "DIPYRIDAMOLE 25MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5304114", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 76.0, "discounted_cash": 57.0, "setting": "both", "billing_class": "facility"}]}, {"description": "DIPYRIDAMOLE 25MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5304114", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 76.0, "discounted_cash": 57.0, "setting": "both", "billing_class": "facility"}]}, {"description": "DIPYRIDAMOLE 50MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5304118", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 85.0, "discounted_cash": 63.75, "setting": "both", "billing_class": "facility"}]}, {"description": "DIPYRIDAMOLE 50MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5304118", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 85.0, "discounted_cash": 63.75, "setting": "both", "billing_class": "facility"}]}, {"description": "DIRECTED RBC L/R CMV IRR", "code_information": [{"code": "P9058", "type": "HCPCS"}, {"code": "4509059", "type": "CDM"}, {"code": "399", "type": "RC"}], "standard_charges": [{"gross_charge": 1437.0, "discounted_cash": 1077.75, "setting": "both", "billing_class": "facility"}]}, {"description": "DISCOGRAPHY LUMBAR", "code_information": [{"code": "72295", "type": "CPT"}, {"code": "4902290", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 14947.0, "discounted_cash": 11210.25, "setting": "both", "billing_class": "facility"}]}, {"description": "DISOPYRAMIDE", "code_information": [{"code": "80375", "type": "CPT"}, {"code": "7252498", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 665.0, "discounted_cash": 498.75, "setting": "both", "billing_class": "facility"}]}, {"description": "DISULFIRAM 250MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5304178", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 128.0, "discounted_cash": 96.0, "setting": "both", "billing_class": "facility"}]}, {"description": "DISULFIRAM 250MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5304178", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 128.0, "discounted_cash": 96.0, "setting": "both", "billing_class": "facility"}]}, {"description": "DIVALPROX NA 125MG EC TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5304190", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 63.0, "discounted_cash": 47.25, "setting": "both", "billing_class": "facility"}]}, {"description": "DIVALPROX NA 125MG EC TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5304190", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 63.0, "discounted_cash": 47.25, "setting": "both", "billing_class": "facility"}]}, {"description": "DIVALPROX NA 125MG XR CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5312260", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 85.0, "discounted_cash": 63.75, "setting": "both", "billing_class": "facility"}]}, {"description": "DIVALPROX NA 125MG XR CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5312260", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 85.0, "discounted_cash": 63.75, "setting": "both", "billing_class": "facility"}]}, {"description": "DIVALPROX NA 250MG EC TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5304191", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 66.0, "discounted_cash": 49.5, "setting": "both", "billing_class": "facility"}]}, {"description": "DIVALPROX NA 250MG EC TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5304191", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 66.0, "discounted_cash": 49.5, "setting": "both", "billing_class": "facility"}]}, {"description": "DIVALPROX NA 250MG XR TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5304196", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 64.0, "discounted_cash": 48.0, "setting": "both", "billing_class": "facility"}]}, {"description": "DIVALPROX NA 250MG XR TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5304196", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 64.0, "discounted_cash": 48.0, "setting": "both", "billing_class": "facility"}]}, {"description": "DIVALPROX NA 500MG XR TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5304195", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 65.0, "discounted_cash": 48.75, "setting": "both", "billing_class": "facility"}]}, {"description": "DIVALPROX NA 500MG XR TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5304195", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 65.0, "discounted_cash": 48.75, "setting": "both", "billing_class": "facility"}]}, {"description": "DLAY PLC PROX ANEU EA ADDL+S&I", "code_information": [{"code": "4614711", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 26094.0, "discounted_cash": 19570.5, "setting": "both", "billing_class": "facility"}]}, {"description": "DNA ANTIBODY", "code_information": [{"code": "86215", "type": "CPT"}, {"code": "7256217", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 64.0, "discounted_cash": 48.0, "setting": "both", "billing_class": "facility"}]}, {"description": "DNA ANTIBODY DBL STRAND", "code_information": [{"code": "86225", "type": "CPT"}, {"code": "4106220", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 1466.0, "discounted_cash": 1099.5, "setting": "both", "billing_class": "facility"}]}, {"description": "DNA ANTIBODY DBL STRAND", "code_information": [{"code": "86225", "type": "CPT"}, {"code": "7256220", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 985.0, "discounted_cash": 738.75, "setting": "both", "billing_class": "facility"}]}, {"description": "DNA ANTIBODY SNGL STRAND", "code_information": [{"code": "86226", "type": "CPT"}, {"code": "7256225", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 34.0, "discounted_cash": 25.5, "setting": "both", "billing_class": "facility"}]}, {"description": "DOBUTAMINE NEO PER1MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5320184", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 26.0, "discounted_cash": 19.5, "setting": "both", "billing_class": "facility"}]}, {"description": "DOBUTAMINE NEO PER1ML IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5320192", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 322.0, "discounted_cash": 241.5, "setting": "both", "billing_class": "facility"}]}, {"description": "DOBUTAMINE PER250MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J1250", "type": "HCPCS"}, {"code": "5320185", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 249.0, "discounted_cash": 186.75, "setting": "both", "billing_class": "facility"}]}, {"description": "DOBUTAMINE PER250MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J1250", "type": "HCPCS"}, {"code": "5320185", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 249.0, "discounted_cash": 186.75, "setting": "both", "billing_class": "facility"}]}, {"description": "DOBUTAMN PER250MG PMX IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J1250", "type": "HCPCS"}, {"code": "5320186", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 780.0, "discounted_cash": 585.0, "setting": "both", "billing_class": "facility"}]}, {"description": "DOBUTAMN PER250MG PMX IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J1250", "type": "HCPCS"}, {"code": "5320186", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 780.0, "discounted_cash": 585.0, "setting": "both", "billing_class": "facility"}]}, {"description": "DOCETAXEL PER 1MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J9171", "type": "HCPCS"}, {"code": "5320194", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 28.0, "discounted_cash": 21.0, "setting": "both", "billing_class": "facility"}]}, {"description": "DOCETAXEL PER 1MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J9171", "type": "HCPCS"}, {"code": "5320194", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 28.0, "discounted_cash": 21.0, "setting": "both", "billing_class": "facility"}]}, {"description": "DOCOSANOL 10% 2GM CR", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5335290", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 201.0, "discounted_cash": 150.75, "setting": "both", "billing_class": "facility"}]}, {"description": "DOCOSANOL 10% 2GM CR", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5335290", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 201.0, "discounted_cash": 150.75, "setting": "both", "billing_class": "facility"}]}, {"description": "DOCUSATE 100MG CP", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5304219", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 68.0, "discounted_cash": 51.0, "setting": "both", "billing_class": "facility"}]}, {"description": "DOCUSATE 100MG CP", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5304219", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 68.0, "discounted_cash": 51.0, "setting": "both", "billing_class": "facility"}]}, {"description": "DOCUSATE 100MG/10ML LQ", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5315054", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 78.0, "discounted_cash": 58.5, "setting": "both", "billing_class": "facility"}]}, {"description": "DOCUSATE 100MG/10ML LQ", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5315054", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 78.0, "discounted_cash": 58.5, "setting": "both", "billing_class": "facility"}]}, {"description": "DOCUSATE 240MG CP", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5304203", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 99.0, "discounted_cash": 74.25, "setting": "both", "billing_class": "facility"}]}, {"description": "DOCUSATE 240MG CP", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5304203", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 99.0, "discounted_cash": 74.25, "setting": "both", "billing_class": "facility"}]}, {"description": "DOCUSATE/SENNA TB", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5310756", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 71.0, "discounted_cash": 53.25, "setting": "both", "billing_class": "facility"}]}, {"description": "DOCUSATE/SENNA TB", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5310756", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 71.0, "discounted_cash": 53.25, "setting": "both", "billing_class": "facility"}]}, {"description": "DOLUTEGRAVIR 50MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5304257", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 487.0, "discounted_cash": 365.25, "setting": "both", "billing_class": "facility"}]}, {"description": "DOLUTEGRAVIR 50MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5304257", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 487.0, "discounted_cash": 365.25, "setting": "both", "billing_class": "facility"}]}, {"description": "DONEPEZIL 5MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5304250", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 128.0, "discounted_cash": 96.0, "setting": "both", "billing_class": "facility"}]}, {"description": "DONEPEZIL 5MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5304250", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 128.0, "discounted_cash": 96.0, "setting": "both", "billing_class": "facility"}]}, {"description": "DOPAMINE NEO PER 1MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5320205", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 11.0, "discounted_cash": 8.25, "setting": "both", "billing_class": "facility"}]}, {"description": "DOPAMINE NEO PER 1ML IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5320207", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 84.0, "discounted_cash": 63.0, "setting": "both", "billing_class": "facility"}]}, {"description": "DOPAMINE PER40MG IV IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J1265", "type": "HCPCS"}, {"code": "5320210", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 17.0, "discounted_cash": 12.75, "setting": "both", "billing_class": "facility"}]}, {"description": "DOPAMINE PER40MG IV IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J1265", "type": "HCPCS"}, {"code": "5320210", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 17.0, "discounted_cash": 12.75, "setting": "both", "billing_class": "facility"}]}, {"description": "DOPAMINE PER40MG PMX IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J1265", "type": "HCPCS"}, {"code": "5320208", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 59.0, "discounted_cash": 44.25, "setting": "both", "billing_class": "facility"}]}, {"description": "DOPAMINE PER40MG PMX IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J1265", "type": "HCPCS"}, {"code": "5320208", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 59.0, "discounted_cash": 44.25, "setting": "both", "billing_class": "facility"}]}, {"description": "DOPLR VELOC FETL UMB ART", "code_information": [{"code": "76820", "type": "CPT"}, {"code": "5067682", "type": "CDM"}, {"code": "402", "type": "RC"}], "standard_charges": [{"gross_charge": 1687.0, "discounted_cash": 1265.25, "setting": "both", "billing_class": "facility"}]}, {"description": "DOPP FLW/PR MSMNT ADDL", "code_information": [{"code": "93572", "type": "CPT"}, {"code": "4613658", "type": "CDM"}, {"code": "480", "type": "RC"}], "standard_charges": [{"gross_charge": 7233.0, "discounted_cash": 5424.75, "setting": "both", "billing_class": "facility"}]}, {"description": "DOPP FLW/PR MSMNT ADDL", "code_information": [{"code": "93572", "type": "CPT"}, {"code": "4613658", "type": "CDM"}, {"code": "481", "type": "RC"}], "standard_charges": [{"gross_charge": 7233.0, "discounted_cash": 5424.75, "setting": "both", "billing_class": "facility"}]}, {"description": "DOPP FLW/PR MSMNT INIT", "code_information": [{"code": "93571", "type": "CPT"}, {"code": "4613657", "type": "CDM"}, {"code": "480", "type": "RC"}], "standard_charges": [{"gross_charge": 9491.0, "discounted_cash": 7118.25, "setting": "both", "billing_class": "facility"}]}, {"description": "DOPP FLW/PR MSMNT INIT", "code_information": [{"code": "93571", "type": "CPT"}, {"code": "4613657", "type": "CDM"}, {"code": "481", "type": "RC"}], "standard_charges": [{"gross_charge": 9491.0, "discounted_cash": 7118.25, "setting": "both", "billing_class": "facility"}]}, {"description": "DOPPLER ECHO COLOR FLOW", "code_information": [{"code": "93325", "type": "CPT"}, {"code": "4603330", "type": "CDM"}, {"code": "483", "type": "RC"}], "standard_charges": [{"gross_charge": 2298.0, "discounted_cash": 1723.5, "setting": "both", "billing_class": "facility"}]}, {"description": "DORZOLAMIDE 2% 10ML OS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5330786", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 541.0, "discounted_cash": 405.75, "setting": "both", "billing_class": "facility"}]}, {"description": "DORZOLAMIDE 2% 10ML OS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5330786", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 541.0, "discounted_cash": 405.75, "setting": "both", "billing_class": "facility"}]}, {"description": "DORZOLAMIDE 2% 5ML OS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5330785", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 771.0, "discounted_cash": 578.25, "setting": "both", "billing_class": "facility"}]}, {"description": "DORZOLAMIDE 2% 5ML OS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5330785", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 771.0, "discounted_cash": 578.25, "setting": "both", "billing_class": "facility"}]}, {"description": "DORZOLAMIDE/TIMOLO10MLOS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5330788", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 61.0, "discounted_cash": 45.75, "setting": "both", "billing_class": "facility"}]}, {"description": "DORZOLAMIDE/TIMOLO10MLOS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5330788", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 61.0, "discounted_cash": 45.75, "setting": "both", "billing_class": "facility"}]}, {"description": "DOXAZOSIN 2MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5304336", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 61.0, "discounted_cash": 45.75, "setting": "both", "billing_class": "facility"}]}, {"description": "DOXAZOSIN 2MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5304336", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 61.0, "discounted_cash": 45.75, "setting": "both", "billing_class": "facility"}]}, {"description": "DOXAZOSIN 4MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5304337", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 66.0, "discounted_cash": 49.5, "setting": "both", "billing_class": "facility"}]}, {"description": "DOXAZOSIN 4MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5304337", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 66.0, "discounted_cash": 49.5, "setting": "both", "billing_class": "facility"}]}, {"description": "DOXEPIN 10MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5304342", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 85.0, "discounted_cash": 63.75, "setting": "both", "billing_class": "facility"}]}, {"description": "DOXEPIN 10MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5304342", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 85.0, "discounted_cash": 63.75, "setting": "both", "billing_class": "facility"}]}, {"description": "DOXEPIN 25MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5304365", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 61.0, "discounted_cash": 45.75, "setting": "both", "billing_class": "facility"}]}, {"description": "DOXEPIN 25MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5304365", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 61.0, "discounted_cash": 45.75, "setting": "both", "billing_class": "facility"}]}, {"description": "DOXEPIN 50MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5304367", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 85.0, "discounted_cash": 63.75, "setting": "both", "billing_class": "facility"}]}, {"description": "DOXEPIN 50MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5304367", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 85.0, "discounted_cash": 63.75, "setting": "both", "billing_class": "facility"}]}, {"description": "DOXYCYCLINE 100MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5304392", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 61.0, "discounted_cash": 45.75, "setting": "both", "billing_class": "facility"}]}, {"description": "DOXYCYCLINE 100MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5304392", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 61.0, "discounted_cash": 45.75, "setting": "both", "billing_class": "facility"}]}, {"description": "DOXYCYCLINE 10MG/ML 10ML LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5315103", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 173.0, "discounted_cash": 129.75, "setting": "both", "billing_class": "facility"}]}, {"description": "DOXYCYCLINE 10MG/ML 10ML LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5315103", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 173.0, "discounted_cash": 129.75, "setting": "both", "billing_class": "facility"}]}, {"description": "DOXYCYCLINE 50MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5304388", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 63.0, "discounted_cash": 47.25, "setting": "both", "billing_class": "facility"}]}, {"description": "DOXYCYCLINE 50MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5304388", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 63.0, "discounted_cash": 47.25, "setting": "both", "billing_class": "facility"}]}, {"description": "DOXYCYCLINE 5MG/ML 5MLLQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5315102", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 47.0, "discounted_cash": 35.25, "setting": "both", "billing_class": "facility"}]}, {"description": "DOXYCYCLINE 5MG/ML 5MLLQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5315102", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 47.0, "discounted_cash": 35.25, "setting": "both", "billing_class": "facility"}]}, {"description": "DOXYCYCLINE 5MG/ML 60 LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5315096", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 598.0, "discounted_cash": 448.5, "setting": "both", "billing_class": "facility"}]}, {"description": "DOXYCYCLINE 5MG/ML 60 LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5315096", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 598.0, "discounted_cash": 448.5, "setting": "both", "billing_class": "facility"}]}, {"description": "DOXYCYCLINE HYCLATE PER 1MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J1271", "type": "HCPCS"}, {"code": "5320295", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 5.0, "discounted_cash": 3.75, "setting": "both", "billing_class": "facility"}]}, {"description": "DOXYCYCLINE HYCLATE PER 1MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J1271", "type": "HCPCS"}, {"code": "5320295", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 5.0, "discounted_cash": 3.75, "setting": "both", "billing_class": "facility"}]}, {"description": "DRAIN BLD UNDER NAIL", "code_information": [{"code": "6900135", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 267.0, "discounted_cash": 200.25, "setting": "both", "billing_class": "facility"}]}, {"description": "DRAIN BLD UNDER NAIL", "code_information": [{"code": "6900135", "type": "CDM"}, {"code": "361", "type": "RC"}], "standard_charges": [{"gross_charge": 267.0, "discounted_cash": 200.25, "setting": "both", "billing_class": "facility"}]}, {"description": "DRGSCRN DIRCT OPT OBS", "code_information": [{"code": "80305", "type": "CPT"}, {"code": "4100403", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 14.0, "discounted_cash": 10.5, "setting": "both", "billing_class": "facility"}]}, {"description": "DRGSCRN TRIAGE OPT OBS", "code_information": [{"code": "80305", "type": "CPT"}, {"code": "4100402", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 14.0, "discounted_cash": 10.5, "setting": "both", "billing_class": "facility"}]}, {"description": "DRONABINOL 2.5MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5327430", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 148.0, "discounted_cash": 111.0, "setting": "both", "billing_class": "facility"}]}, {"description": "DRONABINOL 2.5MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5327430", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 148.0, "discounted_cash": 111.0, "setting": "both", "billing_class": "facility"}]}, {"description": "DRONEDARONE 400MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5304405", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 112.0, "discounted_cash": 84.0, "setting": "both", "billing_class": "facility"}]}, {"description": "DRONEDARONE 400MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5304405", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 112.0, "discounted_cash": 84.0, "setting": "both", "billing_class": "facility"}]}, {"description": "DROPERIDOL UPTO 5MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J1790", "type": "HCPCS"}, {"code": "5320305", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 222.0, "discounted_cash": 166.5, "setting": "both", "billing_class": "facility"}]}, {"description": "DROPERIDOL UPTO 5MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J1790", "type": "HCPCS"}, {"code": "5320305", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 222.0, "discounted_cash": 166.5, "setting": "both", "billing_class": "facility"}]}, {"description": "DRS INTERCEED", "code_information": [{"code": "C1765", "type": "HCPCS"}, {"code": "8024553", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 4413.0, "discounted_cash": 3309.75, "setting": "both", "billing_class": "facility"}]}, {"description": "DRUG TEST PRSMV CHEM ANLYZR", "code_information": [{"code": "80307", "type": "CPT"}, {"code": "4100100", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 14.0, "discounted_cash": 10.5, "setting": "both", "billing_class": "facility"}]}, {"description": "DRUG TEST PRSMV CHEM ANLYZR", "code_information": [{"code": "80307", "type": "CPT"}, {"code": "4120100", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 48.0, "discounted_cash": 36.0, "setting": "both", "billing_class": "facility"}]}, {"description": "DRUG TEST PRSMV CHEM ANLYZR", "code_information": [{"code": "80307", "type": "CPT"}, {"code": "7250098", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 49.0, "discounted_cash": 36.75, "setting": "both", "billing_class": "facility"}]}, {"description": "DRUG TEST PRSMV CHEM ANLYZR/10", "code_information": [{"code": "80307", "type": "CPT"}, {"code": "4102055", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 1260.0, "discounted_cash": 945.0, "setting": "both", "billing_class": "facility"}]}, {"description": "DRUG TEST PRSMV CHEM ANLYZR/10", "code_information": [{"code": "80307", "type": "CPT"}, {"code": "4172055", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 3.85, "discounted_cash": 2.89, "setting": "both", "billing_class": "facility"}]}, {"description": "DRUG TEST PRSMV CHEM ANLYZR/11", "code_information": [{"code": "80307", "type": "CPT"}, {"code": "4102065", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 50.0, "discounted_cash": 37.5, "setting": "both", "billing_class": "facility"}]}, {"description": "DRUG TEST PRSMV CHEM ANLYZR/12", "code_information": [{"code": "80307", "type": "CPT"}, {"code": "4102213", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 84.0, "discounted_cash": 63.0, "setting": "both", "billing_class": "facility"}]}, {"description": "DRUG TEST PRSMV CHEM ANLYZR/12", "code_information": [{"code": "80307", "type": "CPT"}, {"code": "4173016", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 1.64, "discounted_cash": 1.23, "setting": "both", "billing_class": "facility"}]}, {"description": "DRUG TEST PRSMV CHEM ANLYZR/13", "code_information": [{"code": "80307", "type": "CPT"}, {"code": "7250302", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 390.0, "discounted_cash": 292.5, "setting": "both", "billing_class": "facility"}]}, {"description": "DRUG TEST PRSMV CHEM ANLYZR/14", "code_information": [{"code": "80307", "type": "CPT"}, {"code": "4102560", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 104.0, "discounted_cash": 78.0, "setting": "both", "billing_class": "facility"}]}, {"description": "DRUG TEST PRSMV CHEM ANLYZR/16", "code_information": [{"code": "80307", "type": "CPT"}, {"code": "4103731", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 174.0, "discounted_cash": 130.5, "setting": "both", "billing_class": "facility"}]}, {"description": "DRUG TEST PRSMV CHEM ANLYZR/17", "code_information": [{"code": "80307", "type": "CPT"}, {"code": "4103927", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 84.0, "discounted_cash": 63.0, "setting": "both", "billing_class": "facility"}]}, {"description": "DRUG TEST PRSMV CHEM ANLYZR/17", "code_information": [{"code": "80307", "type": "CPT"}, {"code": "7250310", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 92.0, "discounted_cash": 69.0, "setting": "both", "billing_class": "facility"}]}, {"description": "DRUG TEST PRSMV CHEM ANLYZR/19", "code_information": [{"code": "80307", "type": "CPT"}, {"code": "4104408", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 104.0, "discounted_cash": 78.0, "setting": "both", "billing_class": "facility"}]}, {"description": "DRUG TEST PRSMV CHEM ANLYZR/2", "code_information": [{"code": "80307", "type": "CPT"}, {"code": "4100101", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 84.0, "discounted_cash": 63.0, "setting": "both", "billing_class": "facility"}]}, {"description": "DRUG TEST PRSMV CHEM ANLYZR/2", "code_information": [{"code": "80307", "type": "CPT"}, {"code": "4170102", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 12.84, "discounted_cash": 9.63, "setting": "both", "billing_class": "facility"}]}, {"description": "DRUG TEST PRSMV CHEM ANLYZR/21", "code_information": [{"code": "80307", "type": "CPT"}, {"code": "4106319", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 84.0, "discounted_cash": 63.0, "setting": "both", "billing_class": "facility"}]}, {"description": "DRUG TEST PRSMV CHEM ANLYZR/3", "code_information": [{"code": "80307", "type": "CPT"}, {"code": "4100102", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 84.0, "discounted_cash": 63.0, "setting": "both", "billing_class": "facility"}]}, {"description": "DRUG TEST PRSMV CHEM ANLYZR/3", "code_information": [{"code": "80307", "type": "CPT"}, {"code": "4170301", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 1.64, "discounted_cash": 1.23, "setting": "both", "billing_class": "facility"}]}, {"description": "DRUG TEST PRSMV CHEM ANLYZR/3", "code_information": [{"code": "80307", "type": "CPT"}, {"code": "7250100", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 809.0, "discounted_cash": 606.75, "setting": "both", "billing_class": "facility"}]}, {"description": "DRUG TEST PRSMV CHEM ANLYZR/32", "code_information": [{"code": "80307", "type": "CPT"}, {"code": "7252184", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 83.0, "discounted_cash": 62.25, "setting": "both", "billing_class": "facility"}]}, {"description": "DRUG TEST PRSMV CHEM ANLYZR/33", "code_information": [{"code": "80307", "type": "CPT"}, {"code": "7252213", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 50.0, "discounted_cash": 37.5, "setting": "both", "billing_class": "facility"}]}, {"description": "DRUG TEST PRSMV CHEM ANLYZR/36", "code_information": [{"code": "80307", "type": "CPT"}, {"code": "7253731", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 35.0, "discounted_cash": 26.25, "setting": "both", "billing_class": "facility"}]}, {"description": "DRUG TEST PRSMV CHEM ANLYZR/38", "code_information": [{"code": "80307", "type": "CPT"}, {"code": "7253738", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 198.0, "discounted_cash": 148.5, "setting": "both", "billing_class": "facility"}]}, {"description": "DRUG TEST PRSMV CHEM ANLYZR/39", "code_information": [{"code": "80307", "type": "CPT"}, {"code": "7253927", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 50.0, "discounted_cash": 37.5, "setting": "both", "billing_class": "facility"}]}, {"description": "DRUG TEST PRSMV CHEM ANLYZR/4", "code_information": [{"code": "80307", "type": "CPT"}, {"code": "4100154", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 28.0, "discounted_cash": 21.0, "setting": "both", "billing_class": "facility"}]}, {"description": "DRUG TEST PRSMV CHEM ANLYZR/4", "code_information": [{"code": "80307", "type": "CPT"}, {"code": "4170310", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 1.64, "discounted_cash": 1.23, "setting": "both", "billing_class": "facility"}]}, {"description": "DRUG TEST PRSMV CHEM ANLYZR/4", "code_information": [{"code": "80307", "type": "CPT"}, {"code": "7250101", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 528.0, "discounted_cash": 396.0, "setting": "both", "billing_class": "facility"}]}, {"description": "DRUG TEST PRSMV CHEM ANLYZR/40", "code_information": [{"code": "80307", "type": "CPT"}, {"code": "7253929", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 60.0, "discounted_cash": 45.0, "setting": "both", "billing_class": "facility"}]}, {"description": "DRUG TEST PRSMV CHEM ANLYZR/41", "code_information": [{"code": "80307", "type": "CPT"}, {"code": "7254147", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 35.0, "discounted_cash": 26.25, "setting": "both", "billing_class": "facility"}]}, {"description": "DRUG TEST PRSMV CHEM ANLYZR/42", "code_information": [{"code": "80307", "type": "CPT"}, {"code": "7254408", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 50.0, "discounted_cash": 37.5, "setting": "both", "billing_class": "facility"}]}, {"description": "DRUG TEST PRSMV CHEM ANLYZR/47", "code_information": [{"code": "80307", "type": "CPT"}, {"code": "7258009", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 180.0, "discounted_cash": 135.0, "setting": "both", "billing_class": "facility"}]}, {"description": "DRUG TEST PRSMV CHEM ANLYZR/5", "code_information": [{"code": "80307", "type": "CPT"}, {"code": "4100301", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 14.0, "discounted_cash": 10.5, "setting": "both", "billing_class": "facility"}]}, {"description": "DRUG TEST PRSMV CHEM ANLYZR/5", "code_information": [{"code": "80307", "type": "CPT"}, {"code": "4170311", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 1.64, "discounted_cash": 1.23, "setting": "both", "billing_class": "facility"}]}, {"description": "DRUG TEST PRSMV CHEM ANLYZR/51", "code_information": [{"code": "80307", "type": "CPT"}, {"code": "7258013", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 301.0, "discounted_cash": 225.75, "setting": "both", "billing_class": "facility"}]}, {"description": "DRUG TEST PRSMV CHEM ANLYZR/54", "code_information": [{"code": "80307", "type": "CPT"}, {"code": "7259369", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 555.0, "discounted_cash": 416.25, "setting": "both", "billing_class": "facility"}]}, {"description": "DRUG TEST PRSMV CHEM ANLYZR/6", "code_information": [{"code": "80307", "type": "CPT"}, {"code": "4100302", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 21.0, "discounted_cash": 15.75, "setting": "both", "billing_class": "facility"}]}, {"description": "DRUG TEST PRSMV CHEM ANLYZR/6", "code_information": [{"code": "80307", "type": "CPT"}, {"code": "4170315", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 1.64, "discounted_cash": 1.23, "setting": "both", "billing_class": "facility"}]}, {"description": "DRUG TEST PRSMV CHEM ANLYZR/6", "code_information": [{"code": "80307", "type": "CPT"}, {"code": "7250104", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 790.0, "discounted_cash": 592.5, "setting": "both", "billing_class": "facility"}]}, {"description": "DRUG TEST PRSMV CHEM ANLYZR/7", "code_information": [{"code": "80307", "type": "CPT"}, {"code": "4170317", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 1.64, "discounted_cash": 1.23, "setting": "both", "billing_class": "facility"}]}, {"description": "DRUG TEST PRSMV CHEM ANLYZR/7", "code_information": [{"code": "80307", "type": "CPT"}, {"code": "7250105", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 148.0, "discounted_cash": 111.0, "setting": "both", "billing_class": "facility"}]}, {"description": "DRUG TEST PRSMV CHEM ANLYZR/8", "code_information": [{"code": "80307", "type": "CPT"}, {"code": "4102003", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 1915.0, "discounted_cash": 1436.25, "setting": "both", "billing_class": "facility"}]}, {"description": "DRUG TEST PRSMV CHEM ANLYZR/8", "code_information": [{"code": "80307", "type": "CPT"}, {"code": "4122055", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 23.0, "discounted_cash": 17.25, "setting": "both", "billing_class": "facility"}]}, {"description": "DRUG TEST PRSMV CHEM ANLYZR/8", "code_information": [{"code": "80307", "type": "CPT"}, {"code": "4172003", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 4.29, "discounted_cash": 3.22, "setting": "both", "billing_class": "facility"}]}, {"description": "DRUG TEST PRSMV CHEM ANLYZR/8", "code_information": [{"code": "80307", "type": "CPT"}, {"code": "7250106", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 37.0, "discounted_cash": 27.75, "setting": "both", "billing_class": "facility"}]}, {"description": "DRUG TEST PRSMV CHEM ANLYZR/9", "code_information": [{"code": "80307", "type": "CPT"}, {"code": "4102011", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 1915.0, "discounted_cash": 1436.25, "setting": "both", "billing_class": "facility"}]}, {"description": "DRUGS NOS 7 OR MORE/3", "code_information": [{"code": "80377", "type": "CPT"}, {"code": "7252541", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 401.0, "discounted_cash": 300.75, "setting": "both", "billing_class": "facility"}]}, {"description": "DTAP-HIB-IP VACCINE IJ", "code_information": [{"code": "90698", "type": "CPT"}, {"code": "5320136", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 1288.0, "discounted_cash": 966.0, "setting": "both", "billing_class": "facility"}]}, {"description": "DTAP-HIB-IP VACCINE IJ", "code_information": [{"code": "90698", "type": "CPT"}, {"code": "5320136", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 1288.0, "discounted_cash": 966.0, "setting": "both", "billing_class": "facility"}]}, {"description": "DTAP/HEP B/IPV VAC.5MLIJ", "code_information": [{"code": "90723", "type": "CPT"}, {"code": "5320313", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 6618.0, "discounted_cash": 4963.5, "setting": "both", "billing_class": "facility"}]}, {"description": "DTAP/HEP B/IPV VAC.5MLIJ", "code_information": [{"code": "90723", "type": "CPT"}, {"code": "5320313", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 6618.0, "discounted_cash": 4963.5, "setting": "both", "billing_class": "facility"}]}, {"description": "DULOXETINE 20MG XR CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5304410", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 149.0, "discounted_cash": 111.75, "setting": "both", "billing_class": "facility"}]}, {"description": "DULOXETINE 20MG XR CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5304410", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 149.0, "discounted_cash": 111.75, "setting": "both", "billing_class": "facility"}]}, {"description": "DULOXETINE 30MG XR CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5304411", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 144.0, "discounted_cash": 108.0, "setting": "both", "billing_class": "facility"}]}, {"description": "DULOXETINE 30MG XR CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5304411", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 144.0, "discounted_cash": 108.0, "setting": "both", "billing_class": "facility"}]}, {"description": "DULOXETINE 60MG XR CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5304412", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 114.0, "discounted_cash": 85.5, "setting": "both", "billing_class": "facility"}]}, {"description": "DULOXETINE 60MG XR CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5304412", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 114.0, "discounted_cash": 85.5, "setting": "both", "billing_class": "facility"}]}, {"description": "DUPLEX CAROTID BI/COMP", "code_information": [{"code": "93880", "type": "CPT"}, {"code": "5066541", "type": "CDM"}, {"code": "921", "type": "RC"}], "standard_charges": [{"gross_charge": 4352.0, "discounted_cash": 3264.0, "setting": "both", "billing_class": "facility"}]}, {"description": "DUPLEX CAROTID BI/COMP", "code_information": [{"code": "93880", "type": "CPT"}, {"code": "5116541", "type": "CDM"}, {"code": "921", "type": "RC"}], "standard_charges": [{"gross_charge": 4352.0, "discounted_cash": 3264.0, "setting": "both", "billing_class": "facility"}]}, {"description": "DUPLEX CAROTID UNI/LTD", "code_information": [{"code": "93882", "type": "CPT"}, {"code": "5066540", "type": "CDM"}, {"code": "921", "type": "RC"}], "standard_charges": [{"gross_charge": 3831.0, "discounted_cash": 2873.25, "setting": "both", "billing_class": "facility"}]}, {"description": "DUTASTERIDE .5MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5304415", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 113.0, "discounted_cash": 84.75, "setting": "both", "billing_class": "facility"}]}, {"description": "DUTASTERIDE .5MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5304415", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 113.0, "discounted_cash": 84.75, "setting": "both", "billing_class": "facility"}]}, {"description": "DVC ATRICLIP LAA EXCULSN", "code_information": [{"code": "C1889", "type": "HCPCS"}, {"code": "8192019", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 53420.0, "discounted_cash": 40065.0, "setting": "both", "billing_class": "facility"}]}, {"description": "DVC FEM FIXATION", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8131570", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 12376.0, "discounted_cash": 9282.0, "setting": "both", "billing_class": "facility"}]}, {"description": "DVC FIX STERNUM SGL", "code_information": [{"code": "C1889", "type": "HCPCS"}, {"code": "8174109", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 1099.0, "discounted_cash": 824.25, "setting": "both", "billing_class": "facility"}]}, {"description": "DVC FUSION INTERMEDULARY", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "4011100", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 5486.0, "discounted_cash": 4114.5, "setting": "both", "billing_class": "facility"}]}, {"description": "DVC FX ANKL SYN ZIP DISP", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8137289", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 11957.0, "discounted_cash": 8967.75, "setting": "both", "billing_class": "facility"}]}, {"description": "DVC HEMOSTAT ENDO HEMOSPRAY", "code_information": [{"code": "C1052", "type": "HCPCS"}, {"code": "8031981", "type": "CDM"}, {"code": "272", "type": "RC"}], "standard_charges": [{"gross_charge": 15451.0, "discounted_cash": 11588.25, "setting": "both", "billing_class": "facility"}]}, {"description": "DVC REP URIN TVT OBTUR", "code_information": [{"code": "C1771", "type": "HCPCS"}, {"code": "4021029", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 13940.0, "discounted_cash": 10455.0, "setting": "both", "billing_class": "facility"}]}, {"description": "DVC REP URN SLING DESARA", "code_information": [{"code": "C1771", "type": "HCPCS"}, {"code": "4021027", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 21275.0, "discounted_cash": 15956.25, "setting": "both", "billing_class": "facility"}]}, {"description": "DVC REVASCULARIZATION", "code_information": [{"code": "C1757", "type": "HCPCS"}, {"code": "8174141", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 88068.0, "discounted_cash": 66051.0, "setting": "both", "billing_class": "facility"}]}, {"description": "DVC SUT CAPTR CAPIO SLIM", "code_information": [{"code": "C2631", "type": "HCPCS"}, {"code": "8195406", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 9804.0, "discounted_cash": 7353.0, "setting": "both", "billing_class": "facility"}]}, {"description": "DVC UROLIFT SYS DELIVERY", "code_information": [{"code": "L8699", "type": "HCPCS"}, {"code": "8174022", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 18590.0, "discounted_cash": 13942.5, "setting": "both", "billing_class": "facility"}]}, {"description": "DVC VAS CLSR MYNX", "code_information": [{"code": "C1760", "type": "HCPCS"}, {"code": "8174113", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 3840.0, "discounted_cash": 2880.0, "setting": "both", "billing_class": "facility"}]}, {"description": "DVC VASC ACCESS HERO", "code_information": [{"code": "C1750", "type": "HCPCS"}, {"code": "8174121", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 14299.0, "discounted_cash": 10724.25, "setting": "both", "billing_class": "facility"}]}, {"description": "DVC VASCULAR CLOSURE MANTA", "code_information": [{"code": "C1760", "type": "HCPCS"}, {"code": "8174149", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 15394.0, "discounted_cash": 11545.5, "setting": "both", "billing_class": "facility"}]}, {"description": "DX BONE MARROW ASP/BX MULTI", "code_information": [{"code": "4910364", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 10402.0, "discounted_cash": 7801.5, "setting": "both", "billing_class": "facility"}]}, {"description": "DX BONE MARROW BIOPSIES", "code_information": [{"code": "4918221", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 9116.0, "discounted_cash": 6837.0, "setting": "both", "billing_class": "facility"}]}, {"description": "DX BONE MARROW BIOPSIES", "code_information": [{"code": "5058221", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 6127.0, "discounted_cash": 4595.25, "setting": "both", "billing_class": "facility"}]}, {"description": "DX I-131 SOD PER UCI", "code_information": [{"code": "A9531", "type": "HCPCS"}, {"code": "5199531", "type": "CDM"}, {"code": "343", "type": "RC"}], "standard_charges": [{"gross_charge": 940.0, "discounted_cash": 705.0, "setting": "both", "billing_class": "facility"}]}, {"description": "DX I131 SOD CAP PER MCI", "code_information": [{"code": "A9528", "type": "HCPCS"}, {"code": "5199603", "type": "CDM"}, {"code": "343", "type": "RC"}], "standard_charges": [{"gross_charge": 1519.0, "discounted_cash": 1139.25, "setting": "both", "billing_class": "facility"}]}, {"description": "DX MAMMO+CAD BILAT", "code_information": [{"code": "77066", "type": "CPT"}, {"code": "3070204", "type": "CDM"}, {"code": "401", "type": "RC"}], "standard_charges": [{"gross_charge": 1510.0, "discounted_cash": 1132.5, "setting": "both", "billing_class": "facility"}]}, {"description": "DX MAMMO+CAD UNILAT", "code_information": [{"code": "77065", "type": "CPT"}, {"code": "3070206", "type": "CDM"}, {"code": "401", "type": "RC"}], "standard_charges": [{"gross_charge": 1243.0, "discounted_cash": 932.25, "setting": "both", "billing_class": "facility"}]}, {"description": "E&M-EST. PATIENT-LVL I", "code_information": [{"code": "99211", "type": "CPT"}, {"code": "5070914", "type": "CDM"}, {"code": "510", "type": "RC"}], "standard_charges": [{"gross_charge": 483.0, "discounted_cash": 362.25, "setting": "both", "billing_class": "facility"}]}, {"description": "E&M-EST. PATIENT-LVL I", "code_information": [{"code": "99211", "type": "CPT"}, {"code": "5070914", "type": "CDM"}, {"code": "761", "type": "RC"}], "standard_charges": [{"gross_charge": 483.0, "discounted_cash": 362.25, "setting": "both", "billing_class": "facility"}]}, {"description": "E&M-EST. PATIENT-LVL I", "code_information": [{"code": "99211", "type": "CPT"}, {"code": "6819211", "type": "CDM"}, {"code": "510", "type": "RC"}], "standard_charges": [{"gross_charge": 377.0, "discounted_cash": 282.75, "setting": "both", "billing_class": "facility"}]}, {"description": "E&M-EST. PATIENT-LVL I", "code_information": [{"code": "99211", "type": "CPT"}, {"code": "6819211", "type": "CDM"}, {"code": "761", "type": "RC"}], "standard_charges": [{"gross_charge": 377.0, "discounted_cash": 282.75, "setting": "both", "billing_class": "facility"}]}, {"description": "E&M-EST. PATIENT-LVL I", "code_information": [{"code": "99211", "type": "CPT"}, {"code": "6901603", "type": "CDM"}, {"code": "510", "type": "RC"}], "standard_charges": [{"gross_charge": 456.0, "discounted_cash": 342.0, "setting": "both", "billing_class": "facility"}]}, {"description": "E&M-EST. PATIENT-LVL I", "code_information": [{"code": "99211", "type": "CPT"}, {"code": "6901603", "type": "CDM"}, {"code": "761", "type": "RC"}], "standard_charges": [{"gross_charge": 456.0, "discounted_cash": 342.0, "setting": "both", "billing_class": "facility"}]}, {"description": "E&M-EST. PATIENT-LVL II", "code_information": [{"code": "99212", "type": "CPT"}, {"code": "6819212", "type": "CDM"}, {"code": "510", "type": "RC"}], "standard_charges": [{"gross_charge": 646.0, "discounted_cash": 484.5, "setting": "both", "billing_class": "facility"}]}, {"description": "E&M-EST. PATIENT-LVL II", "code_information": [{"code": "99212", "type": "CPT"}, {"code": "6819212", "type": "CDM"}, {"code": "761", "type": "RC"}], "standard_charges": [{"gross_charge": 646.0, "discounted_cash": 484.5, "setting": "both", "billing_class": "facility"}]}, {"description": "E&M-EST. PATIENT-LVL II", "code_information": [{"code": "99212", "type": "CPT"}, {"code": "6901604", "type": "CDM"}, {"code": "510", "type": "RC"}], "standard_charges": [{"gross_charge": 1234.0, "discounted_cash": 925.5, "setting": "both", "billing_class": "facility"}]}, {"description": "E&M-EST. PATIENT-LVL II", "code_information": [{"code": "99212", "type": "CPT"}, {"code": "6901604", "type": "CDM"}, {"code": "761", "type": "RC"}], "standard_charges": [{"gross_charge": 1234.0, "discounted_cash": 925.5, "setting": "both", "billing_class": "facility"}]}, {"description": "E&M-EST. PATIENT-LVL III", "code_information": [{"code": "99213", "type": "CPT"}, {"code": "6819213", "type": "CDM"}, {"code": "510", "type": "RC"}], "standard_charges": [{"gross_charge": 786.0, "discounted_cash": 589.5, "setting": "both", "billing_class": "facility"}]}, {"description": "E&M-EST. PATIENT-LVL III", "code_information": [{"code": "99213", "type": "CPT"}, {"code": "6819213", "type": "CDM"}, {"code": "761", "type": "RC"}], "standard_charges": [{"gross_charge": 786.0, "discounted_cash": 589.5, "setting": "both", "billing_class": "facility"}]}, {"description": "E&M-EST. PATIENT-LVL III", "code_information": [{"code": "99213", "type": "CPT"}, {"code": "6906005", "type": "CDM"}, {"code": "510", "type": "RC"}], "standard_charges": [{"gross_charge": 1633.0, "discounted_cash": 1224.75, "setting": "both", "billing_class": "facility"}]}, {"description": "E&M-EST. PATIENT-LVL III", "code_information": [{"code": "99213", "type": "CPT"}, {"code": "6906005", "type": "CDM"}, {"code": "761", "type": "RC"}], "standard_charges": [{"gross_charge": 1633.0, "discounted_cash": 1224.75, "setting": "both", "billing_class": "facility"}]}, {"description": "E&M-EST. PATIENT-LVL IV", "code_information": [{"code": "99214", "type": "CPT"}, {"code": "6819214", "type": "CDM"}, {"code": "510", "type": "RC"}], "standard_charges": [{"gross_charge": 1257.0, "discounted_cash": 942.75, "setting": "both", "billing_class": "facility"}]}, {"description": "E&M-EST. PATIENT-LVL IV", "code_information": [{"code": "99214", "type": "CPT"}, {"code": "6819214", "type": "CDM"}, {"code": "761", "type": "RC"}], "standard_charges": [{"gross_charge": 1257.0, "discounted_cash": 942.75, "setting": "both", "billing_class": "facility"}]}, {"description": "E&M-EST. PATIENT-LVL IV", "code_information": [{"code": "99214", "type": "CPT"}, {"code": "6906006", "type": "CDM"}, {"code": "510", "type": "RC"}], "standard_charges": [{"gross_charge": 1672.0, "discounted_cash": 1254.0, "setting": "both", "billing_class": "facility"}]}, {"description": "E&M-EST. PATIENT-LVL IV", "code_information": [{"code": "99214", "type": "CPT"}, {"code": "6906006", "type": "CDM"}, {"code": "761", "type": "RC"}], "standard_charges": [{"gross_charge": 1672.0, "discounted_cash": 1254.0, "setting": "both", "billing_class": "facility"}]}, {"description": "E&M-EST. PATIENT-LVL V", "code_information": [{"code": "99215", "type": "CPT"}, {"code": "6819215", "type": "CDM"}, {"code": "510", "type": "RC"}], "standard_charges": [{"gross_charge": 1224.0, "discounted_cash": 918.0, "setting": "both", "billing_class": "facility"}]}, {"description": "E&M-EST. PATIENT-LVL V", "code_information": [{"code": "99215", "type": "CPT"}, {"code": "6819215", "type": "CDM"}, {"code": "761", "type": "RC"}], "standard_charges": [{"gross_charge": 1224.0, "discounted_cash": 918.0, "setting": "both", "billing_class": "facility"}]}, {"description": "E&M-EST. PATIENT-LVL V", "code_information": [{"code": "99215", "type": "CPT"}, {"code": "6906007", "type": "CDM"}, {"code": "510", "type": "RC"}], "standard_charges": [{"gross_charge": 2027.0, "discounted_cash": 1520.25, "setting": "both", "billing_class": "facility"}]}, {"description": "E&M-EST. PATIENT-LVL V", "code_information": [{"code": "99215", "type": "CPT"}, {"code": "6906007", "type": "CDM"}, {"code": "761", "type": "RC"}], "standard_charges": [{"gross_charge": 2027.0, "discounted_cash": 1520.25, "setting": "both", "billing_class": "facility"}]}, {"description": "E&M-NEW PATIENT-LVL II", "code_information": [{"code": "99202", "type": "CPT"}, {"code": "6819202", "type": "CDM"}, {"code": "510", "type": "RC"}], "standard_charges": [{"gross_charge": 786.0, "discounted_cash": 589.5, "setting": "both", "billing_class": "facility"}]}, {"description": "E&M-NEW PATIENT-LVL II", "code_information": [{"code": "99202", "type": "CPT"}, {"code": "6819202", "type": "CDM"}, {"code": "761", "type": "RC"}], "standard_charges": [{"gross_charge": 786.0, "discounted_cash": 589.5, "setting": "both", "billing_class": "facility"}]}, {"description": "E&M-NEW PATIENT-LVL III", "code_information": [{"code": "99203", "type": "CPT"}, {"code": "6819203", "type": "CDM"}, {"code": "510", "type": "RC"}], "standard_charges": [{"gross_charge": 1095.0, "discounted_cash": 821.25, "setting": "both", "billing_class": "facility"}]}, {"description": "E&M-NEW PATIENT-LVL III", "code_information": [{"code": "99203", "type": "CPT"}, {"code": "6819203", "type": "CDM"}, {"code": "761", "type": "RC"}], "standard_charges": [{"gross_charge": 1095.0, "discounted_cash": 821.25, "setting": "both", "billing_class": "facility"}]}, {"description": "E&M-NEW PATIENT-LVL IV", "code_information": [{"code": "99204", "type": "CPT"}, {"code": "6819204", "type": "CDM"}, {"code": "510", "type": "RC"}], "standard_charges": [{"gross_charge": 1206.0, "discounted_cash": 904.5, "setting": "both", "billing_class": "facility"}]}, {"description": "E&M-NEW PATIENT-LVL IV", "code_information": [{"code": "99204", "type": "CPT"}, {"code": "6819204", "type": "CDM"}, {"code": "761", "type": "RC"}], "standard_charges": [{"gross_charge": 1206.0, "discounted_cash": 904.5, "setting": "both", "billing_class": "facility"}]}, {"description": "E&M-NEW PATIENT-LVL IV", "code_information": [{"code": "99204", "type": "CPT"}, {"code": "6901004", "type": "CDM"}, {"code": "510", "type": "RC"}], "standard_charges": [{"gross_charge": 2325.0, "discounted_cash": 1743.75, "setting": "both", "billing_class": "facility"}]}, {"description": "E&M-NEW PATIENT-LVL IV", "code_information": [{"code": "99204", "type": "CPT"}, {"code": "6901004", "type": "CDM"}, {"code": "761", "type": "RC"}], "standard_charges": [{"gross_charge": 2325.0, "discounted_cash": 1743.75, "setting": "both", "billing_class": "facility"}]}, {"description": "E&M-NEW PATIENT-LVL V", "code_information": [{"code": "99205", "type": "CPT"}, {"code": "6819205", "type": "CDM"}, {"code": "510", "type": "RC"}], "standard_charges": [{"gross_charge": 1890.0, "discounted_cash": 1417.5, "setting": "both", "billing_class": "facility"}]}, {"description": "E&M-NEW PATIENT-LVL V", "code_information": [{"code": "99205", "type": "CPT"}, {"code": "6819205", "type": "CDM"}, {"code": "761", "type": "RC"}], "standard_charges": [{"gross_charge": 1890.0, "discounted_cash": 1417.5, "setting": "both", "billing_class": "facility"}]}, {"description": "E&M-NEW PATIENT-LVL V", "code_information": [{"code": "99205", "type": "CPT"}, {"code": "6901005", "type": "CDM"}, {"code": "510", "type": "RC"}], "standard_charges": [{"gross_charge": 1638.0, "discounted_cash": 1228.5, "setting": "both", "billing_class": "facility"}]}, {"description": "E&M-NEW PATIENT-LVL V", "code_information": [{"code": "99205", "type": "CPT"}, {"code": "6901005", "type": "CDM"}, {"code": "761", "type": "RC"}], "standard_charges": [{"gross_charge": 1638.0, "discounted_cash": 1228.5, "setting": "both", "billing_class": "facility"}]}, {"description": "E.COLI 0157 IA", "code_information": [{"code": "87335", "type": "CPT"}, {"code": "4177335", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 18.55, "discounted_cash": 13.91, "setting": "both", "billing_class": "facility"}]}, {"description": "EA MLTPLX STAIN MANUAL", "code_information": [{"code": "88377", "type": "CPT"}, {"code": "7038837", "type": "CDM"}, {"code": "310", "type": "RC"}], "standard_charges": [{"gross_charge": 751.0, "discounted_cash": 563.25, "setting": "both", "billing_class": "facility"}]}, {"description": "EA MLTPLX STAIN MANUAL", "code_information": [{"code": "88377", "type": "CPT"}, {"code": "7048377", "type": "CDM"}, {"code": "310", "type": "RC"}], "standard_charges": [{"gross_charge": 751.0, "discounted_cash": 563.25, "setting": "both", "billing_class": "facility"}]}, {"description": "EAR TUBE", "code_information": [{"code": "L8699", "type": "HCPCS"}, {"code": "8121065", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 431.0, "discounted_cash": 323.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ECHO TRANSESOPHAGEAL", "code_information": [{"code": "93312", "type": "CPT"}, {"code": "4603400", "type": "CDM"}, {"code": "483", "type": "RC"}], "standard_charges": [{"gross_charge": 6902.0, "discounted_cash": 5176.5, "setting": "both", "billing_class": "facility"}]}, {"description": "ECHO TRANSTHOR 2D COMPL", "code_information": [{"code": "93307", "type": "CPT"}, {"code": "4603210", "type": "CDM"}, {"code": "483", "type": "RC"}], "standard_charges": [{"gross_charge": 4701.0, "discounted_cash": 3525.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ECHO TRANSTHORACIC COMP", "code_information": [{"code": "93303", "type": "CPT"}, {"code": "4606606", "type": "CDM"}, {"code": "483", "type": "RC"}], "standard_charges": [{"gross_charge": 1488.0, "discounted_cash": 1116.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ECHO TRANSTHORACIC LTD", "code_information": [{"code": "93304", "type": "CPT"}, {"code": "4606608", "type": "CDM"}, {"code": "483", "type": "RC"}], "standard_charges": [{"gross_charge": 4289.0, "discounted_cash": 3216.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ECHO TRNSTHR 2D FU/LTD", "code_information": [{"code": "93308", "type": "CPT"}, {"code": "4603308", "type": "CDM"}, {"code": "483", "type": "RC"}], "standard_charges": [{"gross_charge": 1793.0, "discounted_cash": 1344.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ECHO2D SPECTR/COLOR FLO", "code_information": [{"code": "93306", "type": "CPT"}, {"code": "4603306", "type": "CDM"}, {"code": "483", "type": "RC"}], "standard_charges": [{"gross_charge": 7410.0, "discounted_cash": 5557.5, "setting": "both", "billing_class": "facility"}]}, {"description": "ECHOCARDIOGRAM EX STRESS", "code_information": [{"code": "93350", "type": "CPT"}, {"code": "4603350", "type": "CDM"}, {"code": "483", "type": "RC"}], "standard_charges": [{"gross_charge": 4223.0, "discounted_cash": 3167.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ECONAZOLE 1% 30GM CR", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5335316", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 764.0, "discounted_cash": 573.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ECONAZOLE 1% 30GM CR", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5335316", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 764.0, "discounted_cash": 573.0, "setting": "both", "billing_class": "facility"}]}, {"description": "EEG AWAKE/DROWSY", "code_information": [{"code": "95816", "type": "CPT"}, {"code": "4805817", "type": "CDM"}, {"code": "740", "type": "RC"}], "standard_charges": [{"gross_charge": 4665.0, "discounted_cash": 3498.75, "setting": "both", "billing_class": "facility"}]}, {"description": "EEG AWAKE/SLEEP", "code_information": [{"code": "95819", "type": "CPT"}, {"code": "4805818", "type": "CDM"}, {"code": "740", "type": "RC"}], "standard_charges": [{"gross_charge": 4119.0, "discounted_cash": 3089.25, "setting": "both", "billing_class": "facility"}]}, {"description": "EEG CEREBRAL DEATH EVAL", "code_information": [{"code": "95824", "type": "CPT"}, {"code": "4805824", "type": "CDM"}, {"code": "740", "type": "RC"}], "standard_charges": [{"gross_charge": 3933.0, "discounted_cash": 2949.75, "setting": "both", "billing_class": "facility"}]}, {"description": "EEG MONITOR SLEEP", "code_information": [{"code": "95822", "type": "CPT"}, {"code": "4805822", "type": "CDM"}, {"code": "740", "type": "RC"}], "standard_charges": [{"gross_charge": 5389.0, "discounted_cash": 4041.75, "setting": "both", "billing_class": "facility"}]}, {"description": "EEG MONITORING UP TO 1HR", "code_information": [{"code": "95812", "type": "CPT"}, {"code": "4805959", "type": "CDM"}, {"code": "740", "type": "RC"}], "standard_charges": [{"gross_charge": 2577.0, "discounted_cash": 1932.75, "setting": "both", "billing_class": "facility"}]}, {"description": "EFAVIR/EMTRICT/TENOFV TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5304464", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 661.0, "discounted_cash": 495.75, "setting": "both", "billing_class": "facility"}]}, {"description": "EFAVIR/EMTRICT/TENOFV TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5304464", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 661.0, "discounted_cash": 495.75, "setting": "both", "billing_class": "facility"}]}, {"description": "EFAVIRENZ 200MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5304431", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 213.0, "discounted_cash": 159.75, "setting": "both", "billing_class": "facility"}]}, {"description": "EFAVIRENZ 200MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5304431", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 213.0, "discounted_cash": 159.75, "setting": "both", "billing_class": "facility"}]}, {"description": "EGFR COMMON VARIANTS", "code_information": [{"code": "81235", "type": "CPT"}, {"code": "7061235", "type": "CDM"}, {"code": "310", "type": "RC"}], "standard_charges": [{"gross_charge": 254.0, "discounted_cash": 190.5, "setting": "both", "billing_class": "facility"}]}, {"description": "EHRLICHIA AB/2", "code_information": [{"code": "86666", "type": "CPT"}, {"code": "7256643", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 52.0, "discounted_cash": 39.0, "setting": "both", "billing_class": "facility"}]}, {"description": "EHRLICHIA AB/3", "code_information": [{"code": "86666", "type": "CPT"}, {"code": "7256644", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 52.0, "discounted_cash": 39.0, "setting": "both", "billing_class": "facility"}]}, {"description": "EHRLICHIA AB/4", "code_information": [{"code": "86666", "type": "CPT"}, {"code": "7256649", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 1772.0, "discounted_cash": 1329.0, "setting": "both", "billing_class": "facility"}]}, {"description": "EHRLICHIA AB/5", "code_information": [{"code": "86666", "type": "CPT"}, {"code": "7256666", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 52.0, "discounted_cash": 39.0, "setting": "both", "billing_class": "facility"}]}, {"description": "EKG TRACE ONLY", "code_information": [{"code": "93005", "type": "CPT"}, {"code": "4603000", "type": "CDM"}, {"code": "730", "type": "RC"}], "standard_charges": [{"gross_charge": 1333.0, "discounted_cash": 999.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ELBOW 2 VIEWS", "code_information": [{"code": "73070", "type": "CPT"}, {"code": "4903070", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 1563.0, "discounted_cash": 1172.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ELBOW 2 VIEWS", "code_information": [{"code": "73070", "type": "CPT"}, {"code": "5113070", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 1404.0, "discounted_cash": 1053.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ELBOW 3 VIEW MINIMUM", "code_information": [{"code": "73080", "type": "CPT"}, {"code": "4903080", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 1644.0, "discounted_cash": 1233.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ELBOW 3 VIEW MINIMUM", "code_information": [{"code": "73080", "type": "CPT"}, {"code": "5113080", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 1820.0, "discounted_cash": 1365.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ELECTROLYTE PANEL", "code_information": [{"code": "80051", "type": "CPT"}, {"code": "4100004", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 1053.0, "discounted_cash": 789.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ELECTROLYTE PANEL", "code_information": [{"code": "80051", "type": "CPT"}, {"code": "4170004", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 4.29, "discounted_cash": 3.22, "setting": "both", "billing_class": "facility"}]}, {"description": "ELECTRON MICROSCOPY DIAG", "code_information": [{"code": "88348", "type": "CPT"}, {"code": "4308348", "type": "CDM"}, {"code": "310", "type": "RC"}], "standard_charges": [{"gross_charge": 1659.0, "discounted_cash": 1244.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ELECTROPHORETIC TECHNIQ/2", "code_information": [{"code": "82664", "type": "CPT"}, {"code": "7252665", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 249.0, "discounted_cash": 186.75, "setting": "both", "billing_class": "facility"}]}, {"description": "EMOLLIENT 180ML LT", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5336319", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 68.0, "discounted_cash": 51.0, "setting": "both", "billing_class": "facility"}]}, {"description": "EMOLLIENT 180ML LT", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5336319", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 68.0, "discounted_cash": 51.0, "setting": "both", "billing_class": "facility"}]}, {"description": "EMOLLIENT 60GM CR", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5335327", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 114.0, "discounted_cash": 85.5, "setting": "both", "billing_class": "facility"}]}, {"description": "EMOLLIENT 60GM CR", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5335327", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 114.0, "discounted_cash": 85.5, "setting": "both", "billing_class": "facility"}]}, {"description": "EMOLLIENT ALOE 60GM OI", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5335330", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 143.0, "discounted_cash": 107.25, "setting": "both", "billing_class": "facility"}]}, {"description": "EMOLLIENT ALOE 60GM OI", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5335330", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 143.0, "discounted_cash": 107.25, "setting": "both", "billing_class": "facility"}]}, {"description": "EMOLLIENT SK CL 240ML LT", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5335331", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 162.0, "discounted_cash": 121.5, "setting": "both", "billing_class": "facility"}]}, {"description": "EMOLLIENT SK CL 240ML LT", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5335331", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 162.0, "discounted_cash": 121.5, "setting": "both", "billing_class": "facility"}]}, {"description": "EMTRICITABINE 200MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5304456", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 375.0, "discounted_cash": 281.25, "setting": "both", "billing_class": "facility"}]}, {"description": "EMTRICITABINE 200MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5304456", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 375.0, "discounted_cash": 281.25, "setting": "both", "billing_class": "facility"}]}, {"description": "EMTRICITBINE/TENFOVIR TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5304455", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 592.0, "discounted_cash": 444.0, "setting": "both", "billing_class": "facility"}]}, {"description": "EMTRICITBINE/TENFOVIR TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5304455", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 592.0, "discounted_cash": 444.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ENALAPRIL 10MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5304439", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 71.0, "discounted_cash": 53.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ENALAPRIL 10MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5304439", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 71.0, "discounted_cash": 53.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ENALAPRIL 2.5MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5304434", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 61.0, "discounted_cash": 45.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ENALAPRIL 2.5MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5304434", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 61.0, "discounted_cash": 45.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ENALAPRIL 2.5MG/2ML IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5320396", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 287.0, "discounted_cash": 215.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ENALAPRIL 5MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5304437", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 84.0, "discounted_cash": 63.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ENALAPRIL 5MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5304437", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 84.0, "discounted_cash": 63.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ENALAPRIL CMPD 1 ML LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5315119", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 61.0, "discounted_cash": 45.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ENALAPRIL CMPD 1 ML LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5315119", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 61.0, "discounted_cash": 45.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ENALAPRIL1.25MG/1ML IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5320395", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 323.0, "discounted_cash": 242.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ENALAPRL/HCTZ 10/25MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5304435", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 78.0, "discounted_cash": 58.5, "setting": "both", "billing_class": "facility"}]}, {"description": "ENALAPRL/HCTZ 10/25MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5304435", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 78.0, "discounted_cash": 58.5, "setting": "both", "billing_class": "facility"}]}, {"description": "ENCEPHALITIS CA LCROS AB/2", "code_information": [{"code": "86651", "type": "CPT"}, {"code": "7256651", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 144.0, "discounted_cash": 108.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ENCEPHALITIS CA LCROS AB/4", "code_information": [{"code": "86651", "type": "CPT"}, {"code": "7256657", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 100.0, "discounted_cash": 75.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ENCEPHALITIS EAST EQ AB/2", "code_information": [{"code": "86652", "type": "CPT"}, {"code": "7256652", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 100.0, "discounted_cash": 75.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ENCEPHALITIS EAST EQ AB/4", "code_information": [{"code": "86652", "type": "CPT"}, {"code": "7258668", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 76.0, "discounted_cash": 57.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ENCEPHALITIS ST LOUIS AB", "code_information": [{"code": "86653", "type": "CPT"}, {"code": "7256653", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 90.0, "discounted_cash": 67.5, "setting": "both", "billing_class": "facility"}]}, {"description": "ENCEPHALITIS ST LOUIS AB/5", "code_information": [{"code": "86653", "type": "CPT"}, {"code": "7258665", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 100.0, "discounted_cash": 75.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ENCEPHALITIS WEST EQ AB", "code_information": [{"code": "86654", "type": "CPT"}, {"code": "7256656", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 76.0, "discounted_cash": 57.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ENCEPHALITIS WEST EQ AB/2", "code_information": [{"code": "86654", "type": "CPT"}, {"code": "7256681", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 100.0, "discounted_cash": 75.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ENDO CATH BILIARY SYSTEM", "code_information": [{"code": "74328", "type": "CPT"}, {"code": "4904328", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 2551.0, "discounted_cash": 1913.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ENDO CATH PANCREAS DUCT", "code_information": [{"code": "74329", "type": "CPT"}, {"code": "4904329", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 2688.0, "discounted_cash": 2016.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ENDO RPR AA ENDOGRFT W/RUP+S&I", "code_information": [{"code": "4614702", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 57770.0, "discounted_cash": 43327.5, "setting": "both", "billing_class": "facility"}]}, {"description": "ENDO RPR AA ENDOGRT NO RUP+S&I", "code_information": [{"code": "4614701", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 57733.0, "discounted_cash": 43299.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ENDO RPR AOR-BI-ILI W/BAL OCUL", "code_information": [{"code": "4614706", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 57747.0, "discounted_cash": 43310.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ENDO RPR AORT-BI-ILIAC NO/RUP", "code_information": [{"code": "4614705", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 52979.0, "discounted_cash": 39734.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ENDO RPR AORT-UNI-ILIAC NO RUP", "code_information": [{"code": "4614703", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 57747.0, "discounted_cash": 43310.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ENDO RPR AORT-UNI-ILIAC W/RUP", "code_information": [{"code": "4614704", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 57747.0, "discounted_cash": 43310.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ENDO RPR ILIO-ILIA GFT NO/RUP", "code_information": [{"code": "4614707", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 35063.0, "discounted_cash": 26297.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ENDO RPR ILIO-ILIA GFT W/RUP", "code_information": [{"code": "4614708", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 32388.0, "discounted_cash": 24291.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ENDOMYOCARDIAL BIOPSY", "code_information": [{"code": "93505", "type": "CPT"}, {"code": "4613505", "type": "CDM"}, {"code": "480", "type": "RC"}], "standard_charges": [{"gross_charge": 8436.0, "discounted_cash": 6327.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ENDOMYOCARDIAL BIOPSY", "code_information": [{"code": "93505", "type": "CPT"}, {"code": "4613505", "type": "CDM"}, {"code": "481", "type": "RC"}], "standard_charges": [{"gross_charge": 8436.0, "discounted_cash": 6327.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ENDOMYSIAL AB", "code_information": [{"code": "86231", "type": "CPT"}, {"code": "7258676", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 361.0, "discounted_cash": 270.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ENOXAPARIN PER 10MG PFSIJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J1650", "type": "HCPCS"}, {"code": "5320394", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 305.0, "discounted_cash": 228.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ENOXAPARIN PER 10MG PFSIJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J1650", "type": "HCPCS"}, {"code": "5320394", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 305.0, "discounted_cash": 228.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ENTACAPONE 200MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5304460", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 72.0, "discounted_cash": 54.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ENTACAPONE 200MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5304460", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 72.0, "discounted_cash": 54.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ENTAMOEB HIST GROUP IA", "code_information": [{"code": "87337", "type": "CPT"}, {"code": "7257339", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 225.0, "discounted_cash": 168.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ENTERCOLYSIS SM BOWEL DBL CM", "code_information": [{"code": "74251", "type": "CPT"}, {"code": "4904251", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 966.0, "discounted_cash": 724.5, "setting": "both", "billing_class": "facility"}]}, {"description": "ENTEROVIRUS AB/10", "code_information": [{"code": "86658", "type": "CPT"}, {"code": "7256665", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 122.0, "discounted_cash": 91.5, "setting": "both", "billing_class": "facility"}]}, {"description": "ENTEROVIRUS AB/11", "code_information": [{"code": "86658", "type": "CPT"}, {"code": "7256667", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 122.0, "discounted_cash": 91.5, "setting": "both", "billing_class": "facility"}]}, {"description": "ENTEROVIRUS AB/12", "code_information": [{"code": "86658", "type": "CPT"}, {"code": "7256668", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 1143.0, "discounted_cash": 857.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ENTEROVIRUS AB/13", "code_information": [{"code": "86658", "type": "CPT"}, {"code": "7256669", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 122.0, "discounted_cash": 91.5, "setting": "both", "billing_class": "facility"}]}, {"description": "ENTEROVIRUS AB/15", "code_information": [{"code": "86658", "type": "CPT"}, {"code": "7256673", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 1143.0, "discounted_cash": 857.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ENTEROVIRUS AB/16", "code_information": [{"code": "86658", "type": "CPT"}, {"code": "7256675", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 1143.0, "discounted_cash": 857.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ENTEROVIRUS AB/17", "code_information": [{"code": "86658", "type": "CPT"}, {"code": "7256677", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 1143.0, "discounted_cash": 857.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ENTEROVIRUS AB/18", "code_information": [{"code": "86658", "type": "CPT"}, {"code": "7256678", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 1143.0, "discounted_cash": 857.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ENTEROVIRUS AB/20", "code_information": [{"code": "86658", "type": "CPT"}, {"code": "7256685", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 1246.0, "discounted_cash": 934.5, "setting": "both", "billing_class": "facility"}]}, {"description": "ENTEROVIRUS AB/21", "code_information": [{"code": "86658", "type": "CPT"}, {"code": "7256692", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 1246.0, "discounted_cash": 934.5, "setting": "both", "billing_class": "facility"}]}, {"description": "ENTEROVIRUS AB/23", "code_information": [{"code": "86658", "type": "CPT"}, {"code": "7258660", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 355.0, "discounted_cash": 266.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ENTEROVIRUS AB/24", "code_information": [{"code": "86658", "type": "CPT"}, {"code": "7258679", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 131.0, "discounted_cash": 98.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ENTEROVIRUS AB/27", "code_information": [{"code": "86658", "type": "CPT"}, {"code": "7258728", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 122.0, "discounted_cash": 91.5, "setting": "both", "billing_class": "facility"}]}, {"description": "ENTEROVIRUS AB/4", "code_information": [{"code": "86658", "type": "CPT"}, {"code": "7256658", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 1246.0, "discounted_cash": 934.5, "setting": "both", "billing_class": "facility"}]}, {"description": "ENTEROVIRUS AB/6", "code_information": [{"code": "86658", "type": "CPT"}, {"code": "7256660", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 131.0, "discounted_cash": 98.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ENTEROVIRUS AB/9", "code_information": [{"code": "86658", "type": "CPT"}, {"code": "7256664", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 1143.0, "discounted_cash": 857.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ENTEROVIRUS AMP PROBE/2", "code_information": [{"code": "87498", "type": "CPT"}, {"code": "7258750", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 343.0, "discounted_cash": 257.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ENVELOPE NEURO ABSORB ANTIBACT", "code_information": [{"code": "C1889", "type": "HCPCS"}, {"code": "4028028", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 17804.0, "discounted_cash": 13353.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ENZYME ACTIVITY NES/5", "code_information": [{"code": "82657", "type": "CPT"}, {"code": "7252686", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 479.0, "discounted_cash": 359.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ENZYME ACTIVITY NES/7", "code_information": [{"code": "82657", "type": "CPT"}, {"code": "7258259", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 433.0, "discounted_cash": 324.75, "setting": "both", "billing_class": "facility"}]}, {"description": "EP EVAL AICD LEADS INIT", "code_information": [{"code": "93640", "type": "CPT"}, {"code": "4610640", "type": "CDM"}, {"code": "480", "type": "RC"}], "standard_charges": [{"gross_charge": 3283.0, "discounted_cash": 2462.25, "setting": "both", "billing_class": "facility"}]}, {"description": "EP POST DRUG INFUSION", "code_information": [{"code": "93623", "type": "CPT"}, {"code": "4610631", "type": "CDM"}, {"code": "480", "type": "RC"}], "standard_charges": [{"gross_charge": 16506.0, "discounted_cash": 12379.5, "setting": "both", "billing_class": "facility"}]}, {"description": "EP TEST AICD LEAD & GEN", "code_information": [{"code": "93641", "type": "CPT"}, {"code": "4610635", "type": "CDM"}, {"code": "480", "type": "RC"}], "standard_charges": [{"gross_charge": 48593.0, "discounted_cash": 36444.75, "setting": "both", "billing_class": "facility"}]}, {"description": "EPHEDRINE 50MG/1ML IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5320404", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 144.0, "discounted_cash": 108.0, "setting": "both", "billing_class": "facility"}]}, {"description": "EPHEDRINE25MGNS 5MLPFSIJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5320387", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 233.5, "discounted_cash": 175.13, "setting": "both", "billing_class": "facility"}]}, {"description": "EPIFIX INJECT PER 1MG", "code_information": [{"code": "Q4145", "type": "HCPCS"}, {"code": "4028022", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 360.0, "discounted_cash": 270.0, "setting": "both", "billing_class": "facility"}]}, {"description": "EPIFIX INJECT PER 1MG", "code_information": [{"code": "Q4145", "type": "HCPCS"}, {"code": "4028022", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 360.0, "discounted_cash": 270.0, "setting": "both", "billing_class": "facility"}]}, {"description": "EPIFIX PER SQ CM", "code_information": [{"code": "Q4186", "type": "HCPCS"}, {"code": "4005534", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 1660.0, "discounted_cash": 1245.0, "setting": "both", "billing_class": "facility"}]}, {"description": "EPIFIX PER SQ CM", "code_information": [{"code": "Q4186", "type": "HCPCS"}, {"code": "4005534", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 1660.0, "discounted_cash": 1245.0, "setting": "both", "billing_class": "facility"}]}, {"description": "EPINEPHRINE 2.25%.5ML IS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5330865", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 34.0, "discounted_cash": 25.5, "setting": "both", "billing_class": "facility"}]}, {"description": "EPINEPHRINE 2.25%.5ML IS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5330865", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 34.0, "discounted_cash": 25.5, "setting": "both", "billing_class": "facility"}]}, {"description": "EPINEPHRINE NEO PER1MGIJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5320466", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 214.0, "discounted_cash": 160.5, "setting": "both", "billing_class": "facility"}]}, {"description": "EPINEPHRINE PER 0.1MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0165", "type": "HCPCS"}, {"code": "5320458", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 39.0, "discounted_cash": 29.25, "setting": "both", "billing_class": "facility"}]}, {"description": "EPINEPHRINE PER 0.1MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0165", "type": "HCPCS"}, {"code": "5320458", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 39.0, "discounted_cash": 29.25, "setting": "both", "billing_class": "facility"}]}, {"description": "EPINEPHRINEPER0.1MGPFSIJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0165", "type": "HCPCS"}, {"code": "5320459", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 13.0, "discounted_cash": 9.75, "setting": "both", "billing_class": "facility"}]}, {"description": "EPINEPHRINEPER0.1MGPFSIJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0165", "type": "HCPCS"}, {"code": "5320459", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 13.0, "discounted_cash": 9.75, "setting": "both", "billing_class": "facility"}]}, {"description": "EPOETIN ESRD PER 100U IJ", "code_information": [{"code": "Q4081", "type": "HCPCS"}, {"code": "5320419", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 23.0, "discounted_cash": 17.25, "setting": "both", "billing_class": "facility"}]}, {"description": "EPOETIN ESRD PER 100U IJ", "code_information": [{"code": "Q4081", "type": "HCPCS"}, {"code": "5320419", "type": "CDM"}, {"code": "634", "type": "RC"}], "standard_charges": [{"gross_charge": 23.0, "discounted_cash": 17.25, "setting": "both", "billing_class": "facility"}]}, {"description": "EPOETIN NON-ESRD 1000U IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0885", "type": "HCPCS"}, {"code": "5320431", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 296.0, "discounted_cash": 222.0, "setting": "both", "billing_class": "facility"}]}, {"description": "EPOETIN NON-ESRD 1000U IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0885", "type": "HCPCS"}, {"code": "5320431", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 296.0, "discounted_cash": 222.0, "setting": "both", "billing_class": "facility"}]}, {"description": "EPOETIN-EPBX ESRD PER 100U IJ", "code_information": [{"code": "Q5105", "type": "HCPCS"}, {"code": "5320471", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 66.0, "discounted_cash": 49.5, "setting": "both", "billing_class": "facility"}]}, {"description": "EPOETIN-EPBX ESRD PER 100U IJ", "code_information": [{"code": "Q5105", "type": "HCPCS"}, {"code": "5320471", "type": "CDM"}, {"code": "634", "type": "RC"}], "standard_charges": [{"gross_charge": 66.0, "discounted_cash": 49.5, "setting": "both", "billing_class": "facility"}]}, {"description": "EPOETIN-EPBX NON-ESRD 1000U IJ", "code_information": [{"code": "Q5106", "type": "HCPCS"}, {"code": "5320472", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 360.0, "discounted_cash": 270.0, "setting": "both", "billing_class": "facility"}]}, {"description": "EPOETIN-EPBX NON-ESRD 1000U IJ", "code_information": [{"code": "Q5106", "type": "HCPCS"}, {"code": "5320472", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 360.0, "discounted_cash": 270.0, "setting": "both", "billing_class": "facility"}]}, {"description": "EPSTEIN-BARR VIRUS EA AB/2", "code_information": [{"code": "86663", "type": "CPT"}, {"code": "7259433", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 35.0, "discounted_cash": 26.25, "setting": "both", "billing_class": "facility"}]}, {"description": "EPSTEIN-BARR VIRUS NA AB", "code_information": [{"code": "86664", "type": "CPT"}, {"code": "4109430", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 1742.0, "discounted_cash": 1306.5, "setting": "both", "billing_class": "facility"}]}, {"description": "EPSTEIN-BARR VIRUS NA AB", "code_information": [{"code": "86664", "type": "CPT"}, {"code": "7256663", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 90.0, "discounted_cash": 67.5, "setting": "both", "billing_class": "facility"}]}, {"description": "EPSTEIN-BARR VIRUS VCA AB", "code_information": [{"code": "86665", "type": "CPT"}, {"code": "4109431", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 135.0, "discounted_cash": 101.25, "setting": "both", "billing_class": "facility"}]}, {"description": "EPSTEIN-BARR VIRUS VCA AB/2", "code_information": [{"code": "86665", "type": "CPT"}, {"code": "4109432", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 135.0, "discounted_cash": 101.25, "setting": "both", "billing_class": "facility"}]}, {"description": "EPSTEIN-BARR VIRUS VCA AB/3", "code_information": [{"code": "86665", "type": "CPT"}, {"code": "7258677", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 35.0, "discounted_cash": 26.25, "setting": "both", "billing_class": "facility"}]}, {"description": "EPSTEIN-BARR VIRUS VCA AB/4", "code_information": [{"code": "86665", "type": "CPT"}, {"code": "7258678", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 90.0, "discounted_cash": 67.5, "setting": "both", "billing_class": "facility"}]}, {"description": "EPSTEIN-BARR VIRUS VCA AB/5", "code_information": [{"code": "86665", "type": "CPT"}, {"code": "7259431", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 90.0, "discounted_cash": 67.5, "setting": "both", "billing_class": "facility"}]}, {"description": "EPTIFIBATIDE PER 5MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J1327", "type": "HCPCS"}, {"code": "5320449", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 621.0, "discounted_cash": 465.75, "setting": "both", "billing_class": "facility"}]}, {"description": "EPTIFIBATIDE PER 5MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J1327", "type": "HCPCS"}, {"code": "5320449", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 621.0, "discounted_cash": 465.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ER VISIT LVL I", "code_information": [{"code": "99281", "type": "CPT"}, {"code": "6100510", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 992.0, "discounted_cash": 744.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ER VISIT LVL II", "code_information": [{"code": "99282", "type": "CPT"}, {"code": "6100522", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 2153.0, "discounted_cash": 1614.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ER VISIT LVL III", "code_information": [{"code": "99283", "type": "CPT"}, {"code": "6100524", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 3546.0, "discounted_cash": 2659.5, "setting": "both", "billing_class": "facility"}]}, {"description": "ER VISIT LVL IV", "code_information": [{"code": "99284", "type": "CPT"}, {"code": "6100526", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 5606.0, "discounted_cash": 4204.5, "setting": "both", "billing_class": "facility"}]}, {"description": "ER VISIT LVL V", "code_information": [{"code": "99285", "type": "CPT"}, {"code": "6100527", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 7272.0, "discounted_cash": 5454.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ERCP BILIARY&PANCREATIC", "code_information": [{"code": "74330", "type": "CPT"}, {"code": "4904200", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 3643.0, "discounted_cash": 2732.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ERCP BILIARY&PANCREATIC", "code_information": [{"code": "74330", "type": "CPT"}, {"code": "4914200", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 4588.0, "discounted_cash": 3441.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ERGOCALCIF8000U/ML 60 LQ", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5315127", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 762.0, "discounted_cash": 571.5, "setting": "both", "billing_class": "facility"}]}, {"description": "ERGOCALCIF8000U/ML 60 LQ", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5315127", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 762.0, "discounted_cash": 571.5, "setting": "both", "billing_class": "facility"}]}, {"description": "ERGOCALCIFERL8000U/ML LQ", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5315126", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 96.0, "discounted_cash": 72.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ERGOCALCIFERL8000U/ML LQ", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5315126", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 96.0, "discounted_cash": 72.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ERGOCALCIFEROL 50000U CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5304469", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 61.0, "discounted_cash": 45.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ERGOCALCIFEROL 50000U CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5304469", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 61.0, "discounted_cash": 45.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ERTAPENEM PER 500MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J1335", "type": "HCPCS"}, {"code": "5320491", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 1232.0, "discounted_cash": 924.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ERTAPENEM PER 500MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J1335", "type": "HCPCS"}, {"code": "5320491", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 1232.0, "discounted_cash": 924.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ERYTHROMY200/5 100ML LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5315146", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 1857.0, "discounted_cash": 1392.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ERYTHROMY200/5 100ML LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5315146", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 1857.0, "discounted_cash": 1392.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ERYTHROMY200MG/5ML LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5315145", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 288.0, "discounted_cash": 216.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ERYTHROMY200MG/5ML LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5315145", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 288.0, "discounted_cash": 216.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ERYTHROMYC BASE 250MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5304647", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 147.0, "discounted_cash": 110.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ERYTHROMYC BASE 250MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5304647", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 147.0, "discounted_cash": 110.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ERYTHROMYC BASE 500MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5304653", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 99.0, "discounted_cash": 74.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ERYTHROMYC BASE 500MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5304653", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 99.0, "discounted_cash": 74.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ERYTHROMYC STER 250MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5304655", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 83.0, "discounted_cash": 62.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ERYTHROMYC STER 250MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5304655", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 83.0, "discounted_cash": 62.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ERYTHROMYCIN .5% 1GM OO", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5330923", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 173.0, "discounted_cash": 129.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ERYTHROMYCIN .5% 1GM OO", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5330923", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 173.0, "discounted_cash": 129.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ERYTHROMYCIN .5%3.5GM OO", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5330926", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 349.0, "discounted_cash": 261.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ERYTHROMYCIN .5%3.5GM OO", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5330926", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 349.0, "discounted_cash": 261.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ERYTHROMYCIN 250MG XR CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5304635", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 117.0, "discounted_cash": 87.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ERYTHROMYCIN 250MG XR CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5304635", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 117.0, "discounted_cash": 87.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ERYTHROMYCIN LA500MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J1364", "type": "HCPCS"}, {"code": "5320508", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 379.0, "discounted_cash": 284.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ERYTHROMYCIN LA500MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J1364", "type": "HCPCS"}, {"code": "5320508", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 379.0, "discounted_cash": 284.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ERYTHROMYCIN NEO CMPD LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5315140", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 85.0, "discounted_cash": 63.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ERYTHROMYCIN NEO CMPD LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5315140", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 85.0, "discounted_cash": 63.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ERYTHROMYCIN NEO IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J7999", "type": "HCPCS"}, {"code": "5320502", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 449.0, "discounted_cash": 336.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ERYTHROMYCIN NEO IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J7999", "type": "HCPCS"}, {"code": "5320502", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 449.0, "discounted_cash": 336.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ERYTHROPOIETIN", "code_information": [{"code": "82668", "type": "CPT"}, {"code": "7252668", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 1222.0, "discounted_cash": 916.5, "setting": "both", "billing_class": "facility"}]}, {"description": "ESCITALOPRAM 10MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5304665", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 84.0, "discounted_cash": 63.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ESCITALOPRAM 10MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5304665", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 84.0, "discounted_cash": 63.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ESCITALOPRAM 5MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5304664", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 57.0, "discounted_cash": 42.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ESCITALOPRAM 5MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5304664", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 57.0, "discounted_cash": 42.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ESMOLOL PER 10MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J1805", "type": "HCPCS"}, {"code": "5320528", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 22.0, "discounted_cash": 16.5, "setting": "both", "billing_class": "facility"}]}, {"description": "ESMOLOL PER 10MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J1805", "type": "HCPCS"}, {"code": "5320528", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 22.0, "discounted_cash": 16.5, "setting": "both", "billing_class": "facility"}]}, {"description": "ESMOLOL PER 10MG PMX IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J1805", "type": "HCPCS"}, {"code": "5320529", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 15.0, "discounted_cash": 11.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ESMOLOL PER 10MG PMX IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J1805", "type": "HCPCS"}, {"code": "5320529", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 15.0, "discounted_cash": 11.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ESOMEPRAZOL40MGXR PWLQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5304663", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 142.0, "discounted_cash": 106.5, "setting": "both", "billing_class": "facility"}]}, {"description": "ESOMEPRAZOL40MGXR PWLQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5304663", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 142.0, "discounted_cash": 106.5, "setting": "both", "billing_class": "facility"}]}, {"description": "ESOPH MOTILITY STUDY", "code_information": [{"code": "91010", "type": "CPT"}, {"code": "5071062", "type": "CDM"}, {"code": "750", "type": "RC"}], "standard_charges": [{"gross_charge": 2691.0, "discounted_cash": 2018.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ESOPH PH TST W NSL CATH", "code_information": [{"code": "91034", "type": "CPT"}, {"code": "5071253", "type": "CDM"}, {"code": "750", "type": "RC"}], "standard_charges": [{"gross_charge": 3152.0, "discounted_cash": 2364.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ESOPHAGUS W/DBL CONTRAST", "code_information": [{"code": "74221", "type": "CPT"}, {"code": "4904221", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 2052.0, "discounted_cash": 1539.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ESTRADIOL", "code_information": [{"code": "82670", "type": "CPT"}, {"code": "4102670", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 201.0, "discounted_cash": 150.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ESTRADIOL", "code_information": [{"code": "82670", "type": "CPT"}, {"code": "7252670", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 34.0, "discounted_cash": 25.5, "setting": "both", "billing_class": "facility"}]}, {"description": "ESTRIOL", "code_information": [{"code": "82677", "type": "CPT"}, {"code": "7252677", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 360.0, "discounted_cash": 270.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ESTROGEN CONJ PER25MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J1410", "type": "HCPCS"}, {"code": "5320542", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 2188.0, "discounted_cash": 1641.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ESTROGEN CONJ PER25MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J1410", "type": "HCPCS"}, {"code": "5320542", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 2188.0, "discounted_cash": 1641.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ESTROGENS FRACTIONATED", "code_information": [{"code": "82671", "type": "CPT"}, {"code": "7252671", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 216.0, "discounted_cash": 162.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ESTROGENS TOTAL", "code_information": [{"code": "82672", "type": "CPT"}, {"code": "7252672", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 884.0, "discounted_cash": 663.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ESTRONE/2", "code_information": [{"code": "82679", "type": "CPT"}, {"code": "7252679", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 1582.0, "discounted_cash": 1186.5, "setting": "both", "billing_class": "facility"}]}, {"description": "ETHAMBUTOL 400MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5304774", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 61.0, "discounted_cash": 45.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ETHAMBUTOL 400MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5304774", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 61.0, "discounted_cash": 45.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ETHANOL BREATH", "code_information": [{"code": "82075", "type": "CPT"}, {"code": "4102076", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 256.0, "discounted_cash": 192.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ETHOSUXIMIDE", "code_information": [{"code": "80168", "type": "CPT"}, {"code": "7252692", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 81.0, "discounted_cash": 60.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ETHYLENE GLYCOL", "code_information": [{"code": "82693", "type": "CPT"}, {"code": "7252691", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 130.0, "discounted_cash": 97.5, "setting": "both", "billing_class": "facility"}]}, {"description": "ETOMIDATE20MG/10ML IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5320609", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 422.0, "discounted_cash": 316.5, "setting": "both", "billing_class": "facility"}]}, {"description": "ETOMIDATE40MG/20ML IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5320611", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 530.0, "discounted_cash": 397.5, "setting": "both", "billing_class": "facility"}]}, {"description": "EUGLOBULIN LYSIS", "code_information": [{"code": "85360", "type": "CPT"}, {"code": "7255360", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 256.0, "discounted_cash": 192.0, "setting": "both", "billing_class": "facility"}]}, {"description": "EVAL W/ANALYSIS PM OR LDLES", "code_information": [{"code": "93288", "type": "CPT"}, {"code": "4613288", "type": "CDM"}, {"code": "480", "type": "RC"}], "standard_charges": [{"gross_charge": 279.0, "discounted_cash": 209.25, "setting": "both", "billing_class": "facility"}]}, {"description": "EVEROLIMUS", "code_information": [{"code": "80169", "type": "CPT"}, {"code": "7252532", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 598.0, "discounted_cash": 448.5, "setting": "both", "billing_class": "facility"}]}, {"description": "EXAM MACRO PARASITE", "code_information": [{"code": "87169", "type": "CPT"}, {"code": "4177169", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 7.14, "discounted_cash": 5.36, "setting": "both", "billing_class": "facility"}]}, {"description": "EXC H-F-NK-SP B9+MARG 2.1-3", "code_information": [{"code": "6901423", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 7556.0, "discounted_cash": 5667.0, "setting": "both", "billing_class": "facility"}]}, {"description": "EXC H-F-NK-SP B9+MARG 2.1-3", "code_information": [{"code": "6901423", "type": "CDM"}, {"code": "361", "type": "RC"}], "standard_charges": [{"gross_charge": 7556.0, "discounted_cash": 5667.0, "setting": "both", "billing_class": "facility"}]}, {"description": "EXCH ABSC/CYST DRN CATH", "code_information": [{"code": "4919423", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 3675.0, "discounted_cash": 2756.25, "setting": "both", "billing_class": "facility"}]}, {"description": "EXEMESTANE 25MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5304870", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 458.0, "discounted_cash": 343.5, "setting": "both", "billing_class": "facility"}]}, {"description": "EXEMESTANE 25MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5304870", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 458.0, "discounted_cash": 343.5, "setting": "both", "billing_class": "facility"}]}, {"description": "EXFX HOF CON ROD", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8132125", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 2329.0, "discounted_cash": 1746.75, "setting": "both", "billing_class": "facility"}]}, {"description": "EXFX WIRE BAYONT PT CORT", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8132190", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 1046.0, "discounted_cash": 784.5, "setting": "both", "billing_class": "facility"}]}, {"description": "EXFX WIRE W STOP", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8132191", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 1851.0, "discounted_cash": 1388.25, "setting": "both", "billing_class": "facility"}]}, {"description": "EXPOS FOR ENDOPROSTH ILI", "code_information": [{"code": "4614834", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 17793.0, "discounted_cash": 13344.75, "setting": "both", "billing_class": "facility"}]}, {"description": "EXPOSE ENDOPROS UNILAT", "code_information": [{"code": "4614812", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 12960.0, "discounted_cash": 9720.0, "setting": "both", "billing_class": "facility"}]}, {"description": "EXPOSE ENDPRO ILIAC", "code_information": [{"code": "4614820", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 17793.0, "discounted_cash": 13344.75, "setting": "both", "billing_class": "facility"}]}, {"description": "EXT TB GLAUCOMA VALVE", "code_information": [{"code": "C1783", "type": "HCPCS"}, {"code": "8182350", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 9251.0, "discounted_cash": 6938.25, "setting": "both", "billing_class": "facility"}]}, {"description": "EYE CIRC/BA", "code_information": [{"code": "L8610", "type": "HCPCS"}, {"code": "8122000", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 227.0, "discounted_cash": 170.25, "setting": "both", "billing_class": "facility"}]}, {"description": "EYE DETECTION OF FOR/BDY", "code_information": [{"code": "70030", "type": "CPT"}, {"code": "4900030", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 1174.0, "discounted_cash": 880.5, "setting": "both", "billing_class": "facility"}]}, {"description": "EYE GRFT HUMAN", "code_information": [{"code": "L8610", "type": "HCPCS"}, {"code": "8122027", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 2761.0, "discounted_cash": 2070.75, "setting": "both", "billing_class": "facility"}]}, {"description": "EYE SCLERAL SLEEVE IMP", "code_information": [{"code": "L8610", "type": "HCPCS"}, {"code": "8122095", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 171.0, "discounted_cash": 128.25, "setting": "both", "billing_class": "facility"}]}, {"description": "EYE SPHERE PLSTC", "code_information": [{"code": "V2629", "type": "HCPCS"}, {"code": "8122114", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 319.0, "discounted_cash": 239.25, "setting": "both", "billing_class": "facility"}]}, {"description": "EYE TIRE/S", "code_information": [{"code": "L8610", "type": "HCPCS"}, {"code": "8122125", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 844.0, "discounted_cash": 633.0, "setting": "both", "billing_class": "facility"}]}, {"description": "EZETIMIBE 10MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5304875", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 72.0, "discounted_cash": 54.0, "setting": "both", "billing_class": "facility"}]}, {"description": "EZETIMIBE 10MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5304875", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 72.0, "discounted_cash": 54.0, "setting": "both", "billing_class": "facility"}]}, {"description": "F2 GENE ANLS VARIANT", "code_information": [{"code": "81240", "type": "CPT"}, {"code": "4101204", "type": "CDM"}, {"code": "310", "type": "RC"}], "standard_charges": [{"gross_charge": 222.0, "discounted_cash": 166.5, "setting": "both", "billing_class": "facility"}]}, {"description": "F2 GENE ANLS VARIANT/2", "code_information": [{"code": "81240", "type": "CPT"}, {"code": "7259208", "type": "CDM"}, {"code": "310", "type": "RC"}], "standard_charges": [{"gross_charge": 148.0, "discounted_cash": 111.0, "setting": "both", "billing_class": "facility"}]}, {"description": "F5 LEIDEN VARIANT", "code_information": [{"code": "81241", "type": "CPT"}, {"code": "4101241", "type": "CDM"}, {"code": "310", "type": "RC"}], "standard_charges": [{"gross_charge": 226.0, "discounted_cash": 169.5, "setting": "both", "billing_class": "facility"}]}, {"description": "F5 LEIDEN VARIANT", "code_information": [{"code": "81241", "type": "CPT"}, {"code": "7259207", "type": "CDM"}, {"code": "310", "type": "RC"}], "standard_charges": [{"gross_charge": 149.0, "discounted_cash": 111.75, "setting": "both", "billing_class": "facility"}]}, {"description": "FACIAL BONES 2VW MAX", "code_information": [{"code": "70140", "type": "CPT"}, {"code": "4900140", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 1820.0, "discounted_cash": 1365.0, "setting": "both", "billing_class": "facility"}]}, {"description": "FACIAL BONES 2VW MAX", "code_information": [{"code": "70140", "type": "CPT"}, {"code": "5110141", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 1825.0, "discounted_cash": 1368.75, "setting": "both", "billing_class": "facility"}]}, {"description": "FACIAL BONES 3VW MIN", "code_information": [{"code": "70150", "type": "CPT"}, {"code": "4900150", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 1448.0, "discounted_cash": 1086.0, "setting": "both", "billing_class": "facility"}]}, {"description": "FACIAL BONES 3VW MIN", "code_information": [{"code": "70150", "type": "CPT"}, {"code": "5110150", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 2154.0, "discounted_cash": 1615.5, "setting": "both", "billing_class": "facility"}]}, {"description": "FACTOR 8 HUMAN PER IU IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J7190", "type": "HCPCS"}, {"code": "5320642", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 95.0, "discounted_cash": 71.25, "setting": "both", "billing_class": "facility"}]}, {"description": "FACTOR 8 RECOM PER IU IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J7192", "type": "HCPCS"}, {"code": "5320693", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 85.0, "discounted_cash": 63.75, "setting": "both", "billing_class": "facility"}]}, {"description": "FACTOR 9 CMPLX PER IU IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J7194", "type": "HCPCS"}, {"code": "5320697", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 113.0, "discounted_cash": 84.75, "setting": "both", "billing_class": "facility"}]}, {"description": "FACTOR INHIBITOR/4", "code_information": [{"code": "85335", "type": "CPT"}, {"code": "4105341", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 154.0, "discounted_cash": 115.5, "setting": "both", "billing_class": "facility"}]}, {"description": "FACTOR VIIA PER 1MCG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J7189", "type": "HCPCS"}, {"code": "5320639", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 12.0, "discounted_cash": 9.0, "setting": "both", "billing_class": "facility"}]}, {"description": "FACTR VIII RISTO CO-FCTR", "code_information": [{"code": "85245", "type": "CPT"}, {"code": "4105245", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 180.0, "discounted_cash": 135.0, "setting": "both", "billing_class": "facility"}]}, {"description": "FACTR VIII RISTO CO-FCTR/2", "code_information": [{"code": "85245", "type": "CPT"}, {"code": "7255248", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 122.0, "discounted_cash": 91.5, "setting": "both", "billing_class": "facility"}]}, {"description": "FACTR VIII VW AG CO-FCTR", "code_information": [{"code": "85246", "type": "CPT"}, {"code": "4105246", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 751.0, "discounted_cash": 563.25, "setting": "both", "billing_class": "facility"}]}, {"description": "FACTR VIII VW AG CO-FCTR", "code_information": [{"code": "85246", "type": "CPT"}, {"code": "7255246", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 287.0, "discounted_cash": 215.25, "setting": "both", "billing_class": "facility"}]}, {"description": "FACTR VIII VW AG CO-FCTR/3", "code_information": [{"code": "85246", "type": "CPT"}, {"code": "7258525", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 215.0, "discounted_cash": 161.25, "setting": "both", "billing_class": "facility"}]}, {"description": "FALLOPIAN RING", "code_information": [{"code": "A4264", "type": "HCPCS"}, {"code": "8151500", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 888.0, "discounted_cash": 666.0, "setting": "both", "billing_class": "facility"}]}, {"description": "FAMCICLOVIR 250MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5304902", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 173.0, "discounted_cash": 129.75, "setting": "both", "billing_class": "facility"}]}, {"description": "FAMCICLOVIR 250MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5304902", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 173.0, "discounted_cash": 129.75, "setting": "both", "billing_class": "facility"}]}, {"description": "FAMCICLOVIR 500MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5304898", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 301.0, "discounted_cash": 225.75, "setting": "both", "billing_class": "facility"}]}, {"description": "FAMCICLOVIR 500MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5304898", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 301.0, "discounted_cash": 225.75, "setting": "both", "billing_class": "facility"}]}, {"description": "FAMOTIDINE 10MG TB", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5304899", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 66.0, "discounted_cash": 49.5, "setting": "both", "billing_class": "facility"}]}, {"description": "FAMOTIDINE 10MG TB", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5304899", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 66.0, "discounted_cash": 49.5, "setting": "both", "billing_class": "facility"}]}, {"description": "FAMOTIDINE 20MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5304900", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 84.0, "discounted_cash": 63.0, "setting": "both", "billing_class": "facility"}]}, {"description": "FAMOTIDINE 20MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5304900", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 84.0, "discounted_cash": 63.0, "setting": "both", "billing_class": "facility"}]}, {"description": "FAMOTIDINE PER 0.25MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J1308", "type": "HCPCS"}, {"code": "5320584", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 0.58, "discounted_cash": 0.44, "setting": "both", "billing_class": "facility"}]}, {"description": "FAMOTIDINE PER 0.25MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J1308", "type": "HCPCS"}, {"code": "5320584", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 0.58, "discounted_cash": 0.44, "setting": "both", "billing_class": "facility"}]}, {"description": "FAMOTIDINE20MG/2.5MLPWLQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5315184", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 118.0, "discounted_cash": 88.5, "setting": "both", "billing_class": "facility"}]}, {"description": "FAMOTIDINE20MG/2.5MLPWLQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5315184", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 118.0, "discounted_cash": 88.5, "setting": "both", "billing_class": "facility"}]}, {"description": "FAT EMULS 20% 100ML TPN", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5413460", "type": "CDM"}, {"code": "258", "type": "RC"}], "standard_charges": [{"gross_charge": 87.0, "discounted_cash": 65.25, "setting": "both", "billing_class": "facility"}]}, {"description": "FAT EMULS 20% 250ML TPN", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5413470", "type": "CDM"}, {"code": "258", "type": "RC"}], "standard_charges": [{"gross_charge": 610.0, "discounted_cash": 457.5, "setting": "both", "billing_class": "facility"}]}, {"description": "FAT EMULS 20% 500ML TPN", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5413475", "type": "CDM"}, {"code": "258", "type": "RC"}], "standard_charges": [{"gross_charge": 860.0, "discounted_cash": 645.0, "setting": "both", "billing_class": "facility"}]}, {"description": "FAT EMULS 20% 50ML TPN", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5413455", "type": "CDM"}, {"code": "258", "type": "RC"}], "standard_charges": [{"gross_charge": 102.0, "discounted_cash": 76.5, "setting": "both", "billing_class": "facility"}]}, {"description": "FAT OR LIPID FECES QUAL", "code_information": [{"code": "82705", "type": "CPT"}, {"code": "4102705", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 355.0, "discounted_cash": 266.25, "setting": "both", "billing_class": "facility"}]}, {"description": "FAT OR LIPID FECES QUAL", "code_information": [{"code": "82705", "type": "CPT"}, {"code": "7252705", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 241.0, "discounted_cash": 180.75, "setting": "both", "billing_class": "facility"}]}, {"description": "FAT OR LIPID FECES QUANT", "code_information": [{"code": "82710", "type": "CPT"}, {"code": "7252710", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 52.0, "discounted_cash": 39.0, "setting": "both", "billing_class": "facility"}]}, {"description": "FATTY ACIDS NONESTERFIED", "code_information": [{"code": "82725", "type": "CPT"}, {"code": "7252725", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 1301.0, "discounted_cash": 975.75, "setting": "both", "billing_class": "facility"}]}, {"description": "FCTR VIII VW MLT CO-FCTR", "code_information": [{"code": "85247", "type": "CPT"}, {"code": "7255247", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 450.0, "discounted_cash": 337.5, "setting": "both", "billing_class": "facility"}]}, {"description": "FDP D-DIMER QNT", "code_information": [{"code": "85379", "type": "CPT"}, {"code": "4105350", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 608.0, "discounted_cash": 456.0, "setting": "both", "billing_class": "facility"}]}, {"description": "FDP D-DIMER QNT", "code_information": [{"code": "85379", "type": "CPT"}, {"code": "4175350", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 21.41, "discounted_cash": 16.06, "setting": "both", "billing_class": "facility"}]}, {"description": "FDP D-DIMER SQNT OR QUAL", "code_information": [{"code": "85378", "type": "CPT"}, {"code": "4105381", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 828.0, "discounted_cash": 621.0, "setting": "both", "billing_class": "facility"}]}, {"description": "FDP D-DIMER SQNT OR QUAL", "code_information": [{"code": "85378", "type": "CPT"}, {"code": "4175381", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 14.27, "discounted_cash": 10.7, "setting": "both", "billing_class": "facility"}]}, {"description": "FDP FSP AGGLUTNATN SEMQTY", "code_information": [{"code": "85362", "type": "CPT"}, {"code": "4105362", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 740.0, "discounted_cash": 555.0, "setting": "both", "billing_class": "facility"}]}, {"description": "FDP FSP AGGLUTNATN SEMQTY", "code_information": [{"code": "85362", "type": "CPT"}, {"code": "4175362", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 14.27, "discounted_cash": 10.7, "setting": "both", "billing_class": "facility"}]}, {"description": "FE DEXTRAN PER 50MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J1750", "type": "HCPCS"}, {"code": "5321512", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 377.0, "discounted_cash": 282.75, "setting": "both", "billing_class": "facility"}]}, {"description": "FE DEXTRAN PER 50MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J1750", "type": "HCPCS"}, {"code": "5321512", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 377.0, "discounted_cash": 282.75, "setting": "both", "billing_class": "facility"}]}, {"description": "FE POLYSACCHAR 150MG CP", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5306061", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 66.0, "discounted_cash": 49.5, "setting": "both", "billing_class": "facility"}]}, {"description": "FE POLYSACCHAR 150MG CP", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5306061", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 66.0, "discounted_cash": 49.5, "setting": "both", "billing_class": "facility"}]}, {"description": "FECAL ELASTASE EL1 QN", "code_information": [{"code": "82653", "type": "CPT"}, {"code": "7252654", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 766.0, "discounted_cash": 574.5, "setting": "both", "billing_class": "facility"}]}, {"description": "FELODIPINE 5MG XR TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5304920", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 85.0, "discounted_cash": 63.75, "setting": "both", "billing_class": "facility"}]}, {"description": "FELODIPINE 5MG XR TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5304920", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 85.0, "discounted_cash": 63.75, "setting": "both", "billing_class": "facility"}]}, {"description": "FEM AUGMENT COMP", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "8132503", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 12637.0, "discounted_cash": 9477.75, "setting": "both", "billing_class": "facility"}]}, {"description": "FEM COMPONENT", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "8132500", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 30079.0, "discounted_cash": 22559.25, "setting": "both", "billing_class": "facility"}]}, {"description": "FEM NAIL", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8132510", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 21532.0, "discounted_cash": 16149.0, "setting": "both", "billing_class": "facility"}]}, {"description": "FEM RD", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8132515", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 29034.0, "discounted_cash": 21775.5, "setting": "both", "billing_class": "facility"}]}, {"description": "FEM STEM", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "8132535", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 24559.0, "discounted_cash": 18419.25, "setting": "both", "billing_class": "facility"}]}, {"description": "FEMOR UNI KNEE AESCULAP CL", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "4013352", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 23124.0, "discounted_cash": 17343.0, "setting": "both", "billing_class": "facility"}]}, {"description": "FEMUR 1 VW", "code_information": [{"code": "73551", "type": "CPT"}, {"code": "4903552", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 231.0, "discounted_cash": 173.25, "setting": "both", "billing_class": "facility"}]}, {"description": "FEMUR 2 VIEWS MIN", "code_information": [{"code": "73552", "type": "CPT"}, {"code": "4903551", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 1208.0, "discounted_cash": 906.0, "setting": "both", "billing_class": "facility"}]}, {"description": "FEMUR 2 VIEWS MIN", "code_information": [{"code": "73552", "type": "CPT"}, {"code": "5113550", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 1038.0, "discounted_cash": 778.5, "setting": "both", "billing_class": "facility"}]}, {"description": "FEMUR MOD KNEE OSTEOREMEDS CL", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "4013360", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 27669.0, "discounted_cash": 20751.75, "setting": "both", "billing_class": "facility"}]}, {"description": "FENOFIBRATE 145MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5304938", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 148.0, "discounted_cash": 111.0, "setting": "both", "billing_class": "facility"}]}, {"description": "FENOFIBRATE 145MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5304938", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 148.0, "discounted_cash": 111.0, "setting": "both", "billing_class": "facility"}]}, {"description": "FENOFIBRATE 48MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5304933", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 70.0, "discounted_cash": 52.5, "setting": "both", "billing_class": "facility"}]}, {"description": "FENOFIBRATE 48MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5304933", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 70.0, "discounted_cash": 52.5, "setting": "both", "billing_class": "facility"}]}, {"description": "FENT/BUPIV EPID PER1MLIJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J7999", "type": "HCPCS"}, {"code": "5320705", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 1171.0, "discounted_cash": 878.25, "setting": "both", "billing_class": "facility"}]}, {"description": "FENT/BUPIV EPID PER1MLIJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J7999", "type": "HCPCS"}, {"code": "5320705", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 1171.0, "discounted_cash": 878.25, "setting": "both", "billing_class": "facility"}]}, {"description": "FENT/BUPV.125%EPI100MLIJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5320803", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 532.0, "discounted_cash": 399.0, "setting": "both", "billing_class": "facility"}]}, {"description": "FENTANYL 100MCG/HR TD", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5327513", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 579.0, "discounted_cash": 434.25, "setting": "both", "billing_class": "facility"}]}, {"description": "FENTANYL 100MCG/HR TD", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5327513", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 579.0, "discounted_cash": 434.25, "setting": "both", "billing_class": "facility"}]}, {"description": "FENTANYL 10MCG/ML250MLIJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5320598", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 582.0, "discounted_cash": 436.5, "setting": "both", "billing_class": "facility"}]}, {"description": "FENTANYL 25MCG/HR TD", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5327510", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 298.0, "discounted_cash": 223.5, "setting": "both", "billing_class": "facility"}]}, {"description": "FENTANYL 25MCG/HR TD", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5327510", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 298.0, "discounted_cash": 223.5, "setting": "both", "billing_class": "facility"}]}, {"description": "FENTANYL 50MCG/HR TD", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5327511", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 465.0, "discounted_cash": 348.75, "setting": "both", "billing_class": "facility"}]}, {"description": "FENTANYL 50MCG/HR TD", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5327511", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 465.0, "discounted_cash": 348.75, "setting": "both", "billing_class": "facility"}]}, {"description": "FENTANYL 75MCG/HR TD", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5327512", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 665.0, "discounted_cash": 498.75, "setting": "both", "billing_class": "facility"}]}, {"description": "FENTANYL 75MCG/HR TD", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5327512", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 665.0, "discounted_cash": 498.75, "setting": "both", "billing_class": "facility"}]}, {"description": "FENTANYL NEO PER 1MCG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5320599", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 97.0, "discounted_cash": 72.75, "setting": "both", "billing_class": "facility"}]}, {"description": "FENTANYL NEO PER 1ML IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5320711", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 114.0, "discounted_cash": 85.5, "setting": "both", "billing_class": "facility"}]}, {"description": "FENTANYL PER 0.1MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3010", "type": "HCPCS"}, {"code": "5327501", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 196.0, "discounted_cash": 147.0, "setting": "both", "billing_class": "facility"}]}, {"description": "FENTANYL PER 0.1MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3010", "type": "HCPCS"}, {"code": "5327501", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 196.0, "discounted_cash": 147.0, "setting": "both", "billing_class": "facility"}]}, {"description": "FENTANYL/BUPIV 100ML IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J7999", "type": "HCPCS"}, {"code": "5320652", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 1607.0, "discounted_cash": 1205.25, "setting": "both", "billing_class": "facility"}]}, {"description": "FENTANYL/BUPIV 100ML IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J7999", "type": "HCPCS"}, {"code": "5320652", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 1607.0, "discounted_cash": 1205.25, "setting": "both", "billing_class": "facility"}]}, {"description": "FENTANYL/BUPIV 250ML IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J7999", "type": "HCPCS"}, {"code": "5320653", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 208.0, "discounted_cash": 156.0, "setting": "both", "billing_class": "facility"}]}, {"description": "FENTANYL/BUPIV 250ML IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J7999", "type": "HCPCS"}, {"code": "5320653", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 208.0, "discounted_cash": 156.0, "setting": "both", "billing_class": "facility"}]}, {"description": "FERR SULF 15MG/ML50ML LQ", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5315198", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 173.0, "discounted_cash": 129.75, "setting": "both", "billing_class": "facility"}]}, {"description": "FERR SULF 15MG/ML50ML LQ", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5315198", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 173.0, "discounted_cash": 129.75, "setting": "both", "billing_class": "facility"}]}, {"description": "FERRIC SUBSULF 30ML TS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5336682", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 76.0, "discounted_cash": 57.0, "setting": "both", "billing_class": "facility"}]}, {"description": "FERRIC SUBSULF 60ML TS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5335380", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 108.0, "discounted_cash": 81.0, "setting": "both", "billing_class": "facility"}]}, {"description": "FERRIC SUBSULFATE 8ML TS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5335384", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 122.0, "discounted_cash": 91.5, "setting": "both", "billing_class": "facility"}]}, {"description": "FERRITIN", "code_information": [{"code": "82728", "type": "CPT"}, {"code": "4102726", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 600.0, "discounted_cash": 450.0, "setting": "both", "billing_class": "facility"}]}, {"description": "FERRITIN", "code_information": [{"code": "82728", "type": "CPT"}, {"code": "4172726", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 8.56, "discounted_cash": 6.42, "setting": "both", "billing_class": "facility"}]}, {"description": "FERRITIN", "code_information": [{"code": "82728", "type": "CPT"}, {"code": "7252726", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 11.0, "discounted_cash": 8.25, "setting": "both", "billing_class": "facility"}]}, {"description": "FERROUS GLUCONT 324MG TB", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5305014", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 85.0, "discounted_cash": 63.75, "setting": "both", "billing_class": "facility"}]}, {"description": "FERROUS GLUCONT 324MG TB", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5305014", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 85.0, "discounted_cash": 63.75, "setting": "both", "billing_class": "facility"}]}, {"description": "FERROUS GLUCONT 325MG TB", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5305013", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 78.0, "discounted_cash": 58.5, "setting": "both", "billing_class": "facility"}]}, {"description": "FERROUS GLUCONT 325MG TB", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5305013", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 78.0, "discounted_cash": 58.5, "setting": "both", "billing_class": "facility"}]}, {"description": "FERROUS SULF 1ML LQ", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5315199", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 113.0, "discounted_cash": 84.75, "setting": "both", "billing_class": "facility"}]}, {"description": "FERROUS SULF 1ML LQ", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5315199", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 113.0, "discounted_cash": 84.75, "setting": "both", "billing_class": "facility"}]}, {"description": "FERROUS SULF 300MG/5MLLQ", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5315207", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 61.0, "discounted_cash": 45.75, "setting": "both", "billing_class": "facility"}]}, {"description": "FERROUS SULF 300MG/5MLLQ", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5315207", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 61.0, "discounted_cash": 45.75, "setting": "both", "billing_class": "facility"}]}, {"description": "FERROUS SULFATE 325MG TB", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5305044", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 70.0, "discounted_cash": 52.5, "setting": "both", "billing_class": "facility"}]}, {"description": "FERROUS SULFATE 325MG TB", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5305044", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 70.0, "discounted_cash": 52.5, "setting": "both", "billing_class": "facility"}]}, {"description": "FETAL BIOPHYS PROFLE NST", "code_information": [{"code": "76818", "type": "CPT"}, {"code": "3100175", "type": "CDM"}, {"code": "402", "type": "RC"}], "standard_charges": [{"gross_charge": 2785.0, "discounted_cash": 2088.75, "setting": "both", "billing_class": "facility"}]}, {"description": "FETAL BIOPHYS PROFLE NST", "code_information": [{"code": "76818", "type": "CPT"}, {"code": "5066818", "type": "CDM"}, {"code": "402", "type": "RC"}], "standard_charges": [{"gross_charge": 2817.0, "discounted_cash": 2112.75, "setting": "both", "billing_class": "facility"}]}, {"description": "FETAL BIOPHYS PROFLE NST", "code_information": [{"code": "76818", "type": "CPT"}, {"code": "6166818", "type": "CDM"}, {"code": "402", "type": "RC"}], "standard_charges": [{"gross_charge": 2817.0, "discounted_cash": 2112.75, "setting": "both", "billing_class": "facility"}]}, {"description": "FETAL BIOPHYS W/O STRESS", "code_information": [{"code": "76819", "type": "CPT"}, {"code": "5066180", "type": "CDM"}, {"code": "402", "type": "RC"}], "standard_charges": [{"gross_charge": 1519.0, "discounted_cash": 1139.25, "setting": "both", "billing_class": "facility"}]}, {"description": "FETAL LUNG MAT L/S RATIO", "code_information": [{"code": "83661", "type": "CPT"}, {"code": "7253661", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 1158.0, "discounted_cash": 868.5, "setting": "both", "billing_class": "facility"}]}, {"description": "FETAL NON-STRESS TEST", "code_information": [{"code": "59025", "type": "CPT"}, {"code": "3100176", "type": "CDM"}, {"code": "920", "type": "RC"}], "standard_charges": [{"gross_charge": 1854.0, "discounted_cash": 1390.5, "setting": "both", "billing_class": "facility"}]}, {"description": "FETAL NON-STRESS TEST", "code_information": [{"code": "59025", "type": "CPT"}, {"code": "6169025", "type": "CDM"}, {"code": "920", "type": "RC"}], "standard_charges": [{"gross_charge": 1850.0, "discounted_cash": 1387.5, "setting": "both", "billing_class": "facility"}]}, {"description": "FETAL RBC ROSETTE", "code_information": [{"code": "85461", "type": "CPT"}, {"code": "4102720", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 590.0, "discounted_cash": 442.5, "setting": "both", "billing_class": "facility"}]}, {"description": "FETAL RBC ROSETTE", "code_information": [{"code": "85461", "type": "CPT"}, {"code": "4175461", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 19.98, "discounted_cash": 14.99, "setting": "both", "billing_class": "facility"}]}, {"description": "FETL LNG MAT LAM DENS", "code_information": [{"code": "83664", "type": "CPT"}, {"code": "7253665", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 179.0, "discounted_cash": 134.25, "setting": "both", "billing_class": "facility"}]}, {"description": "FEXOFENADINE 60MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5305062", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 85.0, "discounted_cash": 63.75, "setting": "both", "billing_class": "facility"}]}, {"description": "FEXOFENADINE 60MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5305062", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 85.0, "discounted_cash": 63.75, "setting": "both", "billing_class": "facility"}]}, {"description": "FFP THAW EA UNIT", "code_information": [{"code": "86927", "type": "CPT"}, {"code": "4106264", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 1729.0, "discounted_cash": 1296.75, "setting": "both", "billing_class": "facility"}]}, {"description": "FIBRIN SEALAN 10ML KT TS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3590", "type": "HCPCS"}, {"code": "5335400", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 6026.0, "discounted_cash": 4519.5, "setting": "both", "billing_class": "facility"}]}, {"description": "FIBRIN SEALANT 2ML TS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5335406", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 2559.0, "discounted_cash": 1919.25, "setting": "both", "billing_class": "facility"}]}, {"description": "FIBRIN SEALANT 4ML KT TS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3590", "type": "HCPCS"}, {"code": "5335402", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 3925.0, "discounted_cash": 2943.75, "setting": "both", "billing_class": "facility"}]}, {"description": "FIBRINOGEN ACTIVITY", "code_information": [{"code": "85384", "type": "CPT"}, {"code": "4105384", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 377.0, "discounted_cash": 282.75, "setting": "both", "billing_class": "facility"}]}, {"description": "FIBRINOGEN ACTIVITY", "code_information": [{"code": "85384", "type": "CPT"}, {"code": "4175384", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 7.14, "discounted_cash": 5.36, "setting": "both", "billing_class": "facility"}]}, {"description": "FIBRNOLTIC PLSMNOGEN XCPT AG", "code_information": [{"code": "85420", "type": "CPT"}, {"code": "7255420", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 230.0, "discounted_cash": 172.5, "setting": "both", "billing_class": "facility"}]}, {"description": "FIBROBLAST GROWTH FACTOR 23", "code_information": [{"code": "83520", "type": "CPT"}, {"code": "7253482", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 389.0, "discounted_cash": 291.75, "setting": "both", "billing_class": "facility"}]}, {"description": "FIDAXOMICIN 200MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5305069", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 1579.0, "discounted_cash": 1184.25, "setting": "both", "billing_class": "facility"}]}, {"description": "FIDAXOMICIN 200MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5305069", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 1579.0, "discounted_cash": 1184.25, "setting": "both", "billing_class": "facility"}]}, {"description": "FILGRASTIM G-CSF 1MCG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J1442", "type": "HCPCS"}, {"code": "5320783", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 17.0, "discounted_cash": 12.75, "setting": "both", "billing_class": "facility"}]}, {"description": "FILGRASTIM G-CSF 1MCG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J1442", "type": "HCPCS"}, {"code": "5320783", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 17.0, "discounted_cash": 12.75, "setting": "both", "billing_class": "facility"}]}, {"description": "FILTER VENA CAVA", "code_information": [{"code": "C1880", "type": "HCPCS"}, {"code": "8240143", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 13472.0, "discounted_cash": 10104.0, "setting": "both", "billing_class": "facility"}]}, {"description": "FINASTERIDE 5MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5305066", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 90.0, "discounted_cash": 67.5, "setting": "both", "billing_class": "facility"}]}, {"description": "FINASTERIDE 5MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5305066", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 90.0, "discounted_cash": 67.5, "setting": "both", "billing_class": "facility"}]}, {"description": "FINGER(S) 2 VIEWS", "code_information": [{"code": "73140", "type": "CPT"}, {"code": "4903140", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 1372.0, "discounted_cash": 1029.0, "setting": "both", "billing_class": "facility"}]}, {"description": "FINGER(S) 2 VIEWS", "code_information": [{"code": "73140", "type": "CPT"}, {"code": "5113140", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 1101.0, "discounted_cash": 825.75, "setting": "both", "billing_class": "facility"}]}, {"description": "FISTULA-SINUS TRCT STDY", "code_information": [{"code": "76080", "type": "CPT"}, {"code": "4906082", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 3144.0, "discounted_cash": 2358.0, "setting": "both", "billing_class": "facility"}]}, {"description": "FISTULA-SINUS TRCT STDY", "code_information": [{"code": "76080", "type": "CPT"}, {"code": "4916082", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 2496.0, "discounted_cash": 1872.0, "setting": "both", "billing_class": "facility"}]}, {"description": "FLECAINIDE 100MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5305085", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 93.0, "discounted_cash": 69.75, "setting": "both", "billing_class": "facility"}]}, {"description": "FLECAINIDE 100MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5305085", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 93.0, "discounted_cash": 69.75, "setting": "both", "billing_class": "facility"}]}, {"description": "FLECAINIDE 50MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5305084", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 37.0, "discounted_cash": 27.75, "setting": "both", "billing_class": "facility"}]}, {"description": "FLECAINIDE 50MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5305084", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 37.0, "discounted_cash": 27.75, "setting": "both", "billing_class": "facility"}]}, {"description": "FLECAINIDE/2", "code_information": [{"code": "80181", "type": "CPT"}, {"code": "7250300", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 90.0, "discounted_cash": 67.5, "setting": "both", "billing_class": "facility"}]}, {"description": "FLEX GRAFTON", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8141598", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 17933.0, "discounted_cash": 13449.75, "setting": "both", "billing_class": "facility"}]}, {"description": "FLEXIBLE NAIL AS", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8132615", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 4482.0, "discounted_cash": 3361.5, "setting": "both", "billing_class": "facility"}]}, {"description": "FLOW CYTO ADD MARKER", "code_information": [{"code": "88185", "type": "CPT"}, {"code": "4100076", "type": "CDM"}, {"code": "310", "type": "RC"}], "standard_charges": [{"gross_charge": 614.0, "discounted_cash": 460.5, "setting": "both", "billing_class": "facility"}]}, {"description": "FLOW CYTO ADD MARKER/2", "code_information": [{"code": "88185", "type": "CPT"}, {"code": "4300076", "type": "CDM"}, {"code": "310", "type": "RC"}], "standard_charges": [{"gross_charge": 614.0, "discounted_cash": 460.5, "setting": "both", "billing_class": "facility"}]}, {"description": "FLOW CYTO ADD MARKER/2", "code_information": [{"code": "88185", "type": "CPT"}, {"code": "7030076", "type": "CDM"}, {"code": "310", "type": "RC"}], "standard_charges": [{"gross_charge": 97.0, "discounted_cash": 72.75, "setting": "both", "billing_class": "facility"}]}, {"description": "FLOW CYTO ADD MARKER/2", "code_information": [{"code": "88185", "type": "CPT"}, {"code": "7250076", "type": "CDM"}, {"code": "310", "type": "RC"}], "standard_charges": [{"gross_charge": 412.0, "discounted_cash": 309.0, "setting": "both", "billing_class": "facility"}]}, {"description": "FLOW CYTO CEL FIRST MRKR", "code_information": [{"code": "88184", "type": "CPT"}, {"code": "4108818", "type": "CDM"}, {"code": "310", "type": "RC"}], "standard_charges": [{"gross_charge": 614.0, "discounted_cash": 460.5, "setting": "both", "billing_class": "facility"}]}, {"description": "FLOW CYTO CEL FIRST MRKR", "code_information": [{"code": "88184", "type": "CPT"}, {"code": "4300009", "type": "CDM"}, {"code": "310", "type": "RC"}], "standard_charges": [{"gross_charge": 614.0, "discounted_cash": 460.5, "setting": "both", "billing_class": "facility"}]}, {"description": "FLOW CYTO CEL FIRST MRKR", "code_information": [{"code": "88184", "type": "CPT"}, {"code": "7030009", "type": "CDM"}, {"code": "310", "type": "RC"}], "standard_charges": [{"gross_charge": 1596.0, "discounted_cash": 1197.0, "setting": "both", "billing_class": "facility"}]}, {"description": "FLOW CYTO CEL FIRST MRKR", "code_information": [{"code": "88184", "type": "CPT"}, {"code": "7250009", "type": "CDM"}, {"code": "310", "type": "RC"}], "standard_charges": [{"gross_charge": 412.0, "discounted_cash": 309.0, "setting": "both", "billing_class": "facility"}]}, {"description": "FLOW CYTO CELL CYCLE/DNA", "code_information": [{"code": "88182", "type": "CPT"}, {"code": "7258182", "type": "CDM"}, {"code": "310", "type": "RC"}], "standard_charges": [{"gross_charge": 392.0, "discounted_cash": 294.0, "setting": "both", "billing_class": "facility"}]}, {"description": "FLOW CYTO INTERP 16+ MARK", "code_information": [{"code": "88189", "type": "CPT"}, {"code": "7258189", "type": "CDM"}, {"code": "310", "type": "RC"}], "standard_charges": [{"gross_charge": 543.0, "discounted_cash": 407.25, "setting": "both", "billing_class": "facility"}]}, {"description": "FLOW CYTO INTERP 2-8 MARK/2", "code_information": [{"code": "88187", "type": "CPT"}, {"code": "7250079", "type": "CDM"}, {"code": "310", "type": "RC"}], "standard_charges": [{"gross_charge": 199.0, "discounted_cash": 149.25, "setting": "both", "billing_class": "facility"}]}, {"description": "FLOW CYTO INTERP 9-15 MARK", "code_information": [{"code": "88188", "type": "CPT"}, {"code": "7250080", "type": "CDM"}, {"code": "310", "type": "RC"}], "standard_charges": [{"gross_charge": 433.0, "discounted_cash": 324.75, "setting": "both", "billing_class": "facility"}]}, {"description": "FLTR VC GUNTHER TULIP", "code_information": [{"code": "C1880", "type": "HCPCS"}, {"code": "4021036", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 16366.0, "discounted_cash": 12274.5, "setting": "both", "billing_class": "facility"}]}, {"description": "FLTR VC TRAPEASE CORDIS", "code_information": [{"code": "C1880", "type": "HCPCS"}, {"code": "8246305", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 7592.0, "discounted_cash": 5694.0, "setting": "both", "billing_class": "facility"}]}, {"description": "FLU VAC < 3 YRS IM PF IJ", "code_information": [{"code": "90655", "type": "CPT"}, {"code": "5320685", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 702.0, "discounted_cash": 526.5, "setting": "both", "billing_class": "facility"}]}, {"description": "FLU VAC <3Y 4 VAL PF IJ", "code_information": [{"code": "90685", "type": "CPT"}, {"code": "5320789", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 737.0, "discounted_cash": 552.75, "setting": "both", "billing_class": "facility"}]}, {"description": "FLU VAC > 3 YRS IM PF IJ", "code_information": [{"code": "90656", "type": "CPT"}, {"code": "5320686", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 568.0, "discounted_cash": 426.0, "setting": "both", "billing_class": "facility"}]}, {"description": "FLU VAC >3Y 4 VAL PF IJ", "code_information": [{"code": "90686", "type": "CPT"}, {"code": "5320777", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 564.0, "discounted_cash": 423.0, "setting": "both", "billing_class": "facility"}]}, {"description": "FLU VAC CCIIV3 >6M 0.5ML IJ", "code_information": [{"code": "90661", "type": "CPT"}, {"code": "5320583", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 621.0, "discounted_cash": 465.75, "setting": "both", "billing_class": "facility"}]}, {"description": "FLU VAC CELL CULT PF IJ", "code_information": [{"code": "90674", "type": "CPT"}, {"code": "5320729", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 690.0, "discounted_cash": 517.5, "setting": "both", "billing_class": "facility"}]}, {"description": "FLU VAC PF IA HD 0.5MLIJ", "code_information": [{"code": "90662", "type": "CPT"}, {"code": "5320603", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 787.0, "discounted_cash": 590.25, "setting": "both", "billing_class": "facility"}]}, {"description": "FLU VAC>3Y AFLURIA IM IJ", "code_information": [{"code": "Q2035", "type": "HCPCS"}, {"code": "5320701", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 113.0, "discounted_cash": 84.75, "setting": "both", "billing_class": "facility"}]}, {"description": "FLUCONAZ 10MG/ML 5MLPWLQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5315220", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 76.0, "discounted_cash": 57.0, "setting": "both", "billing_class": "facility"}]}, {"description": "FLUCONAZ 10MG/ML 5MLPWLQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5315220", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 76.0, "discounted_cash": 57.0, "setting": "both", "billing_class": "facility"}]}, {"description": "FLUCONAZ 40MG/ML 5MLPWLQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5315221", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 210.0, "discounted_cash": 157.5, "setting": "both", "billing_class": "facility"}]}, {"description": "FLUCONAZ 40MG/ML 5MLPWLQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5315221", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 210.0, "discounted_cash": 157.5, "setting": "both", "billing_class": "facility"}]}, {"description": "FLUCONAZ PER200MG PMX IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J1450", "type": "HCPCS"}, {"code": "5320677", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 566.0, "discounted_cash": 424.5, "setting": "both", "billing_class": "facility"}]}, {"description": "FLUCONAZ PER200MG PMX IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J1450", "type": "HCPCS"}, {"code": "5320677", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 566.0, "discounted_cash": 424.5, "setting": "both", "billing_class": "facility"}]}, {"description": "FLUCONAZOLE 100MG PMX IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J1450", "type": "HCPCS"}, {"code": "5320700", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 972.0, "discounted_cash": 729.0, "setting": "both", "billing_class": "facility"}]}, {"description": "FLUCONAZOLE 100MG PMX IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J1450", "type": "HCPCS"}, {"code": "5320700", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 972.0, "discounted_cash": 729.0, "setting": "both", "billing_class": "facility"}]}, {"description": "FLUCONAZOLE 100MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5305096", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 198.0, "discounted_cash": 148.5, "setting": "both", "billing_class": "facility"}]}, {"description": "FLUCONAZOLE 100MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5305096", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 198.0, "discounted_cash": 148.5, "setting": "both", "billing_class": "facility"}]}, {"description": "FLUCONAZOLE ORAL CMPD LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5315219", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 113.0, "discounted_cash": 84.75, "setting": "both", "billing_class": "facility"}]}, {"description": "FLUCONAZOLE ORAL CMPD LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5315219", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 113.0, "discounted_cash": 84.75, "setting": "both", "billing_class": "facility"}]}, {"description": "FLUCONAZOLE PER 1ML IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5320716", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 3.0, "discounted_cash": 2.25, "setting": "both", "billing_class": "facility"}]}, {"description": "FLUCONAZOLE10MG/ML35PWLQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5315224", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 713.0, "discounted_cash": 534.75, "setting": "both", "billing_class": "facility"}]}, {"description": "FLUCONAZOLE10MG/ML35PWLQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5315224", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 713.0, "discounted_cash": 534.75, "setting": "both", "billing_class": "facility"}]}, {"description": "FLUCYTOSINE 500MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5305106", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 564.0, "discounted_cash": 423.0, "setting": "both", "billing_class": "facility"}]}, {"description": "FLUCYTOSINE 500MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5305106", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 564.0, "discounted_cash": 423.0, "setting": "both", "billing_class": "facility"}]}, {"description": "FLUCYTOSINE CMPD SOL LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5315223", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 43.0, "discounted_cash": 32.25, "setting": "both", "billing_class": "facility"}]}, {"description": "FLUCYTOSINE CMPD SOL LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5315223", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 43.0, "discounted_cash": 32.25, "setting": "both", "billing_class": "facility"}]}, {"description": "FLUCYTOSINE/3", "code_information": [{"code": "80375", "type": "CPT"}, {"code": "7250388", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 280.0, "discounted_cash": 210.0, "setting": "both", "billing_class": "facility"}]}, {"description": "FLUDROCORTISONE .1MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5305129", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 61.0, "discounted_cash": 45.75, "setting": "both", "billing_class": "facility"}]}, {"description": "FLUDROCORTISONE .1MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5305129", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 61.0, "discounted_cash": 45.75, "setting": "both", "billing_class": "facility"}]}, {"description": "FLUMAZENIL .1MG/ML 5MLIJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5320681", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 301.0, "discounted_cash": 225.75, "setting": "both", "billing_class": "facility"}]}, {"description": "FLUMAZENIL .1MG/ML10MLIJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5320682", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 3847.0, "discounted_cash": 2885.25, "setting": "both", "billing_class": "facility"}]}, {"description": "FLUOCINONIDE .05%15GM OI", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5335503", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 802.0, "discounted_cash": 601.5, "setting": "both", "billing_class": "facility"}]}, {"description": "FLUOCINONIDE .05%15GM OI", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5335503", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 802.0, "discounted_cash": 601.5, "setting": "both", "billing_class": "facility"}]}, {"description": "FLUOCINONIDE .05%30GM CR", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5335513", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 535.0, "discounted_cash": 401.25, "setting": "both", "billing_class": "facility"}]}, {"description": "FLUOCINONIDE .05%30GM CR", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5335513", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 535.0, "discounted_cash": 401.25, "setting": "both", "billing_class": "facility"}]}, {"description": "FLUORESCEIN STRIP 1 EACH", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5330968", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 66.0, "discounted_cash": 49.5, "setting": "both", "billing_class": "facility"}]}, {"description": "FLUORESCENT AB TITER EA", "code_information": [{"code": "86256", "type": "CPT"}, {"code": "7253026", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 27.0, "discounted_cash": 20.25, "setting": "both", "billing_class": "facility"}]}, {"description": "FLUORESCENT AB TITER EA/10", "code_information": [{"code": "86256", "type": "CPT"}, {"code": "7256255", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 215.0, "discounted_cash": 161.25, "setting": "both", "billing_class": "facility"}]}, {"description": "FLUORESCENT AB TITER EA/11", "code_information": [{"code": "86256", "type": "CPT"}, {"code": "7256256", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 215.0, "discounted_cash": 161.25, "setting": "both", "billing_class": "facility"}]}, {"description": "FLUORESCENT AB TITER EA/13", "code_information": [{"code": "86256", "type": "CPT"}, {"code": "7256259", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 235.0, "discounted_cash": 176.25, "setting": "both", "billing_class": "facility"}]}, {"description": "FLUORESCENT AB TITER EA/14", "code_information": [{"code": "86256", "type": "CPT"}, {"code": "7256261", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 52.0, "discounted_cash": 39.0, "setting": "both", "billing_class": "facility"}]}, {"description": "FLUORESCENT AB TITER EA/15", "code_information": [{"code": "86256", "type": "CPT"}, {"code": "7256267", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 557.0, "discounted_cash": 417.75, "setting": "both", "billing_class": "facility"}]}, {"description": "FLUORESCENT AB TITER EA/16", "code_information": [{"code": "86256", "type": "CPT"}, {"code": "7256268", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 235.0, "discounted_cash": 176.25, "setting": "both", "billing_class": "facility"}]}, {"description": "FLUORESCENT AB TITER EA/19", "code_information": [{"code": "86256", "type": "CPT"}, {"code": "7258625", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 125.0, "discounted_cash": 93.75, "setting": "both", "billing_class": "facility"}]}, {"description": "FLUORESCENT AB TITER EA/2", "code_information": [{"code": "86256", "type": "CPT"}, {"code": "7254218", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 140.0, "discounted_cash": 105.0, "setting": "both", "billing_class": "facility"}]}, {"description": "FLUORESCENT AB TITER EA/20", "code_information": [{"code": "86256", "type": "CPT"}, {"code": "7258638", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 235.0, "discounted_cash": 176.25, "setting": "both", "billing_class": "facility"}]}, {"description": "FLUORESCENT AB TITER EA/3", "code_information": [{"code": "86256", "type": "CPT"}, {"code": "7254219", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 235.0, "discounted_cash": 176.25, "setting": "both", "billing_class": "facility"}]}, {"description": "FLUORESCNT SCRN EA AB", "code_information": [{"code": "86255", "type": "CPT"}, {"code": "7258627", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 884.0, "discounted_cash": 663.0, "setting": "both", "billing_class": "facility"}]}, {"description": "FLUORESCNT SCRN EA AB/2", "code_information": [{"code": "86255", "type": "CPT"}, {"code": "7256254", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 884.0, "discounted_cash": 663.0, "setting": "both", "billing_class": "facility"}]}, {"description": "FLUORO BX/ASP/INJ/GUIDE", "code_information": [{"code": "77002", "type": "CPT"}, {"code": "4616003", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 2790.0, "discounted_cash": 2092.5, "setting": "both", "billing_class": "facility"}]}, {"description": "FLUORO BX/ASP/INJ/GUIDE", "code_information": [{"code": "77002", "type": "CPT"}, {"code": "4906010", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 2562.0, "discounted_cash": 1921.5, "setting": "both", "billing_class": "facility"}]}, {"description": "FLUORO BX/ASP/INJ/GUIDE", "code_information": [{"code": "77002", "type": "CPT"}, {"code": "4916010", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 2214.0, "discounted_cash": 1660.5, "setting": "both", "billing_class": "facility"}]}, {"description": "FLUORO GUIDE SPINE INJ", "code_information": [{"code": "77003", "type": "CPT"}, {"code": "4906011", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 2606.0, "discounted_cash": 1954.5, "setting": "both", "billing_class": "facility"}]}, {"description": "FLUOROGUID FOR VEIN DVCE", "code_information": [{"code": "77001", "type": "CPT"}, {"code": "4905997", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 300.0, "discounted_cash": 225.0, "setting": "both", "billing_class": "facility"}]}, {"description": "FLUOROGUID FOR VEIN DVCE", "code_information": [{"code": "77001", "type": "CPT"}, {"code": "4915997", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 476.0, "discounted_cash": 357.0, "setting": "both", "billing_class": "facility"}]}, {"description": "FLUOROSCOPY <1HOUR", "code_information": [{"code": "76000", "type": "CPT"}, {"code": "4615998", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 1739.0, "discounted_cash": 1304.25, "setting": "both", "billing_class": "facility"}]}, {"description": "FLUOROSCOPY <1HOUR", "code_information": [{"code": "76000", "type": "CPT"}, {"code": "4905998", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 1263.0, "discounted_cash": 947.25, "setting": "both", "billing_class": "facility"}]}, {"description": "FLUOROSCOPY <1HOUR", "code_information": [{"code": "76000", "type": "CPT"}, {"code": "4916008", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 1723.0, "discounted_cash": 1292.25, "setting": "both", "billing_class": "facility"}]}, {"description": "FLUOROURACIL PER500MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J9190", "type": "HCPCS"}, {"code": "5320708", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 655.0, "discounted_cash": 491.25, "setting": "both", "billing_class": "facility"}]}, {"description": "FLUOROURACIL PER500MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J9190", "type": "HCPCS"}, {"code": "5320708", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 655.0, "discounted_cash": 491.25, "setting": "both", "billing_class": "facility"}]}, {"description": "FLUOXETINE 10MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5305159", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 76.0, "discounted_cash": 57.0, "setting": "both", "billing_class": "facility"}]}, {"description": "FLUOXETINE 10MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5305159", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 76.0, "discounted_cash": 57.0, "setting": "both", "billing_class": "facility"}]}, {"description": "FLUOXETINE 20MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5305160", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 83.0, "discounted_cash": 62.25, "setting": "both", "billing_class": "facility"}]}, {"description": "FLUOXETINE 20MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5305160", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 83.0, "discounted_cash": 62.25, "setting": "both", "billing_class": "facility"}]}, {"description": "FLUOXETINE(PROZAC) QUANT", "code_information": [{"code": "80332", "type": "CPT"}, {"code": "7252494", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 108.0, "discounted_cash": 81.0, "setting": "both", "billing_class": "facility"}]}, {"description": "FLUOXETINE20MG/5ML LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5315228", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 174.0, "discounted_cash": 130.5, "setting": "both", "billing_class": "facility"}]}, {"description": "FLUOXETINE20MG/5ML LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5315228", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 174.0, "discounted_cash": 130.5, "setting": "both", "billing_class": "facility"}]}, {"description": "FLUPHENAZ DC UPTO25MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J2680", "type": "HCPCS"}, {"code": "5320725", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 1695.0, "discounted_cash": 1271.25, "setting": "both", "billing_class": "facility"}]}, {"description": "FLUPHENAZ DC UPTO25MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J2680", "type": "HCPCS"}, {"code": "5320725", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 1695.0, "discounted_cash": 1271.25, "setting": "both", "billing_class": "facility"}]}, {"description": "FLUPHENAZINE 5MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5305207", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 66.0, "discounted_cash": 49.5, "setting": "both", "billing_class": "facility"}]}, {"description": "FLUPHENAZINE 5MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5305207", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 66.0, "discounted_cash": 49.5, "setting": "both", "billing_class": "facility"}]}, {"description": "FLURAZEPAM 15MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5305221", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 85.0, "discounted_cash": 63.75, "setting": "both", "billing_class": "facility"}]}, {"description": "FLURAZEPAM 15MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5305221", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 85.0, "discounted_cash": 63.75, "setting": "both", "billing_class": "facility"}]}, {"description": "FLURBIPROFEN.03%2.5ML OS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5330992", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 158.0, "discounted_cash": 118.5, "setting": "both", "billing_class": "facility"}]}, {"description": "FLURBIPROFEN.03%2.5ML OS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5330992", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 158.0, "discounted_cash": 118.5, "setting": "both", "billing_class": "facility"}]}, {"description": "FLUTICASONE .05MG16GM SP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3535", "type": "HCPCS"}, {"code": "5330995", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 621.0, "discounted_cash": 465.75, "setting": "both", "billing_class": "facility"}]}, {"description": "FLUTICASONE .05MG16GM SP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3535", "type": "HCPCS"}, {"code": "5330995", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 621.0, "discounted_cash": 465.75, "setting": "both", "billing_class": "facility"}]}, {"description": "FLUTICASONE 50MCG60DS IH", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3535", "type": "HCPCS"}, {"code": "5330973", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 1215.0, "discounted_cash": 911.25, "setting": "both", "billing_class": "facility"}]}, {"description": "FLUTICASONE 50MCG60DS IH", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3535", "type": "HCPCS"}, {"code": "5330973", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 1215.0, "discounted_cash": 911.25, "setting": "both", "billing_class": "facility"}]}, {"description": "FLUTICASONE PER 50MCG SP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3535", "type": "HCPCS"}, {"code": "5331014", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 853.0, "discounted_cash": 639.75, "setting": "both", "billing_class": "facility"}]}, {"description": "FLUTICASONE PER 50MCG SP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3535", "type": "HCPCS"}, {"code": "5331014", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 853.0, "discounted_cash": 639.75, "setting": "both", "billing_class": "facility"}]}, {"description": "FLUTICASONE100MCG60DS IH", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3535", "type": "HCPCS"}, {"code": "5330974", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 889.0, "discounted_cash": 666.75, "setting": "both", "billing_class": "facility"}]}, {"description": "FLUTICASONE100MCG60DS IH", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3535", "type": "HCPCS"}, {"code": "5330974", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 889.0, "discounted_cash": 666.75, "setting": "both", "billing_class": "facility"}]}, {"description": "FLUTICASONE220MCG12GM IH", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3535", "type": "HCPCS"}, {"code": "5330977", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 3844.0, "discounted_cash": 2883.0, "setting": "both", "billing_class": "facility"}]}, {"description": "FLUTICASONE220MCG12GM IH", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3535", "type": "HCPCS"}, {"code": "5330977", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 3844.0, "discounted_cash": 2883.0, "setting": "both", "billing_class": "facility"}]}, {"description": "FLUTICASONE250MCG60DS IH", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3535", "type": "HCPCS"}, {"code": "5330975", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 1190.0, "discounted_cash": 892.5, "setting": "both", "billing_class": "facility"}]}, {"description": "FLUTICASONE250MCG60DS IH", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3535", "type": "HCPCS"}, {"code": "5330975", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 1190.0, "discounted_cash": 892.5, "setting": "both", "billing_class": "facility"}]}, {"description": "FLUVOXAMINE 50MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5305235", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 87.0, "discounted_cash": 65.25, "setting": "both", "billing_class": "facility"}]}, {"description": "FLUVOXAMINE 50MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5305235", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 87.0, "discounted_cash": 65.25, "setting": "both", "billing_class": "facility"}]}, {"description": "FMLY THRPY 60 MIN", "code_information": [{"code": "90847", "type": "CPT"}, {"code": "6401974", "type": "CDM"}, {"code": "916", "type": "RC"}], "standard_charges": [{"gross_charge": 1949.0, "discounted_cash": 1461.75, "setting": "both", "billing_class": "facility"}]}, {"description": "FMR1 ABNL ALLELES/2", "code_information": [{"code": "81243", "type": "CPT"}, {"code": "7259206", "type": "CDM"}, {"code": "310", "type": "RC"}], "standard_charges": [{"gross_charge": 628.0, "discounted_cash": 471.0, "setting": "both", "billing_class": "facility"}]}, {"description": "FNA BX CT GUIDANCE 1ST LES", "code_information": [{"code": "5050114", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 4171.0, "discounted_cash": 3128.25, "setting": "both", "billing_class": "facility"}]}, {"description": "FNA BX US GUIDANCE 1ST LESION", "code_information": [{"code": "4910110", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 4284.0, "discounted_cash": 3213.0, "setting": "both", "billing_class": "facility"}]}, {"description": "FNA BX US GUIDANCE 1ST LESION", "code_information": [{"code": "5060110", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 3852.0, "discounted_cash": 2889.0, "setting": "both", "billing_class": "facility"}]}, {"description": "FNA BX W/O IMG GUIDE 1ST LES", "code_information": [{"code": "4910026", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 2364.0, "discounted_cash": 1773.0, "setting": "both", "billing_class": "facility"}]}, {"description": "FOLIC ACID", "code_information": [{"code": "82746", "type": "CPT"}, {"code": "4102746", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 1337.0, "discounted_cash": 1002.75, "setting": "both", "billing_class": "facility"}]}, {"description": "FOLIC ACID", "code_information": [{"code": "82746", "type": "CPT"}, {"code": "4172746", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 8.56, "discounted_cash": 6.42, "setting": "both", "billing_class": "facility"}]}, {"description": "FOLIC ACID", "code_information": [{"code": "82746", "type": "CPT"}, {"code": "7252746", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 12.0, "discounted_cash": 9.0, "setting": "both", "billing_class": "facility"}]}, {"description": "FOLIC ACID 1MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5305233", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 70.0, "discounted_cash": 52.5, "setting": "both", "billing_class": "facility"}]}, {"description": "FOLIC ACID 1MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5305233", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 70.0, "discounted_cash": 52.5, "setting": "both", "billing_class": "facility"}]}, {"description": "FOLIC ACID PER 0.1MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J1808", "type": "HCPCS"}, {"code": "5320818", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 2.0, "discounted_cash": 1.5, "setting": "both", "billing_class": "facility"}]}, {"description": "FOLIC ACID PER 0.1MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J1808", "type": "HCPCS"}, {"code": "5320818", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 2.0, "discounted_cash": 1.5, "setting": "both", "billing_class": "facility"}]}, {"description": "FOLIC ACID RBC", "code_information": [{"code": "82747", "type": "CPT"}, {"code": "4102747", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 635.0, "discounted_cash": 476.25, "setting": "both", "billing_class": "facility"}]}, {"description": "FOLIC ACID RBC", "code_information": [{"code": "82747", "type": "CPT"}, {"code": "7252747", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 1306.0, "discounted_cash": 979.5, "setting": "both", "billing_class": "facility"}]}, {"description": "FOLLICLE STIMLAT HORMONE", "code_information": [{"code": "83001", "type": "CPT"}, {"code": "4103001", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 726.0, "discounted_cash": 544.5, "setting": "both", "billing_class": "facility"}]}, {"description": "FOLLICLE STIMLAT HORMONE", "code_information": [{"code": "83001", "type": "CPT"}, {"code": "4173001", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 8.56, "discounted_cash": 6.42, "setting": "both", "billing_class": "facility"}]}, {"description": "FOLLICLE STIMLAT HORMONE", "code_information": [{"code": "83001", "type": "CPT"}, {"code": "7253001", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 649.0, "discounted_cash": 486.75, "setting": "both", "billing_class": "facility"}]}, {"description": "FOMEPIZOLE PER 15MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J1451", "type": "HCPCS"}, {"code": "5320731", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 86.0, "discounted_cash": 64.5, "setting": "both", "billing_class": "facility"}]}, {"description": "FOMEPIZOLE PER 15MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J1451", "type": "HCPCS"}, {"code": "5320731", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 86.0, "discounted_cash": 64.5, "setting": "both", "billing_class": "facility"}]}, {"description": "FONDAPARINUX PER.5MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J1652", "type": "HCPCS"}, {"code": "5320766", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 1010.0, "discounted_cash": 757.5, "setting": "both", "billing_class": "facility"}]}, {"description": "FONDAPARINUX PER.5MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J1652", "type": "HCPCS"}, {"code": "5320766", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 1010.0, "discounted_cash": 757.5, "setting": "both", "billing_class": "facility"}]}, {"description": "FOOT 2 VIEWS", "code_information": [{"code": "73620", "type": "CPT"}, {"code": "4903620", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 1908.0, "discounted_cash": 1431.0, "setting": "both", "billing_class": "facility"}]}, {"description": "FOOT 2 VIEWS", "code_information": [{"code": "73620", "type": "CPT"}, {"code": "5113620", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 1515.0, "discounted_cash": 1136.25, "setting": "both", "billing_class": "facility"}]}, {"description": "FOOT 2 VIEWS", "code_information": [{"code": "73620", "type": "CPT"}, {"code": "6813620", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 407.0, "discounted_cash": 305.25, "setting": "both", "billing_class": "facility"}]}, {"description": "FOOT 3 VIEWS MINIMUM", "code_information": [{"code": "73630", "type": "CPT"}, {"code": "4903630", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 1831.0, "discounted_cash": 1373.25, "setting": "both", "billing_class": "facility"}]}, {"description": "FOOT 3 VIEWS MINIMUM", "code_information": [{"code": "73630", "type": "CPT"}, {"code": "5113630", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 1831.0, "discounted_cash": 1373.25, "setting": "both", "billing_class": "facility"}]}, {"description": "FOOT 3 VIEWS MINIMUM", "code_information": [{"code": "73630", "type": "CPT"}, {"code": "6813630", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 388.0, "discounted_cash": 291.0, "setting": "both", "billing_class": "facility"}]}, {"description": "FOREARM 2 VIEWS", "code_information": [{"code": "73090", "type": "CPT"}, {"code": "4903091", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 2478.0, "discounted_cash": 1858.5, "setting": "both", "billing_class": "facility"}]}, {"description": "FOREARM 2 VIEWS", "code_information": [{"code": "73090", "type": "CPT"}, {"code": "5113090", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 1581.0, "discounted_cash": 1185.75, "setting": "both", "billing_class": "facility"}]}, {"description": "FOSINOPRIL 10MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5305240", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 85.0, "discounted_cash": 63.75, "setting": "both", "billing_class": "facility"}]}, {"description": "FOSINOPRIL 10MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5305240", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 85.0, "discounted_cash": 63.75, "setting": "both", "billing_class": "facility"}]}, {"description": "FOSPHENYTOIN PER 50MG IJ", "code_information": [{"code": "Q2009", "type": "HCPCS"}, {"code": "5320749", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 474.0, "discounted_cash": 355.5, "setting": "both", "billing_class": "facility"}]}, {"description": "FOSPHENYTOIN PER 50MG IJ", "code_information": [{"code": "Q2009", "type": "HCPCS"}, {"code": "5320749", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 474.0, "discounted_cash": 355.5, "setting": "both", "billing_class": "facility"}]}, {"description": "FRANCISELLA TULARENS AB", "code_information": [{"code": "86668", "type": "CPT"}, {"code": "7258666", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 1536.0, "discounted_cash": 1152.0, "setting": "both", "billing_class": "facility"}]}, {"description": "FROZEN BLOOD THAW UNIT", "code_information": [{"code": "86931", "type": "CPT"}, {"code": "4206266", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 365.0, "discounted_cash": 273.75, "setting": "both", "billing_class": "facility"}]}, {"description": "FUNGUS AB NES", "code_information": [{"code": "86671", "type": "CPT"}, {"code": "7256671", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 1299.0, "discounted_cash": 974.25, "setting": "both", "billing_class": "facility"}]}, {"description": "FUNGUS AB NES/2", "code_information": [{"code": "86671", "type": "CPT"}, {"code": "7256672", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 1299.0, "discounted_cash": 974.25, "setting": "both", "billing_class": "facility"}]}, {"description": "FUNGUS AB NES/4", "code_information": [{"code": "86671", "type": "CPT"}, {"code": "7256696", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 1417.0, "discounted_cash": 1062.75, "setting": "both", "billing_class": "facility"}]}, {"description": "FUNGUS AB NES/5", "code_information": [{"code": "86671", "type": "CPT"}, {"code": "7256736", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 1417.0, "discounted_cash": 1062.75, "setting": "both", "billing_class": "facility"}]}, {"description": "FUROSEMIDE 20MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5305279", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 92.0, "discounted_cash": 69.0, "setting": "both", "billing_class": "facility"}]}, {"description": "FUROSEMIDE 20MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5305279", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 92.0, "discounted_cash": 69.0, "setting": "both", "billing_class": "facility"}]}, {"description": "FUROSEMIDE 40MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5305283", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 68.0, "discounted_cash": 51.0, "setting": "both", "billing_class": "facility"}]}, {"description": "FUROSEMIDE 40MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5305283", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 68.0, "discounted_cash": 51.0, "setting": "both", "billing_class": "facility"}]}, {"description": "FUROSEMIDE 40MG/5ML LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5315248", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 85.0, "discounted_cash": 63.75, "setting": "both", "billing_class": "facility"}]}, {"description": "FUROSEMIDE 40MG/5ML LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5315248", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 85.0, "discounted_cash": 63.75, "setting": "both", "billing_class": "facility"}]}, {"description": "FUROSEMIDE 80MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5305287", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 61.0, "discounted_cash": 45.75, "setting": "both", "billing_class": "facility"}]}, {"description": "FUROSEMIDE 80MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5305287", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 61.0, "discounted_cash": 45.75, "setting": "both", "billing_class": "facility"}]}, {"description": "FUROSEMIDE PER 1MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J1938", "type": "HCPCS"}, {"code": "5320822", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 2.0, "discounted_cash": 1.5, "setting": "both", "billing_class": "facility"}]}, {"description": "FUROSEMIDE PER 1MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J1938", "type": "HCPCS"}, {"code": "5320822", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 2.0, "discounted_cash": 1.5, "setting": "both", "billing_class": "facility"}]}, {"description": "FUROSEMIDE10MG/ML 1ML LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5315211", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 72.0, "discounted_cash": 54.0, "setting": "both", "billing_class": "facility"}]}, {"description": "FUROSEMIDE10MG/ML 1ML LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5315211", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 72.0, "discounted_cash": 54.0, "setting": "both", "billing_class": "facility"}]}, {"description": "FUROSEMIDE10MG/ML 4ML LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5315245", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 11.0, "discounted_cash": 8.25, "setting": "both", "billing_class": "facility"}]}, {"description": "FUROSEMIDE10MG/ML 4ML LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5315245", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 11.0, "discounted_cash": 8.25, "setting": "both", "billing_class": "facility"}]}, {"description": "FUROSEMIDE10MG/ML60ML LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5315244", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 189.0, "discounted_cash": 141.75, "setting": "both", "billing_class": "facility"}]}, {"description": "FUROSEMIDE10MG/ML60ML LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5315244", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 189.0, "discounted_cash": 141.75, "setting": "both", "billing_class": "facility"}]}, {"description": "FXN GENE ANALYSIS", "code_information": [{"code": "81284", "type": "CPT"}, {"code": "7250123", "type": "CDM"}, {"code": "310", "type": "RC"}], "standard_charges": [{"gross_charge": 677.0, "discounted_cash": 507.75, "setting": "both", "billing_class": "facility"}]}, {"description": "G6PD QUANT", "code_information": [{"code": "82955", "type": "CPT"}, {"code": "7252955", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 628.0, "discounted_cash": 471.0, "setting": "both", "billing_class": "facility"}]}, {"description": "GA67 CITRATE 1MCI", "code_information": [{"code": "A9556", "type": "HCPCS"}, {"code": "5191400", "type": "CDM"}, {"code": "343", "type": "RC"}], "standard_charges": [{"gross_charge": 997.0, "discounted_cash": 747.75, "setting": "both", "billing_class": "facility"}]}, {"description": "GABAPENTIN", "code_information": [{"code": "80171", "type": "CPT"}, {"code": "7250250", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 140.0, "discounted_cash": 105.0, "setting": "both", "billing_class": "facility"}]}, {"description": "GABAPENTIN 100MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5305290", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 66.0, "discounted_cash": 49.5, "setting": "both", "billing_class": "facility"}]}, {"description": "GABAPENTIN 100MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5305290", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 66.0, "discounted_cash": 49.5, "setting": "both", "billing_class": "facility"}]}, {"description": "GABAPENTIN 300MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5305291", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 77.0, "discounted_cash": 57.75, "setting": "both", "billing_class": "facility"}]}, {"description": "GABAPENTIN 300MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5305291", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 77.0, "discounted_cash": 57.75, "setting": "both", "billing_class": "facility"}]}, {"description": "GABAPENTIN 400MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5305292", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 72.0, "discounted_cash": 54.0, "setting": "both", "billing_class": "facility"}]}, {"description": "GABAPENTIN 400MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5305292", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 72.0, "discounted_cash": 54.0, "setting": "both", "billing_class": "facility"}]}, {"description": "GADOBENATE DIM PER1ML IJ", "code_information": [{"code": "A9577", "type": "HCPCS"}, {"code": "5356161", "type": "CDM"}, {"code": "255", "type": "RC"}], "standard_charges": [{"gross_charge": 22.0, "discounted_cash": 16.5, "setting": "both", "billing_class": "facility"}]}, {"description": "GADOBENATE DIM PER1ML IJ", "code_information": [{"code": "A9577", "type": "HCPCS"}, {"code": "5356161", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 22.0, "discounted_cash": 16.5, "setting": "both", "billing_class": "facility"}]}, {"description": "GADOTERATE MEG 0.1ML IJ", "code_information": [{"code": "A9575", "type": "HCPCS"}, {"code": "5356164", "type": "CDM"}, {"code": "255", "type": "RC"}], "standard_charges": [{"gross_charge": 8.0, "discounted_cash": 6.0, "setting": "both", "billing_class": "facility"}]}, {"description": "GADOTERATE MEG 0.1ML IJ", "code_information": [{"code": "A9575", "type": "HCPCS"}, {"code": "5356164", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 8.0, "discounted_cash": 6.0, "setting": "both", "billing_class": "facility"}]}, {"description": "GALAC-1-PH/URID/TRNSFRSE/2", "code_information": [{"code": "82775", "type": "CPT"}, {"code": "7252775", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 1199.0, "discounted_cash": 899.25, "setting": "both", "billing_class": "facility"}]}, {"description": "GALACTOSE QUANTITATIVE", "code_information": [{"code": "82760", "type": "CPT"}, {"code": "7258321", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 1003.0, "discounted_cash": 752.25, "setting": "both", "billing_class": "facility"}]}, {"description": "GALANTAMINE 4MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5305299", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 102.0, "discounted_cash": 76.5, "setting": "both", "billing_class": "facility"}]}, {"description": "GALANTAMINE 4MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5305299", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 102.0, "discounted_cash": 76.5, "setting": "both", "billing_class": "facility"}]}, {"description": "GAMMAGLOBULIN EA/10", "code_information": [{"code": "82784", "type": "CPT"}, {"code": "7253564", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 22.0, "discounted_cash": 16.5, "setting": "both", "billing_class": "facility"}]}, {"description": "GAMMAGLOBULIN EA/11", "code_information": [{"code": "82784", "type": "CPT"}, {"code": "7258278", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 241.0, "discounted_cash": 180.75, "setting": "both", "billing_class": "facility"}]}, {"description": "GAMMAGLOBULIN EA/13", "code_information": [{"code": "82784", "type": "CPT"}, {"code": "7258296", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 90.0, "discounted_cash": 67.5, "setting": "both", "billing_class": "facility"}]}, {"description": "GAMMAGLOBULIN EA/2", "code_information": [{"code": "82784", "type": "CPT"}, {"code": "4102784", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 629.0, "discounted_cash": 471.75, "setting": "both", "billing_class": "facility"}]}, {"description": "GAMMAGLOBULIN EA/2", "code_information": [{"code": "82784", "type": "CPT"}, {"code": "7252783", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 26.0, "discounted_cash": 19.5, "setting": "both", "billing_class": "facility"}]}, {"description": "GAMMAGLOBULIN EA/3", "code_information": [{"code": "82784", "type": "CPT"}, {"code": "4103512", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 502.0, "discounted_cash": 376.5, "setting": "both", "billing_class": "facility"}]}, {"description": "GAMMAGLOBULIN EA/4", "code_information": [{"code": "82784", "type": "CPT"}, {"code": "4103514", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 462.0, "discounted_cash": 346.5, "setting": "both", "billing_class": "facility"}]}, {"description": "GAMMAGLOBULIN EA/4", "code_information": [{"code": "82784", "type": "CPT"}, {"code": "7252786", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 565.0, "discounted_cash": 423.75, "setting": "both", "billing_class": "facility"}]}, {"description": "GAMMAGLOBULIN EA/5", "code_information": [{"code": "82784", "type": "CPT"}, {"code": "4103515", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 423.0, "discounted_cash": 317.25, "setting": "both", "billing_class": "facility"}]}, {"description": "GAMMAGLOBULIN EA/5", "code_information": [{"code": "82784", "type": "CPT"}, {"code": "7252787", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 26.0, "discounted_cash": 19.5, "setting": "both", "billing_class": "facility"}]}, {"description": "GAMMAGLOBULIN EA/6", "code_information": [{"code": "82784", "type": "CPT"}, {"code": "4173512", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 7.14, "discounted_cash": 5.36, "setting": "both", "billing_class": "facility"}]}, {"description": "GAMMAGLOBULIN EA/6", "code_information": [{"code": "82784", "type": "CPT"}, {"code": "7253512", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 17.0, "discounted_cash": 12.75, "setting": "both", "billing_class": "facility"}]}, {"description": "GAMMAGLOBULIN EA/7", "code_information": [{"code": "82784", "type": "CPT"}, {"code": "4103519", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 629.0, "discounted_cash": 471.75, "setting": "both", "billing_class": "facility"}]}, {"description": "GAMMAGLOBULIN EA/7", "code_information": [{"code": "82784", "type": "CPT"}, {"code": "4173514", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 7.14, "discounted_cash": 5.36, "setting": "both", "billing_class": "facility"}]}, {"description": "GAMMAGLOBULIN EA/7", "code_information": [{"code": "82784", "type": "CPT"}, {"code": "7253514", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 614.0, "discounted_cash": 460.5, "setting": "both", "billing_class": "facility"}]}, {"description": "GAMMAGLOBULIN EA/8", "code_information": [{"code": "82784", "type": "CPT"}, {"code": "4173515", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 7.14, "discounted_cash": 5.36, "setting": "both", "billing_class": "facility"}]}, {"description": "GAMMAGLOBULIN EA/8", "code_information": [{"code": "82784", "type": "CPT"}, {"code": "7253515", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 17.0, "discounted_cash": 12.75, "setting": "both", "billing_class": "facility"}]}, {"description": "GAMMAGLOBULIN EA/9", "code_information": [{"code": "82784", "type": "CPT"}, {"code": "7253521", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 60.0, "discounted_cash": 45.0, "setting": "both", "billing_class": "facility"}]}, {"description": "GANGLIOSIDE AB", "code_information": [{"code": "83516", "type": "CPT"}, {"code": "7250054", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 141.0, "discounted_cash": 105.75, "setting": "both", "billing_class": "facility"}]}, {"description": "GANGLIOSIDE AB/4", "code_information": [{"code": "83516", "type": "CPT"}, {"code": "7253571", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 109.0, "discounted_cash": 81.75, "setting": "both", "billing_class": "facility"}]}, {"description": "GANGLIOSIDE AB/8", "code_information": [{"code": "83520", "type": "CPT"}, {"code": "7258372", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 166.0, "discounted_cash": 124.5, "setting": "both", "billing_class": "facility"}]}, {"description": "GAS BLD ANY COMB W/CALO2", "code_information": [{"code": "82803", "type": "CPT"}, {"code": "4102803", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 1231.0, "discounted_cash": 923.25, "setting": "both", "billing_class": "facility"}]}, {"description": "GAS BLD ANY COMB W/CALO2", "code_information": [{"code": "82803", "type": "CPT"}, {"code": "4172803", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 6.0, "discounted_cash": 4.5, "setting": "both", "billing_class": "facility"}]}, {"description": "GAS BLD ANY COMB W/O2", "code_information": [{"code": "82805", "type": "CPT"}, {"code": "4102805", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 2097.0, "discounted_cash": 1572.75, "setting": "both", "billing_class": "facility"}]}, {"description": "GASTRIC EMP SM BOWEL", "code_information": [{"code": "78265", "type": "CPT"}, {"code": "5208265", "type": "CDM"}, {"code": "341", "type": "RC"}], "standard_charges": [{"gross_charge": 1849.0, "discounted_cash": 1386.75, "setting": "both", "billing_class": "facility"}]}, {"description": "GASTRIC EMPTYING STUDY", "code_information": [{"code": "78264", "type": "CPT"}, {"code": "5208276", "type": "CDM"}, {"code": "341", "type": "RC"}], "standard_charges": [{"gross_charge": 5525.0, "discounted_cash": 4143.75, "setting": "both", "billing_class": "facility"}]}, {"description": "GASTRIC SM BOWEL+COL", "code_information": [{"code": "78266", "type": "CPT"}, {"code": "5208266", "type": "CDM"}, {"code": "341", "type": "RC"}], "standard_charges": [{"gross_charge": 2451.0, "discounted_cash": 1838.25, "setting": "both", "billing_class": "facility"}]}, {"description": "GASTRIN", "code_information": [{"code": "82941", "type": "CPT"}, {"code": "7252941", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 570.0, "discounted_cash": 427.5, "setting": "both", "billing_class": "facility"}]}, {"description": "GATED HEART PLANAR SNGL", "code_information": [{"code": "78472", "type": "CPT"}, {"code": "5208402", "type": "CDM"}, {"code": "341", "type": "RC"}], "standard_charges": [{"gross_charge": 4709.0, "discounted_cash": 3531.75, "setting": "both", "billing_class": "facility"}]}, {"description": "GC DNA AMP PROBE", "code_information": [{"code": "87591", "type": "CPT"}, {"code": "4107592", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 213.0, "discounted_cash": 159.75, "setting": "both", "billing_class": "facility"}]}, {"description": "GC DNA AMP PROBE", "code_information": [{"code": "87591", "type": "CPT"}, {"code": "7257592", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 377.0, "discounted_cash": 282.75, "setting": "both", "billing_class": "facility"}]}, {"description": "GC DNA DIR PROBE", "code_information": [{"code": "87590", "type": "CPT"}, {"code": "4107174", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 844.0, "discounted_cash": 633.0, "setting": "both", "billing_class": "facility"}]}, {"description": "GCATH MACH 1", "code_information": [{"code": "C1887", "type": "HCPCS"}, {"code": "8241085", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 834.0, "discounted_cash": 625.5, "setting": "both", "billing_class": "facility"}]}, {"description": "GD1A ANTIBODY/2", "code_information": [{"code": "83516", "type": "CPT"}, {"code": "7253053", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 167.0, "discounted_cash": 125.25, "setting": "both", "billing_class": "facility"}]}, {"description": "GD1A ANTIBODY/3", "code_information": [{"code": "83516", "type": "CPT"}, {"code": "7253052", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 167.0, "discounted_cash": 125.25, "setting": "both", "billing_class": "facility"}]}, {"description": "GELATIN FILM OPHTHALM EA", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3590", "type": "HCPCS"}, {"code": "5335711", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 83.0, "discounted_cash": 62.25, "setting": "both", "billing_class": "facility"}]}, {"description": "GELATIN SPNG COMP100SZEA", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3590", "type": "HCPCS"}, {"code": "5335697", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 876.0, "discounted_cash": 657.0, "setting": "both", "billing_class": "facility"}]}, {"description": "GELATIN SPONG ABS100SZEA", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3590", "type": "HCPCS"}, {"code": "5335698", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 174.0, "discounted_cash": 130.5, "setting": "both", "billing_class": "facility"}]}, {"description": "GELATIN SPONGE ABS12X7EA", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3590", "type": "HCPCS"}, {"code": "5335703", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 201.0, "discounted_cash": 150.75, "setting": "both", "billing_class": "facility"}]}, {"description": "GEMCITABINE PER 200MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J9201", "type": "HCPCS"}, {"code": "5320840", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 96.0, "discounted_cash": 72.0, "setting": "both", "billing_class": "facility"}]}, {"description": "GEMCITABINE PER 200MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J9201", "type": "HCPCS"}, {"code": "5320840", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 96.0, "discounted_cash": 72.0, "setting": "both", "billing_class": "facility"}]}, {"description": "GEMFIBROZIL 600MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5305311", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 61.0, "discounted_cash": 45.75, "setting": "both", "billing_class": "facility"}]}, {"description": "GEMFIBROZIL 600MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5305311", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 61.0, "discounted_cash": 45.75, "setting": "both", "billing_class": "facility"}]}, {"description": "GEN HEALTH PANEL", "code_information": [{"code": "80050", "type": "CPT"}, {"code": "4100052", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 1850.0, "discounted_cash": 1387.5, "setting": "both", "billing_class": "facility"}]}, {"description": "GEN NSTIM INTERSTIM 3058", "code_information": [{"code": "C1767", "type": "HCPCS"}, {"code": "4021480", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 134607.0, "discounted_cash": 100955.25, "setting": "both", "billing_class": "facility"}]}, {"description": "GEN NSTIM VAGUS NRV", "code_information": [{"code": "C1767", "type": "HCPCS"}, {"code": "4021481", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 428448.0, "discounted_cash": 321336.0, "setting": "both", "billing_class": "facility"}]}, {"description": "GEN NSTM PROCLAIM ELITE 3662", "code_information": [{"code": "C1767", "type": "HCPCS"}, {"code": "4008504", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 276585.0, "discounted_cash": 207438.75, "setting": "both", "billing_class": "facility"}]}, {"description": "GENETIC TESTING SEV INH COND", "code_information": [{"code": "81443", "type": "CPT"}, {"code": "7250038", "type": "CDM"}, {"code": "310", "type": "RC"}], "standard_charges": [{"gross_charge": 4410.0, "discounted_cash": 3307.5, "setting": "both", "billing_class": "facility"}]}, {"description": "GENTAMICIN", "code_information": [{"code": "80170", "type": "CPT"}, {"code": "4103004", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 1092.0, "discounted_cash": 819.0, "setting": "both", "billing_class": "facility"}]}, {"description": "GENTAMICIN .1% 15GM CR", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5335724", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 518.0, "discounted_cash": 388.5, "setting": "both", "billing_class": "facility"}]}, {"description": "GENTAMICIN .1% 15GM CR", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5335724", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 518.0, "discounted_cash": 388.5, "setting": "both", "billing_class": "facility"}]}, {"description": "GENTAMICIN .1% 15GM OI", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5335729", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 114.0, "discounted_cash": 85.5, "setting": "both", "billing_class": "facility"}]}, {"description": "GENTAMICIN .1% 15GM OI", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5335729", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 114.0, "discounted_cash": 85.5, "setting": "both", "billing_class": "facility"}]}, {"description": "GENTAMICIN .3% 3.5GM OO", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5331031", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 326.0, "discounted_cash": 244.5, "setting": "both", "billing_class": "facility"}]}, {"description": "GENTAMICIN .3% 3.5GM OO", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5331031", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 326.0, "discounted_cash": 244.5, "setting": "both", "billing_class": "facility"}]}, {"description": "GENTAMICIN .3% 5ML OS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5331038", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 158.0, "discounted_cash": 118.5, "setting": "both", "billing_class": "facility"}]}, {"description": "GENTAMICIN .3% 5ML OS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5331038", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 158.0, "discounted_cash": 118.5, "setting": "both", "billing_class": "facility"}]}, {"description": "GENTAMICIN NEO CMPD IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J7999", "type": "HCPCS"}, {"code": "5320851", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 97.0, "discounted_cash": 72.75, "setting": "both", "billing_class": "facility"}]}, {"description": "GENTAMICIN NEO CMPD IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J7999", "type": "HCPCS"}, {"code": "5320851", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 97.0, "discounted_cash": 72.75, "setting": "both", "billing_class": "facility"}]}, {"description": "GENTAMICIN UPTO 80 PMXIJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J1580", "type": "HCPCS"}, {"code": "5320846", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 537.0, "discounted_cash": 402.75, "setting": "both", "billing_class": "facility"}]}, {"description": "GENTAMICIN UPTO 80 PMXIJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J1580", "type": "HCPCS"}, {"code": "5320846", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 537.0, "discounted_cash": 402.75, "setting": "both", "billing_class": "facility"}]}, {"description": "GENTAMICIN UPTO 80MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J1580", "type": "HCPCS"}, {"code": "5320852", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 279.0, "discounted_cash": 209.25, "setting": "both", "billing_class": "facility"}]}, {"description": "GENTAMICIN UPTO 80MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J1580", "type": "HCPCS"}, {"code": "5320852", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 279.0, "discounted_cash": 209.25, "setting": "both", "billing_class": "facility"}]}, {"description": "GENTAMICIN/2", "code_information": [{"code": "80170", "type": "CPT"}, {"code": "4103009", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 1289.0, "discounted_cash": 966.75, "setting": "both", "billing_class": "facility"}]}, {"description": "GENTAMICIN/2", "code_information": [{"code": "80170", "type": "CPT"}, {"code": "4173004", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 8.56, "discounted_cash": 6.42, "setting": "both", "billing_class": "facility"}]}, {"description": "GENTAMICIN/3", "code_information": [{"code": "80170", "type": "CPT"}, {"code": "4103012", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 1575.0, "discounted_cash": 1181.25, "setting": "both", "billing_class": "facility"}]}, {"description": "GENTAMICIN/3", "code_information": [{"code": "80170", "type": "CPT"}, {"code": "4173009", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 8.56, "discounted_cash": 6.42, "setting": "both", "billing_class": "facility"}]}, {"description": "GENTRIX SURGICAL MATRIX", "code_information": [{"code": "C1763", "type": "HCPCS"}, {"code": "4023908", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 17147.0, "discounted_cash": 12860.25, "setting": "both", "billing_class": "facility"}]}, {"description": "GENTRIX SURGICAL MATRIX PLUS", "code_information": [{"code": "C1763", "type": "HCPCS"}, {"code": "4023920", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 24778.46, "discounted_cash": 18583.85, "setting": "both", "billing_class": "facility"}]}, {"description": "GENTRIX SURGICAL MATRIX THICK", "code_information": [{"code": "C1763", "type": "HCPCS"}, {"code": "4023914", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 79030.0, "discounted_cash": 59272.5, "setting": "both", "billing_class": "facility"}]}, {"description": "GF/CODEINE10-100/5 10LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5315290", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 85.0, "discounted_cash": 63.75, "setting": "both", "billing_class": "facility"}]}, {"description": "GF/CODEINE10-100/5 10LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5315290", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 85.0, "discounted_cash": 63.75, "setting": "both", "billing_class": "facility"}]}, {"description": "GF/CODEINE10-100/5 5MLLQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5315288", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 65.0, "discounted_cash": 48.75, "setting": "both", "billing_class": "facility"}]}, {"description": "GF/CODEINE10-100/5 5MLLQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5315288", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 65.0, "discounted_cash": 48.75, "setting": "both", "billing_class": "facility"}]}, {"description": "GF/DM 100-10/5 10ML LQ", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5315304", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 78.0, "discounted_cash": 58.5, "setting": "both", "billing_class": "facility"}]}, {"description": "GF/DM 100-10/5 10ML LQ", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5315304", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 78.0, "discounted_cash": 58.5, "setting": "both", "billing_class": "facility"}]}, {"description": "GF/DM 100-10/5 120ML LQ", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5315301", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 158.0, "discounted_cash": 118.5, "setting": "both", "billing_class": "facility"}]}, {"description": "GF/DM 100-10/5 120ML LQ", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5315301", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 158.0, "discounted_cash": 118.5, "setting": "both", "billing_class": "facility"}]}, {"description": "GF/DM 100-10/5 5ML LQ", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5315303", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 76.0, "discounted_cash": 57.0, "setting": "both", "billing_class": "facility"}]}, {"description": "GF/DM 100-10/5 5ML LQ", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5315303", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 76.0, "discounted_cash": 57.0, "setting": "both", "billing_class": "facility"}]}, {"description": "GGT", "code_information": [{"code": "82977", "type": "CPT"}, {"code": "4102980", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 656.0, "discounted_cash": 492.0, "setting": "both", "billing_class": "facility"}]}, {"description": "GGT", "code_information": [{"code": "82977", "type": "CPT"}, {"code": "4172980", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 1.12, "discounted_cash": 0.84, "setting": "both", "billing_class": "facility"}]}, {"description": "GI COCKTAIL LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5315254", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 535.0, "discounted_cash": 401.25, "setting": "both", "billing_class": "facility"}]}, {"description": "GI COCKTAIL LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5315254", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 535.0, "discounted_cash": 401.25, "setting": "both", "billing_class": "facility"}]}, {"description": "GI PATHOGEN 12-15 AMP PROBE", "code_information": [{"code": "87507", "type": "CPT"}, {"code": "7257508", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 548.0, "discounted_cash": 411.0, "setting": "both", "billing_class": "facility"}]}, {"description": "GI SURG LVL I EA ADD 15", "code_information": [{"code": "5073551", "type": "CDM"}, {"code": "750", "type": "RC"}], "standard_charges": [{"gross_charge": 4641.0, "discounted_cash": 3480.75, "setting": "both", "billing_class": "facility"}]}, {"description": "GI SURG LVL I INT 30MIN", "code_information": [{"code": "5073550", "type": "CDM"}, {"code": "750", "type": "RC"}], "standard_charges": [{"gross_charge": 11053.0, "discounted_cash": 8289.75, "setting": "both", "billing_class": "facility"}]}, {"description": "GI SURG LVL II EA ADD 15", "code_information": [{"code": "5073553", "type": "CDM"}, {"code": "750", "type": "RC"}], "standard_charges": [{"gross_charge": 4916.0, "discounted_cash": 3687.0, "setting": "both", "billing_class": "facility"}]}, {"description": "GI SURG LVL II INT 30MIN", "code_information": [{"code": "5073552", "type": "CDM"}, {"code": "750", "type": "RC"}], "standard_charges": [{"gross_charge": 12773.0, "discounted_cash": 9579.75, "setting": "both", "billing_class": "facility"}]}, {"description": "GI SURG LVL III EA ADD15", "code_information": [{"code": "5073555", "type": "CDM"}, {"code": "750", "type": "RC"}], "standard_charges": [{"gross_charge": 5273.0, "discounted_cash": 3954.75, "setting": "both", "billing_class": "facility"}]}, {"description": "GI SURG LVL III INT 30M", "code_information": [{"code": "5073554", "type": "CDM"}, {"code": "750", "type": "RC"}], "standard_charges": [{"gross_charge": 12858.0, "discounted_cash": 9643.5, "setting": "both", "billing_class": "facility"}]}, {"description": "GI TUBE INTRO W/FLUORO", "code_information": [{"code": "74340", "type": "CPT"}, {"code": "4904340", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 1831.0, "discounted_cash": 1373.25, "setting": "both", "billing_class": "facility"}]}, {"description": "GI TUBE INTRO W/FLUORO", "code_information": [{"code": "74340", "type": "CPT"}, {"code": "4914340", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 2116.0, "discounted_cash": 1587.0, "setting": "both", "billing_class": "facility"}]}, {"description": "GIARDIA IA", "code_information": [{"code": "87329", "type": "CPT"}, {"code": "4107328", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 152.0, "discounted_cash": 114.0, "setting": "both", "billing_class": "facility"}]}, {"description": "GIARDIA IA", "code_information": [{"code": "87329", "type": "CPT"}, {"code": "4177328", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 4.29, "discounted_cash": 3.22, "setting": "both", "billing_class": "facility"}]}, {"description": "GIARDIA IA", "code_information": [{"code": "87329", "type": "CPT"}, {"code": "7252934", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 162.0, "discounted_cash": 121.5, "setting": "both", "billing_class": "facility"}]}, {"description": "GIARDIA LAMBLIA AB", "code_information": [{"code": "86674", "type": "CPT"}, {"code": "7256674", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 324.0, "discounted_cash": 243.0, "setting": "both", "billing_class": "facility"}]}, {"description": "GINTRO EP IC FC PEELAWAY", "code_information": [{"code": "C1892", "type": "HCPCS"}, {"code": "8240175", "type": "CDM"}, {"code": "272", "type": "RC"}], "standard_charges": [{"gross_charge": 1352.0, "discounted_cash": 1014.0, "setting": "both", "billing_class": "facility"}]}, {"description": "GINTRO FASTCATH", "code_information": [{"code": "C1893", "type": "HCPCS"}, {"code": "8241110", "type": "CDM"}, {"code": "272", "type": "RC"}], "standard_charges": [{"gross_charge": 179.0, "discounted_cash": 134.25, "setting": "both", "billing_class": "facility"}]}, {"description": "GLENOSPHERE GLENOID DJO CL", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "4013422", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 16469.0, "discounted_cash": 12351.75, "setting": "both", "billing_class": "facility"}]}, {"description": "GLIADIN AB", "code_information": [{"code": "86258", "type": "CPT"}, {"code": "7253508", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 296.0, "discounted_cash": 222.0, "setting": "both", "billing_class": "facility"}]}, {"description": "GLIADIN AB/2", "code_information": [{"code": "86258", "type": "CPT"}, {"code": "7254213", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 296.0, "discounted_cash": 222.0, "setting": "both", "billing_class": "facility"}]}, {"description": "GLIMEPIRIDE 2MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5305321", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 78.0, "discounted_cash": 58.5, "setting": "both", "billing_class": "facility"}]}, {"description": "GLIMEPIRIDE 2MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5305321", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 78.0, "discounted_cash": 58.5, "setting": "both", "billing_class": "facility"}]}, {"description": "GLIMEPIRIDE 4MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5305322", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 78.0, "discounted_cash": 58.5, "setting": "both", "billing_class": "facility"}]}, {"description": "GLIMEPIRIDE 4MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5305322", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 78.0, "discounted_cash": 58.5, "setting": "both", "billing_class": "facility"}]}, {"description": "GLIPIZIDE 10MG XR TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5305348", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 66.0, "discounted_cash": 49.5, "setting": "both", "billing_class": "facility"}]}, {"description": "GLIPIZIDE 10MG XR TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5305348", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 66.0, "discounted_cash": 49.5, "setting": "both", "billing_class": "facility"}]}, {"description": "GLIPIZIDE 2.5MG XR TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5305344", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 66.0, "discounted_cash": 49.5, "setting": "both", "billing_class": "facility"}]}, {"description": "GLIPIZIDE 2.5MG XR TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5305344", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 66.0, "discounted_cash": 49.5, "setting": "both", "billing_class": "facility"}]}, {"description": "GLIPIZIDE 5MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5305345", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 71.0, "discounted_cash": 53.25, "setting": "both", "billing_class": "facility"}]}, {"description": "GLIPIZIDE 5MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5305345", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 71.0, "discounted_cash": 53.25, "setting": "both", "billing_class": "facility"}]}, {"description": "GLIPIZIDE 5MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5305346", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 66.0, "discounted_cash": 49.5, "setting": "both", "billing_class": "facility"}]}, {"description": "GLIPIZIDE 5MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5305346", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 66.0, "discounted_cash": 49.5, "setting": "both", "billing_class": "facility"}]}, {"description": "GLUCAGON", "code_information": [{"code": "82943", "type": "CPT"}, {"code": "7252943", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 76.0, "discounted_cash": 57.0, "setting": "both", "billing_class": "facility"}]}, {"description": "GLUCAGON PER 1MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J1610", "type": "HCPCS"}, {"code": "5320898", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 2738.0, "discounted_cash": 2053.5, "setting": "both", "billing_class": "facility"}]}, {"description": "GLUCAGON PER 1MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J1610", "type": "HCPCS"}, {"code": "5320898", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 2738.0, "discounted_cash": 2053.5, "setting": "both", "billing_class": "facility"}]}, {"description": "GLUCONIC AC/CITAC500MLTS", "code_information": [{"code": "Q2004", "type": "HCPCS"}, {"code": "5335774", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 1155.0, "discounted_cash": 866.25, "setting": "both", "billing_class": "facility"}]}, {"description": "GLUCONIC AC/CITAC500MLTS", "code_information": [{"code": "Q2004", "type": "HCPCS"}, {"code": "5335774", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 1155.0, "discounted_cash": 866.25, "setting": "both", "billing_class": "facility"}]}, {"description": "GLUCOSE 40% 15GM GL LQ", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5315259", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 111.0, "discounted_cash": 83.25, "setting": "both", "billing_class": "facility"}]}, {"description": "GLUCOSE 40% 15GM GL LQ", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5315259", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 111.0, "discounted_cash": 83.25, "setting": "both", "billing_class": "facility"}]}, {"description": "GLUCOSE BLD BY MONIT DEV", "code_information": [{"code": "82962", "type": "CPT"}, {"code": "4102962", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 140.0, "discounted_cash": 105.0, "setting": "both", "billing_class": "facility"}]}, {"description": "GLUCOSE BODY FLUID", "code_information": [{"code": "82945", "type": "CPT"}, {"code": "4102945", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 308.0, "discounted_cash": 231.0, "setting": "both", "billing_class": "facility"}]}, {"description": "GLUCOSE BODY FLUID", "code_information": [{"code": "82945", "type": "CPT"}, {"code": "4172945", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 1.12, "discounted_cash": 0.84, "setting": "both", "billing_class": "facility"}]}, {"description": "GLUCOSE BODY FLUID", "code_information": [{"code": "82945", "type": "CPT"}, {"code": "7252945", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 11.0, "discounted_cash": 8.25, "setting": "both", "billing_class": "facility"}]}, {"description": "GLUCOSE BODY FLUID/2", "code_information": [{"code": "82945", "type": "CPT"}, {"code": "4102953", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 358.0, "discounted_cash": 268.5, "setting": "both", "billing_class": "facility"}]}, {"description": "GLUCOSE BODY FLUID/2", "code_information": [{"code": "82945", "type": "CPT"}, {"code": "4172958", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 5.71, "discounted_cash": 4.28, "setting": "both", "billing_class": "facility"}]}, {"description": "GLUCOSE BODY FLUID/2", "code_information": [{"code": "82945", "type": "CPT"}, {"code": "7252002", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 11.0, "discounted_cash": 8.25, "setting": "both", "billing_class": "facility"}]}, {"description": "GLUCOSE BODY FLUID/4", "code_information": [{"code": "82945", "type": "CPT"}, {"code": "4102958", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 358.0, "discounted_cash": 268.5, "setting": "both", "billing_class": "facility"}]}, {"description": "GLUCOSE POST DOSE", "code_information": [{"code": "82950", "type": "CPT"}, {"code": "4102950", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 473.0, "discounted_cash": 354.75, "setting": "both", "billing_class": "facility"}]}, {"description": "GLUCOSE POST DOSE", "code_information": [{"code": "82950", "type": "CPT"}, {"code": "4172950", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 1.12, "discounted_cash": 0.84, "setting": "both", "billing_class": "facility"}]}, {"description": "GLUCOSE QUANTITATIVE", "code_information": [{"code": "82947", "type": "CPT"}, {"code": "4102947", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 469.0, "discounted_cash": 351.75, "setting": "both", "billing_class": "facility"}]}, {"description": "GLUCOSE QUANTITATIVE", "code_information": [{"code": "82947", "type": "CPT"}, {"code": "4122947", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 3.0, "discounted_cash": 2.25, "setting": "both", "billing_class": "facility"}]}, {"description": "GLUCOSE QUANTITATIVE", "code_information": [{"code": "82947", "type": "CPT"}, {"code": "4172947", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 1.12, "discounted_cash": 0.84, "setting": "both", "billing_class": "facility"}]}, {"description": "GLUCOSE TOLERANCE 3SPEC", "code_information": [{"code": "82951", "type": "CPT"}, {"code": "4102951", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 1276.0, "discounted_cash": 957.0, "setting": "both", "billing_class": "facility"}]}, {"description": "GLUCOSE TOLERANCE 3SPEC", "code_information": [{"code": "82951", "type": "CPT"}, {"code": "4172951", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 2.86, "discounted_cash": 2.15, "setting": "both", "billing_class": "facility"}]}, {"description": "GLUTAMIC ACID AB", "code_information": [{"code": "83519", "type": "CPT"}, {"code": "7253538", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 90.0, "discounted_cash": 67.5, "setting": "both", "billing_class": "facility"}]}, {"description": "GLYBUR/METF 2.5/500MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5305416", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 85.0, "discounted_cash": 63.75, "setting": "both", "billing_class": "facility"}]}, {"description": "GLYBUR/METF 2.5/500MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5305416", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 85.0, "discounted_cash": 63.75, "setting": "both", "billing_class": "facility"}]}, {"description": "GLYBUR/METF1.25/250MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5305414", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 85.0, "discounted_cash": 63.75, "setting": "both", "billing_class": "facility"}]}, {"description": "GLYBUR/METF1.25/250MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5305414", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 85.0, "discounted_cash": 63.75, "setting": "both", "billing_class": "facility"}]}, {"description": "GLYBUR/METFRM 5/500MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5305417", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 85.0, "discounted_cash": 63.75, "setting": "both", "billing_class": "facility"}]}, {"description": "GLYBUR/METFRM 5/500MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5305417", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 85.0, "discounted_cash": 63.75, "setting": "both", "billing_class": "facility"}]}, {"description": "GLYBURIDE 1.25MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5305409", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 78.0, "discounted_cash": 58.5, "setting": "both", "billing_class": "facility"}]}, {"description": "GLYBURIDE 1.25MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5305409", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 78.0, "discounted_cash": 58.5, "setting": "both", "billing_class": "facility"}]}, {"description": "GLYBURIDE 2.5MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5305411", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 78.0, "discounted_cash": 58.5, "setting": "both", "billing_class": "facility"}]}, {"description": "GLYBURIDE 2.5MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5305411", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 78.0, "discounted_cash": 58.5, "setting": "both", "billing_class": "facility"}]}, {"description": "GLYBURIDE 5MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5305413", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 66.0, "discounted_cash": 49.5, "setting": "both", "billing_class": "facility"}]}, {"description": "GLYBURIDE 5MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5305413", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 66.0, "discounted_cash": 49.5, "setting": "both", "billing_class": "facility"}]}, {"description": "GLYBURIDE MIC 3MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5305407", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 85.0, "discounted_cash": 63.75, "setting": "both", "billing_class": "facility"}]}, {"description": "GLYBURIDE MIC 3MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5305407", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 85.0, "discounted_cash": 63.75, "setting": "both", "billing_class": "facility"}]}, {"description": "GLYCATED PROTEIN", "code_information": [{"code": "82985", "type": "CPT"}, {"code": "7252985", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 277.0, "discounted_cash": 207.75, "setting": "both", "billing_class": "facility"}]}, {"description": "GLYCATED PROTEIN/2", "code_information": [{"code": "82985", "type": "CPT"}, {"code": "7252993", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 316.0, "discounted_cash": 237.0, "setting": "both", "billing_class": "facility"}]}, {"description": "GLYCERIN ADULT SU", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5338409", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 61.0, "discounted_cash": 45.75, "setting": "both", "billing_class": "facility"}]}, {"description": "GLYCERIN ADULT SU", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5338409", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 61.0, "discounted_cash": 45.75, "setting": "both", "billing_class": "facility"}]}, {"description": "GLYCERIN INFANT SU", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5338413", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 71.0, "discounted_cash": 53.25, "setting": "both", "billing_class": "facility"}]}, {"description": "GLYCERIN INFANT SU", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5338413", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 71.0, "discounted_cash": 53.25, "setting": "both", "billing_class": "facility"}]}, {"description": "GLYCOPYRROLATE 1MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5305429", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 85.0, "discounted_cash": 63.75, "setting": "both", "billing_class": "facility"}]}, {"description": "GLYCOPYRROLATE 1MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5305429", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 85.0, "discounted_cash": 63.75, "setting": "both", "billing_class": "facility"}]}, {"description": "GLYCOPYRROLATE PER 0.1MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J1596", "type": "HCPCS"}, {"code": "5320923", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 37.0, "discounted_cash": 27.75, "setting": "both", "billing_class": "facility"}]}, {"description": "GLYCOPYRROLATE PER 0.1MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J1596", "type": "HCPCS"}, {"code": "5320923", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 37.0, "discounted_cash": 27.75, "setting": "both", "billing_class": "facility"}]}, {"description": "GONADTOPN CHORNC(HCG)QNT", "code_information": [{"code": "84702", "type": "CPT"}, {"code": "4103014", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 1039.0, "discounted_cash": 779.25, "setting": "both", "billing_class": "facility"}]}, {"description": "GONADTOPN CHORNC(HCG)QNT", "code_information": [{"code": "84702", "type": "CPT"}, {"code": "4173014", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 8.56, "discounted_cash": 6.42, "setting": "both", "billing_class": "facility"}]}, {"description": "GONADTOPN CHORNC(HCG)QNT", "code_information": [{"code": "84702", "type": "CPT"}, {"code": "7253014", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 113.0, "discounted_cash": 84.75, "setting": "both", "billing_class": "facility"}]}, {"description": "GONADTOPN CHRONC(HCG)QL", "code_information": [{"code": "84703", "type": "CPT"}, {"code": "4103013", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 1121.0, "discounted_cash": 840.75, "setting": "both", "billing_class": "facility"}]}, {"description": "GONADTOPN CHRONC(HCG)QL", "code_information": [{"code": "84703", "type": "CPT"}, {"code": "4173013", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 8.56, "discounted_cash": 6.42, "setting": "both", "billing_class": "facility"}]}, {"description": "GRAFIX CORE PER SQ CM", "code_information": [{"code": "Q4132", "type": "HCPCS"}, {"code": "4021505", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 1947.0, "discounted_cash": 1460.25, "setting": "both", "billing_class": "facility"}]}, {"description": "GRAFIX CORE PER SQ CM", "code_information": [{"code": "Q4132", "type": "HCPCS"}, {"code": "4021505", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 1947.0, "discounted_cash": 1460.25, "setting": "both", "billing_class": "facility"}]}, {"description": "GRAFIX PRIME PER SQ CM", "code_information": [{"code": "Q4133", "type": "HCPCS"}, {"code": "4021503", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 1947.0, "discounted_cash": 1460.25, "setting": "both", "billing_class": "facility"}]}, {"description": "GRAFIX PRIME PER SQ CM", "code_information": [{"code": "Q4133", "type": "HCPCS"}, {"code": "4021503", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 1947.0, "discounted_cash": 1460.25, "setting": "both", "billing_class": "facility"}]}, {"description": "GRAM STAIN SMEAR", "code_information": [{"code": "87205", "type": "CPT"}, {"code": "4107205", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 304.0, "discounted_cash": 228.0, "setting": "both", "billing_class": "facility"}]}, {"description": "GRAM STAIN SMEAR", "code_information": [{"code": "87205", "type": "CPT"}, {"code": "4177205", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 4.29, "discounted_cash": 3.22, "setting": "both", "billing_class": "facility"}]}, {"description": "GRAM STAIN SMEAR/3", "code_information": [{"code": "87205", "type": "CPT"}, {"code": "4177212", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 5.71, "discounted_cash": 4.28, "setting": "both", "billing_class": "facility"}]}, {"description": "GRAM STAIN SMEAR/4", "code_information": [{"code": "87205", "type": "CPT"}, {"code": "4108705", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 342.0, "discounted_cash": 256.5, "setting": "both", "billing_class": "facility"}]}, {"description": "GREENFIELD V-C", "code_information": [{"code": "C1880", "type": "HCPCS"}, {"code": "8142000", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 20419.0, "discounted_cash": 15314.25, "setting": "both", "billing_class": "facility"}]}, {"description": "GRFT ALLOMAX 10X10", "code_information": [{"code": "C1781", "type": "HCPCS"}, {"code": "4021489", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 50516.0, "discounted_cash": 37887.0, "setting": "both", "billing_class": "facility"}]}, {"description": "GRFT ALLOMAX 5X10CM", "code_information": [{"code": "C1781", "type": "HCPCS"}, {"code": "4021486", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 25265.0, "discounted_cash": 18948.75, "setting": "both", "billing_class": "facility"}]}, {"description": "GRFT ALLOMAX SURGICAL", "code_information": [{"code": "C1781", "type": "HCPCS"}, {"code": "4021494", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 87537.0, "discounted_cash": 65652.75, "setting": "both", "billing_class": "facility"}]}, {"description": "GRFT CNTRLTRL LEG", "code_information": [{"code": "C1768", "type": "HCPCS"}, {"code": "4022321", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 114540.0, "discounted_cash": 85905.0, "setting": "both", "billing_class": "facility"}]}, {"description": "GRFT DVF WOVN HEMASHLD2", "code_information": [{"code": "C1768", "type": "HCPCS"}, {"code": "4021490", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 7815.0, "discounted_cash": 5861.25, "setting": "both", "billing_class": "facility"}]}, {"description": "GRFT GRTX PTCH", "code_information": [{"code": "C1768", "type": "HCPCS"}, {"code": "8142065", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 4060.0, "discounted_cash": 3045.0, "setting": "both", "billing_class": "facility"}]}, {"description": "GRFT IPSLTRL LEG", "code_information": [{"code": "C1768", "type": "HCPCS"}, {"code": "4022322", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 235478.0, "discounted_cash": 176608.5, "setting": "both", "billing_class": "facility"}]}, {"description": "GRFT MESH COMPOSIX OVAL", "code_information": [{"code": "C1781", "type": "HCPCS"}, {"code": "8142101", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 11862.0, "discounted_cash": 8896.5, "setting": "both", "billing_class": "facility"}]}, {"description": "GRFT MESH PROLN", "code_information": [{"code": "C1781", "type": "HCPCS"}, {"code": "8142090", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 4309.0, "discounted_cash": 3231.75, "setting": "both", "billing_class": "facility"}]}, {"description": "GRFT OCULAR AMNIO MEMBRN", "code_information": [{"code": "V2790", "type": "HCPCS"}, {"code": "8122167", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 9001.0, "discounted_cash": 6750.75, "setting": "both", "billing_class": "facility"}]}, {"description": "GRFT PATCH DACRON", "code_information": [{"code": "C1768", "type": "HCPCS"}, {"code": "8142116", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 2249.0, "discounted_cash": 1686.75, "setting": "both", "billing_class": "facility"}]}, {"description": "GRFT PERICARDIAL", "code_information": [{"code": "C1768", "type": "HCPCS"}, {"code": "8142118", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 5086.0, "discounted_cash": 3814.5, "setting": "both", "billing_class": "facility"}]}, {"description": "GRFT PTCH", "code_information": [{"code": "C1768", "type": "HCPCS"}, {"code": "8142125", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 3218.0, "discounted_cash": 2413.5, "setting": "both", "billing_class": "facility"}]}, {"description": "GRFT PV BYP DISTAFLO", "code_information": [{"code": "C1768", "type": "HCPCS"}, {"code": "4022316", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 34889.0, "discounted_cash": 26166.75, "setting": "both", "billing_class": "facility"}]}, {"description": "GRFT SAPHNOUS OVER 80CM", "code_information": [{"code": "C1768", "type": "HCPCS"}, {"code": "8141769", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 181578.0, "discounted_cash": 136183.5, "setting": "both", "billing_class": "facility"}]}, {"description": "GRFT SAPHNOUS UP TO 45CM", "code_information": [{"code": "C1768", "type": "HCPCS"}, {"code": "8141772", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 93851.0, "discounted_cash": 70388.25, "setting": "both", "billing_class": "facility"}]}, {"description": "GRFT SAPHNOUS UP TO 60CM", "code_information": [{"code": "C1768", "type": "HCPCS"}, {"code": "8141770", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 104013.0, "discounted_cash": 78009.75, "setting": "both", "billing_class": "facility"}]}, {"description": "GRFT SAPHNOUS UP TO 70CM", "code_information": [{"code": "C1768", "type": "HCPCS"}, {"code": "8141773", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 119471.0, "discounted_cash": 89603.25, "setting": "both", "billing_class": "facility"}]}, {"description": "GRFT SAPHNOUS UP TO 80CM", "code_information": [{"code": "C1768", "type": "HCPCS"}, {"code": "8141771", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 88356.0, "discounted_cash": 66267.0, "setting": "both", "billing_class": "facility"}]}, {"description": "GRFT STNT AORTIC EXTEN", "code_information": [{"code": "C1889", "type": "HCPCS"}, {"code": "4025603", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 64487.0, "discounted_cash": 48365.25, "setting": "both", "billing_class": "facility"}]}, {"description": "GRFT STNT CNTRLTRL ILIAC", "code_information": [{"code": "C1889", "type": "HCPCS"}, {"code": "4025602", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 93111.0, "discounted_cash": 69833.25, "setting": "both", "billing_class": "facility"}]}, {"description": "GRFT STNT TRNK IPSIL LEG", "code_information": [{"code": "C1768", "type": "HCPCS"}, {"code": "4028452", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 110481.0, "discounted_cash": 82860.75, "setting": "both", "billing_class": "facility"}]}, {"description": "GRFT TUTOPLAST DERMIS", "code_information": [{"code": "C1762", "type": "HCPCS"}, {"code": "4022012", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 4901.0, "discounted_cash": 3675.75, "setting": "both", "billing_class": "facility"}]}, {"description": "GRFT V IMPRAVNFL C STP35", "code_information": [{"code": "C1768", "type": "HCPCS"}, {"code": "8241240", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 15715.0, "discounted_cash": 11786.25, "setting": "both", "billing_class": "facility"}]}, {"description": "GRFT V IMPRAVNFL C STP45", "code_information": [{"code": "C1768", "type": "HCPCS"}, {"code": "8241244", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 12165.0, "discounted_cash": 9123.75, "setting": "both", "billing_class": "facility"}]}, {"description": "GRFT VASC 6MM", "code_information": [{"code": "C1768", "type": "HCPCS"}, {"code": "8142300", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 3422.0, "discounted_cash": 2566.5, "setting": "both", "billing_class": "facility"}]}, {"description": "GRFT VASC AXBFC", "code_information": [{"code": "C1768", "type": "HCPCS"}, {"code": "8142130", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 53418.0, "discounted_cash": 40063.5, "setting": "both", "billing_class": "facility"}]}, {"description": "GRFT VASC BIF C", "code_information": [{"code": "C1768", "type": "HCPCS"}, {"code": "8142140", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 9097.0, "discounted_cash": 6822.75, "setting": "both", "billing_class": "facility"}]}, {"description": "GRFT VASC BIF D", "code_information": [{"code": "C1768", "type": "HCPCS"}, {"code": "8142145", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 8021.0, "discounted_cash": 6015.75, "setting": "both", "billing_class": "facility"}]}, {"description": "GRFT VASC ILIAC LEG EXT", "code_information": [{"code": "C1874", "type": "HCPCS"}, {"code": "4022325", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 52106.0, "discounted_cash": 39079.5, "setting": "both", "billing_class": "facility"}]}, {"description": "GRFT VASC STR B", "code_information": [{"code": "C1768", "type": "HCPCS"}, {"code": "8142185", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 7623.0, "discounted_cash": 5717.25, "setting": "both", "billing_class": "facility"}]}, {"description": "GRFT VASC STR M", "code_information": [{"code": "C1768", "type": "HCPCS"}, {"code": "8142260", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 3950.0, "discounted_cash": 2962.5, "setting": "both", "billing_class": "facility"}]}, {"description": "GRFT VASC STR W", "code_information": [{"code": "C1768", "type": "HCPCS"}, {"code": "8142275", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 10211.0, "discounted_cash": 7658.25, "setting": "both", "billing_class": "facility"}]}, {"description": "GRFT VASC STR W", "code_information": [{"code": "C1768", "type": "HCPCS"}, {"code": "8142280", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 5765.0, "discounted_cash": 4323.75, "setting": "both", "billing_class": "facility"}]}, {"description": "GRFT VASCULAR", "code_information": [{"code": "C1768", "type": "HCPCS"}, {"code": "8240177", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 10402.0, "discounted_cash": 7801.5, "setting": "both", "billing_class": "facility"}]}, {"description": "GRFT VSC FELT TEFLON", "code_information": [{"code": "C1768", "type": "HCPCS"}, {"code": "8241245", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 1743.0, "discounted_cash": 1307.25, "setting": "both", "billing_class": "facility"}]}, {"description": "GRFT VSC FLEX SM/CF", "code_information": [{"code": "C1768", "type": "HCPCS"}, {"code": "4000350", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 10587.0, "discounted_cash": 7940.25, "setting": "both", "billing_class": "facility"}]}, {"description": "GRFT Y-MESH KNT ALYTE", "code_information": [{"code": "C1763", "type": "HCPCS"}, {"code": "4021495", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 12858.0, "discounted_cash": 9643.5, "setting": "both", "billing_class": "facility"}]}, {"description": "GROWTH HORMONE(HGH)", "code_information": [{"code": "83003", "type": "CPT"}, {"code": "4103003", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 1315.0, "discounted_cash": 986.25, "setting": "both", "billing_class": "facility"}]}, {"description": "GROWTH HORMONE(HGH)", "code_information": [{"code": "83003", "type": "CPT"}, {"code": "7253003", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 47.0, "discounted_cash": 35.25, "setting": "both", "billing_class": "facility"}]}, {"description": "GRP PSYCHTHRPY 60 MIN", "code_information": [{"code": "90853", "type": "CPT"}, {"code": "6401944", "type": "CDM"}, {"code": "915", "type": "RC"}], "standard_charges": [{"gross_charge": 1001.0, "discounted_cash": 750.75, "setting": "both", "billing_class": "facility"}]}, {"description": "GSHTH PREFACE BRAIDED", "code_information": [{"code": "C1893", "type": "HCPCS"}, {"code": "8241200", "type": "CDM"}, {"code": "272", "type": "RC"}], "standard_charges": [{"gross_charge": 1654.0, "discounted_cash": 1240.5, "setting": "both", "billing_class": "facility"}]}, {"description": "GTT EA ADD >3SPEC", "code_information": [{"code": "82952", "type": "CPT"}, {"code": "4102952", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 519.0, "discounted_cash": 389.25, "setting": "both", "billing_class": "facility"}]}, {"description": "GTT EA ADD >3SPEC", "code_information": [{"code": "82952", "type": "CPT"}, {"code": "4172952", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 2.86, "discounted_cash": 2.15, "setting": "both", "billing_class": "facility"}]}, {"description": "GUAF 100MG/5ML 5ML LQ", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5315285", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 61.0, "discounted_cash": 45.75, "setting": "both", "billing_class": "facility"}]}, {"description": "GUAF 100MG/5ML 5ML LQ", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5315285", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 61.0, "discounted_cash": 45.75, "setting": "both", "billing_class": "facility"}]}, {"description": "GUAF 200MG/10ML LQ", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5315280", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 85.0, "discounted_cash": 63.75, "setting": "both", "billing_class": "facility"}]}, {"description": "GUAF 200MG/10ML LQ", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5315280", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 85.0, "discounted_cash": 63.75, "setting": "both", "billing_class": "facility"}]}, {"description": "GUAIFENESIN 600MG XR TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5305481", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 61.0, "discounted_cash": 45.75, "setting": "both", "billing_class": "facility"}]}, {"description": "GUAIFENESIN 600MG XR TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5305481", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 61.0, "discounted_cash": 45.75, "setting": "both", "billing_class": "facility"}]}, {"description": "GUAIFENESIN/DM 600/30 TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5305490", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 61.0, "discounted_cash": 45.75, "setting": "both", "billing_class": "facility"}]}, {"description": "GUAIFENESIN/DM 600/30 TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5305490", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 61.0, "discounted_cash": 45.75, "setting": "both", "billing_class": "facility"}]}, {"description": "GUANFACINE 1MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5305540", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 85.0, "discounted_cash": 63.75, "setting": "both", "billing_class": "facility"}]}, {"description": "GUANFACINE 1MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5305540", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 85.0, "discounted_cash": 63.75, "setting": "both", "billing_class": "facility"}]}, {"description": "GUIDE CATH FLUID DRAINAG", "code_information": [{"code": "5051030", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 1242.0, "discounted_cash": 931.5, "setting": "both", "billing_class": "facility"}]}, {"description": "GUIDEWIRE", "code_information": [{"code": "C1769", "type": "HCPCS"}, {"code": "8240179", "type": "CDM"}, {"code": "272", "type": "RC"}], "standard_charges": [{"gross_charge": 1085.0, "discounted_cash": 813.75, "setting": "both", "billing_class": "facility"}]}, {"description": "GUIDEWIRE III", "code_information": [{"code": "C1769", "type": "HCPCS"}, {"code": "8240167", "type": "CDM"}, {"code": "272", "type": "RC"}], "standard_charges": [{"gross_charge": 1034.0, "discounted_cash": 775.5, "setting": "both", "billing_class": "facility"}]}, {"description": "GUIDEWIRE IV", "code_information": [{"code": "C1769", "type": "HCPCS"}, {"code": "8240161", "type": "CDM"}, {"code": "272", "type": "RC"}], "standard_charges": [{"gross_charge": 388.0, "discounted_cash": 291.0, "setting": "both", "billing_class": "facility"}]}, {"description": "GW", "code_information": [{"code": "C1769", "type": "HCPCS"}, {"code": "8073055", "type": "CDM"}, {"code": "272", "type": "RC"}], "standard_charges": [{"gross_charge": 1852.0, "discounted_cash": 1389.0, "setting": "both", "billing_class": "facility"}]}, {"description": "GW", "code_information": [{"code": "C1769", "type": "HCPCS"}, {"code": "8073060", "type": "CDM"}, {"code": "272", "type": "RC"}], "standard_charges": [{"gross_charge": 981.0, "discounted_cash": 735.75, "setting": "both", "billing_class": "facility"}]}, {"description": "GW", "code_information": [{"code": "C1769", "type": "HCPCS"}, {"code": "8073075", "type": "CDM"}, {"code": "272", "type": "RC"}], "standard_charges": [{"gross_charge": 1090.0, "discounted_cash": 817.5, "setting": "both", "billing_class": "facility"}]}, {"description": "GW", "code_information": [{"code": "C1769", "type": "HCPCS"}, {"code": "8073080", "type": "CDM"}, {"code": "272", "type": "RC"}], "standard_charges": [{"gross_charge": 280.0, "discounted_cash": 210.0, "setting": "both", "billing_class": "facility"}]}, {"description": "GW", "code_information": [{"code": "C1769", "type": "HCPCS"}, {"code": "8073085", "type": "CDM"}, {"code": "272", "type": "RC"}], "standard_charges": [{"gross_charge": 790.0, "discounted_cash": 592.5, "setting": "both", "billing_class": "facility"}]}, {"description": "GW", "code_information": [{"code": "C1769", "type": "HCPCS"}, {"code": "8073086", "type": "CDM"}, {"code": "272", "type": "RC"}], "standard_charges": [{"gross_charge": 5017.0, "discounted_cash": 3762.75, "setting": "both", "billing_class": "facility"}]}, {"description": "GW AMPLATZ XSTIFF", "code_information": [{"code": "C1769", "type": "HCPCS"}, {"code": "8246593", "type": "CDM"}, {"code": "272", "type": "RC"}], "standard_charges": [{"gross_charge": 588.0, "discounted_cash": 441.0, "setting": "both", "billing_class": "facility"}]}, {"description": "GW ASAHI CONFLANZA PRO", "code_information": [{"code": "C1769", "type": "HCPCS"}, {"code": "8246597", "type": "CDM"}, {"code": "272", "type": "RC"}], "standard_charges": [{"gross_charge": 2390.0, "discounted_cash": 1792.5, "setting": "both", "billing_class": "facility"}]}, {"description": "GW ASAHI PROWATER", "code_information": [{"code": "C1769", "type": "HCPCS"}, {"code": "8073099", "type": "CDM"}, {"code": "272", "type": "RC"}], "standard_charges": [{"gross_charge": 2966.0, "discounted_cash": 2224.5, "setting": "both", "billing_class": "facility"}]}, {"description": "GW BLUNT", "code_information": [{"code": "C1769", "type": "HCPCS"}, {"code": "4032518", "type": "CDM"}, {"code": "272", "type": "RC"}], "standard_charges": [{"gross_charge": 2710.0, "discounted_cash": 2032.5, "setting": "both", "billing_class": "facility"}]}, {"description": "GW COOK", "code_information": [{"code": "C1769", "type": "HCPCS"}, {"code": "8073100", "type": "CDM"}, {"code": "272", "type": "RC"}], "standard_charges": [{"gross_charge": 4030.0, "discounted_cash": 3022.5, "setting": "both", "billing_class": "facility"}]}, {"description": "GW CURVED TEFLON", "code_information": [{"code": "C1769", "type": "HCPCS"}, {"code": "8073104", "type": "CDM"}, {"code": "272", "type": "RC"}], "standard_charges": [{"gross_charge": 520.0, "discounted_cash": 390.0, "setting": "both", "billing_class": "facility"}]}, {"description": "GW DRILL TIP", "code_information": [{"code": "C1769", "type": "HCPCS"}, {"code": "8073144", "type": "CDM"}, {"code": "272", "type": "RC"}], "standard_charges": [{"gross_charge": 1365.0, "discounted_cash": 1023.75, "setting": "both", "billing_class": "facility"}]}, {"description": "GW F/TIP", "code_information": [{"code": "C1769", "type": "HCPCS"}, {"code": "8073150", "type": "CDM"}, {"code": "272", "type": "RC"}], "standard_charges": [{"gross_charge": 918.0, "discounted_cash": 688.5, "setting": "both", "billing_class": "facility"}]}, {"description": "GW GLIDEWIRE STD ANGLE", "code_information": [{"code": "C1769", "type": "HCPCS"}, {"code": "8246666", "type": "CDM"}, {"code": "272", "type": "RC"}], "standard_charges": [{"gross_charge": 626.0, "discounted_cash": 469.5, "setting": "both", "billing_class": "facility"}]}, {"description": "GW GLIDEWIRE STD STRT", "code_information": [{"code": "C1769", "type": "HCPCS"}, {"code": "8246668", "type": "CDM"}, {"code": "272", "type": "RC"}], "standard_charges": [{"gross_charge": 591.0, "discounted_cash": 443.25, "setting": "both", "billing_class": "facility"}]}, {"description": "GW GLIDEWIRE STIFF", "code_information": [{"code": "C1769", "type": "HCPCS"}, {"code": "8246669", "type": "CDM"}, {"code": "272", "type": "RC"}], "standard_charges": [{"gross_charge": 1563.0, "discounted_cash": 1172.25, "setting": "both", "billing_class": "facility"}]}, {"description": "GW GLIDEWIRE STIFF ANG", "code_information": [{"code": "C1769", "type": "HCPCS"}, {"code": "8246664", "type": "CDM"}, {"code": "272", "type": "RC"}], "standard_charges": [{"gross_charge": 677.0, "discounted_cash": 507.75, "setting": "both", "billing_class": "facility"}]}, {"description": "GW HI-TORQ PILOT", "code_information": [{"code": "C1769", "type": "HCPCS"}, {"code": "8241281", "type": "CDM"}, {"code": "272", "type": "RC"}], "standard_charges": [{"gross_charge": 1001.0, "discounted_cash": 750.75, "setting": "both", "billing_class": "facility"}]}, {"description": "GW HITORQ FLOPPY II", "code_information": [{"code": "C1769", "type": "HCPCS"}, {"code": "8246676", "type": "CDM"}, {"code": "272", "type": "RC"}], "standard_charges": [{"gross_charge": 2930.0, "discounted_cash": 2197.5, "setting": "both", "billing_class": "facility"}]}, {"description": "GW HP JAGWIRE SNGL USE", "code_information": [{"code": "C1769", "type": "HCPCS"}, {"code": "8246725", "type": "CDM"}, {"code": "272", "type": "RC"}], "standard_charges": [{"gross_charge": 2050.0, "discounted_cash": 1537.5, "setting": "both", "billing_class": "facility"}]}, {"description": "GW NITINOL PLATINUM TIP", "code_information": [{"code": "C1769", "type": "HCPCS"}, {"code": "8241315", "type": "CDM"}, {"code": "272", "type": "RC"}], "standard_charges": [{"gross_charge": 1359.0, "discounted_cash": 1019.25, "setting": "both", "billing_class": "facility"}]}, {"description": "GW PERIPH THRUWAY STR", "code_information": [{"code": "C1769", "type": "HCPCS"}, {"code": "8073505", "type": "CDM"}, {"code": "272", "type": "RC"}], "standard_charges": [{"gross_charge": 1581.0, "discounted_cash": 1185.75, "setting": "both", "billing_class": "facility"}]}, {"description": "GW PT2 LT SUPPORT", "code_information": [{"code": "C1769", "type": "HCPCS"}, {"code": "8246794", "type": "CDM"}, {"code": "272", "type": "RC"}], "standard_charges": [{"gross_charge": 996.0, "discounted_cash": 747.0, "setting": "both", "billing_class": "facility"}]}, {"description": "GW PTCA CHOICE 182/300", "code_information": [{"code": "C1769", "type": "HCPCS"}, {"code": "8241210", "type": "CDM"}, {"code": "272", "type": "RC"}], "standard_charges": [{"gross_charge": 1497.0, "discounted_cash": 1122.75, "setting": "both", "billing_class": "facility"}]}, {"description": "GW PTCA MAILMAN 182/300", "code_information": [{"code": "C1769", "type": "HCPCS"}, {"code": "8241214", "type": "CDM"}, {"code": "272", "type": "RC"}], "standard_charges": [{"gross_charge": 967.0, "discounted_cash": 725.25, "setting": "both", "billing_class": "facility"}]}, {"description": "GW S/TIP", "code_information": [{"code": "C1769", "type": "HCPCS"}, {"code": "8073180", "type": "CDM"}, {"code": "272", "type": "RC"}], "standard_charges": [{"gross_charge": 868.0, "discounted_cash": 651.0, "setting": "both", "billing_class": "facility"}]}, {"description": "GW ST/HD", "code_information": [{"code": "C1769", "type": "HCPCS"}, {"code": "8073220", "type": "CDM"}, {"code": "272", "type": "RC"}], "standard_charges": [{"gross_charge": 1388.0, "discounted_cash": 1041.0, "setting": "both", "billing_class": "facility"}]}, {"description": "GW ST/NC", "code_information": [{"code": "C1769", "type": "HCPCS"}, {"code": "8073235", "type": "CDM"}, {"code": "272", "type": "RC"}], "standard_charges": [{"gross_charge": 272.0, "discounted_cash": 204.0, "setting": "both", "billing_class": "facility"}]}, {"description": "GW STRI FIX CORE ALL", "code_information": [{"code": "C1769", "type": "HCPCS"}, {"code": "8073244", "type": "CDM"}, {"code": "272", "type": "RC"}], "standard_charges": [{"gross_charge": 289.0, "discounted_cash": 216.75, "setting": "both", "billing_class": "facility"}]}, {"description": "GW SYNCHRO", "code_information": [{"code": "C1769", "type": "HCPCS"}, {"code": "4032519", "type": "CDM"}, {"code": "272", "type": "RC"}], "standard_charges": [{"gross_charge": 4461.0, "discounted_cash": 3345.75, "setting": "both", "billing_class": "facility"}]}, {"description": "GW TRACER METRO WILSONCK", "code_information": [{"code": "C1769", "type": "HCPCS"}, {"code": "8246910", "type": "CDM"}, {"code": "272", "type": "RC"}], "standard_charges": [{"gross_charge": 2729.0, "discounted_cash": 2046.75, "setting": "both", "billing_class": "facility"}]}, {"description": "GW TRACER WILSONCOOK", "code_information": [{"code": "C1769", "type": "HCPCS"}, {"code": "8246915", "type": "CDM"}, {"code": "272", "type": "RC"}], "standard_charges": [{"gross_charge": 2817.0, "discounted_cash": 2112.75, "setting": "both", "billing_class": "facility"}]}, {"description": "GW TRANSEND", "code_information": [{"code": "C1769", "type": "HCPCS"}, {"code": "8241321", "type": "CDM"}, {"code": "272", "type": "RC"}], "standard_charges": [{"gross_charge": 1814.0, "discounted_cash": 1360.5, "setting": "both", "billing_class": "facility"}]}, {"description": "GW VIPERWIRE", "code_information": [{"code": "C1769", "type": "HCPCS"}, {"code": "4032529", "type": "CDM"}, {"code": "272", "type": "RC"}], "standard_charges": [{"gross_charge": 1010.0, "discounted_cash": 757.5, "setting": "both", "billing_class": "facility"}]}, {"description": "H PYLORI BRTH TST", "code_information": [{"code": "83013", "type": "CPT"}, {"code": "7253007", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 405.0, "discounted_cash": 303.75, "setting": "both", "billing_class": "facility"}]}, {"description": "H. PYLORI STOOL IA", "code_information": [{"code": "87338", "type": "CPT"}, {"code": "4107338", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 657.0, "discounted_cash": 492.75, "setting": "both", "billing_class": "facility"}]}, {"description": "H. PYLORI STOOL IA", "code_information": [{"code": "87338", "type": "CPT"}, {"code": "7257338", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 588.0, "discounted_cash": 441.0, "setting": "both", "billing_class": "facility"}]}, {"description": "HAEMOPH B PRP-T VAC IJ", "code_information": [{"code": "90648", "type": "CPT"}, {"code": "5320963", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 834.0, "discounted_cash": 625.5, "setting": "both", "billing_class": "facility"}]}, {"description": "HAEMOPH B PRP-T VAC IJ", "code_information": [{"code": "90648", "type": "CPT"}, {"code": "5320963", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 834.0, "discounted_cash": 625.5, "setting": "both", "billing_class": "facility"}]}, {"description": "HAEMOPHIL B/TET TX.5MLIJ", "code_information": [{"code": "90749", "type": "CPT"}, {"code": "5320980", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 1295.0, "discounted_cash": 971.25, "setting": "both", "billing_class": "facility"}]}, {"description": "HAEMOPHIL B/TET TX.5MLIJ", "code_information": [{"code": "90749", "type": "CPT"}, {"code": "5320980", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 1295.0, "discounted_cash": 971.25, "setting": "both", "billing_class": "facility"}]}, {"description": "HALO CERV INTO JCKT VEST", "code_information": [{"code": "L0810", "type": "HCPCS"}, {"code": "8130078", "type": "CDM"}, {"code": "274", "type": "RC"}], "standard_charges": [{"gross_charge": 122348.0, "discounted_cash": 91761.0, "setting": "both", "billing_class": "facility"}]}, {"description": "HALOPERID DEC PER 50MGIJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J1631", "type": "HCPCS"}, {"code": "5320973", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 1455.0, "discounted_cash": 1091.25, "setting": "both", "billing_class": "facility"}]}, {"description": "HALOPERID DEC PER 50MGIJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J1631", "type": "HCPCS"}, {"code": "5320973", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 1455.0, "discounted_cash": 1091.25, "setting": "both", "billing_class": "facility"}]}, {"description": "HALOPERIDOL", "code_information": [{"code": "80173", "type": "CPT"}, {"code": "7250304", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 319.0, "discounted_cash": 239.25, "setting": "both", "billing_class": "facility"}]}, {"description": "HALOPERIDOL .5MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5305610", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 78.0, "discounted_cash": 58.5, "setting": "both", "billing_class": "facility"}]}, {"description": "HALOPERIDOL .5MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5305610", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 78.0, "discounted_cash": 58.5, "setting": "both", "billing_class": "facility"}]}, {"description": "HALOPERIDOL 10MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5305626", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 66.0, "discounted_cash": 49.5, "setting": "both", "billing_class": "facility"}]}, {"description": "HALOPERIDOL 10MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5305626", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 66.0, "discounted_cash": 49.5, "setting": "both", "billing_class": "facility"}]}, {"description": "HALOPERIDOL 1MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5305614", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 84.0, "discounted_cash": 63.0, "setting": "both", "billing_class": "facility"}]}, {"description": "HALOPERIDOL 1MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5305614", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 84.0, "discounted_cash": 63.0, "setting": "both", "billing_class": "facility"}]}, {"description": "HALOPERIDOL 5MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5305622", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 66.0, "discounted_cash": 49.5, "setting": "both", "billing_class": "facility"}]}, {"description": "HALOPERIDOL 5MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5305622", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 66.0, "discounted_cash": 49.5, "setting": "both", "billing_class": "facility"}]}, {"description": "HALOPERIDOL UP TO 5MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J1630", "type": "HCPCS"}, {"code": "5320972", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 508.0, "discounted_cash": 381.0, "setting": "both", "billing_class": "facility"}]}, {"description": "HALOPERIDOL UP TO 5MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J1630", "type": "HCPCS"}, {"code": "5320972", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 508.0, "discounted_cash": 381.0, "setting": "both", "billing_class": "facility"}]}, {"description": "HALOPERIDOL2MG/ML15ML LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5315315", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 66.0, "discounted_cash": 49.5, "setting": "both", "billing_class": "facility"}]}, {"description": "HALOPERIDOL2MG/ML15ML LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5315315", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 66.0, "discounted_cash": 49.5, "setting": "both", "billing_class": "facility"}]}, {"description": "HAND 2 VIEWS", "code_information": [{"code": "73120", "type": "CPT"}, {"code": "4903120", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 1618.0, "discounted_cash": 1213.5, "setting": "both", "billing_class": "facility"}]}, {"description": "HAND 2 VIEWS", "code_information": [{"code": "73120", "type": "CPT"}, {"code": "5113120", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 2099.0, "discounted_cash": 1574.25, "setting": "both", "billing_class": "facility"}]}, {"description": "HAND 3 VIEWS MINIMUM", "code_information": [{"code": "73130", "type": "CPT"}, {"code": "4903130", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 1607.0, "discounted_cash": 1205.25, "setting": "both", "billing_class": "facility"}]}, {"description": "HAND 3 VIEWS MINIMUM", "code_information": [{"code": "73130", "type": "CPT"}, {"code": "5113130", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 1927.0, "discounted_cash": 1445.25, "setting": "both", "billing_class": "facility"}]}, {"description": "HAND HELD NEB TREATMENT", "code_information": [{"code": "94640", "type": "CPT"}, {"code": "5500122", "type": "CDM"}, {"code": "410", "type": "RC"}], "standard_charges": [{"gross_charge": 780.0, "discounted_cash": 585.0, "setting": "both", "billing_class": "facility"}]}, {"description": "HAPTOGLOBIN QUANT", "code_information": [{"code": "83010", "type": "CPT"}, {"code": "4103010", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 819.0, "discounted_cash": 614.25, "setting": "both", "billing_class": "facility"}]}, {"description": "HAPTOGLOBIN QUANT", "code_information": [{"code": "83010", "type": "CPT"}, {"code": "7253010", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 552.0, "discounted_cash": 414.0, "setting": "both", "billing_class": "facility"}]}, {"description": "HB FUL BDY CHMBR P 30MIN", "code_information": [{"code": "G0277", "type": "HCPCS"}, {"code": "6620020", "type": "CDM"}, {"code": "413", "type": "RC"}], "standard_charges": [{"gross_charge": 2116.0, "discounted_cash": 1587.0, "setting": "both", "billing_class": "facility"}]}, {"description": "HBA 1/2 DELETES/VARIANTS/2", "code_information": [{"code": "81257", "type": "CPT"}, {"code": "7259209", "type": "CDM"}, {"code": "310", "type": "RC"}], "standard_charges": [{"gross_charge": 1192.0, "discounted_cash": 894.0, "setting": "both", "billing_class": "facility"}]}, {"description": "HBB COMMON VARIANTS/2", "code_information": [{"code": "81361", "type": "CPT"}, {"code": "7250552", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 362.0, "discounted_cash": 271.5, "setting": "both", "billing_class": "facility"}]}, {"description": "HBS IA", "code_information": [{"code": "87467", "type": "CPT"}, {"code": "4106287", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 1211.0, "discounted_cash": 908.25, "setting": "both", "billing_class": "facility"}]}, {"description": "HBS IA", "code_information": [{"code": "87467", "type": "CPT"}, {"code": "4126287", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 31.0, "discounted_cash": 23.25, "setting": "both", "billing_class": "facility"}]}, {"description": "HBS IA", "code_information": [{"code": "87467", "type": "CPT"}, {"code": "4176287", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 9.98, "discounted_cash": 7.49, "setting": "both", "billing_class": "facility"}]}, {"description": "HBS IA", "code_information": [{"code": "87467", "type": "CPT"}, {"code": "7256287", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 78.0, "discounted_cash": 58.5, "setting": "both", "billing_class": "facility"}]}, {"description": "HCS 17-OHCS", "code_information": [{"code": "83491", "type": "CPT"}, {"code": "7253495", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 1182.0, "discounted_cash": 886.5, "setting": "both", "billing_class": "facility"}]}, {"description": "HCTS .2% 15GM OI", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5335891", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 398.0, "discounted_cash": 298.5, "setting": "both", "billing_class": "facility"}]}, {"description": "HCTS .2% 15GM OI", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5335891", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 398.0, "discounted_cash": 298.5, "setting": "both", "billing_class": "facility"}]}, {"description": "HCTS .5% 30GM CR", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5335886", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 183.0, "discounted_cash": 137.25, "setting": "both", "billing_class": "facility"}]}, {"description": "HCTS .5% 30GM CR", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5335886", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 183.0, "discounted_cash": 137.25, "setting": "both", "billing_class": "facility"}]}, {"description": "HCTS 1% 28.4GM CR", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5335920", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 93.0, "discounted_cash": 69.75, "setting": "both", "billing_class": "facility"}]}, {"description": "HCTS 1% 28.4GM CR", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5335920", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 93.0, "discounted_cash": 69.75, "setting": "both", "billing_class": "facility"}]}, {"description": "HCTS 1% 30GM CR", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5335911", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 128.0, "discounted_cash": 96.0, "setting": "both", "billing_class": "facility"}]}, {"description": "HCTS 1% 30GM CR", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5335911", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 128.0, "discounted_cash": 96.0, "setting": "both", "billing_class": "facility"}]}, {"description": "HCTS 1% 30GM OI", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5335895", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 97.0, "discounted_cash": 72.75, "setting": "both", "billing_class": "facility"}]}, {"description": "HCTS 1% 30GM OI", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5335895", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 97.0, "discounted_cash": 72.75, "setting": "both", "billing_class": "facility"}]}, {"description": "HCTS 100MG/60ML RE", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5338488", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 964.0, "discounted_cash": 723.0, "setting": "both", "billing_class": "facility"}]}, {"description": "HCTS 100MG/60ML RE", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5338488", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 964.0, "discounted_cash": 723.0, "setting": "both", "billing_class": "facility"}]}, {"description": "HCTS 2.5% 30GM CR", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5335913", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 463.0, "discounted_cash": 347.25, "setting": "both", "billing_class": "facility"}]}, {"description": "HCTS 2.5% 30GM CR", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5335913", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 463.0, "discounted_cash": 347.25, "setting": "both", "billing_class": "facility"}]}, {"description": "HCTS 25MG SU", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5338493", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 63.0, "discounted_cash": 47.25, "setting": "both", "billing_class": "facility"}]}, {"description": "HCTS 25MG SU", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5338493", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 63.0, "discounted_cash": 47.25, "setting": "both", "billing_class": "facility"}]}, {"description": "HCTS SS PER 100MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J1720", "type": "HCPCS"}, {"code": "5321243", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 159.0, "discounted_cash": 119.25, "setting": "both", "billing_class": "facility"}]}, {"description": "HCTS SS PER 100MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J1720", "type": "HCPCS"}, {"code": "5321243", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 159.0, "discounted_cash": 119.25, "setting": "both", "billing_class": "facility"}]}, {"description": "HCTS/PRAMOX 10GM R FOAM", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5335906", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 682.0, "discounted_cash": 511.5, "setting": "both", "billing_class": "facility"}]}, {"description": "HCTS/PRAMOX 10GM R FOAM", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5335906", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 682.0, "discounted_cash": 511.5, "setting": "both", "billing_class": "facility"}]}, {"description": "HCTZ 12.5MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5305713", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 34.0, "discounted_cash": 25.5, "setting": "both", "billing_class": "facility"}]}, {"description": "HCTZ 12.5MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5305713", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 34.0, "discounted_cash": 25.5, "setting": "both", "billing_class": "facility"}]}, {"description": "HCTZ 25MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5305715", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 66.0, "discounted_cash": 49.5, "setting": "both", "billing_class": "facility"}]}, {"description": "HCTZ 25MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5305715", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 66.0, "discounted_cash": 49.5, "setting": "both", "billing_class": "facility"}]}, {"description": "HCV GENOTYPE", "code_information": [{"code": "87902", "type": "CPT"}, {"code": "7257523", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 646.0, "discounted_cash": 484.5, "setting": "both", "billing_class": "facility"}]}, {"description": "HD FM MTL LESS/EQ 36MM GLOB CL", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "4013231", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 9284.0, "discounted_cash": 6963.0, "setting": "both", "billing_class": "facility"}]}, {"description": "HD SHLD MDSPCR ANTIB OSTEOR CL", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "4013366", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 47556.0, "discounted_cash": 35667.0, "setting": "both", "billing_class": "facility"}]}, {"description": "HEAD FEM ALL MTL UNIPL DPY CL", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "4012811", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 9284.0, "discounted_cash": 6963.0, "setting": "both", "billing_class": "facility"}]}, {"description": "HEAD FEM ALL MTL UNIPOL DJO CL", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "4013396", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 5765.0, "discounted_cash": 4323.75, "setting": "both", "billing_class": "facility"}]}, {"description": "HEAD FEM CERAM ANY SZ DPY CL", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "4012812", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 12068.0, "discounted_cash": 9051.0, "setting": "both", "billing_class": "facility"}]}, {"description": "HEAD FEM METL UNPLR AESCULP CL", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "4013332", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 9407.0, "discounted_cash": 7055.25, "setting": "both", "billing_class": "facility"}]}, {"description": "HEAD FEM UNIPOLAR DEPUY CL", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "4012809", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 6497.0, "discounted_cash": 4872.75, "setting": "both", "billing_class": "facility"}]}, {"description": "HEAD FEMOR CERAM ANY SZ DJO CL", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "4013397", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 9058.0, "discounted_cash": 6793.5, "setting": "both", "billing_class": "facility"}]}, {"description": "HEAD FEMORAL BIPOLAR STRYK CL", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "4013052", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 4864.0, "discounted_cash": 3648.0, "setting": "both", "billing_class": "facility"}]}, {"description": "HEAD FEMORL ALL METAL STRK CL", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "4013051", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 4864.0, "discounted_cash": 3648.0, "setting": "both", "billing_class": "facility"}]}, {"description": "HEAD HUM STD OFST ECC DEPY CL", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "4013117", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 20753.0, "discounted_cash": 15564.75, "setting": "both", "billing_class": "facility"}]}, {"description": "HEAD HUM STD/OFFSET/ECC DJO CL", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "4013425", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 16469.0, "discounted_cash": 12351.75, "setting": "both", "billing_class": "facility"}]}, {"description": "HEAVY METAL QUAN/10", "code_information": [{"code": "83018", "type": "CPT"}, {"code": "7254410", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 344.0, "discounted_cash": 258.0, "setting": "both", "billing_class": "facility"}]}, {"description": "HEAVY METAL QUAN/5", "code_information": [{"code": "83018", "type": "CPT"}, {"code": "7253019", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 136.0, "discounted_cash": 102.0, "setting": "both", "billing_class": "facility"}]}, {"description": "HELICOBACTER PYLORI AB", "code_information": [{"code": "86677", "type": "CPT"}, {"code": "4176056", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 15.71, "discounted_cash": 11.78, "setting": "both", "billing_class": "facility"}]}, {"description": "HELICOBACTER PYLORI AB", "code_information": [{"code": "86677", "type": "CPT"}, {"code": "7256057", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 731.0, "discounted_cash": 548.25, "setting": "both", "billing_class": "facility"}]}, {"description": "HELICOBACTER PYLORI AB/2", "code_information": [{"code": "86677", "type": "CPT"}, {"code": "4106056", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 747.0, "discounted_cash": 560.25, "setting": "both", "billing_class": "facility"}]}, {"description": "HELICOBACTER PYLORI AB/2", "code_information": [{"code": "86677", "type": "CPT"}, {"code": "7256074", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 799.0, "discounted_cash": 599.25, "setting": "both", "billing_class": "facility"}]}, {"description": "HELICOBACTER PYLORI AB/3", "code_information": [{"code": "86677", "type": "CPT"}, {"code": "7256076", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 799.0, "discounted_cash": 599.25, "setting": "both", "billing_class": "facility"}]}, {"description": "HELMINTH AB NES", "code_information": [{"code": "86682", "type": "CPT"}, {"code": "7250050", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 233.0, "discounted_cash": 174.75, "setting": "both", "billing_class": "facility"}]}, {"description": "HELMINTH AB NES/2", "code_information": [{"code": "86682", "type": "CPT"}, {"code": "7254183", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 385.0, "discounted_cash": 288.75, "setting": "both", "billing_class": "facility"}]}, {"description": "HELMINTH AB NES/3", "code_information": [{"code": "86682", "type": "CPT"}, {"code": "7255605", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 1243.0, "discounted_cash": 932.25, "setting": "both", "billing_class": "facility"}]}, {"description": "HELMINTH AB NES/4", "code_information": [{"code": "86682", "type": "CPT"}, {"code": "7256263", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 494.0, "discounted_cash": 370.5, "setting": "both", "billing_class": "facility"}]}, {"description": "HELMINTH AB NES/5", "code_information": [{"code": "86682", "type": "CPT"}, {"code": "7256342", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 385.0, "discounted_cash": 288.75, "setting": "both", "billing_class": "facility"}]}, {"description": "HELMINTH AB NES/7", "code_information": [{"code": "86682", "type": "CPT"}, {"code": "7256680", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 179.0, "discounted_cash": 134.25, "setting": "both", "billing_class": "facility"}]}, {"description": "HEMATOCRIT", "code_information": [{"code": "85014", "type": "CPT"}, {"code": "4105014", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 235.0, "discounted_cash": 176.25, "setting": "both", "billing_class": "facility"}]}, {"description": "HEMATOCRIT", "code_information": [{"code": "85014", "type": "CPT"}, {"code": "4175014", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 2.86, "discounted_cash": 2.15, "setting": "both", "billing_class": "facility"}]}, {"description": "HEMATOCRIT", "code_information": [{"code": "85014", "type": "CPT"}, {"code": "7255014", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 213.0, "discounted_cash": 159.75, "setting": "both", "billing_class": "facility"}]}, {"description": "HEMGLBN METHEMOGLBN QUAN", "code_information": [{"code": "83050", "type": "CPT"}, {"code": "4103050", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 1264.0, "discounted_cash": 948.0, "setting": "both", "billing_class": "facility"}]}, {"description": "HEMGLBN METHEMOGLBN QUAN", "code_information": [{"code": "83050", "type": "CPT"}, {"code": "4173050", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 29.98, "discounted_cash": 22.49, "setting": "both", "billing_class": "facility"}]}, {"description": "HEMICAP KNE RESRF ARTHROSRF CL", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "4013297", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 53284.0, "discounted_cash": 39963.0, "setting": "both", "billing_class": "facility"}]}, {"description": "HEMOCHROM COMMON VARIANT/2", "code_information": [{"code": "81256", "type": "CPT"}, {"code": "7259211", "type": "CDM"}, {"code": "310", "type": "RC"}], "standard_charges": [{"gross_charge": 398.0, "discounted_cash": 298.5, "setting": "both", "billing_class": "facility"}]}, {"description": "HEMOGLOBIN FRAC & QNT", "code_information": [{"code": "83021", "type": "CPT"}, {"code": "7253021", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 635.0, "discounted_cash": 476.25, "setting": "both", "billing_class": "facility"}]}, {"description": "HEMOGLOBIN FRAC & QNT/2", "code_information": [{"code": "83021", "type": "CPT"}, {"code": "7253067", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 36.0, "discounted_cash": 27.0, "setting": "both", "billing_class": "facility"}]}, {"description": "HEMOGLOBIN GLYCATED", "code_information": [{"code": "83036", "type": "CPT"}, {"code": "4102994", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 1127.0, "discounted_cash": 845.25, "setting": "both", "billing_class": "facility"}]}, {"description": "HEMOGLOBIN GLYCATED", "code_information": [{"code": "83036", "type": "CPT"}, {"code": "4122994", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 918.0, "discounted_cash": 688.5, "setting": "both", "billing_class": "facility"}]}, {"description": "HEMOGLOBIN GLYCATED", "code_information": [{"code": "83036", "type": "CPT"}, {"code": "4172994", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 14.27, "discounted_cash": 10.7, "setting": "both", "billing_class": "facility"}]}, {"description": "HEMOGLOBIN GLYCATED", "code_information": [{"code": "83036", "type": "CPT"}, {"code": "7252994", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 14.0, "discounted_cash": 10.5, "setting": "both", "billing_class": "facility"}]}, {"description": "HEMOGLOBIN PLASMA", "code_information": [{"code": "83051", "type": "CPT"}, {"code": "7253051", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 180.0, "discounted_cash": 135.0, "setting": "both", "billing_class": "facility"}]}, {"description": "HEMOGLOBN ELECTRPHORESIS", "code_information": [{"code": "83020", "type": "CPT"}, {"code": "7253023", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 36.0, "discounted_cash": 27.0, "setting": "both", "billing_class": "facility"}]}, {"description": "HEMOGLOBN FETAL QUAL-APT", "code_information": [{"code": "83033", "type": "CPT"}, {"code": "4103033", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 607.0, "discounted_cash": 455.25, "setting": "both", "billing_class": "facility"}]}, {"description": "HEMOPHILUS INFLUENZA AB", "code_information": [{"code": "86684", "type": "CPT"}, {"code": "7256193", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 388.0, "discounted_cash": 291.0, "setting": "both", "billing_class": "facility"}]}, {"description": "HEMOSIDERIN QUAL", "code_information": [{"code": "83070", "type": "CPT"}, {"code": "4103070", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 576.0, "discounted_cash": 432.0, "setting": "both", "billing_class": "facility"}]}, {"description": "HEMOSIDERIN QUAL", "code_information": [{"code": "83070", "type": "CPT"}, {"code": "7253070", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 134.0, "discounted_cash": 100.5, "setting": "both", "billing_class": "facility"}]}, {"description": "HEP B CORE AB IGM", "code_information": [{"code": "86705", "type": "CPT"}, {"code": "4106294", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 242.0, "discounted_cash": 181.5, "setting": "both", "billing_class": "facility"}]}, {"description": "HEP B CORE AB IGM", "code_information": [{"code": "86705", "type": "CPT"}, {"code": "4176294", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 12.84, "discounted_cash": 9.63, "setting": "both", "billing_class": "facility"}]}, {"description": "HEP B CORE AB IGM", "code_information": [{"code": "86705", "type": "CPT"}, {"code": "7256294", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 11.0, "discounted_cash": 8.25, "setting": "both", "billing_class": "facility"}]}, {"description": "HEP B CORE AB TOTAL", "code_information": [{"code": "86704", "type": "CPT"}, {"code": "4106289", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 1298.0, "discounted_cash": 973.5, "setting": "both", "billing_class": "facility"}]}, {"description": "HEP B CORE AB TOTAL", "code_information": [{"code": "86704", "type": "CPT"}, {"code": "4126289", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 33.0, "discounted_cash": 24.75, "setting": "both", "billing_class": "facility"}]}, {"description": "HEP B CORE AB TOTAL", "code_information": [{"code": "86704", "type": "CPT"}, {"code": "4176289", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 8.56, "discounted_cash": 6.42, "setting": "both", "billing_class": "facility"}]}, {"description": "HEP B CORE AB TOTAL/2", "code_information": [{"code": "86704", "type": "CPT"}, {"code": "7256704", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 22.0, "discounted_cash": 16.5, "setting": "both", "billing_class": "facility"}]}, {"description": "HEP B GENOTYPE", "code_information": [{"code": "87912", "type": "CPT"}, {"code": "7257913", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 1770.0, "discounted_cash": 1327.5, "setting": "both", "billing_class": "facility"}]}, {"description": "HEP B SURFACE AB", "code_information": [{"code": "86706", "type": "CPT"}, {"code": "4126292", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 33.0, "discounted_cash": 24.75, "setting": "both", "billing_class": "facility"}]}, {"description": "HEP B SURFACE AB", "code_information": [{"code": "86706", "type": "CPT"}, {"code": "4176292", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 9.98, "discounted_cash": 7.49, "setting": "both", "billing_class": "facility"}]}, {"description": "HEP B SURFACE AB", "code_information": [{"code": "86706", "type": "CPT"}, {"code": "7256706", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 423.0, "discounted_cash": 317.25, "setting": "both", "billing_class": "facility"}]}, {"description": "HEP B SURFACE AB/2", "code_information": [{"code": "86706", "type": "CPT"}, {"code": "4106292", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 567.0, "discounted_cash": 425.25, "setting": "both", "billing_class": "facility"}]}, {"description": "HEP B VAC PED/ADOL3DS IJ", "code_information": [{"code": "90744", "type": "CPT"}, {"code": "5321115", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 671.0, "discounted_cash": 503.25, "setting": "both", "billing_class": "facility"}]}, {"description": "HEP C AMPLIFIED PROBE/2", "code_information": [{"code": "87521", "type": "CPT"}, {"code": "7253504", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 2214.0, "discounted_cash": 1660.5, "setting": "both", "billing_class": "facility"}]}, {"description": "HEP C QUANT", "code_information": [{"code": "87522", "type": "CPT"}, {"code": "4107522", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 1805.0, "discounted_cash": 1353.75, "setting": "both", "billing_class": "facility"}]}, {"description": "HEP C QUANT/2", "code_information": [{"code": "87522", "type": "CPT"}, {"code": "7253934", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 1010.0, "discounted_cash": 757.5, "setting": "both", "billing_class": "facility"}]}, {"description": "HEPARIN ASSAY", "code_information": [{"code": "85520", "type": "CPT"}, {"code": "7255520", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 238.0, "discounted_cash": 178.5, "setting": "both", "billing_class": "facility"}]}, {"description": "HEPARIN ASSAY/3", "code_information": [{"code": "85520", "type": "CPT"}, {"code": "7258552", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 156.0, "discounted_cash": 117.0, "setting": "both", "billing_class": "facility"}]}, {"description": "HEPARIN FL PER10U PFS IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J1642", "type": "HCPCS"}, {"code": "5321010", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 104.0, "discounted_cash": 78.0, "setting": "both", "billing_class": "facility"}]}, {"description": "HEPARIN FL PER10U PFS IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J1642", "type": "HCPCS"}, {"code": "5321010", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 104.0, "discounted_cash": 78.0, "setting": "both", "billing_class": "facility"}]}, {"description": "HEPARIN FLUSH PER 10U IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J1642", "type": "HCPCS"}, {"code": "5320991", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 4.0, "discounted_cash": 3.0, "setting": "both", "billing_class": "facility"}]}, {"description": "HEPARIN FLUSH PER 10U IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J1642", "type": "HCPCS"}, {"code": "5320991", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 4.0, "discounted_cash": 3.0, "setting": "both", "billing_class": "facility"}]}, {"description": "HEPARIN NEO FL CMPD3MLIJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5321094", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 85.0, "discounted_cash": 63.75, "setting": "both", "billing_class": "facility"}]}, {"description": "HEPARIN NEO PER 1ML IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5321096", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 31.0, "discounted_cash": 23.25, "setting": "both", "billing_class": "facility"}]}, {"description": "HEPARIN NEO PER 1U IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5321090", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 77.0, "discounted_cash": 57.75, "setting": "both", "billing_class": "facility"}]}, {"description": "HEPARIN PER 1000U IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J1644", "type": "HCPCS"}, {"code": "5321063", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 52.0, "discounted_cash": 39.0, "setting": "both", "billing_class": "facility"}]}, {"description": "HEPARIN PER 1000U IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J1644", "type": "HCPCS"}, {"code": "5321063", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 52.0, "discounted_cash": 39.0, "setting": "both", "billing_class": "facility"}]}, {"description": "HEPARIN PER 1000U PMX IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J1644", "type": "HCPCS"}, {"code": "5321102", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 225.0, "discounted_cash": 168.75, "setting": "both", "billing_class": "facility"}]}, {"description": "HEPARIN PER 1000U PMX IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J1644", "type": "HCPCS"}, {"code": "5321102", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 225.0, "discounted_cash": 168.75, "setting": "both", "billing_class": "facility"}]}, {"description": "HEPATIC FUNCTION PANEL", "code_information": [{"code": "80076", "type": "CPT"}, {"code": "4100109", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 1519.0, "discounted_cash": 1139.25, "setting": "both", "billing_class": "facility"}]}, {"description": "HEPATIC FUNCTION PANEL", "code_information": [{"code": "80076", "type": "CPT"}, {"code": "4120109", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 5.0, "discounted_cash": 3.75, "setting": "both", "billing_class": "facility"}]}, {"description": "HEPATIC FUNCTION PANEL", "code_information": [{"code": "80076", "type": "CPT"}, {"code": "4170109", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 4.29, "discounted_cash": 3.22, "setting": "both", "billing_class": "facility"}]}, {"description": "HEPATIC FUNCTION PANEL", "code_information": [{"code": "80076", "type": "CPT"}, {"code": "7250114", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 27.0, "discounted_cash": 20.25, "setting": "both", "billing_class": "facility"}]}, {"description": "HEPATIC VENGPHY WO/EVAL", "code_information": [{"code": "75891", "type": "CPT"}, {"code": "4915892", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 8536.0, "discounted_cash": 6402.0, "setting": "both", "billing_class": "facility"}]}, {"description": "HEPATIC VENGRPHY W/EVAL", "code_information": [{"code": "75889", "type": "CPT"}, {"code": "4915890", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 11264.0, "discounted_cash": 8448.0, "setting": "both", "billing_class": "facility"}]}, {"description": "HEPATITIS A AB", "code_information": [{"code": "86708", "type": "CPT"}, {"code": "4106291", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 60.0, "discounted_cash": 45.0, "setting": "both", "billing_class": "facility"}]}, {"description": "HEPATITIS A AB", "code_information": [{"code": "86708", "type": "CPT"}, {"code": "4176291", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 8.56, "discounted_cash": 6.42, "setting": "both", "billing_class": "facility"}]}, {"description": "HEPATITIS A AB", "code_information": [{"code": "86708", "type": "CPT"}, {"code": "7256291", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 39.0, "discounted_cash": 29.25, "setting": "both", "billing_class": "facility"}]}, {"description": "HEPATITIS A AB IGM", "code_information": [{"code": "86709", "type": "CPT"}, {"code": "4106297", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 960.0, "discounted_cash": 720.0, "setting": "both", "billing_class": "facility"}]}, {"description": "HEPATITIS A AB IGM", "code_information": [{"code": "86709", "type": "CPT"}, {"code": "7256303", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 21.0, "discounted_cash": 15.75, "setting": "both", "billing_class": "facility"}]}, {"description": "HEPATITIS B IG IM .5MLIJ", "code_information": [{"code": "90371", "type": "CPT"}, {"code": "5321108", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 1743.0, "discounted_cash": 1307.25, "setting": "both", "billing_class": "facility"}]}, {"description": "HEPATITIS B QUANT/3", "code_information": [{"code": "87517", "type": "CPT"}, {"code": "7258675", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 324.0, "discounted_cash": 243.0, "setting": "both", "billing_class": "facility"}]}, {"description": "HEPATITIS B VACC ADMIN", "code_information": [{"code": "G0010", "type": "HCPCS"}, {"code": "6100010", "type": "CDM"}, {"code": "771", "type": "RC"}], "standard_charges": [{"gross_charge": 358.0, "discounted_cash": 268.5, "setting": "both", "billing_class": "facility"}]}, {"description": "HEPATITIS B VACC ADMIN", "code_information": [{"code": "G0010", "type": "HCPCS"}, {"code": "6160010", "type": "CDM"}, {"code": "771", "type": "RC"}], "standard_charges": [{"gross_charge": 358.0, "discounted_cash": 268.5, "setting": "both", "billing_class": "facility"}]}, {"description": "HEPATITIS B VACC ADMIN", "code_information": [{"code": "G0010", "type": "HCPCS"}, {"code": "6290010", "type": "CDM"}, {"code": "771", "type": "RC"}], "standard_charges": [{"gross_charge": 358.0, "discounted_cash": 268.5, "setting": "both", "billing_class": "facility"}]}, {"description": "HEPATITIS BE ANTIBODY", "code_information": [{"code": "86707", "type": "CPT"}, {"code": "7256296", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 613.0, "discounted_cash": 459.75, "setting": "both", "billing_class": "facility"}]}, {"description": "HEPATITIS BE IA", "code_information": [{"code": "87350", "type": "CPT"}, {"code": "7256293", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 613.0, "discounted_cash": 459.75, "setting": "both", "billing_class": "facility"}]}, {"description": "HEPATITIS C AB CONFIRM TST", "code_information": [{"code": "86804", "type": "CPT"}, {"code": "7256804", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 974.0, "discounted_cash": 730.5, "setting": "both", "billing_class": "facility"}]}, {"description": "HEPATITIS C AB CONFIRM TST/2", "code_information": [{"code": "86804", "type": "CPT"}, {"code": "7256805", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 649.0, "discounted_cash": 486.75, "setting": "both", "billing_class": "facility"}]}, {"description": "HEPATITIS C ANTIBODY", "code_information": [{"code": "86803", "type": "CPT"}, {"code": "4106304", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 2178.0, "discounted_cash": 1633.5, "setting": "both", "billing_class": "facility"}]}, {"description": "HEPATITIS C ANTIBODY", "code_information": [{"code": "86803", "type": "CPT"}, {"code": "4126304", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 38.0, "discounted_cash": 28.5, "setting": "both", "billing_class": "facility"}]}, {"description": "HEPATITIS C ANTIBODY", "code_information": [{"code": "86803", "type": "CPT"}, {"code": "4176304", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 14.27, "discounted_cash": 10.7, "setting": "both", "billing_class": "facility"}]}, {"description": "HEPATITIS C ANTIBODY", "code_information": [{"code": "86803", "type": "CPT"}, {"code": "7256304", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 38.0, "discounted_cash": 28.5, "setting": "both", "billing_class": "facility"}]}, {"description": "HEPATITIS DELTA AGENT AB", "code_information": [{"code": "86692", "type": "CPT"}, {"code": "7256297", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 557.0, "discounted_cash": 417.75, "setting": "both", "billing_class": "facility"}]}, {"description": "HEPATITIS E AB", "code_information": [{"code": "86790", "type": "CPT"}, {"code": "7256790", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 227.0, "discounted_cash": 170.25, "setting": "both", "billing_class": "facility"}]}, {"description": "HEPATOBIL IMAGE W/DRUG", "code_information": [{"code": "78227", "type": "CPT"}, {"code": "5208227", "type": "CDM"}, {"code": "341", "type": "RC"}], "standard_charges": [{"gross_charge": 5181.0, "discounted_cash": 3885.75, "setting": "both", "billing_class": "facility"}]}, {"description": "HEPATOBILIARY SYSTEM IMG", "code_information": [{"code": "78226", "type": "CPT"}, {"code": "5208226", "type": "CDM"}, {"code": "341", "type": "RC"}], "standard_charges": [{"gross_charge": 4668.0, "discounted_cash": 3501.0, "setting": "both", "billing_class": "facility"}]}, {"description": "HERPES AB SMPLX", "code_information": [{"code": "86694", "type": "CPT"}, {"code": "4106690", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 102.0, "discounted_cash": 76.5, "setting": "both", "billing_class": "facility"}]}, {"description": "HERPES AB SMPLX TYPE 1", "code_information": [{"code": "86695", "type": "CPT"}, {"code": "7256298", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 76.0, "discounted_cash": 57.0, "setting": "both", "billing_class": "facility"}]}, {"description": "HERPES AB SMPLX TYPE 1/2", "code_information": [{"code": "86695", "type": "CPT"}, {"code": "7256301", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 537.0, "discounted_cash": 402.75, "setting": "both", "billing_class": "facility"}]}, {"description": "HERPES AB SMPLX TYPE 1/3", "code_information": [{"code": "86695", "type": "CPT"}, {"code": "7256697", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 46.0, "discounted_cash": 34.5, "setting": "both", "billing_class": "facility"}]}, {"description": "HERPES AB SMPLX TYPE 2/2", "code_information": [{"code": "86696", "type": "CPT"}, {"code": "7256299", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 60.0, "discounted_cash": 45.0, "setting": "both", "billing_class": "facility"}]}, {"description": "HERPES AB SMPLX TYPE 2/7", "code_information": [{"code": "86696", "type": "CPT"}, {"code": "7258680", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 46.0, "discounted_cash": 34.5, "setting": "both", "billing_class": "facility"}]}, {"description": "HERPES AB SMPLX/2", "code_information": [{"code": "86694", "type": "CPT"}, {"code": "7256695", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 112.0, "discounted_cash": 84.0, "setting": "both", "billing_class": "facility"}]}, {"description": "HERPES HUMAN HHV", "code_information": [{"code": "86790", "type": "CPT"}, {"code": "7256792", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 362.0, "discounted_cash": 271.5, "setting": "both", "billing_class": "facility"}]}, {"description": "HERPES HUMAN HHV/3", "code_information": [{"code": "86790", "type": "CPT"}, {"code": "7258722", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 87.0, "discounted_cash": 65.25, "setting": "both", "billing_class": "facility"}]}, {"description": "HERPES SIMPLX AMP PRB", "code_information": [{"code": "87529", "type": "CPT"}, {"code": "7257531", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 1057.0, "discounted_cash": 792.75, "setting": "both", "billing_class": "facility"}]}, {"description": "HERPES SIMPLX AMP PRB/2", "code_information": [{"code": "87529", "type": "CPT"}, {"code": "7257530", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 1057.0, "discounted_cash": 792.75, "setting": "both", "billing_class": "facility"}]}, {"description": "HERPES SIMPLX AMP PRB/3", "code_information": [{"code": "87529", "type": "CPT"}, {"code": "4107529", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 2360.0, "discounted_cash": 1770.0, "setting": "both", "billing_class": "facility"}]}, {"description": "HETASTARCH 6% 500ML IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5321127", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 681.0, "discounted_cash": 510.75, "setting": "both", "billing_class": "facility"}]}, {"description": "HETEROPHILE AB SCREEN", "code_information": [{"code": "86308", "type": "CPT"}, {"code": "4106003", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 588.0, "discounted_cash": 441.0, "setting": "both", "billing_class": "facility"}]}, {"description": "HETEROPHILE AB SCREEN", "code_information": [{"code": "86308", "type": "CPT"}, {"code": "4176003", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 9.98, "discounted_cash": 7.49, "setting": "both", "billing_class": "facility"}]}, {"description": "HEXAMINOLEVULINT 100MGIJ", "code_information": [{"code": "A9589", "type": "HCPCS"}, {"code": "5356169", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 6723.0, "discounted_cash": 5042.25, "setting": "both", "billing_class": "facility"}]}, {"description": "HEXAMINOLEVULINT 100MGIJ", "code_information": [{"code": "A9589", "type": "HCPCS"}, {"code": "5356169", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 6723.0, "discounted_cash": 5042.25, "setting": "both", "billing_class": "facility"}]}, {"description": "HGB FECAL IA", "code_information": [{"code": "82274", "type": "CPT"}, {"code": "4102274", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 264.0, "discounted_cash": 198.0, "setting": "both", "billing_class": "facility"}]}, {"description": "HHN TX DEMO AND/OR EVAL", "code_information": [{"code": "94664", "type": "CPT"}, {"code": "5500120", "type": "CDM"}, {"code": "410", "type": "RC"}], "standard_charges": [{"gross_charge": 1116.0, "discounted_cash": 837.0, "setting": "both", "billing_class": "facility"}]}, {"description": "HIGH RISK OBSTETRICS", "code_information": [{"code": "1990098", "type": "CDM"}, {"code": "206", "type": "RC"}], "standard_charges": [{"gross_charge": 4900.0, "discounted_cash": 3675.0, "setting": "both", "billing_class": "facility"}]}, {"description": "HIGH RISK OBSTETRICS", "code_information": [{"code": "2510098", "type": "CDM"}, {"code": "206", "type": "RC"}], "standard_charges": [{"gross_charge": 4900.0, "discounted_cash": 3675.0, "setting": "both", "billing_class": "facility"}]}, {"description": "HIP ARTHROGRAPHY", "code_information": [{"code": "73525", "type": "CPT"}, {"code": "4903525", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 2578.0, "discounted_cash": 1933.5, "setting": "both", "billing_class": "facility"}]}, {"description": "HIP BI W/PEL 2WS", "code_information": [{"code": "73521", "type": "CPT"}, {"code": "4903520", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 2383.0, "discounted_cash": 1787.25, "setting": "both", "billing_class": "facility"}]}, {"description": "HIP BI W/PEL 2WS", "code_information": [{"code": "73521", "type": "CPT"}, {"code": "5113520", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 2383.0, "discounted_cash": 1787.25, "setting": "both", "billing_class": "facility"}]}, {"description": "HIP BI W/PEL 3-4 VWS", "code_information": [{"code": "73522", "type": "CPT"}, {"code": "4903522", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 447.0, "discounted_cash": 335.25, "setting": "both", "billing_class": "facility"}]}, {"description": "HIP BI W/PEL 3-4 VWS", "code_information": [{"code": "73522", "type": "CPT"}, {"code": "5113522", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 2702.0, "discounted_cash": 2026.5, "setting": "both", "billing_class": "facility"}]}, {"description": "HIP BI W/PEL 5VWS", "code_information": [{"code": "73523", "type": "CPT"}, {"code": "4903523", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 903.0, "discounted_cash": 677.25, "setting": "both", "billing_class": "facility"}]}, {"description": "HIP CENTRALIZER ACC DEPUY CL", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "4012800", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 1319.0, "discounted_cash": 989.25, "setting": "both", "billing_class": "facility"}]}, {"description": "HIP NAIL/PLATE", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8132825", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 18969.0, "discounted_cash": 14226.75, "setting": "both", "billing_class": "facility"}]}, {"description": "HIP PART SLF CENT COMP DPY CL", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "4012821", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 7947.0, "discounted_cash": 5960.25, "setting": "both", "billing_class": "facility"}]}, {"description": "HIP UNI SINGLE VIEW", "code_information": [{"code": "73501", "type": "CPT"}, {"code": "4903500", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 2112.0, "discounted_cash": 1584.0, "setting": "both", "billing_class": "facility"}]}, {"description": "HIP UNI SINGLE VIEW", "code_information": [{"code": "73501", "type": "CPT"}, {"code": "5113500", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 1887.0, "discounted_cash": 1415.25, "setting": "both", "billing_class": "facility"}]}, {"description": "HIP UNI W/PEL 4+VWS", "code_information": [{"code": "73503", "type": "CPT"}, {"code": "4903503", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 530.0, "discounted_cash": 397.5, "setting": "both", "billing_class": "facility"}]}, {"description": "HIP UNI W/PELV 2-3 VWS", "code_information": [{"code": "73502", "type": "CPT"}, {"code": "4903505", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 327.0, "discounted_cash": 245.25, "setting": "both", "billing_class": "facility"}]}, {"description": "HIP UNI W/PELV 2-3 VWS", "code_information": [{"code": "73502", "type": "CPT"}, {"code": "5113505", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 2112.0, "discounted_cash": 1584.0, "setting": "both", "billing_class": "facility"}]}, {"description": "HIP UNI W/PELVIS 1VW", "code_information": [{"code": "73501", "type": "CPT"}, {"code": "4903501", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 231.0, "discounted_cash": 173.25, "setting": "both", "billing_class": "facility"}]}, {"description": "HIP UNILATERAL 2-3 VWS", "code_information": [{"code": "73502", "type": "CPT"}, {"code": "4903510", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 2112.0, "discounted_cash": 1584.0, "setting": "both", "billing_class": "facility"}]}, {"description": "HIP UNILATERAL 2-3VWS", "code_information": [{"code": "73502", "type": "CPT"}, {"code": "5113510", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 1373.0, "discounted_cash": 1029.75, "setting": "both", "billing_class": "facility"}]}, {"description": "HIS BUNDLE RECORDING", "code_information": [{"code": "93600", "type": "CPT"}, {"code": "4613600", "type": "CDM"}, {"code": "480", "type": "RC"}], "standard_charges": [{"gross_charge": 10526.0, "discounted_cash": 7894.5, "setting": "both", "billing_class": "facility"}]}, {"description": "HISTAMINE/2", "code_information": [{"code": "83088", "type": "CPT"}, {"code": "7253088", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 469.0, "discounted_cash": 351.75, "setting": "both", "billing_class": "facility"}]}, {"description": "HISTAMINE/3", "code_information": [{"code": "83088", "type": "CPT"}, {"code": "7253092", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 469.0, "discounted_cash": 351.75, "setting": "both", "billing_class": "facility"}]}, {"description": "HISTOCHEM STN W/FRZ SECT", "code_information": [{"code": "88314", "type": "CPT"}, {"code": "4303502", "type": "CDM"}, {"code": "310", "type": "RC"}], "standard_charges": [{"gross_charge": 555.0, "discounted_cash": 416.25, "setting": "both", "billing_class": "facility"}]}, {"description": "HISTONE AB", "code_information": [{"code": "86255", "type": "CPT"}, {"code": "7258673", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 81.0, "discounted_cash": 60.75, "setting": "both", "billing_class": "facility"}]}, {"description": "HISTOPLASMA IA", "code_information": [{"code": "87385", "type": "CPT"}, {"code": "7257386", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 376.0, "discounted_cash": 282.0, "setting": "both", "billing_class": "facility"}]}, {"description": "HISTOPLASMA IA/3", "code_information": [{"code": "87385", "type": "CPT"}, {"code": "7253507", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 343.0, "discounted_cash": 257.25, "setting": "both", "billing_class": "facility"}]}, {"description": "HISTOPLASMOSIS AB", "code_information": [{"code": "86698", "type": "CPT"}, {"code": "7256176", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 230.0, "discounted_cash": 172.5, "setting": "both", "billing_class": "facility"}]}, {"description": "HIV 1 AB", "code_information": [{"code": "86701", "type": "CPT"}, {"code": "4176701", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 15.71, "discounted_cash": 11.78, "setting": "both", "billing_class": "facility"}]}, {"description": "HIV 1 AB", "code_information": [{"code": "86701", "type": "CPT"}, {"code": "7256701", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 554.0, "discounted_cash": 415.5, "setting": "both", "billing_class": "facility"}]}, {"description": "HIV 1 AB/2", "code_information": [{"code": "86701", "type": "CPT"}, {"code": "4106701", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 1744.0, "discounted_cash": 1308.0, "setting": "both", "billing_class": "facility"}]}, {"description": "HIV 1 AG HIV1/2 AB DIR OPT", "code_information": [{"code": "87806", "type": "CPT"}, {"code": "4107827", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 179.0, "discounted_cash": 134.25, "setting": "both", "billing_class": "facility"}]}, {"description": "HIV 1 AMP PROBE", "code_information": [{"code": "87535", "type": "CPT"}, {"code": "7256323", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 287.0, "discounted_cash": 215.25, "setting": "both", "billing_class": "facility"}]}, {"description": "HIV 1/HIV 2 SNGL RESULT", "code_information": [{"code": "86703", "type": "CPT"}, {"code": "4106703", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 880.0, "discounted_cash": 660.0, "setting": "both", "billing_class": "facility"}]}, {"description": "HIV 1/HIV 2 SNGL RESULT", "code_information": [{"code": "86703", "type": "CPT"}, {"code": "4126703", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 112.0, "discounted_cash": 84.0, "setting": "both", "billing_class": "facility"}]}, {"description": "HIV 1/HIV 2 SNGL RESULT", "code_information": [{"code": "86703", "type": "CPT"}, {"code": "4176703", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 11.42, "discounted_cash": 8.57, "setting": "both", "billing_class": "facility"}]}, {"description": "HIV 1/HIV 2 SNGL RESULT/2", "code_information": [{"code": "86703", "type": "CPT"}, {"code": "4108670", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 693.0, "discounted_cash": 519.75, "setting": "both", "billing_class": "facility"}]}, {"description": "HIV 2 AB", "code_information": [{"code": "86702", "type": "CPT"}, {"code": "7256702", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 201.0, "discounted_cash": 150.75, "setting": "both", "billing_class": "facility"}]}, {"description": "HIV 2 AMP PROBE", "code_information": [{"code": "87538", "type": "CPT"}, {"code": "7257538", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 247.0, "discounted_cash": 185.25, "setting": "both", "billing_class": "facility"}]}, {"description": "HIV GENO PROTEAS REGION", "code_information": [{"code": "87901", "type": "CPT"}, {"code": "7257902", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 1624.0, "discounted_cash": 1218.0, "setting": "both", "billing_class": "facility"}]}, {"description": "HIV GENO PROTEAS REGION/2", "code_information": [{"code": "87901", "type": "CPT"}, {"code": "7257901", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 267.0, "discounted_cash": 200.25, "setting": "both", "billing_class": "facility"}]}, {"description": "HIV I AG HIV I HIV II AB", "code_information": [{"code": "87389", "type": "CPT"}, {"code": "7257391", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 31.0, "discounted_cash": 23.25, "setting": "both", "billing_class": "facility"}]}, {"description": "HIV-1 QUANT", "code_information": [{"code": "87536", "type": "CPT"}, {"code": "4106248", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 3156.0, "discounted_cash": 2367.0, "setting": "both", "billing_class": "facility"}]}, {"description": "HIV-1 QUANT", "code_information": [{"code": "87536", "type": "CPT"}, {"code": "7257536", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 342.0, "discounted_cash": 256.5, "setting": "both", "billing_class": "facility"}]}, {"description": "HIV-1 QUANT/5", "code_information": [{"code": "87536", "type": "CPT"}, {"code": "7257537", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 1415.0, "discounted_cash": 1061.25, "setting": "both", "billing_class": "facility"}]}, {"description": "HLA I AG EQUIV EACH LOW/2", "code_information": [{"code": "81374", "type": "CPT"}, {"code": "7259200", "type": "CDM"}, {"code": "310", "type": "RC"}], "standard_charges": [{"gross_charge": 318.0, "discounted_cash": 238.5, "setting": "both", "billing_class": "facility"}]}, {"description": "HLA I ONE ALELE/GRP HIGH", "code_information": [{"code": "81381", "type": "CPT"}, {"code": "7251381", "type": "CDM"}, {"code": "310", "type": "RC"}], "standard_charges": [{"gross_charge": 324.0, "discounted_cash": 243.0, "setting": "both", "billing_class": "facility"}]}, {"description": "HLA I ONE LOCUS LOW", "code_information": [{"code": "81373", "type": "CPT"}, {"code": "7251373", "type": "CDM"}, {"code": "310", "type": "RC"}], "standard_charges": [{"gross_charge": 238.0, "discounted_cash": 178.5, "setting": "both", "billing_class": "facility"}]}, {"description": "HLA II AG EQUIV EACH LOW", "code_information": [{"code": "81377", "type": "CPT"}, {"code": "7251374", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 251.0, "discounted_cash": 188.25, "setting": "both", "billing_class": "facility"}]}, {"description": "HLA SPECIFIC COMPONENT", "code_information": [{"code": "P9052", "type": "HCPCS"}, {"code": "4509052", "type": "CDM"}, {"code": "399", "type": "RC"}], "standard_charges": [{"gross_charge": 2480.0, "discounted_cash": 1860.0, "setting": "both", "billing_class": "facility"}]}, {"description": "HLA TYPING ABC MULTI AG", "code_information": [{"code": "86813", "type": "CPT"}, {"code": "4106134", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 4749.0, "discounted_cash": 3561.75, "setting": "both", "billing_class": "facility"}]}, {"description": "HLA TYPING ABC SNGL AG", "code_information": [{"code": "86812", "type": "CPT"}, {"code": "7256598", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 344.0, "discounted_cash": 258.0, "setting": "both", "billing_class": "facility"}]}, {"description": "HMOGLBN FETAL(KLEIHAUER)", "code_information": [{"code": "85460", "type": "CPT"}, {"code": "4105460", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 1020.0, "discounted_cash": 765.0, "setting": "both", "billing_class": "facility"}]}, {"description": "HMOGLBN FETAL(KLEIHAUER)", "code_information": [{"code": "85460", "type": "CPT"}, {"code": "4175460", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 52.8, "discounted_cash": 39.6, "setting": "both", "billing_class": "facility"}]}, {"description": "HOCM < = 149MG/ML ID 1ML", "code_information": [{"code": "Q9958", "type": "HCPCS"}, {"code": "5356181", "type": "CDM"}, {"code": "255", "type": "RC"}], "standard_charges": [{"gross_charge": 3.0, "discounted_cash": 2.25, "setting": "both", "billing_class": "facility"}]}, {"description": "HOCM < = 149MG/ML ID 1ML", "code_information": [{"code": "Q9958", "type": "HCPCS"}, {"code": "5356181", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 3.0, "discounted_cash": 2.25, "setting": "both", "billing_class": "facility"}]}, {"description": "HOMOCYSTEINE QUANT", "code_information": [{"code": "83090", "type": "CPT"}, {"code": "4103094", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 488.0, "discounted_cash": 366.0, "setting": "both", "billing_class": "facility"}]}, {"description": "HOMOCYSTEINE QUANT/2", "code_information": [{"code": "83090", "type": "CPT"}, {"code": "7253089", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 327.0, "discounted_cash": 245.25, "setting": "both", "billing_class": "facility"}]}, {"description": "HOMOVNLLC ACID(HVA)", "code_information": [{"code": "83150", "type": "CPT"}, {"code": "7253150", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 928.0, "discounted_cash": 696.0, "setting": "both", "billing_class": "facility"}]}, {"description": "HOMOVNLLC ACID(HVA)/2", "code_information": [{"code": "83150", "type": "CPT"}, {"code": "7258315", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 928.0, "discounted_cash": 696.0, "setting": "both", "billing_class": "facility"}]}, {"description": "HOOK LUMB-LAM", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8132840", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 12101.0, "discounted_cash": 9075.75, "setting": "both", "billing_class": "facility"}]}, {"description": "HSV CUL W/ID NON IMMUNO", "code_information": [{"code": "87255", "type": "CPT"}, {"code": "7257260", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 96.0, "discounted_cash": 72.0, "setting": "both", "billing_class": "facility"}]}, {"description": "HTLV/HIV CONFIRM AB", "code_information": [{"code": "86689", "type": "CPT"}, {"code": "7256322", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 408.0, "discounted_cash": 306.0, "setting": "both", "billing_class": "facility"}]}, {"description": "HTT GENE DETC ABNOR ALLELES", "code_information": [{"code": "81271", "type": "CPT"}, {"code": "7251009", "type": "CDM"}, {"code": "310", "type": "RC"}], "standard_charges": [{"gross_charge": 446.0, "discounted_cash": 334.5, "setting": "both", "billing_class": "facility"}]}, {"description": "HU ANTIBODY SCREEN", "code_information": [{"code": "86255", "type": "CPT"}, {"code": "7254193", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 215.0, "discounted_cash": 161.25, "setting": "both", "billing_class": "facility"}]}, {"description": "HUMAN DONOR MILK 20 KCAL 90ML", "code_information": [{"code": "8030886", "type": "CDM"}, {"code": "271", "type": "RC"}], "standard_charges": [{"gross_charge": 177.0, "discounted_cash": 132.75, "setting": "both", "billing_class": "facility"}]}, {"description": "HUMERUS 2 VIEW MINIMUM", "code_information": [{"code": "73060", "type": "CPT"}, {"code": "4903060", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 1971.0, "discounted_cash": 1478.25, "setting": "both", "billing_class": "facility"}]}, {"description": "HUMERUS 2 VIEW MINIMUM", "code_information": [{"code": "73060", "type": "CPT"}, {"code": "5113060", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 1328.0, "discounted_cash": 996.0, "setting": "both", "billing_class": "facility"}]}, {"description": "HYALURON/CHONDR .5ML IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5321197", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 2849.0, "discounted_cash": 2136.75, "setting": "both", "billing_class": "facility"}]}, {"description": "HYALURON/CHONDR.5MLKTIJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5335851", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 2617.0, "discounted_cash": 1962.75, "setting": "both", "billing_class": "facility"}]}, {"description": "HYALURON10MG/ML.85MLSGIJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5331161", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 1318.0, "discounted_cash": 988.5, "setting": "both", "billing_class": "facility"}]}, {"description": "HYALURON12MG/ML.8ML SGIJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5331156", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 2884.0, "discounted_cash": 2163.0, "setting": "both", "billing_class": "facility"}]}, {"description": "HYALURON16MG/ML.8ML SGIJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5331166", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 2617.0, "discounted_cash": 1962.75, "setting": "both", "billing_class": "facility"}]}, {"description": "HYALURONIC ACID", "code_information": [{"code": "83520", "type": "CPT"}, {"code": "7253005", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 482.0, "discounted_cash": 361.5, "setting": "both", "billing_class": "facility"}]}, {"description": "HYALURONIDASE RECOMB 1U", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3473", "type": "HCPCS"}, {"code": "5321201", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 12.0, "discounted_cash": 9.0, "setting": "both", "billing_class": "facility"}]}, {"description": "HYALURONIDASE RECOMB 1U", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3473", "type": "HCPCS"}, {"code": "5321201", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 12.0, "discounted_cash": 9.0, "setting": "both", "billing_class": "facility"}]}, {"description": "HYALURONIDASE UPTO150UIJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3470", "type": "HCPCS"}, {"code": "5321181", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 1812.0, "discounted_cash": 1359.0, "setting": "both", "billing_class": "facility"}]}, {"description": "HYALURONIDASE UPTO150UIJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3470", "type": "HCPCS"}, {"code": "5321181", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 1812.0, "discounted_cash": 1359.0, "setting": "both", "billing_class": "facility"}]}, {"description": "HYDRALAZINE 10MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5305672", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 61.0, "discounted_cash": 45.75, "setting": "both", "billing_class": "facility"}]}, {"description": "HYDRALAZINE 10MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5305672", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 61.0, "discounted_cash": 45.75, "setting": "both", "billing_class": "facility"}]}, {"description": "HYDRALAZINE 25MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5305676", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 77.0, "discounted_cash": 57.75, "setting": "both", "billing_class": "facility"}]}, {"description": "HYDRALAZINE 25MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5305676", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 77.0, "discounted_cash": 57.75, "setting": "both", "billing_class": "facility"}]}, {"description": "HYDRALAZINE 50MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5305680", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 66.0, "discounted_cash": 49.5, "setting": "both", "billing_class": "facility"}]}, {"description": "HYDRALAZINE 50MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5305680", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 66.0, "discounted_cash": 49.5, "setting": "both", "billing_class": "facility"}]}, {"description": "HYDRALAZINE UPTO 20MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0360", "type": "HCPCS"}, {"code": "5321202", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 635.0, "discounted_cash": 476.25, "setting": "both", "billing_class": "facility"}]}, {"description": "HYDRALAZINE UPTO 20MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0360", "type": "HCPCS"}, {"code": "5321202", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 635.0, "discounted_cash": 476.25, "setting": "both", "billing_class": "facility"}]}, {"description": "HYDROCOD/APAP 10/325 TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5327565", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 85.0, "discounted_cash": 63.75, "setting": "both", "billing_class": "facility"}]}, {"description": "HYDROCOD/APAP 10/325 TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5327565", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 85.0, "discounted_cash": 63.75, "setting": "both", "billing_class": "facility"}]}, {"description": "HYDROCOD/APAP 15ML LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5327558", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 97.0, "discounted_cash": 72.75, "setting": "both", "billing_class": "facility"}]}, {"description": "HYDROCOD/APAP 15ML LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5327558", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 97.0, "discounted_cash": 72.75, "setting": "both", "billing_class": "facility"}]}, {"description": "HYDROCOD/APAP 5/325 TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5327554", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 85.0, "discounted_cash": 63.75, "setting": "both", "billing_class": "facility"}]}, {"description": "HYDROCOD/APAP 5/325 TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5327554", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 85.0, "discounted_cash": 63.75, "setting": "both", "billing_class": "facility"}]}, {"description": "HYDROCOD/APAP 7.5/325TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5327557", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 77.0, "discounted_cash": 57.75, "setting": "both", "billing_class": "facility"}]}, {"description": "HYDROCOD/APAP 7.5/325TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5327557", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 77.0, "discounted_cash": 57.75, "setting": "both", "billing_class": "facility"}]}, {"description": "HYDROCOD/APAP 7.5/500TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5327579", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 85.0, "discounted_cash": 63.75, "setting": "both", "billing_class": "facility"}]}, {"description": "HYDROCOD/APAP 7.5/500TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5327579", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 85.0, "discounted_cash": 63.75, "setting": "both", "billing_class": "facility"}]}, {"description": "HYDROCORTISONE 10MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5305742", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 66.0, "discounted_cash": 49.5, "setting": "both", "billing_class": "facility"}]}, {"description": "HYDROCORTISONE 10MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5305742", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 66.0, "discounted_cash": 49.5, "setting": "both", "billing_class": "facility"}]}, {"description": "HYDROMORPH PER 0.1MG PCA IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J1171", "type": "HCPCS"}, {"code": "5327690", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 5.0, "discounted_cash": 3.75, "setting": "both", "billing_class": "facility"}]}, {"description": "HYDROMORPH PER 0.1MG PCA IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J1171", "type": "HCPCS"}, {"code": "5327690", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 5.0, "discounted_cash": 3.75, "setting": "both", "billing_class": "facility"}]}, {"description": "HYDROMORPHONE 2MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5327587", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 61.0, "discounted_cash": 45.75, "setting": "both", "billing_class": "facility"}]}, {"description": "HYDROMORPHONE 2MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5327587", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 61.0, "discounted_cash": 45.75, "setting": "both", "billing_class": "facility"}]}, {"description": "HYDROMORPHONE PER 0.1MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J1171", "type": "HCPCS"}, {"code": "5327673", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 5.0, "discounted_cash": 3.75, "setting": "both", "billing_class": "facility"}]}, {"description": "HYDROMORPHONE PER 0.1MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J1171", "type": "HCPCS"}, {"code": "5327673", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 5.0, "discounted_cash": 3.75, "setting": "both", "billing_class": "facility"}]}, {"description": "HYDROXY METHYL2.5%15MLOS", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5331479", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 129.0, "discounted_cash": 96.75, "setting": "both", "billing_class": "facility"}]}, {"description": "HYDROXY METHYL2.5%15MLOS", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5331479", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 129.0, "discounted_cash": 96.75, "setting": "both", "billing_class": "facility"}]}, {"description": "HYDROXYCHLOROQUINE", "code_information": [{"code": "80220", "type": "CPT"}, {"code": "7250372", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 504.0, "discounted_cash": 378.0, "setting": "both", "billing_class": "facility"}]}, {"description": "HYDROXYCHLOROQUN200MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5305788", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 61.0, "discounted_cash": 45.75, "setting": "both", "billing_class": "facility"}]}, {"description": "HYDROXYCHLOROQUN200MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5305788", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 61.0, "discounted_cash": 45.75, "setting": "both", "billing_class": "facility"}]}, {"description": "HYDROXYUREA 500MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5305811", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 61.0, "discounted_cash": 45.75, "setting": "both", "billing_class": "facility"}]}, {"description": "HYDROXYUREA 500MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5305811", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 61.0, "discounted_cash": 45.75, "setting": "both", "billing_class": "facility"}]}, {"description": "HYDROXYZINE 10/5 1ML LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5315332", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 66.0, "discounted_cash": 49.5, "setting": "both", "billing_class": "facility"}]}, {"description": "HYDROXYZINE 10/5 1ML LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5315332", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 66.0, "discounted_cash": 49.5, "setting": "both", "billing_class": "facility"}]}, {"description": "HYDROXYZINE 10MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5305830", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 61.0, "discounted_cash": 45.75, "setting": "both", "billing_class": "facility"}]}, {"description": "HYDROXYZINE 10MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5305830", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 61.0, "discounted_cash": 45.75, "setting": "both", "billing_class": "facility"}]}, {"description": "HYDROXYZINE 10MG/5ML LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5315325", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 61.0, "discounted_cash": 45.75, "setting": "both", "billing_class": "facility"}]}, {"description": "HYDROXYZINE 10MG/5ML LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5315325", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 61.0, "discounted_cash": 45.75, "setting": "both", "billing_class": "facility"}]}, {"description": "HYDROXYZINE 25MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5305834", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 63.0, "discounted_cash": 47.25, "setting": "both", "billing_class": "facility"}]}, {"description": "HYDROXYZINE 25MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5305834", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 63.0, "discounted_cash": 47.25, "setting": "both", "billing_class": "facility"}]}, {"description": "HYDROXYZINE 25MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5305835", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 71.0, "discounted_cash": 53.25, "setting": "both", "billing_class": "facility"}]}, {"description": "HYDROXYZINE 25MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5305835", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 71.0, "discounted_cash": 53.25, "setting": "both", "billing_class": "facility"}]}, {"description": "HYDROXYZINE UPTO25MGIJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3410", "type": "HCPCS"}, {"code": "5321315", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 55.0, "discounted_cash": 41.25, "setting": "both", "billing_class": "facility"}]}, {"description": "HYDROXYZINE UPTO25MGIJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3410", "type": "HCPCS"}, {"code": "5321315", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 55.0, "discounted_cash": 41.25, "setting": "both", "billing_class": "facility"}]}, {"description": "HYDRXINDOL ACD5(HIAA)QT", "code_information": [{"code": "83497", "type": "CPT"}, {"code": "7253497", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 628.0, "discounted_cash": 471.0, "setting": "both", "billing_class": "facility"}]}, {"description": "HYDRXINDOL ACD5(HIAA)QT/2", "code_information": [{"code": "83497", "type": "CPT"}, {"code": "7253499", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 628.0, "discounted_cash": 471.0, "setting": "both", "billing_class": "facility"}]}, {"description": "HYDRXYPRGSTRONE 17-D/2", "code_information": [{"code": "83498", "type": "CPT"}, {"code": "7253498", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 1214.0, "discounted_cash": 910.5, "setting": "both", "billing_class": "facility"}]}, {"description": "HYDRXYPROLINE FREE", "code_information": [{"code": "83500", "type": "CPT"}, {"code": "7253500", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 1003.0, "discounted_cash": 752.25, "setting": "both", "billing_class": "facility"}]}, {"description": "HYOSCYAM.125/ML 15MLDRLQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5315334", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 331.0, "discounted_cash": 248.25, "setting": "both", "billing_class": "facility"}]}, {"description": "HYOSCYAM.125/ML 15MLDRLQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5315334", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 331.0, "discounted_cash": 248.25, "setting": "both", "billing_class": "facility"}]}, {"description": "HYOSCYAMINE .125MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5305865", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 63.0, "discounted_cash": 47.25, "setting": "both", "billing_class": "facility"}]}, {"description": "HYOSCYAMINE .125MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5305865", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 63.0, "discounted_cash": 47.25, "setting": "both", "billing_class": "facility"}]}, {"description": "HYOSCYAMINE PEDI DOSE LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5315345", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 65.0, "discounted_cash": 48.75, "setting": "both", "billing_class": "facility"}]}, {"description": "HYOSCYAMINE PEDI DOSE LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5315345", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 65.0, "discounted_cash": 48.75, "setting": "both", "billing_class": "facility"}]}, {"description": "HYOSCYAMINE PER 1ML LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5315353", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 83.0, "discounted_cash": 62.25, "setting": "both", "billing_class": "facility"}]}, {"description": "HYOSCYAMINE PER 1ML LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5315353", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 83.0, "discounted_cash": 62.25, "setting": "both", "billing_class": "facility"}]}, {"description": "HYSTEROSALPINGOGRAPHY", "code_information": [{"code": "74740", "type": "CPT"}, {"code": "4904740", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 2510.0, "discounted_cash": 1882.5, "setting": "both", "billing_class": "facility"}]}, {"description": "I 123 SOD CAP PER 100UCI", "code_information": [{"code": "A9516", "type": "HCPCS"}, {"code": "5199516", "type": "CDM"}, {"code": "343", "type": "RC"}], "standard_charges": [{"gross_charge": 1260.0, "discounted_cash": 945.0, "setting": "both", "billing_class": "facility"}]}, {"description": "I&D ABSCESS SIMP/SNGL", "code_information": [{"code": "6810512", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 772.0, "discounted_cash": 579.0, "setting": "both", "billing_class": "facility"}]}, {"description": "I&D ABSCESS SIMP/SNGL", "code_information": [{"code": "6810512", "type": "CDM"}, {"code": "361", "type": "RC"}], "standard_charges": [{"gross_charge": 772.0, "discounted_cash": 579.0, "setting": "both", "billing_class": "facility"}]}, {"description": "I&D ABSCESS SIMP/SNGL", "code_information": [{"code": "6900051", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 655.0, "discounted_cash": 491.25, "setting": "both", "billing_class": "facility"}]}, {"description": "I&D ABSCESS SIMP/SNGL", "code_information": [{"code": "6900051", "type": "CDM"}, {"code": "361", "type": "RC"}], "standard_charges": [{"gross_charge": 655.0, "discounted_cash": 491.25, "setting": "both", "billing_class": "facility"}]}, {"description": "I&D COMPLEX DRAIN WOUND", "code_information": [{"code": "6900133", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 12718.0, "discounted_cash": 9538.5, "setting": "both", "billing_class": "facility"}]}, {"description": "I&D COMPLEX DRAIN WOUND", "code_information": [{"code": "6900133", "type": "CDM"}, {"code": "361", "type": "RC"}], "standard_charges": [{"gross_charge": 12718.0, "discounted_cash": 9538.5, "setting": "both", "billing_class": "facility"}]}, {"description": "I&D HEMA SEROMA FL", "code_information": [{"code": "4910140", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 4146.0, "discounted_cash": 3109.5, "setting": "both", "billing_class": "facility"}]}, {"description": "I&D HEMA SEROMA FL", "code_information": [{"code": "6909896", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 772.0, "discounted_cash": 579.0, "setting": "both", "billing_class": "facility"}]}, {"description": "I&D HEMA SEROMA FL", "code_information": [{"code": "6909896", "type": "CDM"}, {"code": "361", "type": "RC"}], "standard_charges": [{"gross_charge": 772.0, "discounted_cash": 579.0, "setting": "both", "billing_class": "facility"}]}, {"description": "I&D SKIN ABSCESS COMPLEX", "code_information": [{"code": "6900052", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 1365.0, "discounted_cash": 1023.75, "setting": "both", "billing_class": "facility"}]}, {"description": "I&D SKIN ABSCESS COMPLEX", "code_information": [{"code": "6900052", "type": "CDM"}, {"code": "361", "type": "RC"}], "standard_charges": [{"gross_charge": 1365.0, "discounted_cash": 1023.75, "setting": "both", "billing_class": "facility"}]}, {"description": "IA INFECT AGENT AB QN NOS", "code_information": [{"code": "86317", "type": "CPT"}, {"code": "7256072", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 92.0, "discounted_cash": 69.0, "setting": "both", "billing_class": "facility"}]}, {"description": "IA INFECT AGENT AB QN NOS/2", "code_information": [{"code": "86317", "type": "CPT"}, {"code": "4176315", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 27.11, "discounted_cash": 20.33, "setting": "both", "billing_class": "facility"}]}, {"description": "IA INFECT AGENT AB QN NOS/2", "code_information": [{"code": "86317", "type": "CPT"}, {"code": "7256313", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 92.0, "discounted_cash": 69.0, "setting": "both", "billing_class": "facility"}]}, {"description": "IA INFECT AGENT AB QN NOS/4", "code_information": [{"code": "86317", "type": "CPT"}, {"code": "7256315", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 12.0, "discounted_cash": 9.0, "setting": "both", "billing_class": "facility"}]}, {"description": "IA INFECT AGENT AB QN NOS/5", "code_information": [{"code": "86317", "type": "CPT"}, {"code": "7256317", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 388.0, "discounted_cash": 291.0, "setting": "both", "billing_class": "facility"}]}, {"description": "IA INFECT AGENT AB QN NOS/7", "code_information": [{"code": "86317", "type": "CPT"}, {"code": "7256320", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 35.0, "discounted_cash": 26.25, "setting": "both", "billing_class": "facility"}]}, {"description": "IA INFECT AGENT AB QN NOS/8", "code_information": [{"code": "86317", "type": "CPT"}, {"code": "7256325", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 122.0, "discounted_cash": 91.5, "setting": "both", "billing_class": "facility"}]}, {"description": "IA INFECT AGENT AB QN NOS/9", "code_information": [{"code": "86317", "type": "CPT"}, {"code": "7256617", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 1662.0, "discounted_cash": 1246.5, "setting": "both", "billing_class": "facility"}]}, {"description": "IA NFCT AB SARSCOV2 MULT", "code_information": [{"code": "86769", "type": "CPT"}, {"code": "7250045", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 160.0, "discounted_cash": 120.0, "setting": "both", "billing_class": "facility"}]}, {"description": "IA TUMOR AG NES QUAN", "code_information": [{"code": "86316", "type": "CPT"}, {"code": "7252399", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 70.0, "discounted_cash": 52.5, "setting": "both", "billing_class": "facility"}]}, {"description": "IA TUMOR AG NES QUAN/3", "code_information": [{"code": "86316", "type": "CPT"}, {"code": "7253883", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 199.0, "discounted_cash": 149.25, "setting": "both", "billing_class": "facility"}]}, {"description": "IA TUMOR CA 125 QUAN", "code_information": [{"code": "86304", "type": "CPT"}, {"code": "4104904", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 1111.0, "discounted_cash": 833.25, "setting": "both", "billing_class": "facility"}]}, {"description": "IA TUMOR CA 125 QUAN", "code_information": [{"code": "86304", "type": "CPT"}, {"code": "4174904", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 11.42, "discounted_cash": 8.57, "setting": "both", "billing_class": "facility"}]}, {"description": "IA TUMOR CA 125 QUAN", "code_information": [{"code": "86304", "type": "CPT"}, {"code": "7256900", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 742.0, "discounted_cash": 556.5, "setting": "both", "billing_class": "facility"}]}, {"description": "IA TUMOR CA 15-3 QUAN", "code_information": [{"code": "86300", "type": "CPT"}, {"code": "7254898", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 95.0, "discounted_cash": 71.25, "setting": "both", "billing_class": "facility"}]}, {"description": "IA TUMOR CA 15-3 QUAN/2", "code_information": [{"code": "86300", "type": "CPT"}, {"code": "4104998", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 142.0, "discounted_cash": 106.5, "setting": "both", "billing_class": "facility"}]}, {"description": "IA TUMOR CA 15-3 QUAN/2", "code_information": [{"code": "86300", "type": "CPT"}, {"code": "7254998", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 909.0, "discounted_cash": 681.75, "setting": "both", "billing_class": "facility"}]}, {"description": "IA TUMOR CA 19-9 QUAN", "code_information": [{"code": "86301", "type": "CPT"}, {"code": "4104900", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 1404.0, "discounted_cash": 1053.0, "setting": "both", "billing_class": "facility"}]}, {"description": "IA TUMOR CA 19-9 QUAN", "code_information": [{"code": "86301", "type": "CPT"}, {"code": "7254900", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 1045.0, "discounted_cash": 783.75, "setting": "both", "billing_class": "facility"}]}, {"description": "IBUPROFEN 100MG/5ML LQ", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5315335", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 71.0, "discounted_cash": 53.25, "setting": "both", "billing_class": "facility"}]}, {"description": "IBUPROFEN 100MG/5ML LQ", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5315335", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 71.0, "discounted_cash": 53.25, "setting": "both", "billing_class": "facility"}]}, {"description": "IBUPROFEN 200MG TB", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5305909", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 77.0, "discounted_cash": 57.75, "setting": "both", "billing_class": "facility"}]}, {"description": "IBUPROFEN 200MG TB", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5305909", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 77.0, "discounted_cash": 57.75, "setting": "both", "billing_class": "facility"}]}, {"description": "IBUPROFEN 400MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5305915", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 85.0, "discounted_cash": 63.75, "setting": "both", "billing_class": "facility"}]}, {"description": "IBUPROFEN 400MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5305915", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 85.0, "discounted_cash": 63.75, "setting": "both", "billing_class": "facility"}]}, {"description": "IBUPROFEN 600MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5305919", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 85.0, "discounted_cash": 63.75, "setting": "both", "billing_class": "facility"}]}, {"description": "IBUPROFEN 600MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5305919", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 85.0, "discounted_cash": 63.75, "setting": "both", "billing_class": "facility"}]}, {"description": "IBUPROFEN NEO CMPD IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J1741", "type": "HCPCS"}, {"code": "5321304", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 909.0, "discounted_cash": 681.75, "setting": "both", "billing_class": "facility"}]}, {"description": "IBUPROFEN NEO CMPD IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J1741", "type": "HCPCS"}, {"code": "5321304", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 909.0, "discounted_cash": 681.75, "setting": "both", "billing_class": "facility"}]}, {"description": "IBUPROFEN PER 100MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J1741", "type": "HCPCS"}, {"code": "5321302", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 113.0, "discounted_cash": 84.75, "setting": "both", "billing_class": "facility"}]}, {"description": "IBUPROFEN PER 100MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J1741", "type": "HCPCS"}, {"code": "5321302", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 113.0, "discounted_cash": 84.75, "setting": "both", "billing_class": "facility"}]}, {"description": "IBUTILIDE PER 1MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J1742", "type": "HCPCS"}, {"code": "5321314", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 7891.0, "discounted_cash": 5918.25, "setting": "both", "billing_class": "facility"}]}, {"description": "IBUTILIDE PER 1MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J1742", "type": "HCPCS"}, {"code": "5321314", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 7891.0, "discounted_cash": 5918.25, "setting": "both", "billing_class": "facility"}]}, {"description": "IEP OTHER SOURCE/3", "code_information": [{"code": "86325", "type": "CPT"}, {"code": "4106329", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 213.0, "discounted_cash": 159.75, "setting": "both", "billing_class": "facility"}]}, {"description": "IEP SERUM", "code_information": [{"code": "86320", "type": "CPT"}, {"code": "4106320", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 1041.0, "discounted_cash": 780.75, "setting": "both", "billing_class": "facility"}]}, {"description": "IG-E SERUM", "code_information": [{"code": "82785", "type": "CPT"}, {"code": "4103513", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 737.0, "discounted_cash": 552.75, "setting": "both", "billing_class": "facility"}]}, {"description": "IG-E SERUM", "code_information": [{"code": "82785", "type": "CPT"}, {"code": "7252780", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 16.0, "discounted_cash": 12.0, "setting": "both", "billing_class": "facility"}]}, {"description": "IG-E SERUM/3", "code_information": [{"code": "82785", "type": "CPT"}, {"code": "7253513", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 718.0, "discounted_cash": 538.5, "setting": "both", "billing_class": "facility"}]}, {"description": "ILIAC ART BI W CARD CTH", "code_information": [{"code": "G0278", "type": "HCPCS"}, {"code": "4610278", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 30791.0, "discounted_cash": 23093.25, "setting": "both", "billing_class": "facility"}]}, {"description": "IMG CATH FLUID COL VISC", "code_information": [{"code": "4919415", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 6459.0, "discounted_cash": 4844.25, "setting": "both", "billing_class": "facility"}]}, {"description": "IMG CATH FLUID COL VISC", "code_information": [{"code": "5059405", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 7462.0, "discounted_cash": 5596.5, "setting": "both", "billing_class": "facility"}]}, {"description": "IMG CATH FLUID COL VISC", "code_information": [{"code": "5069405", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 6889.0, "discounted_cash": 5166.75, "setting": "both", "billing_class": "facility"}]}, {"description": "IMG CATH FLUID PERI/RETR", "code_information": [{"code": "4919406", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 5184.0, "discounted_cash": 3888.0, "setting": "both", "billing_class": "facility"}]}, {"description": "IMG CATH FLUID PERI/RETR", "code_information": [{"code": "5059406", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 5184.0, "discounted_cash": 3888.0, "setting": "both", "billing_class": "facility"}]}, {"description": "IMG CATH FLUID PERI/RETR", "code_information": [{"code": "5069406", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 6748.0, "discounted_cash": 5061.0, "setting": "both", "billing_class": "facility"}]}, {"description": "IMG CATH FLUID TRNS/RCTL", "code_information": [{"code": "4919408", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 4623.0, "discounted_cash": 3467.25, "setting": "both", "billing_class": "facility"}]}, {"description": "IMG CATH FLUID TRNS/VAG", "code_information": [{"code": "4919407", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 4623.0, "discounted_cash": 3467.25, "setting": "both", "billing_class": "facility"}]}, {"description": "IMG CATH FLUID TRNS/VAG", "code_information": [{"code": "5059407", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 4623.0, "discounted_cash": 3467.25, "setting": "both", "billing_class": "facility"}]}, {"description": "IMG CATH FLUID TRNS/VAG", "code_information": [{"code": "5069407", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 4623.0, "discounted_cash": 3467.25, "setting": "both", "billing_class": "facility"}]}, {"description": "IMIPENEM/CIL PER 5MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5321301", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 113.0, "discounted_cash": 84.75, "setting": "both", "billing_class": "facility"}]}, {"description": "IMIPRAMINE 10MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5305949", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 72.0, "discounted_cash": 54.0, "setting": "both", "billing_class": "facility"}]}, {"description": "IMIPRAMINE 10MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5305949", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 72.0, "discounted_cash": 54.0, "setting": "both", "billing_class": "facility"}]}, {"description": "IMIPRAMINE 25MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5305950", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 85.0, "discounted_cash": 63.75, "setting": "both", "billing_class": "facility"}]}, {"description": "IMIPRAMINE 25MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5305950", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 85.0, "discounted_cash": 63.75, "setting": "both", "billing_class": "facility"}]}, {"description": "IMM ADM EA ADDL VACCINE", "code_information": [{"code": "90472", "type": "CPT"}, {"code": "3100472", "type": "CDM"}, {"code": "771", "type": "RC"}], "standard_charges": [{"gross_charge": 159.0, "discounted_cash": 119.25, "setting": "both", "billing_class": "facility"}]}, {"description": "IMM ADM EA ADDL VACCINE", "code_information": [{"code": "90472", "type": "CPT"}, {"code": "6103998", "type": "CDM"}, {"code": "771", "type": "RC"}], "standard_charges": [{"gross_charge": 179.0, "discounted_cash": 134.25, "setting": "both", "billing_class": "facility"}]}, {"description": "IMM ADM EA ADDL VACCINE", "code_information": [{"code": "90472", "type": "CPT"}, {"code": "6290472", "type": "CDM"}, {"code": "771", "type": "RC"}], "standard_charges": [{"gross_charge": 159.0, "discounted_cash": 119.25, "setting": "both", "billing_class": "facility"}]}, {"description": "IMM ADMIN SNGL/COMBO VAC", "code_information": [{"code": "90471", "type": "CPT"}, {"code": "3100471", "type": "CDM"}, {"code": "771", "type": "RC"}], "standard_charges": [{"gross_charge": 258.0, "discounted_cash": 193.5, "setting": "both", "billing_class": "facility"}]}, {"description": "IMM ADMIN SNGL/COMBO VAC", "code_information": [{"code": "90471", "type": "CPT"}, {"code": "6103996", "type": "CDM"}, {"code": "771", "type": "RC"}], "standard_charges": [{"gross_charge": 405.0, "discounted_cash": 303.75, "setting": "both", "billing_class": "facility"}]}, {"description": "IMM ADMIN SNGL/COMBO VAC", "code_information": [{"code": "90471", "type": "CPT"}, {"code": "6290471", "type": "CDM"}, {"code": "771", "type": "RC"}], "standard_charges": [{"gross_charge": 258.0, "discounted_cash": 193.5, "setting": "both", "billing_class": "facility"}]}, {"description": "IMM ADMIN SNGL/COMBO VAC", "code_information": [{"code": "90471", "type": "CPT"}, {"code": "6810471", "type": "CDM"}, {"code": "771", "type": "RC"}], "standard_charges": [{"gross_charge": 315.0, "discounted_cash": 236.25, "setting": "both", "billing_class": "facility"}]}, {"description": "IMMUN NONINFC QL/SEMI/M", "code_information": [{"code": "83516", "type": "CPT"}, {"code": "4103500", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 252.0, "discounted_cash": 189.0, "setting": "both", "billing_class": "facility"}]}, {"description": "IMMUN NONINFC QL/SEMI/M", "code_information": [{"code": "83516", "type": "CPT"}, {"code": "7253509", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 595.0, "discounted_cash": 446.25, "setting": "both", "billing_class": "facility"}]}, {"description": "IMMUN NONINFC QL/SEMI/M/2", "code_information": [{"code": "83516", "type": "CPT"}, {"code": "7253516", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 113.0, "discounted_cash": 84.75, "setting": "both", "billing_class": "facility"}]}, {"description": "IMMUN NONINFC QL/SEMI/M/3", "code_information": [{"code": "83516", "type": "CPT"}, {"code": "7253517", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 171.0, "discounted_cash": 128.25, "setting": "both", "billing_class": "facility"}]}, {"description": "IMMUN NONINFC QL/SEMI/M/4", "code_information": [{"code": "83516", "type": "CPT"}, {"code": "7256641", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 128.0, "discounted_cash": 96.0, "setting": "both", "billing_class": "facility"}]}, {"description": "IMMUN NONINFC QL/SEMI/M/5", "code_information": [{"code": "83516", "type": "CPT"}, {"code": "7250203", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 149.0, "discounted_cash": 111.75, "setting": "both", "billing_class": "facility"}]}, {"description": "IMMUN NONINFC QL/SEMI/M/6", "code_information": [{"code": "83516", "type": "CPT"}, {"code": "7250204", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 16.3, "discounted_cash": 12.23, "setting": "both", "billing_class": "facility"}]}, {"description": "IMMUN NONINFC QL/SEMI/SG", "code_information": [{"code": "83518", "type": "CPT"}, {"code": "7258379", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 404.0, "discounted_cash": 303.0, "setting": "both", "billing_class": "facility"}]}, {"description": "IMMUNCYT 1ST AB PER SPEC", "code_information": [{"code": "88342", "type": "CPT"}, {"code": "4308314", "type": "CDM"}, {"code": "310", "type": "RC"}], "standard_charges": [{"gross_charge": 908.0, "discounted_cash": 681.0, "setting": "both", "billing_class": "facility"}]}, {"description": "IMMUNE COMPLEX/2", "code_information": [{"code": "86332", "type": "CPT"}, {"code": "7254239", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 144.0, "discounted_cash": 108.0, "setting": "both", "billing_class": "facility"}]}, {"description": "IMMUNE COMPLEX/3", "code_information": [{"code": "86332", "type": "CPT"}, {"code": "7256372", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 59.0, "discounted_cash": 44.25, "setting": "both", "billing_class": "facility"}]}, {"description": "IMMUNOCYTO EA ADD AB STN", "code_information": [{"code": "88341", "type": "CPT"}, {"code": "4308369", "type": "CDM"}, {"code": "310", "type": "RC"}], "standard_charges": [{"gross_charge": 865.0, "discounted_cash": 648.75, "setting": "both", "billing_class": "facility"}]}, {"description": "IMMUNOCYTO EA ADD AB STN", "code_information": [{"code": "88341", "type": "CPT"}, {"code": "4328369", "type": "CDM"}, {"code": "310", "type": "RC"}], "standard_charges": [{"gross_charge": 230.0, "discounted_cash": 172.5, "setting": "both", "billing_class": "facility"}]}, {"description": "IMMUNODIFFUSION GEL QUAL/3", "code_information": [{"code": "86331", "type": "CPT"}, {"code": "7256346", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 87.0, "discounted_cash": 65.25, "setting": "both", "billing_class": "facility"}]}, {"description": "IMMUNODIFFUSION NES", "code_information": [{"code": "86329", "type": "CPT"}, {"code": "7253511", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 83.0, "discounted_cash": 62.25, "setting": "both", "billing_class": "facility"}]}, {"description": "IMMUNOFIX ELECTRO OTHER SR", "code_information": [{"code": "86335", "type": "CPT"}, {"code": "7256335", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 452.0, "discounted_cash": 339.0, "setting": "both", "billing_class": "facility"}]}, {"description": "IMMUNOFIX ELECTRO OTHER SR/2", "code_information": [{"code": "86335", "type": "CPT"}, {"code": "4106340", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 184.0, "discounted_cash": 138.0, "setting": "both", "billing_class": "facility"}]}, {"description": "IMMUNOFIX ELECTRO OTHER SR/2", "code_information": [{"code": "86335", "type": "CPT"}, {"code": "7256337", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 58.0, "discounted_cash": 43.5, "setting": "both", "billing_class": "facility"}]}, {"description": "IMMUNOFIX ELECTRO OTHER SR/4", "code_information": [{"code": "86335", "type": "CPT"}, {"code": "7256344", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 120.0, "discounted_cash": 90.0, "setting": "both", "billing_class": "facility"}]}, {"description": "IMMUNOFIX ELECTRO SERUM", "code_information": [{"code": "86334", "type": "CPT"}, {"code": "4106334", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 108.0, "discounted_cash": 81.0, "setting": "both", "billing_class": "facility"}]}, {"description": "IMMUNOFIX ELECTRO SERUM", "code_information": [{"code": "86334", "type": "CPT"}, {"code": "7252785", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 130.0, "discounted_cash": 97.5, "setting": "both", "billing_class": "facility"}]}, {"description": "IMMUNOFLOR 1ST AB PER SPEC", "code_information": [{"code": "88346", "type": "CPT"}, {"code": "4308345", "type": "CDM"}, {"code": "310", "type": "RC"}], "standard_charges": [{"gross_charge": 1729.0, "discounted_cash": 1296.75, "setting": "both", "billing_class": "facility"}]}, {"description": "IMMUNOGLOB SUBCLASS EA", "code_information": [{"code": "82787", "type": "CPT"}, {"code": "7252788", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 26.0, "discounted_cash": 19.5, "setting": "both", "billing_class": "facility"}]}, {"description": "IMMUNOGLOB SUBCLASS EA/2", "code_information": [{"code": "82787", "type": "CPT"}, {"code": "7252789", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 26.0, "discounted_cash": 19.5, "setting": "both", "billing_class": "facility"}]}, {"description": "IMMUNOGLOB SUBCLASS EA/3", "code_information": [{"code": "82787", "type": "CPT"}, {"code": "7252790", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 26.0, "discounted_cash": 19.5, "setting": "both", "billing_class": "facility"}]}, {"description": "IMMUNOGLOB SUBCLASS EA/4", "code_information": [{"code": "82787", "type": "CPT"}, {"code": "7252791", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 26.0, "discounted_cash": 19.5, "setting": "both", "billing_class": "facility"}]}, {"description": "IMMUNOGLOB SUBCLASS EA/5", "code_information": [{"code": "82787", "type": "CPT"}, {"code": "7252792", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 28.0, "discounted_cash": 21.0, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP ACL TIGHTROPE", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "4012003", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 5143.0, "discounted_cash": 3857.25, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP ARTHROERESIS SUBFIX", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "4011188", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 42742.0, "discounted_cash": 32056.5, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP BLD SPIRAL", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "4011190", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 8654.0, "discounted_cash": 6490.5, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP BLN PRES REG", "code_information": [{"code": "C1815", "type": "HCPCS"}, {"code": "8172500", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 61993.0, "discounted_cash": 46494.75, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP BN", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8132900", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 8168.0, "discounted_cash": 6126.0, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP BN CORTICAL", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8132904", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 11345.0, "discounted_cash": 8508.75, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP BN DOWEL", "code_information": [{"code": "L8699", "type": "HCPCS"}, {"code": "8132903", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 16120.0, "discounted_cash": 12090.0, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP BN FEMORAL HEAD", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "8132908", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 13533.0, "discounted_cash": 10149.75, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP BN GRFT SUB OSTEO 10", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8247015", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 8656.0, "discounted_cash": 6492.0, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP BN MATRIX 1", "code_information": [{"code": "L8699", "type": "HCPCS"}, {"code": "8132911", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 22870.0, "discounted_cash": 17152.5, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP BN MATRIX 2", "code_information": [{"code": "L8699", "type": "HCPCS"}, {"code": "8132912", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 36131.0, "discounted_cash": 27098.25, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP BN MATRIX 5", "code_information": [{"code": "L8699", "type": "HCPCS"}, {"code": "8132892", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 31088.0, "discounted_cash": 23316.0, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP BN MATRIX 6", "code_information": [{"code": "L8699", "type": "HCPCS"}, {"code": "8132893", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 73447.0, "discounted_cash": 55085.25, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP BN MATRIX 8", "code_information": [{"code": "L8699", "type": "HCPCS"}, {"code": "8132895", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 62178.0, "discounted_cash": 46633.5, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP BN SUBST FOAM", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "4011200", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 38188.0, "discounted_cash": 28641.0, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP BN SUBST FOAM 10CC", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "4010686", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 32501.0, "discounted_cash": 24375.75, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP BN SUBST FOAM 5CC", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "4011201", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 17612.0, "discounted_cash": 13209.0, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP BN-TNDN-BN HEMI QUAD", "code_information": [{"code": "C1762", "type": "HCPCS"}, {"code": "8132886", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 23684.0, "discounted_cash": 17763.0, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP BUTTN DOG BN AC REPR", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "4012005", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 11005.0, "discounted_cash": 8253.75, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP CAGE-X CERVICAL 4MM CAVUX", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8136423", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 28822.0, "discounted_cash": 21616.5, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP CAP LOCKING SPFUSN", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8132915", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 15031.0, "discounted_cash": 11273.25, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP CARTRIDGE UROLIFT UL2-C", "code_information": [{"code": "L8699", "type": "HCPCS"}, {"code": "8174039", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 16303.0, "discounted_cash": 12227.25, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP CLIP FALLOPIAN", "code_information": [{"code": "A4264", "type": "HCPCS"}, {"code": "8151998", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 924.0, "discounted_cash": 693.0, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP CONFIRM CARD DM2102", "code_information": [{"code": "C1764", "type": "HCPCS"}, {"code": "4000361", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 71948.0, "discounted_cash": 53961.0, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP CONNECT TISS CTM FLW 2.0ML", "code_information": [{"code": "C1762", "type": "HCPCS"}, {"code": "4022997", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 90838.0, "discounted_cash": 68128.5, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP CRAN SKULL PEEK CUST", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "4012022", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 299779.0, "discounted_cash": 224834.25, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP CUFF URIN SPHINCTER", "code_information": [{"code": "C1815", "type": "HCPCS"}, {"code": "8151993", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 115506.0, "discounted_cash": 86629.5, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP DEX MESH", "code_information": [{"code": "C1781", "type": "HCPCS"}, {"code": "8152005", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 2581.0, "discounted_cash": 1935.75, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP END CAP SPINAL", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8132921", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 17880.0, "discounted_cash": 13410.0, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP FEMORAL W/INSERTER", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "4012060", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 15820.0, "discounted_cash": 11865.0, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP GEN NSTIM N-RECHG", "code_information": [{"code": "C1767", "type": "HCPCS"}, {"code": "8240186", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 135661.0, "discounted_cash": 101745.75, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP GEN NSTIM N-RECHG1", "code_information": [{"code": "C1767", "type": "HCPCS"}, {"code": "8241454", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 114402.0, "discounted_cash": 85801.5, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP GEN NSTIM N-RECHG2", "code_information": [{"code": "C1767", "type": "HCPCS"}, {"code": "8240235", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 105246.0, "discounted_cash": 78934.5, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP GEN NSTIM PRECISION", "code_information": [{"code": "C1820", "type": "HCPCS"}, {"code": "4023001", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 195554.0, "discounted_cash": 146665.5, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP GEN NSTIM RECHARGE", "code_information": [{"code": "C1820", "type": "HCPCS"}, {"code": "8241453", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 161097.0, "discounted_cash": 120822.75, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP GEN NSTIM RECHG", "code_information": [{"code": "C1820", "type": "HCPCS"}, {"code": "4023004", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 137163.0, "discounted_cash": 102872.25, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP GEN NSTIM SENZA HF/HFX", "code_information": [{"code": "C1822", "type": "HCPCS"}, {"code": "4008509", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 558581.0, "discounted_cash": 418935.75, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP GEN NSTM RESTORESNSR", "code_information": [{"code": "C1820", "type": "HCPCS"}, {"code": "8174861", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 172968.0, "discounted_cash": 129726.0, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP GEN NSTM SENZA HF NIPG3000", "code_information": [{"code": "C1822", "type": "HCPCS"}, {"code": "4008671", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 292209.0, "discounted_cash": 219156.75, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP HELICAL BLADE", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8132924", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 9009.0, "discounted_cash": 6756.75, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP HIP ANCILLARY MICROPORT CL", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "4013272", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 310.0, "discounted_cash": 232.5, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP JOINT FINGER", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "8240208", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 7206.0, "discounted_cash": 5404.5, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP JOINT TOE", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "8240149", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 11878.0, "discounted_cash": 8908.5, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP LD CARD/DFIB NEC/D/S", "code_information": [{"code": "C1896", "type": "HCPCS"}, {"code": "8240191", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 10104.0, "discounted_cash": 7578.0, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP LD EXT NSTIM RESTORE", "code_information": [{"code": "C1883", "type": "HCPCS"}, {"code": "4023005", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 17145.0, "discounted_cash": 12858.75, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP LD NSTIM TEST KT", "code_information": [{"code": "C1897", "type": "HCPCS"}, {"code": "8240195", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 5113.0, "discounted_cash": 3834.75, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP MENISCAL SYS", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8132919", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 5595.0, "discounted_cash": 4196.25, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP MESH", "code_information": [{"code": "C1781", "type": "HCPCS"}, {"code": "8240199", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 24318.0, "discounted_cash": 18238.5, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP MESH TITAN 2", "code_information": [{"code": "C1781", "type": "HCPCS"}, {"code": "4028499", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 7623.0, "discounted_cash": 5717.25, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP MESH TITANIUM", "code_information": [{"code": "C1781", "type": "HCPCS"}, {"code": "8152019", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 80126.0, "discounted_cash": 60094.5, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP MOBILE BEARING", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "8137550", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 26198.0, "discounted_cash": 19648.5, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP MONITR CARD BIOMNTR2", "code_information": [{"code": "C1764", "type": "HCPCS"}, {"code": "4008506", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 100306.0, "discounted_cash": 75229.5, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP MONITR CARD BIOMNTR3", "code_information": [{"code": "C1764", "type": "HCPCS"}, {"code": "4008525", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 66625.0, "discounted_cash": 49968.75, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP MSH TIT MEDPOR", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "4028503", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 9758.0, "discounted_cash": 7318.5, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP NAIL CAP", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8132946", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 4668.0, "discounted_cash": 3501.0, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP NAIL LOCKING LNG", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8132920", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 26819.0, "discounted_cash": 20114.25, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP NAIL MIDFOOT", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8136464", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 96698.11, "discounted_cash": 72523.58, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP NAIL TROCH CANN", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8132949", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 25832.0, "discounted_cash": 19374.0, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP NAIL TROCHANTER", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8132927", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 23377.0, "discounted_cash": 17532.75, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP NASAL", "code_information": [{"code": "C1889", "type": "HCPCS"}, {"code": "8122168", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 12556.0, "discounted_cash": 9417.0, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP NASAL LATERA ABSORB", "code_information": [{"code": "C1889", "type": "HCPCS"}, {"code": "8174865", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 22347.0, "discounted_cash": 16760.25, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP NSTIM GEN DL RECHRG", "code_information": [{"code": "L8687", "type": "HCPCS"}, {"code": "4008513", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 37283.0, "discounted_cash": 27962.25, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP NSTIM INTELLIS SENSOR MRI", "code_information": [{"code": "C1820", "type": "HCPCS"}, {"code": "4008524", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 265645.0, "discounted_cash": 199233.75, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP ORBITAL W CONFORMER", "code_information": [{"code": "L8610", "type": "HCPCS"}, {"code": "8152013", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 1347.0, "discounted_cash": 1010.25, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP PEG SMOOTH", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8241459", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 1579.0, "discounted_cash": 1184.25, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP PEG THREAD/UNTHREADED", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8241458", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 1624.0, "discounted_cash": 1218.0, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP PIN HALF LONG", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8132943", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 1935.0, "discounted_cash": 1451.25, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP PLATE", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8240213", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 11910.0, "discounted_cash": 8932.5, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP PLATE STRAIGHT", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8132930", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 11407.0, "discounted_cash": 8555.25, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP PLUG ANAL FISTULA", "code_information": [{"code": "C1781", "type": "HCPCS"}, {"code": "4023008", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 14437.0, "discounted_cash": 10827.75, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP PMP CNTRL UR SPHINE", "code_information": [{"code": "C1815", "type": "HCPCS"}, {"code": "8176120", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 105576.0, "discounted_cash": 79182.0, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP PMP INF SYNCHROMED", "code_information": [{"code": "C1772", "type": "HCPCS"}, {"code": "8241468", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 113954.0, "discounted_cash": 85465.5, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP PMP INF SYNCHROMED P", "code_information": [{"code": "C1772", "type": "HCPCS"}, {"code": "8241474", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 113954.0, "discounted_cash": 85465.5, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP POCKET ADPTR SPINAL", "code_information": [{"code": "C1883", "type": "HCPCS"}, {"code": "4000362", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 12065.0, "discounted_cash": 9048.75, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP PORT INDWELLING", "code_information": [{"code": "C1788", "type": "HCPCS"}, {"code": "8240201", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 8504.0, "discounted_cash": 6378.0, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP PORT INDWELLING 3", "code_information": [{"code": "C1788", "type": "HCPCS"}, {"code": "8241477", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 3616.0, "discounted_cash": 2712.0, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP PORT POWER BARD", "code_information": [{"code": "C1788", "type": "HCPCS"}, {"code": "8241475", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 8139.0, "discounted_cash": 6104.25, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP POUCH DEFIB", "code_information": [{"code": "C1889", "type": "HCPCS"}, {"code": "4023021", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 14740.0, "discounted_cash": 11055.0, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP PROS URINARY SPHINCT", "code_information": [{"code": "C1815", "type": "HCPCS"}, {"code": "8240365", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 94752.0, "discounted_cash": 71064.0, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP PROSTHESIS BREAST", "code_information": [{"code": "C1789", "type": "HCPCS"}, {"code": "8240202", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 17969.0, "discounted_cash": 13476.75, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP PRT POWERPORT", "code_information": [{"code": "C1788", "type": "HCPCS"}, {"code": "4028504", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 4300.0, "discounted_cash": 3225.0, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP RCRD CRD REVEAL LINQ", "code_information": [{"code": "C1764", "type": "HCPCS"}, {"code": "4000364", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 53608.0, "discounted_cash": 40206.0, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP RD STABLZTN PHALANGE", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8132928", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 2187.0, "discounted_cash": 1640.25, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP SCREW CAP", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "4023019", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 3321.0, "discounted_cash": 2490.75, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP SCRW BIOTENODESIS", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "4012550", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 5769.0, "discounted_cash": 4326.75, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP SCRW CORTICAL FT 4.5", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8247157", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 2081.0, "discounted_cash": 1560.75, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP SHTH TIBIAL", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8132934", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 25755.0, "discounted_cash": 19316.25, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP SLV CENTERING", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8132947", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 7694.0, "discounted_cash": 5770.5, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP SPACER PEEK", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "4023013", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 12376.0, "discounted_cash": 9282.0, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP SPINE VBR", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "4023012", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 62469.0, "discounted_cash": 46851.75, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP TALAR COMP CEMENTLSS", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "8137703", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 57166.0, "discounted_cash": 42874.5, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP TENDON ACHILLES", "code_information": [{"code": "C1762", "type": "HCPCS"}, {"code": "8132942", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 22523.0, "discounted_cash": 16892.25, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP TENDON GRACILIS", "code_information": [{"code": "C1762", "type": "HCPCS"}, {"code": "8137704", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 18810.0, "discounted_cash": 14107.5, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP TENDON TIBIALIS", "code_information": [{"code": "C1762", "type": "HCPCS"}, {"code": "8132948", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 27625.0, "discounted_cash": 20718.75, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP TIBIAL CANN W/DRIVER", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "4012648", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 7782.0, "discounted_cash": 5836.5, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP TIBIAL COMP CEMNTLSS", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "8137706", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 66810.0, "discounted_cash": 50107.5, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP TISS ILIUM STRIP", "code_information": [{"code": "C1762", "type": "HCPCS"}, {"code": "4023100", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 17878.0, "discounted_cash": 13408.5, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP WEDGE", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "8152025", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 49719.0, "discounted_cash": 37289.25, "setting": "both", "billing_class": "facility"}]}, {"description": "IMPL ANCHOR CRKSCRW 5MM", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8151980", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 4011.0, "discounted_cash": 3008.25, "setting": "both", "billing_class": "facility"}]}, {"description": "IMPL SUTURE ANCHOR", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8152038", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 4502.0, "discounted_cash": 3376.5, "setting": "both", "billing_class": "facility"}]}, {"description": "IMPLANT SPACER", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "4012604", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 37946.0, "discounted_cash": 28459.5, "setting": "both", "billing_class": "facility"}]}, {"description": "IN SITU EA PRB PER SPEC/3", "code_information": [{"code": "88365", "type": "CPT"}, {"code": "7258838", "type": "CDM"}, {"code": "310", "type": "RC"}], "standard_charges": [{"gross_charge": 607.0, "discounted_cash": 455.25, "setting": "both", "billing_class": "facility"}]}, {"description": "IN111 CAPROMAB DOSE", "code_information": [{"code": "A9507", "type": "HCPCS"}, {"code": "5191725", "type": "CDM"}, {"code": "343", "type": "RC"}], "standard_charges": [{"gross_charge": 23588.0, "discounted_cash": 17691.0, "setting": "both", "billing_class": "facility"}]}, {"description": "IN111 DTPA .5MCI", "code_information": [{"code": "A9548", "type": "HCPCS"}, {"code": "5191724", "type": "CDM"}, {"code": "343", "type": "RC"}], "standard_charges": [{"gross_charge": 16030.0, "discounted_cash": 12022.5, "setting": "both", "billing_class": "facility"}]}, {"description": "IN111 OXINE .5MCI", "code_information": [{"code": "A9547", "type": "HCPCS"}, {"code": "5191729", "type": "CDM"}, {"code": "343", "type": "RC"}], "standard_charges": [{"gross_charge": 3754.0, "discounted_cash": 2815.5, "setting": "both", "billing_class": "facility"}]}, {"description": "INCISION REMOVL FB CMPLX", "code_information": [{"code": "10121", "type": "CPT"}, {"code": "5763102", "type": "CDM"}, {"code": "983", "type": "RC"}], "standard_charges": [{"gross_charge": 11470.0, "discounted_cash": 8602.5, "setting": "both", "billing_class": "facility"}]}, {"description": "IND 111 PENTTREOTDE DOSE", "code_information": [{"code": "A9572", "type": "HCPCS"}, {"code": "5199572", "type": "CDM"}, {"code": "343", "type": "RC"}], "standard_charges": [{"gross_charge": 47678.0, "discounted_cash": 35758.5, "setting": "both", "billing_class": "facility"}]}, {"description": "INDAPAMIDE 2.5MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5305977", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 72.0, "discounted_cash": 54.0, "setting": "both", "billing_class": "facility"}]}, {"description": "INDAPAMIDE 2.5MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5305977", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 72.0, "discounted_cash": 54.0, "setting": "both", "billing_class": "facility"}]}, {"description": "INDINAVIR 400MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5305990", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 9993.0, "discounted_cash": 7494.75, "setting": "both", "billing_class": "facility"}]}, {"description": "INDINAVIR 400MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5305990", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 9993.0, "discounted_cash": 7494.75, "setting": "both", "billing_class": "facility"}]}, {"description": "INDOCYANINE GRN 25MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5321337", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 2403.0, "discounted_cash": 1802.25, "setting": "both", "billing_class": "facility"}]}, {"description": "INDOCYANINE GRN 5MG/2ML IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5321534", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 742.0, "discounted_cash": 556.5, "setting": "both", "billing_class": "facility"}]}, {"description": "INDOMETHACIN 1MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5321345", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 8648.0, "discounted_cash": 6486.0, "setting": "both", "billing_class": "facility"}]}, {"description": "INDOMETHACIN 25MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5306000", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 61.0, "discounted_cash": 45.75, "setting": "both", "billing_class": "facility"}]}, {"description": "INDOMETHACIN 25MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5306000", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 61.0, "discounted_cash": 45.75, "setting": "both", "billing_class": "facility"}]}, {"description": "INDOMETHACIN NEO CMPD IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J7999", "type": "HCPCS"}, {"code": "5321303", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 1465.0, "discounted_cash": 1098.75, "setting": "both", "billing_class": "facility"}]}, {"description": "INDOMETHACIN NEO CMPD IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J7999", "type": "HCPCS"}, {"code": "5321303", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 1465.0, "discounted_cash": 1098.75, "setting": "both", "billing_class": "facility"}]}, {"description": "INDUCTN ARRHYTHMIA BY EP", "code_information": [{"code": "93618", "type": "CPT"}, {"code": "4613618", "type": "CDM"}, {"code": "480", "type": "RC"}], "standard_charges": [{"gross_charge": 8563.0, "discounted_cash": 6422.25, "setting": "both", "billing_class": "facility"}]}, {"description": "INFANT HEAD ECHO", "code_information": [{"code": "76506", "type": "CPT"}, {"code": "5066828", "type": "CDM"}, {"code": "402", "type": "RC"}], "standard_charges": [{"gross_charge": 1675.0, "discounted_cash": 1256.25, "setting": "both", "billing_class": "facility"}]}, {"description": "INFANT HEARING SCREEN", "code_information": [{"code": "92551", "type": "CPT"}, {"code": "3112551", "type": "CDM"}, {"code": "471", "type": "RC"}], "standard_charges": [{"gross_charge": 731.0, "discounted_cash": 548.25, "setting": "both", "billing_class": "facility"}]}, {"description": "INFECT AGNT DRUG SUSCEPT", "code_information": [{"code": "87900", "type": "CPT"}, {"code": "7257909", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 938.0, "discounted_cash": 703.5, "setting": "both", "billing_class": "facility"}]}, {"description": "INFECT AGNT DRUG SUSCEPT/2", "code_information": [{"code": "87900", "type": "CPT"}, {"code": "7257911", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 156.0, "discounted_cash": 117.0, "setting": "both", "billing_class": "facility"}]}, {"description": "INFECT AGNT NOS AMP PRB/11", "code_information": [{"code": "87798", "type": "CPT"}, {"code": "7257624", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 488.0, "discounted_cash": 366.0, "setting": "both", "billing_class": "facility"}]}, {"description": "INFECT AGNT NOS AMP PRB/12", "code_information": [{"code": "87798", "type": "CPT"}, {"code": "7256216", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 1772.0, "discounted_cash": 1329.0, "setting": "both", "billing_class": "facility"}]}, {"description": "INFECT AGNT NOS AMP PRB/18", "code_information": [{"code": "87798", "type": "CPT"}, {"code": "7257534", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 314.0, "discounted_cash": 235.5, "setting": "both", "billing_class": "facility"}]}, {"description": "INFECT AGNT NOS AMP PRB/2", "code_information": [{"code": "87798", "type": "CPT"}, {"code": "7256223", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 432.0, "discounted_cash": 324.0, "setting": "both", "billing_class": "facility"}]}, {"description": "INFECT AGNT NOS AMP PRB/21", "code_information": [{"code": "87798", "type": "CPT"}, {"code": "7258798", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 373.0, "discounted_cash": 279.75, "setting": "both", "billing_class": "facility"}]}, {"description": "INFECT AGNT NOS AMP PRB/22", "code_information": [{"code": "87798", "type": "CPT"}, {"code": "7257290", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 588.0, "discounted_cash": 441.0, "setting": "both", "billing_class": "facility"}]}, {"description": "INFECT AGNT NOS AMP PRB/24", "code_information": [{"code": "87798", "type": "CPT"}, {"code": "7258785", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 625.0, "discounted_cash": 468.75, "setting": "both", "billing_class": "facility"}]}, {"description": "INFECT AGNT NOS AMP PRB/25", "code_information": [{"code": "87798", "type": "CPT"}, {"code": "7256690", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 600.0, "discounted_cash": 450.0, "setting": "both", "billing_class": "facility"}]}, {"description": "INFECT AGNT NOS AMP PRB/26", "code_information": [{"code": "87798", "type": "CPT"}, {"code": "7257797", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 283.0, "discounted_cash": 212.25, "setting": "both", "billing_class": "facility"}]}, {"description": "INFECT AGNT NOS AMP PRB/3", "code_information": [{"code": "87798", "type": "CPT"}, {"code": "4100146", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 85.0, "discounted_cash": 63.75, "setting": "both", "billing_class": "facility"}]}, {"description": "INFECT AGNT NOS AMP PRB/30", "code_information": [{"code": "87798", "type": "CPT"}, {"code": "7257782", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 109.0, "discounted_cash": 81.75, "setting": "both", "billing_class": "facility"}]}, {"description": "INFECT AGNT NOS AMP PRB/32", "code_information": [{"code": "87798", "type": "CPT"}, {"code": "7257009", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 311.0, "discounted_cash": 233.25, "setting": "both", "billing_class": "facility"}]}, {"description": "INFECT AGNT NOS AMP PRB/33", "code_information": [{"code": "87798", "type": "CPT"}, {"code": "7257799", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 296.0, "discounted_cash": 222.0, "setting": "both", "billing_class": "facility"}]}, {"description": "INFECT AGNT NOS AMP PRB/4", "code_information": [{"code": "87798", "type": "CPT"}, {"code": "4108779", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 510.0, "discounted_cash": 382.5, "setting": "both", "billing_class": "facility"}]}, {"description": "INFECT AGNT NOS AMP PRB/48", "code_information": [{"code": "87798", "type": "CPT"}, {"code": "7257796", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 425.0, "discounted_cash": 318.75, "setting": "both", "billing_class": "facility"}]}, {"description": "INFECT AGNT NOS AMP PRB/5", "code_information": [{"code": "87798", "type": "CPT"}, {"code": "7258782", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 296.0, "discounted_cash": 222.0, "setting": "both", "billing_class": "facility"}]}, {"description": "INFECT AGNT NOS AMP PRB/50", "code_information": [{"code": "87798", "type": "CPT"}, {"code": "7257798", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 617.0, "discounted_cash": 462.75, "setting": "both", "billing_class": "facility"}]}, {"description": "INFECT AGNT NOS AMP PRB/8", "code_information": [{"code": "87798", "type": "CPT"}, {"code": "7257810", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 296.0, "discounted_cash": 222.0, "setting": "both", "billing_class": "facility"}]}, {"description": "INFECT AGNT NOS AMP PRB/9", "code_information": [{"code": "87798", "type": "CPT"}, {"code": "7257793", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 832.0, "discounted_cash": 624.0, "setting": "both", "billing_class": "facility"}]}, {"description": "INFECT AGNT NOS DIR OPT/12", "code_information": [{"code": "87899", "type": "CPT"}, {"code": "4107892", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 1020.0, "discounted_cash": 765.0, "setting": "both", "billing_class": "facility"}]}, {"description": "INFECT AGNT NOS DIR OPT/13", "code_information": [{"code": "87899", "type": "CPT"}, {"code": "7257893", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 147.0, "discounted_cash": 110.25, "setting": "both", "billing_class": "facility"}]}, {"description": "INFECT AGNT NOS DIR OPT/17", "code_information": [{"code": "87899", "type": "CPT"}, {"code": "4107893", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 816.0, "discounted_cash": 612.0, "setting": "both", "billing_class": "facility"}]}, {"description": "INFECT AGNT NOS DIR OPT/2", "code_information": [{"code": "87899", "type": "CPT"}, {"code": "4108789", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 289.0, "discounted_cash": 216.75, "setting": "both", "billing_class": "facility"}]}, {"description": "INFECT AGNT NOS DIR OPT/3", "code_information": [{"code": "87899", "type": "CPT"}, {"code": "7258793", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 716.0, "discounted_cash": 537.0, "setting": "both", "billing_class": "facility"}]}, {"description": "INFECT AGNT NOS DIR OPT/4", "code_information": [{"code": "87899", "type": "CPT"}, {"code": "7257920", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 727.0, "discounted_cash": 545.25, "setting": "both", "billing_class": "facility"}]}, {"description": "INFECT AGNT NOS DIR OPT/5", "code_information": [{"code": "87899", "type": "CPT"}, {"code": "4177895", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 22.83, "discounted_cash": 17.12, "setting": "both", "billing_class": "facility"}]}, {"description": "INFECT AGNT NOS DIR OPT/5", "code_information": [{"code": "87899", "type": "CPT"}, {"code": "7257899", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 136.0, "discounted_cash": 102.0, "setting": "both", "billing_class": "facility"}]}, {"description": "INFECT AGNT NOS DIR OPT/8", "code_information": [{"code": "87899", "type": "CPT"}, {"code": "4177896", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 22.83, "discounted_cash": 17.12, "setting": "both", "billing_class": "facility"}]}, {"description": "INFECT AGNT NOS DIR OPT/8", "code_information": [{"code": "87899", "type": "CPT"}, {"code": "7257894", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 404.0, "discounted_cash": 303.0, "setting": "both", "billing_class": "facility"}]}, {"description": "INFECT AGNT NOS DIR OPT/9", "code_information": [{"code": "87899", "type": "CPT"}, {"code": "4107888", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 1020.0, "discounted_cash": 765.0, "setting": "both", "billing_class": "facility"}]}, {"description": "INFECT AGNT NOS QUANT", "code_information": [{"code": "87799", "type": "CPT"}, {"code": "7257822", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 504.0, "discounted_cash": 378.0, "setting": "both", "billing_class": "facility"}]}, {"description": "INFECT AGNT NOS QUANT/13", "code_information": [{"code": "87799", "type": "CPT"}, {"code": "7258795", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 2507.0, "discounted_cash": 1880.25, "setting": "both", "billing_class": "facility"}]}, {"description": "INFECT AGNT NOS QUANT/2", "code_information": [{"code": "87799", "type": "CPT"}, {"code": "7257800", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 818.0, "discounted_cash": 613.5, "setting": "both", "billing_class": "facility"}]}, {"description": "INFECT AGNT NOS QUANT/4", "code_information": [{"code": "87799", "type": "CPT"}, {"code": "7257623", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 649.0, "discounted_cash": 486.75, "setting": "both", "billing_class": "facility"}]}, {"description": "INFECTIOUS AGNT NOS IA", "code_information": [{"code": "87449", "type": "CPT"}, {"code": "4107449", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 22.0, "discounted_cash": 16.5, "setting": "both", "billing_class": "facility"}]}, {"description": "INFECTIOUS AGNT NOS IA/10", "code_information": [{"code": "87449", "type": "CPT"}, {"code": "4176412", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 22.83, "discounted_cash": 17.12, "setting": "both", "billing_class": "facility"}]}, {"description": "INFECTIOUS AGNT NOS IA/11", "code_information": [{"code": "87449", "type": "CPT"}, {"code": "4106412", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 646.0, "discounted_cash": 484.5, "setting": "both", "billing_class": "facility"}]}, {"description": "INFECTIOUS AGNT NOS IA/2", "code_information": [{"code": "87449", "type": "CPT"}, {"code": "7257450", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 315.0, "discounted_cash": 236.25, "setting": "both", "billing_class": "facility"}]}, {"description": "INFECTIOUS AGNT NOS IA/3", "code_information": [{"code": "87449", "type": "CPT"}, {"code": "4107453", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 812.0, "discounted_cash": 609.0, "setting": "both", "billing_class": "facility"}]}, {"description": "INFECTIOUS AGNT NOS IA/4", "code_information": [{"code": "87449", "type": "CPT"}, {"code": "4107912", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 812.0, "discounted_cash": 609.0, "setting": "both", "billing_class": "facility"}]}, {"description": "INFECTIOUS AGNT NOS IA/4", "code_information": [{"code": "87449", "type": "CPT"}, {"code": "7258744", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 90.0, "discounted_cash": 67.5, "setting": "both", "billing_class": "facility"}]}, {"description": "INFECTIOUS AGNT NOS IA/5", "code_information": [{"code": "87449", "type": "CPT"}, {"code": "4176938", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 22.83, "discounted_cash": 17.12, "setting": "both", "billing_class": "facility"}]}, {"description": "INFECTIOUS AGNT NOS IA/5", "code_information": [{"code": "87449", "type": "CPT"}, {"code": "7257912", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 83.0, "discounted_cash": 62.25, "setting": "both", "billing_class": "facility"}]}, {"description": "INFECTIOUS AGNT NOS IA/6", "code_information": [{"code": "87449", "type": "CPT"}, {"code": "4106938", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 646.0, "discounted_cash": 484.5, "setting": "both", "billing_class": "facility"}]}, {"description": "INFECTIOUS AGNT NOS IA/7", "code_information": [{"code": "87449", "type": "CPT"}, {"code": "4176940", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 22.83, "discounted_cash": 17.12, "setting": "both", "billing_class": "facility"}]}, {"description": "INFECTIOUS AGNT NOS IA/8", "code_information": [{"code": "87449", "type": "CPT"}, {"code": "4106939", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 646.0, "discounted_cash": 484.5, "setting": "both", "billing_class": "facility"}]}, {"description": "INFECTIOUS AGNT NOS IA/8", "code_information": [{"code": "87449", "type": "CPT"}, {"code": "4176413", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 22.83, "discounted_cash": 17.12, "setting": "both", "billing_class": "facility"}]}, {"description": "INFECTIOUS AGNT NOS IA/9", "code_information": [{"code": "87449", "type": "CPT"}, {"code": "4106940", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 646.0, "discounted_cash": 484.5, "setting": "both", "billing_class": "facility"}]}, {"description": "INFERIOR VENACAVAGRAM", "code_information": [{"code": "75825", "type": "CPT"}, {"code": "4915826", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 7824.0, "discounted_cash": 5868.0, "setting": "both", "billing_class": "facility"}]}, {"description": "INFLIXIMAB/3", "code_information": [{"code": "80230", "type": "CPT"}, {"code": "7250321", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 476.0, "discounted_cash": 357.0, "setting": "both", "billing_class": "facility"}]}, {"description": "INFLU EA ADD TYPE/SUB", "code_information": [{"code": "87503", "type": "CPT"}, {"code": "4107503", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 385.0, "discounted_cash": 288.75, "setting": "both", "billing_class": "facility"}]}, {"description": "INFLUENZA 1ST 2 TYPE/SUB", "code_information": [{"code": "87502", "type": "CPT"}, {"code": "4107502", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 367.0, "discounted_cash": 275.25, "setting": "both", "billing_class": "facility"}]}, {"description": "INFLUENZA 1ST 2 TYPE/SUB", "code_information": [{"code": "87502", "type": "CPT"}, {"code": "7257503", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 625.0, "discounted_cash": 468.75, "setting": "both", "billing_class": "facility"}]}, {"description": "INFLUENZA A DFA", "code_information": [{"code": "87276", "type": "CPT"}, {"code": "4107276", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 43.0, "discounted_cash": 32.25, "setting": "both", "billing_class": "facility"}]}, {"description": "INFLUENZA A/B IA", "code_information": [{"code": "87400", "type": "CPT"}, {"code": "4107400", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 84.0, "discounted_cash": 63.0, "setting": "both", "billing_class": "facility"}]}, {"description": "INFLUENZA A/B IA", "code_information": [{"code": "87400", "type": "CPT"}, {"code": "4178347", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 21.41, "discounted_cash": 16.06, "setting": "both", "billing_class": "facility"}]}, {"description": "INFLUENZA A/B IA/2", "code_information": [{"code": "87400", "type": "CPT"}, {"code": "4107401", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 84.0, "discounted_cash": 63.0, "setting": "both", "billing_class": "facility"}]}, {"description": "INFLUENZA A/B IA/2", "code_information": [{"code": "87400", "type": "CPT"}, {"code": "4177455", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 15.71, "discounted_cash": 11.78, "setting": "both", "billing_class": "facility"}]}, {"description": "INFLUENZA A/B IA/3", "code_information": [{"code": "87400", "type": "CPT"}, {"code": "4178348", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 21.41, "discounted_cash": 16.06, "setting": "both", "billing_class": "facility"}]}, {"description": "INFLUENZA B DFA", "code_information": [{"code": "87275", "type": "CPT"}, {"code": "4107275", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 43.0, "discounted_cash": 32.25, "setting": "both", "billing_class": "facility"}]}, {"description": "INFLUENZA DIR OPT", "code_information": [{"code": "87804", "type": "CPT"}, {"code": "4107804", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 670.0, "discounted_cash": 502.5, "setting": "both", "billing_class": "facility"}]}, {"description": "INFLUENZA DIR OPT", "code_information": [{"code": "87804", "type": "CPT"}, {"code": "4177804", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 13.0, "discounted_cash": 9.75, "setting": "both", "billing_class": "facility"}]}, {"description": "INFLUENZA DIR OPT/2", "code_information": [{"code": "87804", "type": "CPT"}, {"code": "4107805", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 670.0, "discounted_cash": 502.5, "setting": "both", "billing_class": "facility"}]}, {"description": "INFLUENZA DIR OPT/2", "code_information": [{"code": "87804", "type": "CPT"}, {"code": "4177805", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 27.11, "discounted_cash": 20.33, "setting": "both", "billing_class": "facility"}]}, {"description": "INFLUENZA DIR OPT/2", "code_information": [{"code": "87804", "type": "CPT"}, {"code": "7257807", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 726.0, "discounted_cash": 544.5, "setting": "both", "billing_class": "facility"}]}, {"description": "INFLUENZA EA TYPE/SUB", "code_information": [{"code": "87501", "type": "CPT"}, {"code": "4107501", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 306.0, "discounted_cash": 229.5, "setting": "both", "billing_class": "facility"}]}, {"description": "INFLUENZA EA TYPE/SUB", "code_information": [{"code": "87501", "type": "CPT"}, {"code": "7257502", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 311.0, "discounted_cash": 233.25, "setting": "both", "billing_class": "facility"}]}, {"description": "INFLUENZA VACC ADMIN", "code_information": [{"code": "G0008", "type": "HCPCS"}, {"code": "3600007", "type": "CDM"}, {"code": "771", "type": "RC"}], "standard_charges": [{"gross_charge": 280.0, "discounted_cash": 210.0, "setting": "both", "billing_class": "facility"}]}, {"description": "INFLUENZA VACC ADMIN", "code_information": [{"code": "G0008", "type": "HCPCS"}, {"code": "6100008", "type": "CDM"}, {"code": "771", "type": "RC"}], "standard_charges": [{"gross_charge": 271.0, "discounted_cash": 203.25, "setting": "both", "billing_class": "facility"}]}, {"description": "INFLUENZA VACC ADMIN", "code_information": [{"code": "G0008", "type": "HCPCS"}, {"code": "6160008", "type": "CDM"}, {"code": "771", "type": "RC"}], "standard_charges": [{"gross_charge": 287.0, "discounted_cash": 215.25, "setting": "both", "billing_class": "facility"}]}, {"description": "INFLUENZA VACC ADMIN", "code_information": [{"code": "G0008", "type": "HCPCS"}, {"code": "6290008", "type": "CDM"}, {"code": "771", "type": "RC"}], "standard_charges": [{"gross_charge": 287.0, "discounted_cash": 215.25, "setting": "both", "billing_class": "facility"}]}, {"description": "INFLUENZA VIRUS AB/2", "code_information": [{"code": "86710", "type": "CPT"}, {"code": "7256207", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 53.0, "discounted_cash": 39.75, "setting": "both", "billing_class": "facility"}]}, {"description": "INFLUENZA VIRUS AB/3", "code_information": [{"code": "86710", "type": "CPT"}, {"code": "7256208", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 68.0, "discounted_cash": 51.0, "setting": "both", "billing_class": "facility"}]}, {"description": "INFLUENZA VIRUS AB/7", "code_information": [{"code": "86710", "type": "CPT"}, {"code": "7256711", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 85.0, "discounted_cash": 63.75, "setting": "both", "billing_class": "facility"}]}, {"description": "INFLUENZA VIRUS AB/8", "code_information": [{"code": "86710", "type": "CPT"}, {"code": "7256714", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 85.0, "discounted_cash": 63.75, "setting": "both", "billing_class": "facility"}]}, {"description": "INFLUENZA VIRUS AB/9", "code_information": [{"code": "86710", "type": "CPT"}, {"code": "7256716", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 85.0, "discounted_cash": 63.75, "setting": "both", "billing_class": "facility"}]}, {"description": "INHALER SPACER", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5331223", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 85.0, "discounted_cash": 63.75, "setting": "both", "billing_class": "facility"}]}, {"description": "INHALER SPACER", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5331223", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 85.0, "discounted_cash": 63.75, "setting": "both", "billing_class": "facility"}]}, {"description": "INHALER SPACER W/MASK", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5331224", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 788.0, "discounted_cash": 591.0, "setting": "both", "billing_class": "facility"}]}, {"description": "INHALER SPACER W/MASK", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5331224", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 788.0, "discounted_cash": 591.0, "setting": "both", "billing_class": "facility"}]}, {"description": "INHIBIN A", "code_information": [{"code": "86336", "type": "CPT"}, {"code": "7256354", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 549.0, "discounted_cash": 411.75, "setting": "both", "billing_class": "facility"}]}, {"description": "INHIBIN B", "code_information": [{"code": "83520", "type": "CPT"}, {"code": "7253579", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 156.0, "discounted_cash": 117.0, "setting": "both", "billing_class": "facility"}]}, {"description": "INHOUSE TRAUMA III-FL TM", "code_information": [{"code": "6109021", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 14021.0, "discounted_cash": 10515.75, "setting": "both", "billing_class": "facility"}]}, {"description": "INHOUSE TRAUMA III-PT TM", "code_information": [{"code": "6109022", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 8795.0, "discounted_cash": 6596.25, "setting": "both", "billing_class": "facility"}]}, {"description": "INJ ABSC/CYST PREV CATH", "code_information": [{"code": "4909424", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 226.0, "discounted_cash": 169.5, "setting": "both", "billing_class": "facility"}]}, {"description": "INJ ABSC/CYST PREV CATH", "code_information": [{"code": "4919424", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 164.0, "discounted_cash": 123.0, "setting": "both", "billing_class": "facility"}]}, {"description": "INJ ABSC/CYST PREV CATH", "code_information": [{"code": "5059424", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 1975.0, "discounted_cash": 1481.25, "setting": "both", "billing_class": "facility"}]}, {"description": "INJ ADD SEQUENTL IVP", "code_information": [{"code": "96375", "type": "CPT"}, {"code": "3100775", "type": "CDM"}, {"code": "260", "type": "RC"}], "standard_charges": [{"gross_charge": 761.0, "discounted_cash": 570.75, "setting": "both", "billing_class": "facility"}]}, {"description": "INJ ADD SEQUENTL IVP", "code_information": [{"code": "96375", "type": "CPT"}, {"code": "3600775", "type": "CDM"}, {"code": "260", "type": "RC"}], "standard_charges": [{"gross_charge": 883.0, "discounted_cash": 662.25, "setting": "both", "billing_class": "facility"}]}, {"description": "INJ ADD SEQUENTL IVP", "code_information": [{"code": "96375", "type": "CPT"}, {"code": "6100775", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 1041.0, "discounted_cash": 780.75, "setting": "both", "billing_class": "facility"}]}, {"description": "INJ ADD SEQUENTL IVP", "code_information": [{"code": "96375", "type": "CPT"}, {"code": "6160775", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 1041.0, "discounted_cash": 780.75, "setting": "both", "billing_class": "facility"}]}, {"description": "INJ ADD SEQUENTL IVP", "code_information": [{"code": "96375", "type": "CPT"}, {"code": "6290775", "type": "CDM"}, {"code": "260", "type": "RC"}], "standard_charges": [{"gross_charge": 1041.0, "discounted_cash": 780.75, "setting": "both", "billing_class": "facility"}]}, {"description": "INJ ADD SEQUENTL IVP", "code_information": [{"code": "96375", "type": "CPT"}, {"code": "6906375", "type": "CDM"}, {"code": "510", "type": "RC"}], "standard_charges": [{"gross_charge": 826.0, "discounted_cash": 619.5, "setting": "both", "billing_class": "facility"}]}, {"description": "INJ ADD SEQUENTL IVP", "code_information": [{"code": "96375", "type": "CPT"}, {"code": "6906375", "type": "CDM"}, {"code": "761", "type": "RC"}], "standard_charges": [{"gross_charge": 826.0, "discounted_cash": 619.5, "setting": "both", "billing_class": "facility"}]}, {"description": "INJ ANTIBIOTIC IM", "code_information": [{"code": "96372", "type": "CPT"}, {"code": "3600788", "type": "CDM"}, {"code": "260", "type": "RC"}], "standard_charges": [{"gross_charge": 400.0, "discounted_cash": 300.0, "setting": "both", "billing_class": "facility"}]}, {"description": "INJ BLADDER RETRO UR", "code_information": [{"code": "4907620", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 1525.0, "discounted_cash": 1143.75, "setting": "both", "billing_class": "facility"}]}, {"description": "INJ CM EVAL GTUBE", "code_information": [{"code": "4909465", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 583.0, "discounted_cash": 437.25, "setting": "both", "billing_class": "facility"}]}, {"description": "INJ CM EVAL GTUBE", "code_information": [{"code": "4919465", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 729.0, "discounted_cash": 546.75, "setting": "both", "billing_class": "facility"}]}, {"description": "INJ F/CYSTO OR VCUG", "code_information": [{"code": "4907615", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 199.0, "discounted_cash": 149.25, "setting": "both", "billing_class": "facility"}]}, {"description": "INJ GALACTO/DUCTO PROC", "code_information": [{"code": "3071001", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 272.0, "discounted_cash": 204.0, "setting": "both", "billing_class": "facility"}]}, {"description": "INJ MYELOGRAM LUMBAR", "code_information": [{"code": "4907685", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 235.0, "discounted_cash": 176.25, "setting": "both", "billing_class": "facility"}]}, {"description": "INJ NEPHROGRM EXIS ACC", "code_information": [{"code": "4917665", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 193.0, "discounted_cash": 144.75, "setting": "both", "billing_class": "facility"}]}, {"description": "INJ NEPHROSTOGRAM", "code_information": [{"code": "4910430", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 2467.0, "discounted_cash": 1850.25, "setting": "both", "billing_class": "facility"}]}, {"description": "INJ PERC EXT PSEUDANYSM", "code_information": [{"code": "4916002", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 4963.0, "discounted_cash": 3722.25, "setting": "both", "billing_class": "facility"}]}, {"description": "INJ PERC EXT PSEUDANYSM", "code_information": [{"code": "5066002", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 5292.0, "discounted_cash": 3969.0, "setting": "both", "billing_class": "facility"}]}, {"description": "INJ PROC KNEE ARTHROGRM", "code_information": [{"code": "4907670", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 271.0, "discounted_cash": 203.25, "setting": "both", "billing_class": "facility"}]}, {"description": "INJ SHOULDER ARTHROGRAM", "code_information": [{"code": "4907700", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 2159.0, "discounted_cash": 1619.25, "setting": "both", "billing_class": "facility"}]}, {"description": "INJ SINUS TRACT DIAGNSTC", "code_information": [{"code": "4907705", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 222.0, "discounted_cash": 166.5, "setting": "both", "billing_class": "facility"}]}, {"description": "INJ SINUS TRACT DIAGNSTC", "code_information": [{"code": "4917705", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 241.0, "discounted_cash": 180.75, "setting": "both", "billing_class": "facility"}]}, {"description": "INJ T/P/D IVP SAME SUBST", "code_information": [{"code": "96376", "type": "CPT"}, {"code": "3100776", "type": "CDM"}, {"code": "260", "type": "RC"}], "standard_charges": [{"gross_charge": 493.0, "discounted_cash": 369.75, "setting": "both", "billing_class": "facility"}]}, {"description": "INJ T/P/D IVP SAME SUBST", "code_information": [{"code": "96376", "type": "CPT"}, {"code": "3600776", "type": "CDM"}, {"code": "260", "type": "RC"}], "standard_charges": [{"gross_charge": 493.0, "discounted_cash": 369.75, "setting": "both", "billing_class": "facility"}]}, {"description": "INJ T/P/D IVP SAME SUBST", "code_information": [{"code": "96376", "type": "CPT"}, {"code": "6100776", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 451.0, "discounted_cash": 338.25, "setting": "both", "billing_class": "facility"}]}, {"description": "INJ T/P/D IVP SAME SUBST", "code_information": [{"code": "96376", "type": "CPT"}, {"code": "6160776", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 493.0, "discounted_cash": 369.75, "setting": "both", "billing_class": "facility"}]}, {"description": "INJ T/P/D IVP SAME SUBST", "code_information": [{"code": "96376", "type": "CPT"}, {"code": "6290776", "type": "CDM"}, {"code": "260", "type": "RC"}], "standard_charges": [{"gross_charge": 493.0, "discounted_cash": 369.75, "setting": "both", "billing_class": "facility"}]}, {"description": "INJ TX/PROPH/DX SQ/IM", "code_information": [{"code": "96372", "type": "CPT"}, {"code": "3100782", "type": "CDM"}, {"code": "260", "type": "RC"}], "standard_charges": [{"gross_charge": 679.0, "discounted_cash": 509.25, "setting": "both", "billing_class": "facility"}]}, {"description": "INJ TX/PROPH/DX SQ/IM", "code_information": [{"code": "96372", "type": "CPT"}, {"code": "3603072", "type": "CDM"}, {"code": "260", "type": "RC"}], "standard_charges": [{"gross_charge": 314.0, "discounted_cash": 235.5, "setting": "both", "billing_class": "facility"}]}, {"description": "INJ TX/PROPH/DX SQ/IM", "code_information": [{"code": "96372", "type": "CPT"}, {"code": "6102120", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 731.0, "discounted_cash": 548.25, "setting": "both", "billing_class": "facility"}]}, {"description": "INJ TX/PROPH/DX SQ/IM", "code_information": [{"code": "96372", "type": "CPT"}, {"code": "6160772", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 731.0, "discounted_cash": 548.25, "setting": "both", "billing_class": "facility"}]}, {"description": "INJ TX/PROPH/DX SQ/IM", "code_information": [{"code": "96372", "type": "CPT"}, {"code": "6290782", "type": "CDM"}, {"code": "260", "type": "RC"}], "standard_charges": [{"gross_charge": 462.0, "discounted_cash": 346.5, "setting": "both", "billing_class": "facility"}]}, {"description": "INJ TX/PROPH/DX SQ/IM", "code_information": [{"code": "96372", "type": "CPT"}, {"code": "6816372", "type": "CDM"}, {"code": "510", "type": "RC"}], "standard_charges": [{"gross_charge": 198.0, "discounted_cash": 148.5, "setting": "both", "billing_class": "facility"}]}, {"description": "INJ TX/PROPH/DX SQ/IM", "code_information": [{"code": "96372", "type": "CPT"}, {"code": "6816372", "type": "CDM"}, {"code": "761", "type": "RC"}], "standard_charges": [{"gross_charge": 198.0, "discounted_cash": 148.5, "setting": "both", "billing_class": "facility"}]}, {"description": "INJ TX/PROPH/DX SQ/IM", "code_information": [{"code": "96372", "type": "CPT"}, {"code": "6906372", "type": "CDM"}, {"code": "510", "type": "RC"}], "standard_charges": [{"gross_charge": 337.0, "discounted_cash": 252.75, "setting": "both", "billing_class": "facility"}]}, {"description": "INJ TX/PROPH/DX SQ/IM", "code_information": [{"code": "96372", "type": "CPT"}, {"code": "6906372", "type": "CDM"}, {"code": "761", "type": "RC"}], "standard_charges": [{"gross_charge": 337.0, "discounted_cash": 252.75, "setting": "both", "billing_class": "facility"}]}, {"description": "INJ TX/PRPH/DX IVP INT", "code_information": [{"code": "96374", "type": "CPT"}, {"code": "3100774", "type": "CDM"}, {"code": "260", "type": "RC"}], "standard_charges": [{"gross_charge": 761.0, "discounted_cash": 570.75, "setting": "both", "billing_class": "facility"}]}, {"description": "INJ TX/PRPH/DX IVP INT", "code_information": [{"code": "96374", "type": "CPT"}, {"code": "3600774", "type": "CDM"}, {"code": "260", "type": "RC"}], "standard_charges": [{"gross_charge": 903.0, "discounted_cash": 677.25, "setting": "both", "billing_class": "facility"}]}, {"description": "INJ TX/PRPH/DX IVP INT", "code_information": [{"code": "96374", "type": "CPT"}, {"code": "6100774", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 1530.0, "discounted_cash": 1147.5, "setting": "both", "billing_class": "facility"}]}, {"description": "INJ TX/PRPH/DX IVP INT", "code_information": [{"code": "96374", "type": "CPT"}, {"code": "6160774", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 1530.0, "discounted_cash": 1147.5, "setting": "both", "billing_class": "facility"}]}, {"description": "INJ TX/PRPH/DX IVP INT", "code_information": [{"code": "96374", "type": "CPT"}, {"code": "6290774", "type": "CDM"}, {"code": "260", "type": "RC"}], "standard_charges": [{"gross_charge": 1041.0, "discounted_cash": 780.75, "setting": "both", "billing_class": "facility"}]}, {"description": "INJ TX/PRPH/DX IVP INT", "code_information": [{"code": "96374", "type": "CPT"}, {"code": "6900774", "type": "CDM"}, {"code": "260", "type": "RC"}], "standard_charges": [{"gross_charge": 876.0, "discounted_cash": 657.0, "setting": "both", "billing_class": "facility"}]}, {"description": "INJ URETER/ILEAL CONDUIT", "code_information": [{"code": "4907735", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 913.0, "discounted_cash": 684.75, "setting": "both", "billing_class": "facility"}]}, {"description": "INJ URETERAL CATHETER", "code_information": [{"code": "4910684", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 1198.0, "discounted_cash": 898.5, "setting": "both", "billing_class": "facility"}]}, {"description": "INJ VENOGRPHY EXTRMTY", "code_information": [{"code": "4617690", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 3540.0, "discounted_cash": 2655.0, "setting": "both", "billing_class": "facility"}]}, {"description": "INJ VENOGRPHY EXTRMTY", "code_information": [{"code": "4906004", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 4461.0, "discounted_cash": 3345.75, "setting": "both", "billing_class": "facility"}]}, {"description": "INJ VENOGRPHY EXTRMTY", "code_information": [{"code": "4916005", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 3466.0, "discounted_cash": 2599.5, "setting": "both", "billing_class": "facility"}]}, {"description": "INJ&CATH HYSTER/SONOHYST", "code_information": [{"code": "4907740", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 2457.0, "discounted_cash": 1842.75, "setting": "both", "billing_class": "facility"}]}, {"description": "INJECT PROC SACRO JNT", "code_information": [{"code": "4907096", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 238.0, "discounted_cash": 178.5, "setting": "both", "billing_class": "facility"}]}, {"description": "INJECTABLE BULK AGENT", "code_information": [{"code": "L8606", "type": "HCPCS"}, {"code": "8182614", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 10293.0, "discounted_cash": 7719.75, "setting": "both", "billing_class": "facility"}]}, {"description": "INS ANALGLISP50/5010MLIJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5321430", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 3933.0, "discounted_cash": 2949.75, "setting": "both", "billing_class": "facility"}]}, {"description": "INS ANALGLISP50/5010MLIJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5321430", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 3933.0, "discounted_cash": 2949.75, "setting": "both", "billing_class": "facility"}]}, {"description": "INS ASPART PER 5U IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J1815", "type": "HCPCS"}, {"code": "5321256", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 104.0, "discounted_cash": 78.0, "setting": "both", "billing_class": "facility"}]}, {"description": "INS ASPART PER 5U IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J1815", "type": "HCPCS"}, {"code": "5321256", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 104.0, "discounted_cash": 78.0, "setting": "both", "billing_class": "facility"}]}, {"description": "INS ASPR 70/30 PER 5U IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J1815", "type": "HCPCS"}, {"code": "5321269", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 84.0, "discounted_cash": 63.0, "setting": "both", "billing_class": "facility"}]}, {"description": "INS ASPR 70/30 PER 5U IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J1815", "type": "HCPCS"}, {"code": "5321269", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 84.0, "discounted_cash": 63.0, "setting": "both", "billing_class": "facility"}]}, {"description": "INS CATH REN ART 1ST BIL", "code_information": [{"code": "4616252", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 14177.0, "discounted_cash": 10632.75, "setting": "both", "billing_class": "facility"}]}, {"description": "INS CATH REN ART 1ST BIL", "code_information": [{"code": "4916252", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 19464.0, "discounted_cash": 14598.0, "setting": "both", "billing_class": "facility"}]}, {"description": "INS CATH REN ART 1ST UNI", "code_information": [{"code": "4616251", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 19464.0, "discounted_cash": 14598.0, "setting": "both", "billing_class": "facility"}]}, {"description": "INS CATH REN ART 1ST UNI", "code_information": [{"code": "4916251", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 17856.0, "discounted_cash": 13392.0, "setting": "both", "billing_class": "facility"}]}, {"description": "INS CATH REN ART 2ND BIL", "code_information": [{"code": "4916254", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 40256.0, "discounted_cash": 30192.0, "setting": "both", "billing_class": "facility"}]}, {"description": "INS CATH REN ART 2ND UNI", "code_information": [{"code": "4916253", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 40256.0, "discounted_cash": 30192.0, "setting": "both", "billing_class": "facility"}]}, {"description": "INS DETEMIR 1 UNIT IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5321434", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 16.0, "discounted_cash": 12.0, "setting": "both", "billing_class": "facility"}]}, {"description": "INS DETEMIR 1 UNIT IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5321434", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 16.0, "discounted_cash": 12.0, "setting": "both", "billing_class": "facility"}]}, {"description": "INS DETEMR PER 5U IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J1815", "type": "HCPCS"}, {"code": "5321258", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 113.0, "discounted_cash": 84.75, "setting": "both", "billing_class": "facility"}]}, {"description": "INS DETEMR PER 5U IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J1815", "type": "HCPCS"}, {"code": "5321258", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 113.0, "discounted_cash": 84.75, "setting": "both", "billing_class": "facility"}]}, {"description": "INS ENDOVA VENACAVA FILT", "code_information": [{"code": "4617191", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 43632.0, "discounted_cash": 32724.0, "setting": "both", "billing_class": "facility"}]}, {"description": "INS ENDOVA VENACAVA FILT", "code_information": [{"code": "4917191", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 43632.0, "discounted_cash": 32724.0, "setting": "both", "billing_class": "facility"}]}, {"description": "INS GLARG PER 5U IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J1815", "type": "HCPCS"}, {"code": "5321260", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 17.0, "discounted_cash": 12.75, "setting": "both", "billing_class": "facility"}]}, {"description": "INS GLARG PER 5U IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J1815", "type": "HCPCS"}, {"code": "5321260", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 17.0, "discounted_cash": 12.75, "setting": "both", "billing_class": "facility"}]}, {"description": "INS GLARGINE-YFGN PER 5U IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J1815", "type": "HCPCS"}, {"code": "5321518", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 5.0, "discounted_cash": 3.75, "setting": "both", "billing_class": "facility"}]}, {"description": "INS GLARGINE-YFGN PER 5U IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J1815", "type": "HCPCS"}, {"code": "5321518", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 5.0, "discounted_cash": 3.75, "setting": "both", "billing_class": "facility"}]}, {"description": "INS LISP 75/25 PER 5U IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J1815", "type": "HCPCS"}, {"code": "5321266", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 104.0, "discounted_cash": 78.0, "setting": "both", "billing_class": "facility"}]}, {"description": "INS LISP 75/25 PER 5U IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J1815", "type": "HCPCS"}, {"code": "5321266", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 104.0, "discounted_cash": 78.0, "setting": "both", "billing_class": "facility"}]}, {"description": "INS LISPRO PER 5U IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J1815", "type": "HCPCS"}, {"code": "5321264", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 36.0, "discounted_cash": 27.0, "setting": "both", "billing_class": "facility"}]}, {"description": "INS LISPRO PER 5U IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J1815", "type": "HCPCS"}, {"code": "5321264", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 36.0, "discounted_cash": 27.0, "setting": "both", "billing_class": "facility"}]}, {"description": "INS LV LD W/PM OR AICD", "code_information": [{"code": "4613225", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 116396.0, "discounted_cash": 87297.0, "setting": "both", "billing_class": "facility"}]}, {"description": "INS N/R 70/30 PER 5U IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J1815", "type": "HCPCS"}, {"code": "5321270", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 112.0, "discounted_cash": 84.0, "setting": "both", "billing_class": "facility"}]}, {"description": "INS N/R 70/30 PER 5U IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J1815", "type": "HCPCS"}, {"code": "5321270", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 112.0, "discounted_cash": 84.0, "setting": "both", "billing_class": "facility"}]}, {"description": "INS NPH HUM PER 5U IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J1815", "type": "HCPCS"}, {"code": "5321262", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 92.0, "discounted_cash": 69.0, "setting": "both", "billing_class": "facility"}]}, {"description": "INS NPH HUM PER 5U IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J1815", "type": "HCPCS"}, {"code": "5321262", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 92.0, "discounted_cash": 69.0, "setting": "both", "billing_class": "facility"}]}, {"description": "INS REG HUM PER 5U IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J1815", "type": "HCPCS"}, {"code": "5321265", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 118.0, "discounted_cash": 88.5, "setting": "both", "billing_class": "facility"}]}, {"description": "INS REG HUM PER 5U IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J1815", "type": "HCPCS"}, {"code": "5321265", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 118.0, "discounted_cash": 88.5, "setting": "both", "billing_class": "facility"}]}, {"description": "INS REG NEO PER 1U IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5321251", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 12.0, "discounted_cash": 9.0, "setting": "both", "billing_class": "facility"}]}, {"description": "INS TUNN INTRAPER CATH", "code_information": [{"code": "4919418", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 10928.0, "discounted_cash": 8196.0, "setting": "both", "billing_class": "facility"}]}, {"description": "INS VAD LEFT HRT PERC ART", "code_information": [{"code": "4613986", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 12446.0, "discounted_cash": 9334.5, "setting": "both", "billing_class": "facility"}]}, {"description": "INS/PM GEN W/EXIST LD", "code_information": [{"code": "4613212", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 51026.0, "discounted_cash": 38269.5, "setting": "both", "billing_class": "facility"}]}, {"description": "INS/PMGEN W/EXISDUALLDS", "code_information": [{"code": "4612505", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 57411.0, "discounted_cash": 43058.25, "setting": "both", "billing_class": "facility"}]}, {"description": "INS/RPL PM W/TRNSV LD VE", "code_information": [{"code": "4613207", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 45616.0, "discounted_cash": 34212.0, "setting": "both", "billing_class": "facility"}]}, {"description": "INS/RPL PMW/TRNSV LD A-V", "code_information": [{"code": "4613208", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 67403.0, "discounted_cash": 50552.25, "setting": "both", "billing_class": "facility"}]}, {"description": "INSERT HUMERAL STD", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "8137719", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 15038.0, "discounted_cash": 11278.5, "setting": "both", "billing_class": "facility"}]}, {"description": "INSERT PHALAGEAL", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "8137718", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 21111.0, "discounted_cash": 15833.25, "setting": "both", "billing_class": "facility"}]}, {"description": "INSERT SCRW PLT LCK", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8137725", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 1134.0, "discounted_cash": 850.5, "setting": "both", "billing_class": "facility"}]}, {"description": "INSERT SWANGANZ CATHETER", "code_information": [{"code": "93503", "type": "CPT"}, {"code": "4613535", "type": "CDM"}, {"code": "480", "type": "RC"}], "standard_charges": [{"gross_charge": 8991.0, "discounted_cash": 6743.25, "setting": "both", "billing_class": "facility"}]}, {"description": "INSERT SWANGANZ CATHETER", "code_information": [{"code": "93503", "type": "CPT"}, {"code": "4613535", "type": "CDM"}, {"code": "481", "type": "RC"}], "standard_charges": [{"gross_charge": 8991.0, "discounted_cash": 6743.25, "setting": "both", "billing_class": "facility"}]}, {"description": "INSERT THORACOSTMY TUBE", "code_information": [{"code": "4917772", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 6956.0, "discounted_cash": 5217.0, "setting": "both", "billing_class": "facility"}]}, {"description": "INSERT THORACOSTMY TUBE", "code_information": [{"code": "5057576", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 8263.0, "discounted_cash": 6197.25, "setting": "both", "billing_class": "facility"}]}, {"description": "INSERT THORACOSTMY TUBE", "code_information": [{"code": "5066639", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 8211.0, "discounted_cash": 6158.25, "setting": "both", "billing_class": "facility"}]}, {"description": "INSERT TIBIAL", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "8137720", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 6499.0, "discounted_cash": 4874.25, "setting": "both", "billing_class": "facility"}]}, {"description": "INSERT TIBIAL ANY DJO CL", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "4013412", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 9882.0, "discounted_cash": 7411.5, "setting": "both", "billing_class": "facility"}]}, {"description": "INSERT/BEAR HIGH GLOBUS CL", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "4013240", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 12377.0, "discounted_cash": 9282.75, "setting": "both", "billing_class": "facility"}]}, {"description": "INSIT E ADD PRB CMP ASST", "code_information": [{"code": "88373", "type": "CPT"}, {"code": "7038373", "type": "CDM"}, {"code": "310", "type": "RC"}], "standard_charges": [{"gross_charge": 422.0, "discounted_cash": 316.5, "setting": "both", "billing_class": "facility"}]}, {"description": "INSIT MLTIPLX STAIN CMPT", "code_information": [{"code": "88374", "type": "CPT"}, {"code": "4308374", "type": "CDM"}, {"code": "310", "type": "RC"}], "standard_charges": [{"gross_charge": 1171.0, "discounted_cash": 878.25, "setting": "both", "billing_class": "facility"}]}, {"description": "INSITU 1ST PRB CMPT ASSI", "code_information": [{"code": "88367", "type": "CPT"}, {"code": "4300078", "type": "CDM"}, {"code": "310", "type": "RC"}], "standard_charges": [{"gross_charge": 813.0, "discounted_cash": 609.75, "setting": "both", "billing_class": "facility"}]}, {"description": "INSITU 1ST PRB MANUAL", "code_information": [{"code": "88368", "type": "CPT"}, {"code": "7030079", "type": "CDM"}, {"code": "310", "type": "RC"}], "standard_charges": [{"gross_charge": 422.0, "discounted_cash": 316.5, "setting": "both", "billing_class": "facility"}]}, {"description": "INSITU ADD PROBE MANUAL", "code_information": [{"code": "88369", "type": "CPT"}, {"code": "7038391", "type": "CDM"}, {"code": "310", "type": "RC"}], "standard_charges": [{"gross_charge": 422.0, "discounted_cash": 316.5, "setting": "both", "billing_class": "facility"}]}, {"description": "INSITU EA ADD SNGL PROBE", "code_information": [{"code": "88364", "type": "CPT"}, {"code": "7038364", "type": "CDM"}, {"code": "310", "type": "RC"}], "standard_charges": [{"gross_charge": 413.0, "discounted_cash": 309.75, "setting": "both", "billing_class": "facility"}]}, {"description": "INSR TNL VAD 2STS W PRT", "code_information": [{"code": "4916566", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 24092.0, "discounted_cash": 18069.0, "setting": "both", "billing_class": "facility"}]}, {"description": "INSR TNL VAD 2STS WO PRT", "code_information": [{"code": "4916565", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 20756.0, "discounted_cash": 15567.0, "setting": "both", "billing_class": "facility"}]}, {"description": "INSRT AICD W/EXIS LD", "code_information": [{"code": "4613240", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 187719.0, "discounted_cash": 140789.25, "setting": "both", "billing_class": "facility"}]}, {"description": "INSRT BEARNG TIB RP AESCULP CL", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "4013344", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 12540.0, "discounted_cash": 9405.0, "setting": "both", "billing_class": "facility"}]}, {"description": "INSRT BILI DRAIN EXT", "code_information": [{"code": "4917760", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 10437.0, "discounted_cash": 7827.75, "setting": "both", "billing_class": "facility"}]}, {"description": "INSRT BILI DRAIN INT/EXT", "code_information": [{"code": "4917534", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 12667.0, "discounted_cash": 9500.25, "setting": "both", "billing_class": "facility"}]}, {"description": "INSRT CVAD W PORT<5 YRS", "code_information": [{"code": "4916570", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 9324.0, "discounted_cash": 6993.0, "setting": "both", "billing_class": "facility"}]}, {"description": "INSRT CVAD W PRT 5YRS>", "code_information": [{"code": "4916571", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 7848.0, "discounted_cash": 5886.0, "setting": "both", "billing_class": "facility"}]}, {"description": "INSRT LD VEN LTVENT PREV", "code_information": [{"code": "4613221", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 149804.0, "discounted_cash": 112353.0, "setting": "both", "billing_class": "facility"}]}, {"description": "INSRT LNR BEARNG HUMERL DJO CL", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "4013426", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 16469.0, "discounted_cash": 12351.75, "setting": "both", "billing_class": "facility"}]}, {"description": "INSRT MOD TIB OSTEOREMEDIES CL", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "4013362", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 8646.0, "discounted_cash": 6484.5, "setting": "both", "billing_class": "facility"}]}, {"description": "INSRT NON-TUNNL CV CTH<5", "code_information": [{"code": "4916555", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 5113.0, "discounted_cash": 3834.75, "setting": "both", "billing_class": "facility"}]}, {"description": "INSRT NONTUNNL CV CTH 5>", "code_information": [{"code": "4916556", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 4082.0, "discounted_cash": 3061.5, "setting": "both", "billing_class": "facility"}]}, {"description": "INSRT PICC NO PRT/PMP<5 NO IMG", "code_information": [{"code": "4906568", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 6203.0, "discounted_cash": 4652.25, "setting": "both", "billing_class": "facility"}]}, {"description": "INSRT PICC NO PRT/PMP<5 NO IMG", "code_information": [{"code": "4916568", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 6500.0, "discounted_cash": 4875.0, "setting": "both", "billing_class": "facility"}]}, {"description": "INSRT PICC NO PRT/PMP<5 NO IMG", "code_information": [{"code": "6296568", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 4387.0, "discounted_cash": 3290.25, "setting": "both", "billing_class": "facility"}]}, {"description": "INSRT PICC NO PRT/PMP>5 NO IMG", "code_information": [{"code": "4916569", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 6500.0, "discounted_cash": 4875.0, "setting": "both", "billing_class": "facility"}]}, {"description": "INSRT PICC W/IMG 5+YR", "code_information": [{"code": "5076573", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 6068.0, "discounted_cash": 4551.0, "setting": "both", "billing_class": "facility"}]}, {"description": "INSRT POLY KNEE UNI AESCULP CL", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "4013353", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 11758.0, "discounted_cash": 8818.5, "setting": "both", "billing_class": "facility"}]}, {"description": "INSRT SUBQ CAR RHYTHM MNTR", "code_information": [{"code": "4613271", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 37230.0, "discounted_cash": 27922.5, "setting": "both", "billing_class": "facility"}]}, {"description": "INSRT TNL CV CTH5>WO PMP", "code_information": [{"code": "4916558", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 11756.0, "discounted_cash": 8817.0, "setting": "both", "billing_class": "facility"}]}, {"description": "INSRT TRAN ELCTRD SNGL", "code_information": [{"code": "4612510", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 18031.0, "discounted_cash": 13523.25, "setting": "both", "billing_class": "facility"}]}, {"description": "INSRT TUNLD PLEURAL CATH", "code_information": [{"code": "4912019", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 16950.0, "discounted_cash": 12712.5, "setting": "both", "billing_class": "facility"}]}, {"description": "INSRT TUNNEL VAD W PUMP", "code_information": [{"code": "4916563", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 24092.0, "discounted_cash": 18069.0, "setting": "both", "billing_class": "facility"}]}, {"description": "INSRT TUNNL VAD 5>W PORT", "code_information": [{"code": "4916561", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 18165.0, "discounted_cash": 13623.75, "setting": "both", "billing_class": "facility"}]}, {"description": "INSRT/BEAR POLY X3 STRYKER CL", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "4013061", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 16213.0, "discounted_cash": 12159.75, "setting": "both", "billing_class": "facility"}]}, {"description": "INSRT/BEAR VIT E ATTUN DPY CL", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "4012820", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 12996.0, "discounted_cash": 9747.0, "setting": "both", "billing_class": "facility"}]}, {"description": "INSRT/REPL TEMP PM LEAD", "code_information": [{"code": "4613595", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 16697.0, "discounted_cash": 12522.75, "setting": "both", "billing_class": "facility"}]}, {"description": "INSRT/RPLC AICD & LDS", "code_information": [{"code": "4613249", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 250437.0, "discounted_cash": 187827.75, "setting": "both", "billing_class": "facility"}]}, {"description": "INSULIN ANTIBODIES", "code_information": [{"code": "86337", "type": "CPT"}, {"code": "7256042", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 1667.0, "discounted_cash": 1250.25, "setting": "both", "billing_class": "facility"}]}, {"description": "INSULIN FREE", "code_information": [{"code": "83527", "type": "CPT"}, {"code": "7253527", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 70.0, "discounted_cash": 52.5, "setting": "both", "billing_class": "facility"}]}, {"description": "INSULIN GF BINDING PROTEIN/2", "code_information": [{"code": "83520", "type": "CPT"}, {"code": "7253542", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 238.0, "discounted_cash": 178.5, "setting": "both", "billing_class": "facility"}]}, {"description": "INSULIN GF BINDING PROTEIN/4", "code_information": [{"code": "83520", "type": "CPT"}, {"code": "7253547", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 238.0, "discounted_cash": 178.5, "setting": "both", "billing_class": "facility"}]}, {"description": "INSULIN TOTAL", "code_information": [{"code": "83525", "type": "CPT"}, {"code": "4103525", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 97.0, "discounted_cash": 72.75, "setting": "both", "billing_class": "facility"}]}, {"description": "INSULIN TOTAL", "code_information": [{"code": "83525", "type": "CPT"}, {"code": "7253525", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 83.0, "discounted_cash": 62.25, "setting": "both", "billing_class": "facility"}]}, {"description": "INTEGRA 2LAY 10X12.5 PER SQ CM", "code_information": [{"code": "Q4104", "type": "HCPCS"}, {"code": "4023184", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 385.0, "discounted_cash": 288.75, "setting": "both", "billing_class": "facility"}]}, {"description": "INTEGRA 2LAY 10X12.5 PER SQ CM", "code_information": [{"code": "Q4104", "type": "HCPCS"}, {"code": "4023184", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 385.0, "discounted_cash": 288.75, "setting": "both", "billing_class": "facility"}]}, {"description": "INTEGRA 2LAYR MTRX SQ CM", "code_information": [{"code": "Q4104", "type": "HCPCS"}, {"code": "4032750", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 385.0, "discounted_cash": 288.75, "setting": "both", "billing_class": "facility"}]}, {"description": "INTEGRA 2LAYR MTRX SQ CM", "code_information": [{"code": "Q4104", "type": "HCPCS"}, {"code": "4032750", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 385.0, "discounted_cash": 288.75, "setting": "both", "billing_class": "facility"}]}, {"description": "INTEGRA DRML REGEN TEMPL", "code_information": [{"code": "Q4105", "type": "HCPCS"}, {"code": "4032751", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 1092.0, "discounted_cash": 819.0, "setting": "both", "billing_class": "facility"}]}, {"description": "INTEGRA DRML REGEN TEMPL", "code_information": [{"code": "Q4105", "type": "HCPCS"}, {"code": "4032751", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 1092.0, "discounted_cash": 819.0, "setting": "both", "billing_class": "facility"}]}, {"description": "INTENSIVE CARE INTERMED", "code_information": [{"code": "1990062", "type": "CDM"}, {"code": "206", "type": "RC"}], "standard_charges": [{"gross_charge": 7376.0, "discounted_cash": 5532.0, "setting": "both", "billing_class": "facility"}]}, {"description": "INTENSIVE CARE INTERMED", "code_information": [{"code": "2000062", "type": "CDM"}, {"code": "206", "type": "RC"}], "standard_charges": [{"gross_charge": 7376.0, "discounted_cash": 5532.0, "setting": "both", "billing_class": "facility"}]}, {"description": "INTENSIVE CARE INTERMED", "code_information": [{"code": "2010062", "type": "CDM"}, {"code": "206", "type": "RC"}], "standard_charges": [{"gross_charge": 7376.0, "discounted_cash": 5532.0, "setting": "both", "billing_class": "facility"}]}, {"description": "INTENSIVE CARE INTERMED", "code_information": [{"code": "2120062", "type": "CDM"}, {"code": "206", "type": "RC"}], "standard_charges": [{"gross_charge": 7376.0, "discounted_cash": 5532.0, "setting": "both", "billing_class": "facility"}]}, {"description": "INTENSIVE CARE INTERMED", "code_information": [{"code": "2150062", "type": "CDM"}, {"code": "206", "type": "RC"}], "standard_charges": [{"gross_charge": 7376.0, "discounted_cash": 5532.0, "setting": "both", "billing_class": "facility"}]}, {"description": "INTENSIVE CARE INTERMED", "code_information": [{"code": "2300062", "type": "CDM"}, {"code": "206", "type": "RC"}], "standard_charges": [{"gross_charge": 7376.0, "discounted_cash": 5532.0, "setting": "both", "billing_class": "facility"}]}, {"description": "INTENSIVE CARE INTERMED", "code_information": [{"code": "2310062", "type": "CDM"}, {"code": "206", "type": "RC"}], "standard_charges": [{"gross_charge": 7376.0, "discounted_cash": 5532.0, "setting": "both", "billing_class": "facility"}]}, {"description": "INTENSIVE CARE INTERMED", "code_information": [{"code": "2320062", "type": "CDM"}, {"code": "206", "type": "RC"}], "standard_charges": [{"gross_charge": 7376.0, "discounted_cash": 5532.0, "setting": "both", "billing_class": "facility"}]}, {"description": "INTENSIVE CARE TRAUMA", "code_information": [{"code": "1990017", "type": "CDM"}, {"code": "208", "type": "RC"}], "standard_charges": [{"gross_charge": 18401.0, "discounted_cash": 13800.75, "setting": "both", "billing_class": "facility"}]}, {"description": "INTENSIVE CARE TRAUMA", "code_information": [{"code": "2000017", "type": "CDM"}, {"code": "208", "type": "RC"}], "standard_charges": [{"gross_charge": 18401.0, "discounted_cash": 13800.75, "setting": "both", "billing_class": "facility"}]}, {"description": "INTENSIVE CARE TRAUMA", "code_information": [{"code": "2010017", "type": "CDM"}, {"code": "208", "type": "RC"}], "standard_charges": [{"gross_charge": 18401.0, "discounted_cash": 13800.75, "setting": "both", "billing_class": "facility"}]}, {"description": "INTENSIVE CARE UNIT", "code_information": [{"code": "1990022", "type": "CDM"}, {"code": "200", "type": "RC"}], "standard_charges": [{"gross_charge": 12296.0, "discounted_cash": 9222.0, "setting": "both", "billing_class": "facility"}]}, {"description": "INTENSIVE CARE UNIT", "code_information": [{"code": "2000022", "type": "CDM"}, {"code": "200", "type": "RC"}], "standard_charges": [{"gross_charge": 12296.0, "discounted_cash": 9222.0, "setting": "both", "billing_class": "facility"}]}, {"description": "INTENSIVE CARE UNIT", "code_information": [{"code": "2010022", "type": "CDM"}, {"code": "200", "type": "RC"}], "standard_charges": [{"gross_charge": 12296.0, "discounted_cash": 9222.0, "setting": "both", "billing_class": "facility"}]}, {"description": "INTENSIVE CARE UNIT", "code_information": [{"code": "2120022", "type": "CDM"}, {"code": "200", "type": "RC"}], "standard_charges": [{"gross_charge": 12296.0, "discounted_cash": 9222.0, "setting": "both", "billing_class": "facility"}]}, {"description": "INTERFERON", "code_information": [{"code": "83520", "type": "CPT"}, {"code": "7253475", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 206.0, "discounted_cash": 154.5, "setting": "both", "billing_class": "facility"}]}, {"description": "INTERLEUKIN/4", "code_information": [{"code": "83520", "type": "CPT"}, {"code": "7253549", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 358.0, "discounted_cash": 268.5, "setting": "both", "billing_class": "facility"}]}, {"description": "INTESTINE IMAGING", "code_information": [{"code": "78290", "type": "CPT"}, {"code": "5208290", "type": "CDM"}, {"code": "341", "type": "RC"}], "standard_charges": [{"gross_charge": 6564.0, "discounted_cash": 4923.0, "setting": "both", "billing_class": "facility"}]}, {"description": "INTR ACCUSTICK II ROMRKR", "code_information": [{"code": "C1894", "type": "HCPCS"}, {"code": "8247240", "type": "CDM"}, {"code": "272", "type": "RC"}], "standard_charges": [{"gross_charge": 1161.0, "discounted_cash": 870.75, "setting": "both", "billing_class": "facility"}]}, {"description": "INTR NDL TLA", "code_information": [{"code": "C1894", "type": "HCPCS"}, {"code": "8241505", "type": "CDM"}, {"code": "272", "type": "RC"}], "standard_charges": [{"gross_charge": 403.0, "discounted_cash": 302.25, "setting": "both", "billing_class": "facility"}]}, {"description": "INTR SHTH PERIPH PINNACL", "code_information": [{"code": "C1894", "type": "HCPCS"}, {"code": "8241506", "type": "CDM"}, {"code": "272", "type": "RC"}], "standard_charges": [{"gross_charge": 392.0, "discounted_cash": 294.0, "setting": "both", "billing_class": "facility"}]}, {"description": "INTR SHTH SUPER", "code_information": [{"code": "C1894", "type": "HCPCS"}, {"code": "8241503", "type": "CDM"}, {"code": "272", "type": "RC"}], "standard_charges": [{"gross_charge": 159.0, "discounted_cash": 119.25, "setting": "both", "billing_class": "facility"}]}, {"description": "INTRA-ARTERIAL RECORDING", "code_information": [{"code": "93602", "type": "CPT"}, {"code": "4613625", "type": "CDM"}, {"code": "480", "type": "RC"}], "standard_charges": [{"gross_charge": 10329.0, "discounted_cash": 7746.75, "setting": "both", "billing_class": "facility"}]}, {"description": "INTRACARD ABL ARRHY", "code_information": [{"code": "93655", "type": "CPT"}, {"code": "4613659", "type": "CDM"}, {"code": "480", "type": "RC"}], "standard_charges": [{"gross_charge": 56826.0, "discounted_cash": 42619.5, "setting": "both", "billing_class": "facility"}]}, {"description": "INTRACARD ECHO", "code_information": [{"code": "93662", "type": "CPT"}, {"code": "4613662", "type": "CDM"}, {"code": "480", "type": "RC"}], "standard_charges": [{"gross_charge": 20194.0, "discounted_cash": 15145.5, "setting": "both", "billing_class": "facility"}]}, {"description": "INTRACRAN ADM THERA AGNT", "code_information": [{"code": "4611650", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 7892.0, "discounted_cash": 5919.0, "setting": "both", "billing_class": "facility"}]}, {"description": "INTRAVENTRICULAR PACING", "code_information": [{"code": "93612", "type": "CPT"}, {"code": "4613612", "type": "CDM"}, {"code": "480", "type": "RC"}], "standard_charges": [{"gross_charge": 16039.0, "discounted_cash": 12029.25, "setting": "both", "billing_class": "facility"}]}, {"description": "INTRCRD EP 3DMAP", "code_information": [{"code": "93613", "type": "CPT"}, {"code": "4613613", "type": "CDM"}, {"code": "480", "type": "RC"}], "standard_charges": [{"gross_charge": 32014.0, "discounted_cash": 24010.5, "setting": "both", "billing_class": "facility"}]}, {"description": "INTRINSIC FACTOR ANTIBDY", "code_information": [{"code": "86340", "type": "CPT"}, {"code": "7255536", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 909.0, "discounted_cash": 681.75, "setting": "both", "billing_class": "facility"}]}, {"description": "INTRO EP IC N-LSR N-GUID", "code_information": [{"code": "C1894", "type": "HCPCS"}, {"code": "8240223", "type": "CDM"}, {"code": "272", "type": "RC"}], "standard_charges": [{"gross_charge": 3200.0, "discounted_cash": 2400.0, "setting": "both", "billing_class": "facility"}]}, {"description": "INTRO FLEXOR CHECKFLO", "code_information": [{"code": "C1894", "type": "HCPCS"}, {"code": "8241509", "type": "CDM"}, {"code": "272", "type": "RC"}], "standard_charges": [{"gross_charge": 915.0, "discounted_cash": 686.25, "setting": "both", "billing_class": "facility"}]}, {"description": "INTRO LONG GI TUBE", "code_information": [{"code": "4907782", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 4041.0, "discounted_cash": 3030.75, "setting": "both", "billing_class": "facility"}]}, {"description": "INTRO LONG GI TUBE", "code_information": [{"code": "4917782", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 5090.0, "discounted_cash": 3817.5, "setting": "both", "billing_class": "facility"}]}, {"description": "INTRO NDL DIAL-CIRC+S&I", "code_information": [{"code": "4916901", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 3188.0, "discounted_cash": 2391.0, "setting": "both", "billing_class": "facility"}]}, {"description": "INTRO PEEL AWAY", "code_information": [{"code": "C1894", "type": "HCPCS"}, {"code": "8174943", "type": "CDM"}, {"code": "272", "type": "RC"}], "standard_charges": [{"gross_charge": 1224.0, "discounted_cash": 918.0, "setting": "both", "billing_class": "facility"}]}, {"description": "INTRO SHTH COR PINNCL GW", "code_information": [{"code": "C1894", "type": "HCPCS"}, {"code": "8182689", "type": "CDM"}, {"code": "272", "type": "RC"}], "standard_charges": [{"gross_charge": 93.0, "discounted_cash": 69.75, "setting": "both", "billing_class": "facility"}]}, {"description": "INTRO SHTH GLIDE", "code_information": [{"code": "C1894", "type": "HCPCS"}, {"code": "4032851", "type": "CDM"}, {"code": "272", "type": "RC"}], "standard_charges": [{"gross_charge": 1156.0, "discounted_cash": 867.0, "setting": "both", "billing_class": "facility"}]}, {"description": "INTRODUCER LD NSTIM", "code_information": [{"code": "C1894", "type": "HCPCS"}, {"code": "8241511", "type": "CDM"}, {"code": "272", "type": "RC"}], "standard_charges": [{"gross_charge": 4120.0, "discounted_cash": 3090.0, "setting": "both", "billing_class": "facility"}]}, {"description": "INTUBATION", "code_information": [{"code": "5500205", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 1581.0, "discounted_cash": 1185.75, "setting": "both", "billing_class": "facility"}]}, {"description": "IODINE/K IODIDE 5ML LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5315348", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 146.0, "discounted_cash": 109.5, "setting": "both", "billing_class": "facility"}]}, {"description": "IODINE/K IODIDE 5ML LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5315348", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 146.0, "discounted_cash": 109.5, "setting": "both", "billing_class": "facility"}]}, {"description": "IOL ANTERIOR CHAMBER", "code_information": [{"code": "V2630", "type": "HCPCS"}, {"code": "8122064", "type": "CDM"}, {"code": "276", "type": "RC"}], "standard_charges": [{"gross_charge": 1849.0, "discounted_cash": 1386.75, "setting": "both", "billing_class": "facility"}]}, {"description": "IOL POSTERIOR CHMBR", "code_information": [{"code": "V2632", "type": "HCPCS"}, {"code": "8122044", "type": "CDM"}, {"code": "276", "type": "RC"}], "standard_charges": [{"gross_charge": 3742.0, "discounted_cash": 2806.5, "setting": "both", "billing_class": "facility"}]}, {"description": "IP HEMODIALYSIS", "code_information": [{"code": "90935", "type": "CPT"}, {"code": "5600976", "type": "CDM"}, {"code": "801", "type": "RC"}], "standard_charges": [{"gross_charge": 3138.0, "discounted_cash": 2353.5, "setting": "both", "billing_class": "facility"}]}, {"description": "IP HEMODIALYSIS", "code_information": [{"code": "90935", "type": "CPT"}, {"code": "5600976", "type": "CDM"}, {"code": "821", "type": "RC"}], "standard_charges": [{"gross_charge": 3138.0, "discounted_cash": 2353.5, "setting": "both", "billing_class": "facility"}]}, {"description": "IPPB TX", "code_information": [{"code": "94640", "type": "CPT"}, {"code": "5500502", "type": "CDM"}, {"code": "410", "type": "RC"}], "standard_charges": [{"gross_charge": 711.0, "discounted_cash": 533.25, "setting": "both", "billing_class": "facility"}]}, {"description": "IPRATROPIUM .02%2.5ML IS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5331231", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 85.0, "discounted_cash": 63.75, "setting": "both", "billing_class": "facility"}]}, {"description": "IPRATROPIUM .02%2.5ML IS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5331231", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 85.0, "discounted_cash": 63.75, "setting": "both", "billing_class": "facility"}]}, {"description": "IPRATROPIUM17MCG12.9GMIH", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3535", "type": "HCPCS"}, {"code": "5331239", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 907.0, "discounted_cash": 680.25, "setting": "both", "billing_class": "facility"}]}, {"description": "IPRATROPIUM17MCG12.9GMIH", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3535", "type": "HCPCS"}, {"code": "5331239", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 907.0, "discounted_cash": 680.25, "setting": "both", "billing_class": "facility"}]}, {"description": "IPRATROPIUMNAS.03%30MLSP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5331233", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 803.0, "discounted_cash": 602.25, "setting": "both", "billing_class": "facility"}]}, {"description": "IPRATROPIUMNAS.03%30MLSP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5331233", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 803.0, "discounted_cash": 602.25, "setting": "both", "billing_class": "facility"}]}, {"description": "IRBESART/HCTZ 300/12.5TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5306053", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 126.0, "discounted_cash": 94.5, "setting": "both", "billing_class": "facility"}]}, {"description": "IRBESART/HCTZ 300/12.5TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5306053", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 126.0, "discounted_cash": 94.5, "setting": "both", "billing_class": "facility"}]}, {"description": "IRBESARTAN 150MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5306051", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 85.0, "discounted_cash": 63.75, "setting": "both", "billing_class": "facility"}]}, {"description": "IRBESARTAN 150MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5306051", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 85.0, "discounted_cash": 63.75, "setting": "both", "billing_class": "facility"}]}, {"description": "IRBESRTN/HCTZ 150/12.5TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5306054", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 142.0, "discounted_cash": 106.5, "setting": "both", "billing_class": "facility"}]}, {"description": "IRBESRTN/HCTZ 150/12.5TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5306054", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 142.0, "discounted_cash": 106.5, "setting": "both", "billing_class": "facility"}]}, {"description": "IRON ASSAY", "code_information": [{"code": "83540", "type": "CPT"}, {"code": "4103540", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 752.0, "discounted_cash": 564.0, "setting": "both", "billing_class": "facility"}]}, {"description": "IRON ASSAY", "code_information": [{"code": "83540", "type": "CPT"}, {"code": "4173540", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 5.71, "discounted_cash": 4.28, "setting": "both", "billing_class": "facility"}]}, {"description": "IRON ASSAY", "code_information": [{"code": "83540", "type": "CPT"}, {"code": "7253540", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 95.0, "discounted_cash": 71.25, "setting": "both", "billing_class": "facility"}]}, {"description": "IRON BINDING CAPCTY", "code_information": [{"code": "83550", "type": "CPT"}, {"code": "4103550", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 868.0, "discounted_cash": 651.0, "setting": "both", "billing_class": "facility"}]}, {"description": "IRON BINDING CAPCTY", "code_information": [{"code": "83550", "type": "CPT"}, {"code": "4173550", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 11.42, "discounted_cash": 8.57, "setting": "both", "billing_class": "facility"}]}, {"description": "IRON SUCROSE PER 1MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J1756", "type": "HCPCS"}, {"code": "5321529", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 20.0, "discounted_cash": 15.0, "setting": "both", "billing_class": "facility"}]}, {"description": "IRON SUCROSE PER 1MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J1756", "type": "HCPCS"}, {"code": "5321529", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 20.0, "discounted_cash": 15.0, "setting": "both", "billing_class": "facility"}]}, {"description": "IRRIGANT OPHTH 120ML OS", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5331245", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 118.0, "discounted_cash": 88.5, "setting": "both", "billing_class": "facility"}]}, {"description": "IRRIGANT OPHTH 120ML OS", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5331245", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 118.0, "discounted_cash": 88.5, "setting": "both", "billing_class": "facility"}]}, {"description": "ISLET CELL ANTIBODY", "code_information": [{"code": "86341", "type": "CPT"}, {"code": "7256341", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 697.0, "discounted_cash": 522.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ISLET CELL ANTIBODY/5", "code_information": [{"code": "86341", "type": "CPT"}, {"code": "7256430", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 141.0, "discounted_cash": 105.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ISLET CELL ANTIBODY/7", "code_information": [{"code": "86341", "type": "CPT"}, {"code": "7258645", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 322.0, "discounted_cash": 241.5, "setting": "both", "billing_class": "facility"}]}, {"description": "ISOLYTE S 1000ML IVF", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5412520", "type": "CDM"}, {"code": "258", "type": "RC"}], "standard_charges": [{"gross_charge": 702.0, "discounted_cash": 526.5, "setting": "both", "billing_class": "facility"}]}, {"description": "ISONIAZID 300MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5306100", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 61.0, "discounted_cash": 45.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ISONIAZID 300MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5306100", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 61.0, "discounted_cash": 45.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ISOPROTERENOL .2MG/1MLIJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5321551", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 3665.0, "discounted_cash": 2748.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ISOPROTERENOL 1MG/5ML IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5321553", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 440.0, "discounted_cash": 330.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ISOSORBIDE DN 10MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5306177", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 61.0, "discounted_cash": 45.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ISOSORBIDE DN 10MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5306177", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 61.0, "discounted_cash": 45.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ISOSORBIDE DN 20MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5306181", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 61.0, "discounted_cash": 45.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ISOSORBIDE DN 20MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5306181", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 61.0, "discounted_cash": 45.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ISOSORBIDE DN 40MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5306178", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 97.0, "discounted_cash": 72.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ISOSORBIDE DN 40MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5306178", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 97.0, "discounted_cash": 72.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ISOSORBIDE MN 20MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5306182", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 71.0, "discounted_cash": 53.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ISOSORBIDE MN 20MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5306182", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 71.0, "discounted_cash": 53.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ISOSORBIDE MN 30MG XR TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5306184", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 66.0, "discounted_cash": 49.5, "setting": "both", "billing_class": "facility"}]}, {"description": "ISOSORBIDE MN 30MG XR TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5306184", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 66.0, "discounted_cash": 49.5, "setting": "both", "billing_class": "facility"}]}, {"description": "ISOSORBIDE MN 60MG XR TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5306186", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 61.0, "discounted_cash": 45.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ISOSORBIDE MN 60MG XR TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5306186", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 61.0, "discounted_cash": 45.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ISOSULFAN BLUE PER1MG IJ", "code_information": [{"code": "Q9968", "type": "HCPCS"}, {"code": "5358208", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 921.0, "discounted_cash": 690.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ISOSULFAN BLUE PER1MG IJ", "code_information": [{"code": "Q9968", "type": "HCPCS"}, {"code": "5358208", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 921.0, "discounted_cash": 690.75, "setting": "both", "billing_class": "facility"}]}, {"description": "IV INF CONCURRENT", "code_information": [{"code": "96368", "type": "CPT"}, {"code": "3100768", "type": "CDM"}, {"code": "260", "type": "RC"}], "standard_charges": [{"gross_charge": 1466.0, "discounted_cash": 1099.5, "setting": "both", "billing_class": "facility"}]}, {"description": "IV INF CONCURRENT", "code_information": [{"code": "96368", "type": "CPT"}, {"code": "3600768", "type": "CDM"}, {"code": "260", "type": "RC"}], "standard_charges": [{"gross_charge": 1730.0, "discounted_cash": 1297.5, "setting": "both", "billing_class": "facility"}]}, {"description": "IV INF CONCURRENT", "code_information": [{"code": "96368", "type": "CPT"}, {"code": "6100768", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 1457.0, "discounted_cash": 1092.75, "setting": "both", "billing_class": "facility"}]}, {"description": "IV INF CONCURRENT", "code_information": [{"code": "96368", "type": "CPT"}, {"code": "6160768", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 1457.0, "discounted_cash": 1092.75, "setting": "both", "billing_class": "facility"}]}, {"description": "IV INF CONCURRENT", "code_information": [{"code": "96368", "type": "CPT"}, {"code": "6290768", "type": "CDM"}, {"code": "260", "type": "RC"}], "standard_charges": [{"gross_charge": 1730.0, "discounted_cash": 1297.5, "setting": "both", "billing_class": "facility"}]}, {"description": "IV INF HYD EA ADD HR", "code_information": [{"code": "96361", "type": "CPT"}, {"code": "3100761", "type": "CDM"}, {"code": "260", "type": "RC"}], "standard_charges": [{"gross_charge": 800.0, "discounted_cash": 600.0, "setting": "both", "billing_class": "facility"}]}, {"description": "IV INF HYD EA ADD HR", "code_information": [{"code": "96361", "type": "CPT"}, {"code": "6100761", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 700.0, "discounted_cash": 525.0, "setting": "both", "billing_class": "facility"}]}, {"description": "IV INF HYD EA ADD HR", "code_information": [{"code": "96361", "type": "CPT"}, {"code": "6160761", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 800.0, "discounted_cash": 600.0, "setting": "both", "billing_class": "facility"}]}, {"description": "IV INF HYD EA ADD HR", "code_information": [{"code": "96361", "type": "CPT"}, {"code": "6290761", "type": "CDM"}, {"code": "260", "type": "RC"}], "standard_charges": [{"gross_charge": 640.0, "discounted_cash": 480.0, "setting": "both", "billing_class": "facility"}]}, {"description": "IV INF HYD INIT 31-60MIN", "code_information": [{"code": "96360", "type": "CPT"}, {"code": "3100760", "type": "CDM"}, {"code": "260", "type": "RC"}], "standard_charges": [{"gross_charge": 2188.0, "discounted_cash": 1641.0, "setting": "both", "billing_class": "facility"}]}, {"description": "IV INF HYD INIT 31-60MIN", "code_information": [{"code": "96360", "type": "CPT"}, {"code": "6100760", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 1744.0, "discounted_cash": 1308.0, "setting": "both", "billing_class": "facility"}]}, {"description": "IV INF HYD INIT 31-60MIN", "code_information": [{"code": "96360", "type": "CPT"}, {"code": "6160760", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 1744.0, "discounted_cash": 1308.0, "setting": "both", "billing_class": "facility"}]}, {"description": "IV INF HYD INIT 31-60MIN", "code_information": [{"code": "96360", "type": "CPT"}, {"code": "6290760", "type": "CDM"}, {"code": "260", "type": "RC"}], "standard_charges": [{"gross_charge": 1492.0, "discounted_cash": 1119.0, "setting": "both", "billing_class": "facility"}]}, {"description": "IV INF SEQUENTL 1 HR", "code_information": [{"code": "96367", "type": "CPT"}, {"code": "3100767", "type": "CDM"}, {"code": "260", "type": "RC"}], "standard_charges": [{"gross_charge": 678.0, "discounted_cash": 508.5, "setting": "both", "billing_class": "facility"}]}, {"description": "IV INF SEQUENTL 1 HR", "code_information": [{"code": "96367", "type": "CPT"}, {"code": "6100767", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 600.0, "discounted_cash": 450.0, "setting": "both", "billing_class": "facility"}]}, {"description": "IV INF SEQUENTL 1 HR", "code_information": [{"code": "96367", "type": "CPT"}, {"code": "6160767", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 600.0, "discounted_cash": 450.0, "setting": "both", "billing_class": "facility"}]}, {"description": "IV INF SEQUENTL 1 HR", "code_information": [{"code": "96367", "type": "CPT"}, {"code": "6290767", "type": "CDM"}, {"code": "260", "type": "RC"}], "standard_charges": [{"gross_charge": 678.0, "discounted_cash": 508.5, "setting": "both", "billing_class": "facility"}]}, {"description": "IV INF TOCILIZU COV19 1ST DOSE", "code_information": [{"code": "M0249", "type": "HCPCS"}, {"code": "6100011", "type": "CDM"}, {"code": "771", "type": "RC"}], "standard_charges": [{"gross_charge": 3925.0, "discounted_cash": 2943.75, "setting": "both", "billing_class": "facility"}]}, {"description": "IV INF TOCILIZU COV19 1ST DOSE", "code_information": [{"code": "M0249", "type": "HCPCS"}, {"code": "6290018", "type": "CDM"}, {"code": "771", "type": "RC"}], "standard_charges": [{"gross_charge": 3925.0, "discounted_cash": 2943.75, "setting": "both", "billing_class": "facility"}]}, {"description": "IV INF TOCILIZU COV19 2ND DOSE", "code_information": [{"code": "M0250", "type": "HCPCS"}, {"code": "6100012", "type": "CDM"}, {"code": "771", "type": "RC"}], "standard_charges": [{"gross_charge": 3925.0, "discounted_cash": 2943.75, "setting": "both", "billing_class": "facility"}]}, {"description": "IV INF TOCILIZU COV19 2ND DOSE", "code_information": [{"code": "M0250", "type": "HCPCS"}, {"code": "6290019", "type": "CDM"}, {"code": "771", "type": "RC"}], "standard_charges": [{"gross_charge": 3925.0, "discounted_cash": 2943.75, "setting": "both", "billing_class": "facility"}]}, {"description": "IV INF TX EA ADD HR", "code_information": [{"code": "96366", "type": "CPT"}, {"code": "3100766", "type": "CDM"}, {"code": "260", "type": "RC"}], "standard_charges": [{"gross_charge": 465.0, "discounted_cash": 348.75, "setting": "both", "billing_class": "facility"}]}, {"description": "IV INF TX EA ADD HR", "code_information": [{"code": "96366", "type": "CPT"}, {"code": "3600766", "type": "CDM"}, {"code": "260", "type": "RC"}], "standard_charges": [{"gross_charge": 602.0, "discounted_cash": 451.5, "setting": "both", "billing_class": "facility"}]}, {"description": "IV INF TX EA ADD HR", "code_information": [{"code": "96366", "type": "CPT"}, {"code": "6100766", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 747.0, "discounted_cash": 560.25, "setting": "both", "billing_class": "facility"}]}, {"description": "IV INF TX EA ADD HR", "code_information": [{"code": "96366", "type": "CPT"}, {"code": "6160766", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 747.0, "discounted_cash": 560.25, "setting": "both", "billing_class": "facility"}]}, {"description": "IV INF TX EA ADD HR", "code_information": [{"code": "96366", "type": "CPT"}, {"code": "6290766", "type": "CDM"}, {"code": "260", "type": "RC"}], "standard_charges": [{"gross_charge": 640.0, "discounted_cash": 480.0, "setting": "both", "billing_class": "facility"}]}, {"description": "IV INF TX EA ADD HR", "code_information": [{"code": "96366", "type": "CPT"}, {"code": "6811021", "type": "CDM"}, {"code": "260", "type": "RC"}], "standard_charges": [{"gross_charge": 586.0, "discounted_cash": 439.5, "setting": "both", "billing_class": "facility"}]}, {"description": "IV INF TX EA ADD HR", "code_information": [{"code": "96366", "type": "CPT"}, {"code": "6906366", "type": "CDM"}, {"code": "260", "type": "RC"}], "standard_charges": [{"gross_charge": 465.0, "discounted_cash": 348.75, "setting": "both", "billing_class": "facility"}]}, {"description": "IV INF TX INIT <=1 HR", "code_information": [{"code": "96365", "type": "CPT"}, {"code": "3100765", "type": "CDM"}, {"code": "260", "type": "RC"}], "standard_charges": [{"gross_charge": 1794.0, "discounted_cash": 1345.5, "setting": "both", "billing_class": "facility"}]}, {"description": "IV INF TX INIT <=1 HR", "code_information": [{"code": "96365", "type": "CPT"}, {"code": "3600765", "type": "CDM"}, {"code": "260", "type": "RC"}], "standard_charges": [{"gross_charge": 1445.0, "discounted_cash": 1083.75, "setting": "both", "billing_class": "facility"}]}, {"description": "IV INF TX INIT <=1 HR", "code_information": [{"code": "96365", "type": "CPT"}, {"code": "6100765", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 1648.0, "discounted_cash": 1236.0, "setting": "both", "billing_class": "facility"}]}, {"description": "IV INF TX INIT <=1 HR", "code_information": [{"code": "96365", "type": "CPT"}, {"code": "6160765", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 1648.0, "discounted_cash": 1236.0, "setting": "both", "billing_class": "facility"}]}, {"description": "IV INF TX INIT <=1 HR", "code_information": [{"code": "96365", "type": "CPT"}, {"code": "6290765", "type": "CDM"}, {"code": "260", "type": "RC"}], "standard_charges": [{"gross_charge": 1578.0, "discounted_cash": 1183.5, "setting": "both", "billing_class": "facility"}]}, {"description": "IV INF TX INIT <=1 HR", "code_information": [{"code": "96365", "type": "CPT"}, {"code": "6811020", "type": "CDM"}, {"code": "260", "type": "RC"}], "standard_charges": [{"gross_charge": 1446.0, "discounted_cash": 1084.5, "setting": "both", "billing_class": "facility"}]}, {"description": "IV INF TX INIT <=1 HR", "code_information": [{"code": "96365", "type": "CPT"}, {"code": "6906365", "type": "CDM"}, {"code": "260", "type": "RC"}], "standard_charges": [{"gross_charge": 1445.0, "discounted_cash": 1083.75, "setting": "both", "billing_class": "facility"}]}, {"description": "IVERMECTIN 3MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5306261", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 154.0, "discounted_cash": 115.5, "setting": "both", "billing_class": "facility"}]}, {"description": "IVERMECTIN 3MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5306261", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 154.0, "discounted_cash": 115.5, "setting": "both", "billing_class": "facility"}]}, {"description": "IVIG GAMUNEX PER 500MG IV IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J1561", "type": "HCPCS"}, {"code": "5321603", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 613.0, "discounted_cash": 459.75, "setting": "both", "billing_class": "facility"}], "modifiers": "JA"}, {"description": "IVIG GAMUNEX PER 500MG IV IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J1561", "type": "HCPCS"}, {"code": "5321603", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 613.0, "discounted_cash": 459.75, "setting": "both", "billing_class": "facility"}], "modifiers": "JA"}, {"description": "IVIG LYOP PWD PER500MGIJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J1566", "type": "HCPCS"}, {"code": "5321594", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 907.0, "discounted_cash": 680.25, "setting": "both", "billing_class": "facility"}]}, {"description": "IVIG LYOP PWD PER500MGIJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J1566", "type": "HCPCS"}, {"code": "5321594", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 907.0, "discounted_cash": 680.25, "setting": "both", "billing_class": "facility"}]}, {"description": "IVIG OCTAGAM PER 500MGIJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J1568", "type": "HCPCS"}, {"code": "5321600", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 536.0, "discounted_cash": 402.0, "setting": "both", "billing_class": "facility"}]}, {"description": "IVIG OCTAGAM PER 500MGIJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J1568", "type": "HCPCS"}, {"code": "5321600", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 536.0, "discounted_cash": 402.0, "setting": "both", "billing_class": "facility"}]}, {"description": "IVUS CORONARY EA ADD", "code_information": [{"code": "92979", "type": "CPT"}, {"code": "4612922", "type": "CDM"}, {"code": "480", "type": "RC"}], "standard_charges": [{"gross_charge": 12402.0, "discounted_cash": 9301.5, "setting": "both", "billing_class": "facility"}]}, {"description": "IVUS CORONARY INIT VESSL", "code_information": [{"code": "92978", "type": "CPT"}, {"code": "4612920", "type": "CDM"}, {"code": "480", "type": "RC"}], "standard_charges": [{"gross_charge": 9536.0, "discounted_cash": 7152.0, "setting": "both", "billing_class": "facility"}]}, {"description": "IVUS NON CORON ADDL VESL", "code_information": [{"code": "4617251", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 7258.0, "discounted_cash": 5443.5, "setting": "both", "billing_class": "facility"}]}, {"description": "IVUS NON CORONARY INITL", "code_information": [{"code": "4615944", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 17433.0, "discounted_cash": 13074.75, "setting": "both", "billing_class": "facility"}]}, {"description": "JAK2 VARIANT/2", "code_information": [{"code": "81270", "type": "CPT"}, {"code": "7259213", "type": "CDM"}, {"code": "310", "type": "RC"}], "standard_charges": [{"gross_charge": 1070.0, "discounted_cash": 802.5, "setting": "both", "billing_class": "facility"}]}, {"description": "K ACET 40MEQ/20ML IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5323536", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 117.0, "discounted_cash": 87.75, "setting": "both", "billing_class": "facility"}]}, {"description": "K ACETATE PER 1ML IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5323531", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 85.0, "discounted_cash": 63.75, "setting": "both", "billing_class": "facility"}]}, {"description": "K IODIDE/IODINE 15ML LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5316106", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 379.0, "discounted_cash": 284.25, "setting": "both", "billing_class": "facility"}]}, {"description": "K IODIDE/IODINE 15ML LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5316106", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 379.0, "discounted_cash": 284.25, "setting": "both", "billing_class": "facility"}]}, {"description": "K PHOS 3MM/ML 15ML IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5323555", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 55.0, "discounted_cash": 41.25, "setting": "both", "billing_class": "facility"}]}, {"description": "K PHOS 3MM/ML 1ML IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5323562", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 65.0, "discounted_cash": 48.75, "setting": "both", "billing_class": "facility"}]}, {"description": "K PHOS 3MM/ML 5ML IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5323553", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 408.0, "discounted_cash": 306.0, "setting": "both", "billing_class": "facility"}]}, {"description": "K PHOS NEO CMPD IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J7999", "type": "HCPCS"}, {"code": "5323560", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 71.0, "discounted_cash": 53.25, "setting": "both", "billing_class": "facility"}]}, {"description": "K PHOS NEO CMPD IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J7999", "type": "HCPCS"}, {"code": "5323560", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 71.0, "discounted_cash": 53.25, "setting": "both", "billing_class": "facility"}]}, {"description": "K WIRE", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8132950", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 711.0, "discounted_cash": 533.25, "setting": "both", "billing_class": "facility"}]}, {"description": "K WIRE", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8132955", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 457.0, "discounted_cash": 342.75, "setting": "both", "billing_class": "facility"}]}, {"description": "KAPPA LAMBDA LT CHN QUAN", "code_information": [{"code": "83521", "type": "CPT"}, {"code": "7253884", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 156.0, "discounted_cash": 117.0, "setting": "both", "billing_class": "facility"}]}, {"description": "KAPPA LAMBDA LT CHN QUAN/2", "code_information": [{"code": "83521", "type": "CPT"}, {"code": "7253888", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 526.0, "discounted_cash": 394.5, "setting": "both", "billing_class": "facility"}]}, {"description": "KAPPA LAMBDA LT CHN QUAN/3", "code_information": [{"code": "83521", "type": "CPT"}, {"code": "7253889", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 526.0, "discounted_cash": 394.5, "setting": "both", "billing_class": "facility"}]}, {"description": "KCL 2MEQ/1ML 1ML LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5315414", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 85.0, "discounted_cash": 63.75, "setting": "both", "billing_class": "facility"}]}, {"description": "KCL 2MEQ/1ML 1ML LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5315414", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 85.0, "discounted_cash": 63.75, "setting": "both", "billing_class": "facility"}]}, {"description": "KCL 40MEQ 30ML LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5316104", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 71.0, "discounted_cash": 53.25, "setting": "both", "billing_class": "facility"}]}, {"description": "KCL 40MEQ 30ML LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5316104", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 71.0, "discounted_cash": 53.25, "setting": "both", "billing_class": "facility"}]}, {"description": "KCL NEO CMPD IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3480", "type": "HCPCS"}, {"code": "5321621", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 97.0, "discounted_cash": 72.75, "setting": "both", "billing_class": "facility"}]}, {"description": "KCL NEO CMPD IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3480", "type": "HCPCS"}, {"code": "5321621", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 97.0, "discounted_cash": 72.75, "setting": "both", "billing_class": "facility"}]}, {"description": "KCL PED CMPD LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5316100", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 5.0, "discounted_cash": 3.75, "setting": "both", "billing_class": "facility"}]}, {"description": "KCL PED CMPD LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5316100", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 5.0, "discounted_cash": 3.75, "setting": "both", "billing_class": "facility"}]}, {"description": "KCL PER 2MEQ IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3480", "type": "HCPCS"}, {"code": "5321620", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 36.0, "discounted_cash": 27.0, "setting": "both", "billing_class": "facility"}]}, {"description": "KCL PER 2MEQ IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3480", "type": "HCPCS"}, {"code": "5321620", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 36.0, "discounted_cash": 27.0, "setting": "both", "billing_class": "facility"}]}, {"description": "KCL PER 2MEQ PMX IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3480", "type": "HCPCS"}, {"code": "5321619", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 81.0, "discounted_cash": 60.75, "setting": "both", "billing_class": "facility"}]}, {"description": "KCL PER 2MEQ PMX IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3480", "type": "HCPCS"}, {"code": "5321619", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 81.0, "discounted_cash": 60.75, "setting": "both", "billing_class": "facility"}]}, {"description": "KERECIS OMEGA3 3X3.5CM SQ CM", "code_information": [{"code": "Q4158", "type": "HCPCS"}, {"code": "4023320", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 858.0, "discounted_cash": 643.5, "setting": "both", "billing_class": "facility"}]}, {"description": "KERECIS OMEGA3 3X3.5CM SQ CM", "code_information": [{"code": "Q4158", "type": "HCPCS"}, {"code": "4023320", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 858.0, "discounted_cash": 643.5, "setting": "both", "billing_class": "facility"}]}, {"description": "KERECIS OMEGA3 3X7CM PER SQ CM", "code_information": [{"code": "Q4158", "type": "HCPCS"}, {"code": "4023321", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 678.0, "discounted_cash": 508.5, "setting": "both", "billing_class": "facility"}]}, {"description": "KERECIS OMEGA3 3X7CM PER SQ CM", "code_information": [{"code": "Q4158", "type": "HCPCS"}, {"code": "4023321", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 678.0, "discounted_cash": 508.5, "setting": "both", "billing_class": "facility"}]}, {"description": "KERECIS OMEGA3 7X10 PER SQ CM", "code_information": [{"code": "Q4158", "type": "HCPCS"}, {"code": "4023322", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 671.0, "discounted_cash": 503.25, "setting": "both", "billing_class": "facility"}]}, {"description": "KERECIS OMEGA3 7X10 PER SQ CM", "code_information": [{"code": "Q4158", "type": "HCPCS"}, {"code": "4023322", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 671.0, "discounted_cash": 503.25, "setting": "both", "billing_class": "facility"}]}, {"description": "KERECIS OMEGA3 7X20 SQ CM", "code_information": [{"code": "Q4158", "type": "HCPCS"}, {"code": "4023324", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 449.0, "discounted_cash": 336.75, "setting": "both", "billing_class": "facility"}]}, {"description": "KERECIS OMEGA3 7X20 SQ CM", "code_information": [{"code": "Q4158", "type": "HCPCS"}, {"code": "4023324", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 449.0, "discounted_cash": 336.75, "setting": "both", "billing_class": "facility"}]}, {"description": "KERECIS OMEGA3 PER SQ CM", "code_information": [{"code": "Q4158", "type": "HCPCS"}, {"code": "4023326", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 450.0, "discounted_cash": 337.5, "setting": "both", "billing_class": "facility"}]}, {"description": "KERECIS OMEGA3 PER SQ CM", "code_information": [{"code": "Q4158", "type": "HCPCS"}, {"code": "4023326", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 450.0, "discounted_cash": 337.5, "setting": "both", "billing_class": "facility"}]}, {"description": "KETAMINE 100MG/ML 1ML IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5321634", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 81.0, "discounted_cash": 60.75, "setting": "both", "billing_class": "facility"}]}, {"description": "KETAMINE 100MG/ML 5ML", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5321635", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 322.0, "discounted_cash": 241.5, "setting": "both", "billing_class": "facility"}]}, {"description": "KETAMINE 50MG/1ML IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5321631", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 210.0, "discounted_cash": 157.5, "setting": "both", "billing_class": "facility"}]}, {"description": "KETAMINE 50MG/ML 10ML IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5321630", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 625.0, "discounted_cash": 468.75, "setting": "both", "billing_class": "facility"}]}, {"description": "KETAMINE100MG/2ML PFS IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5321624", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 96.0, "discounted_cash": 72.0, "setting": "both", "billing_class": "facility"}]}, {"description": "KETOCONAZL SHMP2%120MLSH", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5336085", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 614.0, "discounted_cash": 460.5, "setting": "both", "billing_class": "facility"}]}, {"description": "KETOCONAZL SHMP2%120MLSH", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5336085", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 614.0, "discounted_cash": 460.5, "setting": "both", "billing_class": "facility"}]}, {"description": "KETOCONAZOLE 2% 15GM CR", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5336084", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 296.0, "discounted_cash": 222.0, "setting": "both", "billing_class": "facility"}]}, {"description": "KETOCONAZOLE 2% 15GM CR", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5336084", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 296.0, "discounted_cash": 222.0, "setting": "both", "billing_class": "facility"}]}, {"description": "KETOCONAZOLE 200MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5306293", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 93.0, "discounted_cash": 69.75, "setting": "both", "billing_class": "facility"}]}, {"description": "KETOCONAZOLE 200MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5306293", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 93.0, "discounted_cash": 69.75, "setting": "both", "billing_class": "facility"}]}, {"description": "KETOPROFEN 75MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5306299", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 85.0, "discounted_cash": 63.75, "setting": "both", "billing_class": "facility"}]}, {"description": "KETOPROFEN 75MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5306299", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 85.0, "discounted_cash": 63.75, "setting": "both", "billing_class": "facility"}]}, {"description": "KETOROLAC 0.5% 10ML OS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5331356", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 1438.0, "discounted_cash": 1078.5, "setting": "both", "billing_class": "facility"}]}, {"description": "KETOROLAC 0.5% 10ML OS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5331356", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 1438.0, "discounted_cash": 1078.5, "setting": "both", "billing_class": "facility"}]}, {"description": "KETOROLAC 0.5% 3ML OS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5331354", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 548.0, "discounted_cash": 411.0, "setting": "both", "billing_class": "facility"}]}, {"description": "KETOROLAC 0.5% 3ML OS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5331354", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 548.0, "discounted_cash": 411.0, "setting": "both", "billing_class": "facility"}]}, {"description": "KETOROLAC 0.5% 5ML OS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5331355", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 747.0, "discounted_cash": 560.25, "setting": "both", "billing_class": "facility"}]}, {"description": "KETOROLAC 0.5% 5ML OS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5331355", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 747.0, "discounted_cash": 560.25, "setting": "both", "billing_class": "facility"}]}, {"description": "KETOROLAC 10MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5306300", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 71.0, "discounted_cash": 53.25, "setting": "both", "billing_class": "facility"}]}, {"description": "KETOROLAC 10MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5306300", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 71.0, "discounted_cash": 53.25, "setting": "both", "billing_class": "facility"}]}, {"description": "KETOROLAC PER 15MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J1885", "type": "HCPCS"}, {"code": "5321633", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 83.0, "discounted_cash": 62.25, "setting": "both", "billing_class": "facility"}]}, {"description": "KETOROLAC PER 15MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J1885", "type": "HCPCS"}, {"code": "5321633", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 83.0, "discounted_cash": 62.25, "setting": "both", "billing_class": "facility"}]}, {"description": "KETOSTEROID 17 TOTAL", "code_information": [{"code": "83586", "type": "CPT"}, {"code": "7253586", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 2147.0, "discounted_cash": 1610.25, "setting": "both", "billing_class": "facility"}]}, {"description": "KETOSTRD 17 FRCT", "code_information": [{"code": "83593", "type": "CPT"}, {"code": "7253590", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 504.0, "discounted_cash": 378.0, "setting": "both", "billing_class": "facility"}]}, {"description": "KID IMG FL/FUN SNG W RX", "code_information": [{"code": "78708", "type": "CPT"}, {"code": "5208706", "type": "CDM"}, {"code": "341", "type": "RC"}], "standard_charges": [{"gross_charge": 7840.0, "discounted_cash": 5880.0, "setting": "both", "billing_class": "facility"}]}, {"description": "KID IMG FL/FUN SNG WO RX", "code_information": [{"code": "78707", "type": "CPT"}, {"code": "5208707", "type": "CDM"}, {"code": "341", "type": "RC"}], "standard_charges": [{"gross_charge": 5121.0, "discounted_cash": 3840.75, "setting": "both", "billing_class": "facility"}]}, {"description": "KIDNEY IMAGING MORPHOLGY", "code_information": [{"code": "78700", "type": "CPT"}, {"code": "5208700", "type": "CDM"}, {"code": "341", "type": "RC"}], "standard_charges": [{"gross_charge": 6557.0, "discounted_cash": 4917.75, "setting": "both", "billing_class": "facility"}]}, {"description": "KIT GENE TARGT SEQ ANLS", "code_information": [{"code": "81272", "type": "CPT"}, {"code": "7061272", "type": "CDM"}, {"code": "310", "type": "RC"}], "standard_charges": [{"gross_charge": 254.0, "discounted_cash": 190.5, "setting": "both", "billing_class": "facility"}]}, {"description": "KIT STIM INTERSTIM TEST", "code_information": [{"code": "C1897", "type": "HCPCS"}, {"code": "8240200", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 7121.0, "discounted_cash": 5340.75, "setting": "both", "billing_class": "facility"}]}, {"description": "KNEE 1-2 VIEWS", "code_information": [{"code": "73560", "type": "CPT"}, {"code": "4903560", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 1672.0, "discounted_cash": 1254.0, "setting": "both", "billing_class": "facility"}]}, {"description": "KNEE 1-2 VIEWS", "code_information": [{"code": "73560", "type": "CPT"}, {"code": "5113560", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 1452.0, "discounted_cash": 1089.0, "setting": "both", "billing_class": "facility"}]}, {"description": "KNEE 3 VIEWS", "code_information": [{"code": "73562", "type": "CPT"}, {"code": "4903562", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 1998.0, "discounted_cash": 1498.5, "setting": "both", "billing_class": "facility"}]}, {"description": "KNEE 3 VIEWS", "code_information": [{"code": "73562", "type": "CPT"}, {"code": "5113562", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 1585.0, "discounted_cash": 1188.75, "setting": "both", "billing_class": "facility"}]}, {"description": "KNEE ARTHROGRAPHY", "code_information": [{"code": "73580", "type": "CPT"}, {"code": "4903580", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 2523.0, "discounted_cash": 1892.25, "setting": "both", "billing_class": "facility"}]}, {"description": "KNEE COMP 4 VW MIN", "code_information": [{"code": "73564", "type": "CPT"}, {"code": "4903570", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 1585.0, "discounted_cash": 1188.75, "setting": "both", "billing_class": "facility"}]}, {"description": "KNEE COMP 4 VW MIN", "code_information": [{"code": "73564", "type": "CPT"}, {"code": "5113564", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 2499.0, "discounted_cash": 1874.25, "setting": "both", "billing_class": "facility"}]}, {"description": "KNEE UNI FEMUR 3PC FEM DPY CL", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "4012830", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 25993.0, "discounted_cash": 19494.75, "setting": "both", "billing_class": "facility"}]}, {"description": "KNEE UNI POLY INSRT RP DPY CL", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "4012831", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 16245.0, "discounted_cash": 12183.75, "setting": "both", "billing_class": "facility"}]}, {"description": "KNEE UNI TIB BASE RP DEPUY CL", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "4012832", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 18567.0, "discounted_cash": 13925.25, "setting": "both", "billing_class": "facility"}]}, {"description": "KNEES/BILAT AP STANDING", "code_information": [{"code": "73565", "type": "CPT"}, {"code": "4903561", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 1301.0, "discounted_cash": 975.75, "setting": "both", "billing_class": "facility"}]}, {"description": "KO IMMOBILIZER", "code_information": [{"code": "L1830", "type": "HCPCS"}, {"code": "8130006", "type": "CDM"}, {"code": "274", "type": "RC"}], "standard_charges": [{"gross_charge": 768.0, "discounted_cash": 576.0, "setting": "both", "billing_class": "facility"}]}, {"description": "KRAS GENE VARIANTS EXON 2", "code_information": [{"code": "81275", "type": "CPT"}, {"code": "7061275", "type": "CDM"}, {"code": "310", "type": "RC"}], "standard_charges": [{"gross_charge": 254.0, "discounted_cash": 190.5, "setting": "both", "billing_class": "facility"}]}, {"description": "KRAS VRNT CONDONS 61/146", "code_information": [{"code": "81276", "type": "CPT"}, {"code": "7061276", "type": "CDM"}, {"code": "310", "type": "RC"}], "standard_charges": [{"gross_charge": 254.0, "discounted_cash": 190.5, "setting": "both", "billing_class": "facility"}]}, {"description": "KT AC REPAIR ACUTE", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "4013089", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 35390.0, "discounted_cash": 26542.5, "setting": "both", "billing_class": "facility"}]}, {"description": "KT ANCH PUSHLOCK", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "4023390", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 4623.0, "discounted_cash": 3467.25, "setting": "both", "billing_class": "facility"}]}, {"description": "KT ANCH SUTR SML JOINT", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "4013090", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 8947.0, "discounted_cash": 6710.25, "setting": "both", "billing_class": "facility"}]}, {"description": "KT BN CEMT W MIXER", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8132958", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 16152.0, "discounted_cash": 12114.0, "setting": "both", "billing_class": "facility"}]}, {"description": "KT BN RESORB BEAD 25CC", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "4013101", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 20469.0, "discounted_cash": 15351.75, "setting": "both", "billing_class": "facility"}]}, {"description": "KT BN RESORB BEAD 5CC", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "4013100", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 9727.0, "discounted_cash": 7295.25, "setting": "both", "billing_class": "facility"}]}, {"description": "KT BN TO BN BUTTN W/DRLL", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "4011768", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 11327.0, "discounted_cash": 8495.25, "setting": "both", "billing_class": "facility"}]}, {"description": "KT BONE GRAFT SUBST GENEX", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8132587", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 37619.0, "discounted_cash": 28214.25, "setting": "both", "billing_class": "facility"}]}, {"description": "KT CATH BENCHMARK 071", "code_information": [{"code": "C1887", "type": "HCPCS"}, {"code": "8056973", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 15729.0, "discounted_cash": 11796.75, "setting": "both", "billing_class": "facility"}]}, {"description": "KT CATH CENT VEN DBL LUM", "code_information": [{"code": "C1751", "type": "HCPCS"}, {"code": "8032573", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 933.0, "discounted_cash": 699.75, "setting": "both", "billing_class": "facility"}]}, {"description": "KT CATH CENT VEN SGL LUM", "code_information": [{"code": "C1751", "type": "HCPCS"}, {"code": "8032572", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 799.0, "discounted_cash": 599.25, "setting": "both", "billing_class": "facility"}]}, {"description": "KT CATH PROVENA MIDLN MAX BAR", "code_information": [{"code": "C1751", "type": "HCPCS"}, {"code": "8058334", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 3370.0, "discounted_cash": 2527.5, "setting": "both", "billing_class": "facility"}]}, {"description": "KT CV CATH PED", "code_information": [{"code": "C1751", "type": "HCPCS"}, {"code": "8081940", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 1770.0, "discounted_cash": 1327.5, "setting": "both", "billing_class": "facility"}]}, {"description": "KT DRILL PIN", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "4013091", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 3849.0, "discounted_cash": 2886.75, "setting": "both", "billing_class": "facility"}]}, {"description": "KT DRN BILIARY", "code_information": [{"code": "C1729", "type": "HCPCS"}, {"code": "8081985", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 1583.0, "discounted_cash": 1187.25, "setting": "both", "billing_class": "facility"}]}, {"description": "KT DRN CATH", "code_information": [{"code": "C1729", "type": "HCPCS"}, {"code": "8081990", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 965.0, "discounted_cash": 723.75, "setting": "both", "billing_class": "facility"}]}, {"description": "KT DRN NRO EXT", "code_information": [{"code": "C1729", "type": "HCPCS"}, {"code": "8175012", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 1429.0, "discounted_cash": 1071.75, "setting": "both", "billing_class": "facility"}]}, {"description": "KT FASTNER SEROSAFUSE IMP", "code_information": [{"code": "C1889", "type": "HCPCS"}, {"code": "8082062", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 86135.0, "discounted_cash": 64601.25, "setting": "both", "billing_class": "facility"}]}, {"description": "KT FEM CROSS PIN", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8175075", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 7580.0, "discounted_cash": 5685.0, "setting": "both", "billing_class": "facility"}]}, {"description": "KT FIBRN SUR SLNT VISTASEAL10M", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3590", "type": "HCPCS"}, {"code": "8082072", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 3045.0, "discounted_cash": 2283.75, "setting": "both", "billing_class": "facility"}]}, {"description": "KT FIBRN SUR SLNT VISTASEAL10M", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3590", "type": "HCPCS"}, {"code": "8082072", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 3045.0, "discounted_cash": 2283.75, "setting": "both", "billing_class": "facility"}]}, {"description": "KT FIXATOR DISTAL RADIUS", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8132960", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 13468.0, "discounted_cash": 10101.0, "setting": "both", "billing_class": "facility"}]}, {"description": "KT IMPELLA 5.5 W/SMARTASSIST", "code_information": [{"code": "C1889", "type": "HCPCS"}, {"code": "8143272", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 719641.0, "discounted_cash": 539730.75, "setting": "both", "billing_class": "facility"}]}, {"description": "KT LD 1X8 COMP 977D260", "code_information": [{"code": "C1778", "type": "HCPCS"}, {"code": "4008562", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 12376.0, "discounted_cash": 9282.0, "setting": "both", "billing_class": "facility"}]}, {"description": "KT LD 1X8 SUBCMP 977D160", "code_information": [{"code": "C1897", "type": "HCPCS"}, {"code": "4008559", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 14609.0, "discounted_cash": 10956.75, "setting": "both", "billing_class": "facility"}]}, {"description": "KT LD ANCHOR SENZA N300", "code_information": [{"code": "L8699", "type": "HCPCS"}, {"code": "8082197", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 1965.41, "discounted_cash": 1474.06, "setting": "both", "billing_class": "facility"}]}, {"description": "KT LD MRI 1X8 COMP 977A2", "code_information": [{"code": "C1778", "type": "HCPCS"}, {"code": "4008561", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 31724.0, "discounted_cash": 23793.0, "setting": "both", "billing_class": "facility"}]}, {"description": "KT LD MRI 2X8 COMP 977C2", "code_information": [{"code": "C1778", "type": "HCPCS"}, {"code": "4008585", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 143292.0, "discounted_cash": 107469.0, "setting": "both", "billing_class": "facility"}]}, {"description": "KT LD NSTIM 1X8 STD 3777", "code_information": [{"code": "C1778", "type": "HCPCS"}, {"code": "4023396", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 26499.0, "discounted_cash": 19874.25, "setting": "both", "billing_class": "facility"}]}, {"description": "KT LD SPECIFY 2X8 39286", "code_information": [{"code": "C1778", "type": "HCPCS"}, {"code": "4008583", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 77935.0, "discounted_cash": 58451.25, "setting": "both", "billing_class": "facility"}]}, {"description": "KT LEAD NEVRO 1058", "code_information": [{"code": "C1778", "type": "HCPCS"}, {"code": "4008661", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 7468.55, "discounted_cash": 5601.41, "setting": "both", "billing_class": "facility"}]}, {"description": "KT LEAD PADDLE SENZA 3005", "code_information": [{"code": "C1778", "type": "HCPCS"}, {"code": "4008553", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 53710.0, "discounted_cash": 40282.5, "setting": "both", "billing_class": "facility"}]}, {"description": "KT LIGAMENT AUGMNT REPR", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "4013118", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 18590.0, "discounted_cash": 13942.5, "setting": "both", "billing_class": "facility"}]}, {"description": "KT LIGAMENT REPR AUGMENT", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "4013120", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 16268.0, "discounted_cash": 12201.0, "setting": "both", "billing_class": "facility"}]}, {"description": "KT MICROPUNCT INTRO", "code_information": [{"code": "C1894", "type": "HCPCS"}, {"code": "8082216", "type": "CDM"}, {"code": "272", "type": "RC"}], "standard_charges": [{"gross_charge": 1463.0, "discounted_cash": 1097.25, "setting": "both", "billing_class": "facility"}]}, {"description": "KT MULTILMR CTH", "code_information": [{"code": "C1751", "type": "HCPCS"}, {"code": "8082230", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 1099.0, "discounted_cash": 824.25, "setting": "both", "billing_class": "facility"}]}, {"description": "KT NSTIM D LD ACCESSORY", "code_information": [{"code": "C1883", "type": "HCPCS"}, {"code": "8082271", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 3673.0, "discounted_cash": 2754.75, "setting": "both", "billing_class": "facility"}]}, {"description": "KT PEC BUTTON IMPL REPR", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "4013149", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 6493.0, "discounted_cash": 4869.75, "setting": "both", "billing_class": "facility"}]}, {"description": "KT PEC BUTTON LARGE", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "4013152", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 37404.0, "discounted_cash": 28053.0, "setting": "both", "billing_class": "facility"}]}, {"description": "KT PERCARDIOCNT", "code_information": [{"code": "C1729", "type": "HCPCS"}, {"code": "8082360", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 1481.0, "discounted_cash": 1110.75, "setting": "both", "billing_class": "facility"}]}, {"description": "KT REPAIR MINI TIGHTROPE", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8132965", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 8395.0, "discounted_cash": 6296.25, "setting": "both", "billing_class": "facility"}]}, {"description": "KT REPAIR SYNDESMOSIS", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8082451", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 13213.0, "discounted_cash": 9909.75, "setting": "both", "billing_class": "facility"}]}, {"description": "KT RPR TGHTRP SYND KNTLS", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "4013151", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 16161.0, "discounted_cash": 12120.75, "setting": "both", "billing_class": "facility"}]}, {"description": "KT SHTH INTRO W/GW/DIL", "code_information": [{"code": "C1894", "type": "HCPCS"}, {"code": "8082516", "type": "CDM"}, {"code": "272", "type": "RC"}], "standard_charges": [{"gross_charge": 1490.0, "discounted_cash": 1117.5, "setting": "both", "billing_class": "facility"}]}, {"description": "KT SHTH LASER GLIDELIGHT", "code_information": [{"code": "C2629", "type": "HCPCS"}, {"code": "8178119", "type": "CDM"}, {"code": "272", "type": "RC"}], "standard_charges": [{"gross_charge": 23459.0, "discounted_cash": 17594.25, "setting": "both", "billing_class": "facility"}]}, {"description": "KT STAPLE BN FIXATION", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8137721", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 21586.0, "discounted_cash": 16189.5, "setting": "both", "billing_class": "facility"}]}, {"description": "KT SUBCHND CMPL FOOT/ANK", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "4013154", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 60064.0, "discounted_cash": 45048.0, "setting": "both", "billing_class": "facility"}]}, {"description": "KT SUBCHONDROPLASTY KNEE", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "4013150", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 43549.0, "discounted_cash": 32661.75, "setting": "both", "billing_class": "facility"}]}, {"description": "L RINGERS 1000ML IVF", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J7120", "type": "HCPCS"}, {"code": "5412550", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 641.0, "discounted_cash": 480.75, "setting": "both", "billing_class": "facility"}]}, {"description": "L RINGERS 1000ML IVF", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J7120", "type": "HCPCS"}, {"code": "5412550", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 641.0, "discounted_cash": 480.75, "setting": "both", "billing_class": "facility"}]}, {"description": "L RINGERS 500ML IVF", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J7120", "type": "HCPCS"}, {"code": "5412545", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 602.0, "discounted_cash": 451.5, "setting": "both", "billing_class": "facility"}]}, {"description": "L RINGERS 500ML IVF", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J7120", "type": "HCPCS"}, {"code": "5412545", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 602.0, "discounted_cash": 451.5, "setting": "both", "billing_class": "facility"}]}, {"description": "L SP FACET INJ+IMAG LVL1", "code_information": [{"code": "4904493", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 4349.0, "discounted_cash": 3261.75, "setting": "both", "billing_class": "facility"}]}, {"description": "L&D EPIDURAL", "code_information": [{"code": "3702299", "type": "CDM"}, {"code": "370", "type": "RC"}], "standard_charges": [{"gross_charge": 3380.0, "discounted_cash": 2535.0, "setting": "both", "billing_class": "facility"}]}, {"description": "L&D RECOVERY ADD 15 MIN", "code_information": [{"code": "3101223", "type": "CDM"}, {"code": "710", "type": "RC"}], "standard_charges": [{"gross_charge": 1332.0, "discounted_cash": 999.0, "setting": "both", "billing_class": "facility"}]}, {"description": "L&D RECOVERY INT 30 MIN", "code_information": [{"code": "3101222", "type": "CDM"}, {"code": "710", "type": "RC"}], "standard_charges": [{"gross_charge": 2398.0, "discounted_cash": 1798.5, "setting": "both", "billing_class": "facility"}]}, {"description": "L&D SPEC PROC ADD 15 MIN", "code_information": [{"code": "3101203", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 412.0, "discounted_cash": 309.0, "setting": "both", "billing_class": "facility"}]}, {"description": "L&D SPEC PROC INT 30 MIN", "code_information": [{"code": "3101202", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 1013.0, "discounted_cash": 759.75, "setting": "both", "billing_class": "facility"}]}, {"description": "L&D SURG LVL I EA 15 MIN", "code_information": [{"code": "3101215", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 3256.0, "discounted_cash": 2442.0, "setting": "both", "billing_class": "facility"}]}, {"description": "L&D SURG LVL II EA 15 M", "code_information": [{"code": "3101217", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 1626.0, "discounted_cash": 1219.5, "setting": "both", "billing_class": "facility"}]}, {"description": "L&D SURG LVL II INT 30 M", "code_information": [{"code": "3101216", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 9227.0, "discounted_cash": 6920.25, "setting": "both", "billing_class": "facility"}]}, {"description": "L&D SURG LVL III EA 15M", "code_information": [{"code": "3101219", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 5788.0, "discounted_cash": 4341.0, "setting": "both", "billing_class": "facility"}]}, {"description": "L&D SURG LVL III INT 30M", "code_information": [{"code": "3101218", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 17355.0, "discounted_cash": 13016.25, "setting": "both", "billing_class": "facility"}]}, {"description": "L&D SURG LVL IV EA 15M", "code_information": [{"code": "3101221", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 6917.0, "discounted_cash": 5187.75, "setting": "both", "billing_class": "facility"}]}, {"description": "L&D SURG LVL IV INT 30M", "code_information": [{"code": "3101220", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 18448.0, "discounted_cash": 13836.0, "setting": "both", "billing_class": "facility"}]}, {"description": "L/S MYELO W/INJ", "code_information": [{"code": "4902304", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 3051.0, "discounted_cash": 2288.25, "setting": "both", "billing_class": "facility"}]}, {"description": "L/S MYELO W/INJ", "code_information": [{"code": "4912304", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 4309.0, "discounted_cash": 3231.75, "setting": "both", "billing_class": "facility"}]}, {"description": "LABETALOL 100MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5306320", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 65.0, "discounted_cash": 48.75, "setting": "both", "billing_class": "facility"}]}, {"description": "LABETALOL 100MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5306320", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 65.0, "discounted_cash": 48.75, "setting": "both", "billing_class": "facility"}]}, {"description": "LABETALOL 200MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5306321", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 61.0, "discounted_cash": 45.75, "setting": "both", "billing_class": "facility"}]}, {"description": "LABETALOL 200MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5306321", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 61.0, "discounted_cash": 45.75, "setting": "both", "billing_class": "facility"}]}, {"description": "LABETALOL PER 5MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J1920", "type": "HCPCS"}, {"code": "5321682", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 5.0, "discounted_cash": 3.75, "setting": "both", "billing_class": "facility"}]}, {"description": "LABETALOL PER 5MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J1920", "type": "HCPCS"}, {"code": "5321682", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 5.0, "discounted_cash": 3.75, "setting": "both", "billing_class": "facility"}]}, {"description": "LABOR COMPLEX 1ST HR", "code_information": [{"code": "3101208", "type": "CDM"}, {"code": "720", "type": "RC"}], "standard_charges": [{"gross_charge": 778.0, "discounted_cash": 583.5, "setting": "both", "billing_class": "facility"}]}, {"description": "LABOR COMPLEX ADD HR", "code_information": [{"code": "3101209", "type": "CDM"}, {"code": "720", "type": "RC"}], "standard_charges": [{"gross_charge": 700.0, "discounted_cash": 525.0, "setting": "both", "billing_class": "facility"}]}, {"description": "LABOR INTERIM 1ST HR", "code_information": [{"code": "3101206", "type": "CDM"}, {"code": "720", "type": "RC"}], "standard_charges": [{"gross_charge": 880.0, "discounted_cash": 660.0, "setting": "both", "billing_class": "facility"}]}, {"description": "LABOR INTERIM ADD HR", "code_information": [{"code": "3101207", "type": "CDM"}, {"code": "720", "type": "RC"}], "standard_charges": [{"gross_charge": 831.0, "discounted_cash": 623.25, "setting": "both", "billing_class": "facility"}]}, {"description": "LABOR SIMPLE 1ST HR", "code_information": [{"code": "3101204", "type": "CDM"}, {"code": "720", "type": "RC"}], "standard_charges": [{"gross_charge": 803.0, "discounted_cash": 602.25, "setting": "both", "billing_class": "facility"}]}, {"description": "LABOR SIMPLE ADD HR", "code_information": [{"code": "3101205", "type": "CDM"}, {"code": "720", "type": "RC"}], "standard_charges": [{"gross_charge": 677.0, "discounted_cash": 507.75, "setting": "both", "billing_class": "facility"}]}, {"description": "LACOSAMIDE", "code_information": [{"code": "80235", "type": "CPT"}, {"code": "7252554", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 558.0, "discounted_cash": 418.5, "setting": "both", "billing_class": "facility"}]}, {"description": "LACOSAMIDE 100MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5327678", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 228.0, "discounted_cash": 171.0, "setting": "both", "billing_class": "facility"}]}, {"description": "LACOSAMIDE 100MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5327678", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 228.0, "discounted_cash": 171.0, "setting": "both", "billing_class": "facility"}]}, {"description": "LACOSAMIDE 50MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5327677", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 149.0, "discounted_cash": 111.75, "setting": "both", "billing_class": "facility"}]}, {"description": "LACOSAMIDE 50MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5327677", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 149.0, "discounted_cash": 111.75, "setting": "both", "billing_class": "facility"}]}, {"description": "LACOSAMIDE PER 1MG IJ", "code_information": [{"code": "C9254", "type": "HCPCS"}, {"code": "5321659", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 4.0, "discounted_cash": 3.0, "setting": "both", "billing_class": "facility"}]}, {"description": "LACOSAMIDE PER 1MG IJ", "code_information": [{"code": "C9254", "type": "HCPCS"}, {"code": "5321659", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 4.0, "discounted_cash": 3.0, "setting": "both", "billing_class": "facility"}]}, {"description": "LACTATE(LACTIC ACID)", "code_information": [{"code": "83605", "type": "CPT"}, {"code": "4103605", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 1036.0, "discounted_cash": 777.0, "setting": "both", "billing_class": "facility"}]}, {"description": "LACTATE(LACTIC ACID)", "code_information": [{"code": "83605", "type": "CPT"}, {"code": "4173605", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 1.12, "discounted_cash": 0.84, "setting": "both", "billing_class": "facility"}]}, {"description": "LACTOBACILLUS GR 1GM PK", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5315440", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 63.0, "discounted_cash": 47.25, "setting": "both", "billing_class": "facility"}]}, {"description": "LACTOBACILLUS GR 1GM PK", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5315440", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 63.0, "discounted_cash": 47.25, "setting": "both", "billing_class": "facility"}]}, {"description": "LACTOBACILLUS TB/CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5306343", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 71.0, "discounted_cash": 53.25, "setting": "both", "billing_class": "facility"}]}, {"description": "LACTOBACILLUS TB/CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5306343", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 71.0, "discounted_cash": 53.25, "setting": "both", "billing_class": "facility"}]}, {"description": "LACTOFERRIN FECAL QNT", "code_information": [{"code": "83631", "type": "CPT"}, {"code": "7253631", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 262.0, "discounted_cash": 196.5, "setting": "both", "billing_class": "facility"}]}, {"description": "LACTULOSE 10/15 30ML LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5315459", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 97.0, "discounted_cash": 72.75, "setting": "both", "billing_class": "facility"}]}, {"description": "LACTULOSE 10/15 30ML LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5315459", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 97.0, "discounted_cash": 72.75, "setting": "both", "billing_class": "facility"}]}, {"description": "LACTULOSE CMPD RE", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J7999", "type": "HCPCS"}, {"code": "5338505", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 208.0, "discounted_cash": 156.0, "setting": "both", "billing_class": "facility"}]}, {"description": "LACTULOSE CMPD RE", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J7999", "type": "HCPCS"}, {"code": "5338505", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 208.0, "discounted_cash": 156.0, "setting": "both", "billing_class": "facility"}]}, {"description": "LAMIVUDINE 150MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5306345", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 160.0, "discounted_cash": 120.0, "setting": "both", "billing_class": "facility"}]}, {"description": "LAMIVUDINE 150MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5306345", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 160.0, "discounted_cash": 120.0, "setting": "both", "billing_class": "facility"}]}, {"description": "LAMIVUDINE10M/ML 1ML LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5315461", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 59.0, "discounted_cash": 44.25, "setting": "both", "billing_class": "facility"}]}, {"description": "LAMIVUDINE10M/ML 1ML LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5315461", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 59.0, "discounted_cash": 44.25, "setting": "both", "billing_class": "facility"}]}, {"description": "LAMIVUDINE10M/ML 5ML LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5315467", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 184.0, "discounted_cash": 138.0, "setting": "both", "billing_class": "facility"}]}, {"description": "LAMIVUDINE10M/ML 5ML LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5315467", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 184.0, "discounted_cash": 138.0, "setting": "both", "billing_class": "facility"}]}, {"description": "LAMOTRIGINE 100MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5306347", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 136.0, "discounted_cash": 102.0, "setting": "both", "billing_class": "facility"}]}, {"description": "LAMOTRIGINE 100MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5306347", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 136.0, "discounted_cash": 102.0, "setting": "both", "billing_class": "facility"}]}, {"description": "LAMOTRIGINE 25MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5306346", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 124.0, "discounted_cash": 93.0, "setting": "both", "billing_class": "facility"}]}, {"description": "LAMOTRIGINE 25MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5306346", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 124.0, "discounted_cash": 93.0, "setting": "both", "billing_class": "facility"}]}, {"description": "LAMOTRIGINE QUANT", "code_information": [{"code": "80175", "type": "CPT"}, {"code": "7250040", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 727.0, "discounted_cash": 545.25, "setting": "both", "billing_class": "facility"}]}, {"description": "LANOLIN 7.5GM OI", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5336125", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 78.0, "discounted_cash": 58.5, "setting": "both", "billing_class": "facility"}]}, {"description": "LANOLIN 7.5GM OI", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5336125", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 78.0, "discounted_cash": 58.5, "setting": "both", "billing_class": "facility"}]}, {"description": "LANSOPRAZOL CMPD 1ML LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5315489", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 86.0, "discounted_cash": 64.5, "setting": "both", "billing_class": "facility"}]}, {"description": "LANSOPRAZOL CMPD 1ML LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5315489", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 86.0, "discounted_cash": 64.5, "setting": "both", "billing_class": "facility"}]}, {"description": "LANSOPRAZOL SUSP CMPD LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5315490", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 374.0, "discounted_cash": 280.5, "setting": "both", "billing_class": "facility"}]}, {"description": "LANSOPRAZOL SUSP CMPD LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5315490", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 374.0, "discounted_cash": 280.5, "setting": "both", "billing_class": "facility"}]}, {"description": "LANSOPRAZOLE 15MG XR CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5306351", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 85.0, "discounted_cash": 63.75, "setting": "both", "billing_class": "facility"}]}, {"description": "LANSOPRAZOLE 15MG XR CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5306351", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 85.0, "discounted_cash": 63.75, "setting": "both", "billing_class": "facility"}]}, {"description": "LANSOPRAZOLE 30MG DT", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5306355", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 122.0, "discounted_cash": 91.5, "setting": "both", "billing_class": "facility"}]}, {"description": "LANSOPRAZOLE 30MG DT", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5306355", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 122.0, "discounted_cash": 91.5, "setting": "both", "billing_class": "facility"}]}, {"description": "LANSOPRAZOLE 30MG XR CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5306352", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 136.0, "discounted_cash": 102.0, "setting": "both", "billing_class": "facility"}]}, {"description": "LANSOPRAZOLE 30MG XR CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5306352", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 136.0, "discounted_cash": 102.0, "setting": "both", "billing_class": "facility"}]}, {"description": "LARONIDASE PER 0.1MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J1931", "type": "HCPCS"}, {"code": "5321663", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 90.0, "discounted_cash": 67.5, "setting": "both", "billing_class": "facility"}]}, {"description": "LARONIDASE PER 0.1MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J1931", "type": "HCPCS"}, {"code": "5321663", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 90.0, "discounted_cash": 67.5, "setting": "both", "billing_class": "facility"}]}, {"description": "LATANOPROST .005%2.5MLOS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5331365", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 656.0, "discounted_cash": 492.0, "setting": "both", "billing_class": "facility"}]}, {"description": "LATANOPROST .005%2.5MLOS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5331365", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 656.0, "discounted_cash": 492.0, "setting": "both", "billing_class": "facility"}]}, {"description": "LD ATTAIN ABILITY 4196", "code_information": [{"code": "C1900", "type": "HCPCS"}, {"code": "4000367", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 31173.0, "discounted_cash": 23379.75, "setting": "both", "billing_class": "facility"}]}, {"description": "LD ATTAIN ABLTY PLS 4296", "code_information": [{"code": "C1900", "type": "HCPCS"}, {"code": "4008565", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 31173.0, "discounted_cash": 23379.75, "setting": "both", "billing_class": "facility"}]}, {"description": "LD ATTAIN ABLTY STR 4396", "code_information": [{"code": "C1900", "type": "HCPCS"}, {"code": "4008566", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 31173.0, "discounted_cash": 23379.75, "setting": "both", "billing_class": "facility"}]}, {"description": "LD ATTAIN UNIPLR 4195", "code_information": [{"code": "C1900", "type": "HCPCS"}, {"code": "4000366", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 33013.0, "discounted_cash": 24759.75, "setting": "both", "billing_class": "facility"}]}, {"description": "LD COROX OTW 354807", "code_information": [{"code": "C1900", "type": "HCPCS"}, {"code": "4000369", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 23379.0, "discounted_cash": 17534.25, "setting": "both", "billing_class": "facility"}]}, {"description": "LD DEFIB LINOX SD 350053", "code_information": [{"code": "C1895", "type": "HCPCS"}, {"code": "4000382", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 60788.0, "discounted_cash": 45591.0, "setting": "both", "billing_class": "facility"}]}, {"description": "LD DFB LINOX SGL 375012", "code_information": [{"code": "C1777", "type": "HCPCS"}, {"code": "4008609", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 60788.0, "discounted_cash": 45591.0, "setting": "both", "billing_class": "facility"}]}, {"description": "LD DFB OPTISURE LDA210Q", "code_information": [{"code": "C1777", "type": "HCPCS"}, {"code": "4008623", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 65465.0, "discounted_cash": 49098.75, "setting": "both", "billing_class": "facility"}]}, {"description": "LD DFIB LINOX TD 359074", "code_information": [{"code": "C1895", "type": "HCPCS"}, {"code": "4008607", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 60788.0, "discounted_cash": 45591.0, "setting": "both", "billing_class": "facility"}]}, {"description": "LD DFIB SPRINT 6944", "code_information": [{"code": "C1895", "type": "HCPCS"}, {"code": "8241754", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 55113.0, "discounted_cash": 41334.75, "setting": "both", "billing_class": "facility"}]}, {"description": "LD DFIB SQ ARRAY XP 0085", "code_information": [{"code": "C1896", "type": "HCPCS"}, {"code": "8241737", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 4701.0, "discounted_cash": 3525.75, "setting": "both", "billing_class": "facility"}]}, {"description": "LD ISOFLEX OPTIM 1948", "code_information": [{"code": "C1898", "type": "HCPCS"}, {"code": "4008650", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 10490.0, "discounted_cash": 7867.5, "setting": "both", "billing_class": "facility"}]}, {"description": "LD NSTIM ARTISIAN", "code_information": [{"code": "C1778", "type": "HCPCS"}, {"code": "4008690", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 61907.0, "discounted_cash": 46430.25, "setting": "both", "billing_class": "facility"}]}, {"description": "LD NSTIM INTERSTIM 3093", "code_information": [{"code": "C1778", "type": "HCPCS"}, {"code": "8241811", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 44654.0, "discounted_cash": 33490.5, "setting": "both", "billing_class": "facility"}]}, {"description": "LD NSTIM INTERSTIM 3889", "code_information": [{"code": "C1778", "type": "HCPCS"}, {"code": "4008698", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 83229.0, "discounted_cash": 62421.75, "setting": "both", "billing_class": "facility"}]}, {"description": "LD NSTIM LAMITRODE 3219", "code_information": [{"code": "C1778", "type": "HCPCS"}, {"code": "4008694", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 117456.0, "discounted_cash": 88092.0, "setting": "both", "billing_class": "facility"}]}, {"description": "LD NSTIM LAMITRODE 3288", "code_information": [{"code": "C1778", "type": "HCPCS"}, {"code": "4008656", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 69586.0, "discounted_cash": 52189.5, "setting": "both", "billing_class": "facility"}]}, {"description": "LD NSTIM OCTAD 3778", "code_information": [{"code": "C1778", "type": "HCPCS"}, {"code": "8241815", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 24023.0, "discounted_cash": 18017.25, "setting": "both", "billing_class": "facility"}]}, {"description": "LD NSTIM PENTA 3228", "code_information": [{"code": "C1778", "type": "HCPCS"}, {"code": "4008696", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 117456.0, "discounted_cash": 88092.0, "setting": "both", "billing_class": "facility"}]}, {"description": "LD NSTIM SPECIFY 3998", "code_information": [{"code": "C1778", "type": "HCPCS"}, {"code": "8241830", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 13434.0, "discounted_cash": 10075.5, "setting": "both", "billing_class": "facility"}]}, {"description": "LD NSTIM SPECIFY 3999", "code_information": [{"code": "C1778", "type": "HCPCS"}, {"code": "8241831", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 28715.0, "discounted_cash": 21536.25, "setting": "both", "billing_class": "facility"}]}, {"description": "LD NSTIM SPECIFY 977C1", "code_information": [{"code": "C1778", "type": "HCPCS"}, {"code": "4008695", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 101700.0, "discounted_cash": 76275.0, "setting": "both", "billing_class": "facility"}]}, {"description": "LD NSTIM TRIAL 3873", "code_information": [{"code": "C1897", "type": "HCPCS"}, {"code": "8241816", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 13989.0, "discounted_cash": 10491.75, "setting": "both", "billing_class": "facility"}]}, {"description": "LD NSTIM TRIAL 3874", "code_information": [{"code": "C1897", "type": "HCPCS"}, {"code": "8241817", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 13989.0, "discounted_cash": 10491.75, "setting": "both", "billing_class": "facility"}]}, {"description": "LD NSTIM VAGUS NRV", "code_information": [{"code": "C1778", "type": "HCPCS"}, {"code": "4023751", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 167965.0, "discounted_cash": 125973.75, "setting": "both", "billing_class": "facility"}]}, {"description": "LD NSTM LINEAR ST SC2218", "code_information": [{"code": "C1778", "type": "HCPCS"}, {"code": "4023741", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 15827.0, "discounted_cash": 11870.25, "setting": "both", "billing_class": "facility"}]}, {"description": "LD PM CAPSURE EPI 4968", "code_information": [{"code": "C1898", "type": "HCPCS"}, {"code": "8241863", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 9267.0, "discounted_cash": 6950.25, "setting": "both", "billing_class": "facility"}]}, {"description": "LD PM CAPSUREFIX 5086MRI", "code_information": [{"code": "C1898", "type": "HCPCS"}, {"code": "4008706", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 12814.0, "discounted_cash": 9610.5, "setting": "both", "billing_class": "facility"}]}, {"description": "LD PM EPI/MYOCARD 5071", "code_information": [{"code": "C1898", "type": "HCPCS"}, {"code": "4008729", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 11145.0, "discounted_cash": 8358.75, "setting": "both", "billing_class": "facility"}]}, {"description": "LD PM INNOMEDICA CRD4047", "code_information": [{"code": "C1898", "type": "HCPCS"}, {"code": "8241907", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 8165.0, "discounted_cash": 6123.75, "setting": "both", "billing_class": "facility"}]}, {"description": "LD PM ISOFLEX-S 1642T", "code_information": [{"code": "C1898", "type": "HCPCS"}, {"code": "4000411", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 11643.0, "discounted_cash": 8732.25, "setting": "both", "billing_class": "facility"}]}, {"description": "LD PM MYOPORE EPI 511211", "code_information": [{"code": "C1898", "type": "HCPCS"}, {"code": "4000412", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 9179.0, "discounted_cash": 6884.25, "setting": "both", "billing_class": "facility"}]}, {"description": "LD PM MYOPORE EPI 511212", "code_information": [{"code": "C1898", "type": "HCPCS"}, {"code": "4000413", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 9304.0, "discounted_cash": 6978.0, "setting": "both", "billing_class": "facility"}]}, {"description": "LD PM SELOX JT45", "code_information": [{"code": "C1898", "type": "HCPCS"}, {"code": "8241944", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 8478.0, "discounted_cash": 6358.5, "setting": "both", "billing_class": "facility"}]}, {"description": "LD PM SELOX JT53", "code_information": [{"code": "C1898", "type": "HCPCS"}, {"code": "4008741", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 9350.0, "discounted_cash": 7012.5, "setting": "both", "billing_class": "facility"}]}, {"description": "LD PM SELOX ST53", "code_information": [{"code": "C1898", "type": "HCPCS"}, {"code": "8241945", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 8478.0, "discounted_cash": 6358.5, "setting": "both", "billing_class": "facility"}]}, {"description": "LD PM SELOX ST60", "code_information": [{"code": "C1898", "type": "HCPCS"}, {"code": "8241946", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 8478.0, "discounted_cash": 6358.5, "setting": "both", "billing_class": "facility"}]}, {"description": "LD PM SETROX S45", "code_information": [{"code": "C1898", "type": "HCPCS"}, {"code": "8241947", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 8478.0, "discounted_cash": 6358.5, "setting": "both", "billing_class": "facility"}]}, {"description": "LD PM SETROX S53", "code_information": [{"code": "C1898", "type": "HCPCS"}, {"code": "8241948", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 8478.0, "discounted_cash": 6358.5, "setting": "both", "billing_class": "facility"}]}, {"description": "LD PM SETROX S60", "code_information": [{"code": "C1898", "type": "HCPCS"}, {"code": "8241949", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 8478.0, "discounted_cash": 6358.5, "setting": "both", "billing_class": "facility"}]}, {"description": "LD PM SOLIA T", "code_information": [{"code": "C1898", "type": "HCPCS"}, {"code": "4008734", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 6028.0, "discounted_cash": 4521.0, "setting": "both", "billing_class": "facility"}]}, {"description": "LD PM TENDRIL SDX 1688TC", "code_information": [{"code": "C1898", "type": "HCPCS"}, {"code": "8241926", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 15156.0, "discounted_cash": 11367.0, "setting": "both", "billing_class": "facility"}]}, {"description": "LD QUARTET QUADPLR 1458Q", "code_information": [{"code": "C1900", "type": "HCPCS"}, {"code": "4008800", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 36628.0, "discounted_cash": 27471.0, "setting": "both", "billing_class": "facility"}]}, {"description": "LD QUICKSITE BPLR 1056T", "code_information": [{"code": "C1900", "type": "HCPCS"}, {"code": "4008801", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 62346.0, "discounted_cash": 46759.5, "setting": "both", "billing_class": "facility"}]}, {"description": "LD TEST INTERSTIM 3057", "code_information": [{"code": "C1778", "type": "HCPCS"}, {"code": "8178126", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 2112.0, "discounted_cash": 1584.0, "setting": "both", "billing_class": "facility"}]}, {"description": "LDH-ISOENZYMES ELCTROPHR", "code_information": [{"code": "83625", "type": "CPT"}, {"code": "4103625", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 711.0, "discounted_cash": 533.25, "setting": "both", "billing_class": "facility"}]}, {"description": "LDH-ISOENZYMES ELCTROPHR", "code_information": [{"code": "83625", "type": "CPT"}, {"code": "7253625", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 66.0, "discounted_cash": 49.5, "setting": "both", "billing_class": "facility"}]}, {"description": "LDH-LACTIC DEHYDROGENASE", "code_information": [{"code": "83615", "type": "CPT"}, {"code": "4103615", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 607.0, "discounted_cash": 455.25, "setting": "both", "billing_class": "facility"}]}, {"description": "LDH-LACTIC DEHYDROGENASE", "code_information": [{"code": "83615", "type": "CPT"}, {"code": "4173615", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 1.12, "discounted_cash": 0.84, "setting": "both", "billing_class": "facility"}]}, {"description": "LDH-LACTIC DEHYDROGENASE", "code_information": [{"code": "83615", "type": "CPT"}, {"code": "7253615", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 180.0, "discounted_cash": 135.0, "setting": "both", "billing_class": "facility"}]}, {"description": "LDH-LACTIC DEHYDROGENASE/2", "code_information": [{"code": "83615", "type": "CPT"}, {"code": "7253616", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 11.0, "discounted_cash": 8.25, "setting": "both", "billing_class": "facility"}]}, {"description": "LDH-LACTIC DEHYDROGENASE/3", "code_information": [{"code": "83615", "type": "CPT"}, {"code": "4103617", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 722.0, "discounted_cash": 541.5, "setting": "both", "billing_class": "facility"}]}, {"description": "LDL CHOLESTOROL", "code_information": [{"code": "83721", "type": "CPT"}, {"code": "4102476", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 1174.0, "discounted_cash": 880.5, "setting": "both", "billing_class": "facility"}]}, {"description": "LDL CHOLESTOROL", "code_information": [{"code": "83721", "type": "CPT"}, {"code": "4172476", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 18.55, "discounted_cash": 13.91, "setting": "both", "billing_class": "facility"}]}, {"description": "LDL CHOLESTOROL", "code_information": [{"code": "83721", "type": "CPT"}, {"code": "7253721", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 31.0, "discounted_cash": 23.25, "setting": "both", "billing_class": "facility"}]}, {"description": "LE ART IMAGING COMP BILAT", "code_information": [{"code": "93925", "type": "CPT"}, {"code": "5062003", "type": "CDM"}, {"code": "921", "type": "RC"}], "standard_charges": [{"gross_charge": 5399.0, "discounted_cash": 4049.25, "setting": "both", "billing_class": "facility"}]}, {"description": "LE ART IMAGING COMP BILAT", "code_information": [{"code": "93925", "type": "CPT"}, {"code": "5112003", "type": "CDM"}, {"code": "921", "type": "RC"}], "standard_charges": [{"gross_charge": 5399.0, "discounted_cash": 4049.25, "setting": "both", "billing_class": "facility"}]}, {"description": "LE ART IMAGING UNI/LTD", "code_information": [{"code": "93926", "type": "CPT"}, {"code": "4604432", "type": "CDM"}, {"code": "921", "type": "RC"}], "standard_charges": [{"gross_charge": 4309.0, "discounted_cash": 3231.75, "setting": "both", "billing_class": "facility"}]}, {"description": "LE ART IMAGING UNI/LTD", "code_information": [{"code": "93926", "type": "CPT"}, {"code": "5067201", "type": "CDM"}, {"code": "921", "type": "RC"}], "standard_charges": [{"gross_charge": 3061.0, "discounted_cash": 2295.75, "setting": "both", "billing_class": "facility"}]}, {"description": "LE ART IMAGING UNI/LTD", "code_information": [{"code": "93926", "type": "CPT"}, {"code": "5117201", "type": "CDM"}, {"code": "921", "type": "RC"}], "standard_charges": [{"gross_charge": 3061.0, "discounted_cash": 2295.75, "setting": "both", "billing_class": "facility"}]}, {"description": "LEAD QUANTITATIVE", "code_information": [{"code": "83655", "type": "CPT"}, {"code": "7253655", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 494.0, "discounted_cash": 370.5, "setting": "both", "billing_class": "facility"}]}, {"description": "LEAD QUANTITATIVE/4", "code_information": [{"code": "83655", "type": "CPT"}, {"code": "7253658", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 50.0, "discounted_cash": 37.5, "setting": "both", "billing_class": "facility"}]}, {"description": "LEGIONELLA AB/2", "code_information": [{"code": "86713", "type": "CPT"}, {"code": "7256724", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 617.0, "discounted_cash": 462.75, "setting": "both", "billing_class": "facility"}]}, {"description": "LEGIONELLA AMP PROBE", "code_information": [{"code": "87541", "type": "CPT"}, {"code": "7257541", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 826.0, "discounted_cash": 619.5, "setting": "both", "billing_class": "facility"}]}, {"description": "LEGIONELLA PNEUMOPHILA/2", "code_information": [{"code": "87278", "type": "CPT"}, {"code": "7257278", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 761.0, "discounted_cash": 570.75, "setting": "both", "billing_class": "facility"}]}, {"description": "LEPTOSPIRA AB", "code_information": [{"code": "86720", "type": "CPT"}, {"code": "7256178", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 392.0, "discounted_cash": 294.0, "setting": "both", "billing_class": "facility"}]}, {"description": "LEPTOSPIRA AB/2", "code_information": [{"code": "86720", "type": "CPT"}, {"code": "7258698", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 392.0, "discounted_cash": 294.0, "setting": "both", "billing_class": "facility"}]}, {"description": "LETROZOLE 2.5MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5306368", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 308.0, "discounted_cash": 231.0, "setting": "both", "billing_class": "facility"}]}, {"description": "LETROZOLE 2.5MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5306368", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 308.0, "discounted_cash": 231.0, "setting": "both", "billing_class": "facility"}]}, {"description": "LEUCOVORIN 5MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8999", "type": "HCPCS"}, {"code": "5306389", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 78.0, "discounted_cash": 58.5, "setting": "both", "billing_class": "facility"}]}, {"description": "LEUCOVORIN 5MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8999", "type": "HCPCS"}, {"code": "5306389", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 78.0, "discounted_cash": 58.5, "setting": "both", "billing_class": "facility"}]}, {"description": "LEUCOVORIN PER 50MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0640", "type": "HCPCS"}, {"code": "5321651", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 167.0, "discounted_cash": 125.25, "setting": "both", "billing_class": "facility"}]}, {"description": "LEUCOVORIN PER 50MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0640", "type": "HCPCS"}, {"code": "5321651", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 167.0, "discounted_cash": 125.25, "setting": "both", "billing_class": "facility"}]}, {"description": "LEUKO ASSMT FECAL QL/SQN", "code_information": [{"code": "89055", "type": "CPT"}, {"code": "4107203", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 284.0, "discounted_cash": 213.0, "setting": "both", "billing_class": "facility"}]}, {"description": "LEUKO ASSMT FECAL QL/SQN", "code_information": [{"code": "89055", "type": "CPT"}, {"code": "4177203", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 7.14, "discounted_cash": 5.36, "setting": "both", "billing_class": "facility"}]}, {"description": "LEUKOCYTE ALKA-PHSPHTASE", "code_information": [{"code": "85540", "type": "CPT"}, {"code": "4105539", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 1140.0, "discounted_cash": 855.0, "setting": "both", "billing_class": "facility"}]}, {"description": "LEUPROLID DEP 3.75MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J1950", "type": "HCPCS"}, {"code": "5321668", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 11627.0, "discounted_cash": 8720.25, "setting": "both", "billing_class": "facility"}]}, {"description": "LEUPROLID DEP 3.75MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J1950", "type": "HCPCS"}, {"code": "5321668", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 11627.0, "discounted_cash": 8720.25, "setting": "both", "billing_class": "facility"}]}, {"description": "LEUPROLID DEP PER7.5MGIJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J9217", "type": "HCPCS"}, {"code": "5321676", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 15735.0, "discounted_cash": 11801.25, "setting": "both", "billing_class": "facility"}]}, {"description": "LEUPROLID DEP PER7.5MGIJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J9217", "type": "HCPCS"}, {"code": "5321676", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 15735.0, "discounted_cash": 11801.25, "setting": "both", "billing_class": "facility"}]}, {"description": "LEVALBUTEROL.31MG/3ML IS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5331377", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 126.0, "discounted_cash": 94.5, "setting": "both", "billing_class": "facility"}]}, {"description": "LEVALBUTEROL.31MG/3ML IS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5331377", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 126.0, "discounted_cash": 94.5, "setting": "both", "billing_class": "facility"}]}, {"description": "LEVALBUTEROL.63MG/3ML IS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5331375", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 102.0, "discounted_cash": 76.5, "setting": "both", "billing_class": "facility"}]}, {"description": "LEVALBUTEROL.63MG/3ML IS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5331375", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 102.0, "discounted_cash": 76.5, "setting": "both", "billing_class": "facility"}]}, {"description": "LEVALBUTEROL1.25MG/3MLIS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5331376", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 104.0, "discounted_cash": 78.0, "setting": "both", "billing_class": "facility"}]}, {"description": "LEVALBUTEROL1.25MG/3MLIS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5331376", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 104.0, "discounted_cash": 78.0, "setting": "both", "billing_class": "facility"}]}, {"description": "LEVETIRACET PER10MGPMXIJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J1953", "type": "HCPCS"}, {"code": "5321697", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 8.0, "discounted_cash": 6.0, "setting": "both", "billing_class": "facility"}]}, {"description": "LEVETIRACET PER10MGPMXIJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J1953", "type": "HCPCS"}, {"code": "5321697", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 8.0, "discounted_cash": 6.0, "setting": "both", "billing_class": "facility"}]}, {"description": "LEVETIRACETAM 250MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5306405", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 81.0, "discounted_cash": 60.75, "setting": "both", "billing_class": "facility"}]}, {"description": "LEVETIRACETAM 250MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5306405", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 81.0, "discounted_cash": 60.75, "setting": "both", "billing_class": "facility"}]}, {"description": "LEVETIRACETAM 500MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5306406", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 96.0, "discounted_cash": 72.0, "setting": "both", "billing_class": "facility"}]}, {"description": "LEVETIRACETAM 500MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5306406", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 96.0, "discounted_cash": 72.0, "setting": "both", "billing_class": "facility"}]}, {"description": "LEVETIRACETAM PER 1ML IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5321694", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 78.0, "discounted_cash": 58.5, "setting": "both", "billing_class": "facility"}]}, {"description": "LEVETIRACETAM PER10MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J1953", "type": "HCPCS"}, {"code": "5321696", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 36.0, "discounted_cash": 27.0, "setting": "both", "billing_class": "facility"}]}, {"description": "LEVETIRACETAM PER10MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J1953", "type": "HCPCS"}, {"code": "5321696", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 36.0, "discounted_cash": 27.0, "setting": "both", "billing_class": "facility"}]}, {"description": "LEVETIRACETAM/2", "code_information": [{"code": "80177", "type": "CPT"}, {"code": "7258297", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 113.0, "discounted_cash": 84.75, "setting": "both", "billing_class": "facility"}]}, {"description": "LEVETIRACETAM500MG/5MLLQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5315478", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 93.0, "discounted_cash": 69.75, "setting": "both", "billing_class": "facility"}]}, {"description": "LEVETIRACETAM500MG/5MLLQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5315478", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 93.0, "discounted_cash": 69.75, "setting": "both", "billing_class": "facility"}]}, {"description": "LEVOBUNOLOL .5% 5ML OS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5331370", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 436.0, "discounted_cash": 327.0, "setting": "both", "billing_class": "facility"}]}, {"description": "LEVOBUNOLOL .5% 5ML OS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5331370", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 436.0, "discounted_cash": 327.0, "setting": "both", "billing_class": "facility"}]}, {"description": "LEVOCARNITINE PER 1GM IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J1955", "type": "HCPCS"}, {"code": "5321714", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 1231.0, "discounted_cash": 923.25, "setting": "both", "billing_class": "facility"}]}, {"description": "LEVOCARNITINE PER 1ML IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5321718", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 117.0, "discounted_cash": 87.75, "setting": "both", "billing_class": "facility"}]}, {"description": "LEVOFLOXAC PER250MGPMXIJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J1956", "type": "HCPCS"}, {"code": "5321712", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 715.0, "discounted_cash": 536.25, "setting": "both", "billing_class": "facility"}]}, {"description": "LEVOFLOXAC PER250MGPMXIJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J1956", "type": "HCPCS"}, {"code": "5321712", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 715.0, "discounted_cash": 536.25, "setting": "both", "billing_class": "facility"}]}, {"description": "LEVOFLOXACIN 250MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5306430", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 303.0, "discounted_cash": 227.25, "setting": "both", "billing_class": "facility"}]}, {"description": "LEVOFLOXACIN 250MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5306430", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 303.0, "discounted_cash": 227.25, "setting": "both", "billing_class": "facility"}]}, {"description": "LEVOFLOXACIN 500MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5306431", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 337.0, "discounted_cash": 252.75, "setting": "both", "billing_class": "facility"}]}, {"description": "LEVOFLOXACIN 500MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5306431", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 337.0, "discounted_cash": 252.75, "setting": "both", "billing_class": "facility"}]}, {"description": "LEVOFLOXACIN 750MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5306428", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 518.0, "discounted_cash": 388.5, "setting": "both", "billing_class": "facility"}]}, {"description": "LEVOFLOXACIN 750MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5306428", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 518.0, "discounted_cash": 388.5, "setting": "both", "billing_class": "facility"}]}, {"description": "LEVOFLOXACN PED PER1MLIJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5321717", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 113.0, "discounted_cash": 84.75, "setting": "both", "billing_class": "facility"}]}, {"description": "LEVONORGESTREL 1.5MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5306433", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 373.0, "discounted_cash": 279.75, "setting": "both", "billing_class": "facility"}]}, {"description": "LEVONORGESTREL 1.5MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5306433", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 373.0, "discounted_cash": 279.75, "setting": "both", "billing_class": "facility"}]}, {"description": "LEVOTHYROXIN .025MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5306447", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 61.0, "discounted_cash": 45.75, "setting": "both", "billing_class": "facility"}]}, {"description": "LEVOTHYROXIN .025MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5306447", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 61.0, "discounted_cash": 45.75, "setting": "both", "billing_class": "facility"}]}, {"description": "LEVOTHYROXIN .05MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5306451", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 72.0, "discounted_cash": 54.0, "setting": "both", "billing_class": "facility"}]}, {"description": "LEVOTHYROXIN .05MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5306451", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 72.0, "discounted_cash": 54.0, "setting": "both", "billing_class": "facility"}]}, {"description": "LEVOTHYROXIN .075MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5306454", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 66.0, "discounted_cash": 49.5, "setting": "both", "billing_class": "facility"}]}, {"description": "LEVOTHYROXIN .075MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5306454", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 66.0, "discounted_cash": 49.5, "setting": "both", "billing_class": "facility"}]}, {"description": "LEVOTHYROXIN .088MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5306435", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 61.0, "discounted_cash": 45.75, "setting": "both", "billing_class": "facility"}]}, {"description": "LEVOTHYROXIN .088MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5306435", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 61.0, "discounted_cash": 45.75, "setting": "both", "billing_class": "facility"}]}, {"description": "LEVOTHYROXIN .112MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5306456", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 61.0, "discounted_cash": 45.75, "setting": "both", "billing_class": "facility"}]}, {"description": "LEVOTHYROXIN .112MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5306456", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 61.0, "discounted_cash": 45.75, "setting": "both", "billing_class": "facility"}]}, {"description": "LEVOTHYROXIN .125MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5306458", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 61.0, "discounted_cash": 45.75, "setting": "both", "billing_class": "facility"}]}, {"description": "LEVOTHYROXIN .125MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5306458", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 61.0, "discounted_cash": 45.75, "setting": "both", "billing_class": "facility"}]}, {"description": "LEVOTHYROXIN .15MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5306455", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 64.0, "discounted_cash": 48.0, "setting": "both", "billing_class": "facility"}]}, {"description": "LEVOTHYROXIN .15MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5306455", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 64.0, "discounted_cash": 48.0, "setting": "both", "billing_class": "facility"}]}, {"description": "LEVOTHYROXIN .1MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5306459", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 65.0, "discounted_cash": 48.75, "setting": "both", "billing_class": "facility"}]}, {"description": "LEVOTHYROXIN .1MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5306459", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 65.0, "discounted_cash": 48.75, "setting": "both", "billing_class": "facility"}]}, {"description": "LEVOTHYROXIN .2MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5306463", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 66.0, "discounted_cash": 49.5, "setting": "both", "billing_class": "facility"}]}, {"description": "LEVOTHYROXIN .2MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5306463", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 66.0, "discounted_cash": 49.5, "setting": "both", "billing_class": "facility"}]}, {"description": "LEVOTHYROXIN CMPD LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5315477", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 40.0, "discounted_cash": 30.0, "setting": "both", "billing_class": "facility"}]}, {"description": "LEVOTHYROXIN CMPD LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5315477", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 40.0, "discounted_cash": 30.0, "setting": "both", "billing_class": "facility"}]}, {"description": "LEVOTHYROXINE NOS PER 10MCG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0650", "type": "HCPCS"}, {"code": "5321693", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 111.0, "discounted_cash": 83.25, "setting": "both", "billing_class": "facility"}]}, {"description": "LEVOTHYROXINE NOS PER 10MCG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0650", "type": "HCPCS"}, {"code": "5321693", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 111.0, "discounted_cash": 83.25, "setting": "both", "billing_class": "facility"}]}, {"description": "LGI1 AB", "code_information": [{"code": "86255", "type": "CPT"}, {"code": "7250401", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 630.0, "discounted_cash": 472.5, "setting": "both", "billing_class": "facility"}]}, {"description": "LIDO/EPI/TETRA 3ML TS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J7999", "type": "HCPCS"}, {"code": "5336207", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 263.0, "discounted_cash": 197.25, "setting": "both", "billing_class": "facility"}]}, {"description": "LIDO/EPI/TETRA 3ML TS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J7999", "type": "HCPCS"}, {"code": "5336207", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 263.0, "discounted_cash": 197.25, "setting": "both", "billing_class": "facility"}]}, {"description": "LIDO/PRILOC 2.5% 30GM CR", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5336205", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 166.0, "discounted_cash": 124.5, "setting": "both", "billing_class": "facility"}]}, {"description": "LIDO/PRILOC 2.5% 5GM CR", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5336204", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 374.0, "discounted_cash": 280.5, "setting": "both", "billing_class": "facility"}]}, {"description": "LIDOCAINE", "code_information": [{"code": "80176", "type": "CPT"}, {"code": "4104625", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 651.0, "discounted_cash": 488.25, "setting": "both", "billing_class": "facility"}]}, {"description": "LIDOCAINE 2% 10ML GL", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5336197", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 818.0, "discounted_cash": 613.5, "setting": "both", "billing_class": "facility"}]}, {"description": "LIDOCAINE 2% 11ML GL", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5336234", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 126.0, "discounted_cash": 94.5, "setting": "both", "billing_class": "facility"}]}, {"description": "LIDOCAINE 2% 5ML GL", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5336202", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 126.0, "discounted_cash": 94.5, "setting": "both", "billing_class": "facility"}]}, {"description": "LIDOCAINE 2% 6ML GL", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5336236", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 98.0, "discounted_cash": 73.5, "setting": "both", "billing_class": "facility"}]}, {"description": "LIDOCAINE 4% 50ML TS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5336208", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 177.0, "discounted_cash": 132.75, "setting": "both", "billing_class": "facility"}]}, {"description": "LIDOCAINE 4% PATCH TD", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5336240", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 47.0, "discounted_cash": 35.25, "setting": "both", "billing_class": "facility"}]}, {"description": "LIDOCAINE 4% PATCH TD", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5336240", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 47.0, "discounted_cash": 35.25, "setting": "both", "billing_class": "facility"}]}, {"description": "LIDOCAINE 5% 35GM OI", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5336212", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 743.0, "discounted_cash": 557.25, "setting": "both", "billing_class": "facility"}]}, {"description": "LIDOCAINE 5% TD", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5336213", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 181.0, "discounted_cash": 135.75, "setting": "both", "billing_class": "facility"}]}, {"description": "LIDOCAINE D5W PER 1MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J2002", "type": "HCPCS"}, {"code": "5321753", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 46.0, "discounted_cash": 34.5, "setting": "both", "billing_class": "facility"}]}, {"description": "LIDOCAINE D5W PER 1MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J2002", "type": "HCPCS"}, {"code": "5321753", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 46.0, "discounted_cash": 34.5, "setting": "both", "billing_class": "facility"}]}, {"description": "LIDOCAINE PER 1MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J2003", "type": "HCPCS"}, {"code": "5321754", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 0.32, "discounted_cash": 0.24, "setting": "both", "billing_class": "facility"}]}, {"description": "LIDOCAINE PER 1MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J2003", "type": "HCPCS"}, {"code": "5321754", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 0.32, "discounted_cash": 0.24, "setting": "both", "billing_class": "facility"}]}, {"description": "LIDOCAINE PER 1MG PF IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J2003", "type": "HCPCS"}, {"code": "5321756", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 3.0, "discounted_cash": 2.25, "setting": "both", "billing_class": "facility"}]}, {"description": "LIDOCAINE PER 1MG PF IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J2003", "type": "HCPCS"}, {"code": "5321756", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 3.0, "discounted_cash": 2.25, "setting": "both", "billing_class": "facility"}]}, {"description": "LIDOCAINE PER 1MG W/EPI IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J2004", "type": "HCPCS"}, {"code": "5321759", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 1.0, "discounted_cash": 0.75, "setting": "both", "billing_class": "facility"}]}, {"description": "LIDOCAINE PER 1MG W/EPI IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J2004", "type": "HCPCS"}, {"code": "5321759", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 1.0, "discounted_cash": 0.75, "setting": "both", "billing_class": "facility"}]}, {"description": "LIDOCAINE VISC 2% 100 LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5315505", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 256.0, "discounted_cash": 192.0, "setting": "both", "billing_class": "facility"}]}, {"description": "LIDOCAINE VISC 2% 100 LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5315505", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 256.0, "discounted_cash": 192.0, "setting": "both", "billing_class": "facility"}]}, {"description": "LIDOCAINE VISC 2% 15MLLQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5315506", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 55.0, "discounted_cash": 41.25, "setting": "both", "billing_class": "facility"}]}, {"description": "LIDOCAINE VISC 2% 15MLLQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5315506", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 55.0, "discounted_cash": 41.25, "setting": "both", "billing_class": "facility"}]}, {"description": "LIDOCAINE VISC 2% 20 LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5315503", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 85.0, "discounted_cash": 63.75, "setting": "both", "billing_class": "facility"}]}, {"description": "LIDOCAINE VISC 2% 20 LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5315503", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 85.0, "discounted_cash": 63.75, "setting": "both", "billing_class": "facility"}]}, {"description": "LIDOCAINE2%UROJET 10MLGL", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5336201", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 122.0, "discounted_cash": 91.5, "setting": "both", "billing_class": "facility"}]}, {"description": "LIDOCAINE2%UROJET 20MLGL", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5336230", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 327.0, "discounted_cash": 245.25, "setting": "both", "billing_class": "facility"}]}, {"description": "LINDANE 1% 60ML LT", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5336250", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 1355.0, "discounted_cash": 1016.25, "setting": "both", "billing_class": "facility"}]}, {"description": "LINDANE 1% 60ML LT", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5336250", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 1355.0, "discounted_cash": 1016.25, "setting": "both", "billing_class": "facility"}]}, {"description": "LINDANE SHAMP 1% 60ML SH", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5336271", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 994.0, "discounted_cash": 745.5, "setting": "both", "billing_class": "facility"}]}, {"description": "LINDANE SHAMP 1% 60ML SH", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5336271", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 994.0, "discounted_cash": 745.5, "setting": "both", "billing_class": "facility"}]}, {"description": "LINER ACE PLY MAR ALTX DPY CL", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "4012804", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 13924.0, "discounted_cash": 10443.0, "setting": "both", "billing_class": "facility"}]}, {"description": "LINER ACET POLY X3 STRYKER CL", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "4013044", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 12160.0, "discounted_cash": 9120.0, "setting": "both", "billing_class": "facility"}]}, {"description": "LINER ACETB BI MENTUM DEPUY CL", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "4012807", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 17639.0, "discounted_cash": 13229.25, "setting": "both", "billing_class": "facility"}]}, {"description": "LINER ACETB CONSTRAIN STRY CL", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "4013039", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 17836.0, "discounted_cash": 13377.0, "setting": "both", "billing_class": "facility"}]}, {"description": "LINEZOLID 600MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5306501", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 1283.0, "discounted_cash": 962.25, "setting": "both", "billing_class": "facility"}]}, {"description": "LINEZOLID 600MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5306501", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 1283.0, "discounted_cash": 962.25, "setting": "both", "billing_class": "facility"}]}, {"description": "LINEZOLID PER 200MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J2020", "type": "HCPCS"}, {"code": "5321853", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 639.0, "discounted_cash": 479.25, "setting": "both", "billing_class": "facility"}]}, {"description": "LINEZOLID PER 200MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J2020", "type": "HCPCS"}, {"code": "5321853", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 639.0, "discounted_cash": 479.25, "setting": "both", "billing_class": "facility"}]}, {"description": "LIOTHYRONINE 25MCG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5306517", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 85.0, "discounted_cash": 63.75, "setting": "both", "billing_class": "facility"}]}, {"description": "LIOTHYRONINE 25MCG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5306517", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 85.0, "discounted_cash": 63.75, "setting": "both", "billing_class": "facility"}]}, {"description": "LIPASE", "code_information": [{"code": "83690", "type": "CPT"}, {"code": "4103690", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 417.0, "discounted_cash": 312.75, "setting": "both", "billing_class": "facility"}]}, {"description": "LIPASE", "code_information": [{"code": "83690", "type": "CPT"}, {"code": "4123690", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 23.0, "discounted_cash": 17.25, "setting": "both", "billing_class": "facility"}]}, {"description": "LIPASE", "code_information": [{"code": "83690", "type": "CPT"}, {"code": "4173690", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 5.71, "discounted_cash": 4.28, "setting": "both", "billing_class": "facility"}]}, {"description": "LIPASE/2", "code_information": [{"code": "83690", "type": "CPT"}, {"code": "4103691", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 280.0, "discounted_cash": 210.0, "setting": "both", "billing_class": "facility"}]}, {"description": "LIPASE/2", "code_information": [{"code": "83690", "type": "CPT"}, {"code": "4173691", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 14.27, "discounted_cash": 10.7, "setting": "both", "billing_class": "facility"}]}, {"description": "LIPASE/2", "code_information": [{"code": "83690", "type": "CPT"}, {"code": "7253691", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 104.0, "discounted_cash": 78.0, "setting": "both", "billing_class": "facility"}]}, {"description": "LIPID PANEL", "code_information": [{"code": "80061", "type": "CPT"}, {"code": "4100062", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 640.0, "discounted_cash": 480.0, "setting": "both", "billing_class": "facility"}]}, {"description": "LIPID PANEL", "code_information": [{"code": "80061", "type": "CPT"}, {"code": "4120062", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 13.0, "discounted_cash": 9.75, "setting": "both", "billing_class": "facility"}]}, {"description": "LIPID PANEL", "code_information": [{"code": "80061", "type": "CPT"}, {"code": "4170062", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 8.56, "discounted_cash": 6.42, "setting": "both", "billing_class": "facility"}]}, {"description": "LIPID PANEL/2", "code_information": [{"code": "80061", "type": "CPT"}, {"code": "7250160", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 249.0, "discounted_cash": 186.75, "setting": "both", "billing_class": "facility"}]}, {"description": "LIPO ULTRCNTRFGTN/QUAN", "code_information": [{"code": "83701", "type": "CPT"}, {"code": "7253714", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 131.0, "discounted_cash": 98.25, "setting": "both", "billing_class": "facility"}]}, {"description": "LIPOPROTEIN (A)", "code_information": [{"code": "83695", "type": "CPT"}, {"code": "7253716", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 954.0, "discounted_cash": 715.5, "setting": "both", "billing_class": "facility"}]}, {"description": "LIPOPROTEIN BLD ELP QN", "code_information": [{"code": "83700", "type": "CPT"}, {"code": "7253706", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 49.0, "discounted_cash": 36.75, "setting": "both", "billing_class": "facility"}]}, {"description": "LIPOPROTEIN BY NMR", "code_information": [{"code": "83704", "type": "CPT"}, {"code": "7253704", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 613.0, "discounted_cash": 459.75, "setting": "both", "billing_class": "facility"}]}, {"description": "LISINOPRIL 10MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5306636", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 85.0, "discounted_cash": 63.75, "setting": "both", "billing_class": "facility"}]}, {"description": "LISINOPRIL 10MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5306636", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 85.0, "discounted_cash": 63.75, "setting": "both", "billing_class": "facility"}]}, {"description": "LISINOPRIL 20MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5306637", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 65.0, "discounted_cash": 48.75, "setting": "both", "billing_class": "facility"}]}, {"description": "LISINOPRIL 20MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5306637", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 65.0, "discounted_cash": 48.75, "setting": "both", "billing_class": "facility"}]}, {"description": "LISINOPRIL 40MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5306638", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 85.0, "discounted_cash": 63.75, "setting": "both", "billing_class": "facility"}]}, {"description": "LISINOPRIL 40MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5306638", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 85.0, "discounted_cash": 63.75, "setting": "both", "billing_class": "facility"}]}, {"description": "LISINOPRIL 5MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5306635", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 71.0, "discounted_cash": 53.25, "setting": "both", "billing_class": "facility"}]}, {"description": "LISINOPRIL 5MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5306635", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 71.0, "discounted_cash": 53.25, "setting": "both", "billing_class": "facility"}]}, {"description": "LISINOPRL/HCTZ20/25 TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5306641", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 66.0, "discounted_cash": 49.5, "setting": "both", "billing_class": "facility"}]}, {"description": "LISINOPRL/HCTZ20/25 TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5306641", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 66.0, "discounted_cash": 49.5, "setting": "both", "billing_class": "facility"}]}, {"description": "LISTERIA MONOCYTOGENES AB", "code_information": [{"code": "86723", "type": "CPT"}, {"code": "7256723", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 1477.0, "discounted_cash": 1107.75, "setting": "both", "billing_class": "facility"}]}, {"description": "LISTERIA MONOCYTOGENES AB/2", "code_information": [{"code": "86723", "type": "CPT"}, {"code": "7256725", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 553.0, "discounted_cash": 414.75, "setting": "both", "billing_class": "facility"}]}, {"description": "LITHIUM", "code_information": [{"code": "80178", "type": "CPT"}, {"code": "4103725", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 501.0, "discounted_cash": 375.75, "setting": "both", "billing_class": "facility"}]}, {"description": "LITHIUM", "code_information": [{"code": "80178", "type": "CPT"}, {"code": "4173725", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 7.14, "discounted_cash": 5.36, "setting": "both", "billing_class": "facility"}]}, {"description": "LITHIUM 300MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5306652", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 61.0, "discounted_cash": 45.75, "setting": "both", "billing_class": "facility"}]}, {"description": "LITHIUM 300MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5306652", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 61.0, "discounted_cash": 45.75, "setting": "both", "billing_class": "facility"}]}, {"description": "LITHIUM 450MG XR TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5306676", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 66.0, "discounted_cash": 49.5, "setting": "both", "billing_class": "facility"}]}, {"description": "LITHIUM 450MG XR TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5306676", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 66.0, "discounted_cash": 49.5, "setting": "both", "billing_class": "facility"}]}, {"description": "LITHIUM CARB 300MG XR TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5306678", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 85.0, "discounted_cash": 63.75, "setting": "both", "billing_class": "facility"}]}, {"description": "LITHIUM CARB 300MG XR TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5306678", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 85.0, "discounted_cash": 63.75, "setting": "both", "billing_class": "facility"}]}, {"description": "LITHOTRIPSY", "code_information": [{"code": "3080590", "type": "CDM"}, {"code": "790", "type": "RC"}], "standard_charges": [{"gross_charge": 54331.0, "discounted_cash": 40748.25, "setting": "both", "billing_class": "facility"}]}, {"description": "LITHOTRIPSY OTHER", "code_information": [{"code": "3080015", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 34934.0, "discounted_cash": 26200.5, "setting": "both", "billing_class": "facility"}]}, {"description": "LIVER/SPLEEN IMAG STATIC", "code_information": [{"code": "78215", "type": "CPT"}, {"code": "5208215", "type": "CDM"}, {"code": "341", "type": "RC"}], "standard_charges": [{"gross_charge": 8552.0, "discounted_cash": 6414.0, "setting": "both", "billing_class": "facility"}]}, {"description": "LNR AC PLY HGH CRSLNK MDACT CL", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "4013439", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 13574.0, "discounted_cash": 10180.5, "setting": "both", "billing_class": "facility"}]}, {"description": "LNR CP HP PRTL SLFCN AESCLP CL", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "4013340", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 4703.0, "discounted_cash": 3527.25, "setting": "both", "billing_class": "facility"}]}, {"description": "LOCM 200-299MG/ML ID 1ML", "code_information": [{"code": "Q9966", "type": "HCPCS"}, {"code": "5358211", "type": "CDM"}, {"code": "255", "type": "RC"}], "standard_charges": [{"gross_charge": 14.0, "discounted_cash": 10.5, "setting": "both", "billing_class": "facility"}]}, {"description": "LOCM 200-299MG/ML ID 1ML", "code_information": [{"code": "Q9966", "type": "HCPCS"}, {"code": "5358211", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 14.0, "discounted_cash": 10.5, "setting": "both", "billing_class": "facility"}]}, {"description": "LOCM 300-399MG/ML ID 1ML", "code_information": [{"code": "Q9967", "type": "HCPCS"}, {"code": "5358209", "type": "CDM"}, {"code": "255", "type": "RC"}], "standard_charges": [{"gross_charge": 14.0, "discounted_cash": 10.5, "setting": "both", "billing_class": "facility"}]}, {"description": "LOCM 300-399MG/ML ID 1ML", "code_information": [{"code": "Q9967", "type": "HCPCS"}, {"code": "5358209", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 14.0, "discounted_cash": 10.5, "setting": "both", "billing_class": "facility"}]}, {"description": "LOPERAMIDE 1/5 10ML LQ", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5315527", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 61.0, "discounted_cash": 45.75, "setting": "both", "billing_class": "facility"}]}, {"description": "LOPERAMIDE 1/5 10ML LQ", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5315527", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 61.0, "discounted_cash": 45.75, "setting": "both", "billing_class": "facility"}]}, {"description": "LOPERAMIDE 1/5 5ML LQ", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5315528", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 66.0, "discounted_cash": 49.5, "setting": "both", "billing_class": "facility"}]}, {"description": "LOPERAMIDE 1/5 5ML LQ", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5315528", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 66.0, "discounted_cash": 49.5, "setting": "both", "billing_class": "facility"}]}, {"description": "LOPERAMIDE 2MG CP", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5306729", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 78.0, "discounted_cash": 58.5, "setting": "both", "billing_class": "facility"}]}, {"description": "LOPERAMIDE 2MG CP", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5306729", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 78.0, "discounted_cash": 58.5, "setting": "both", "billing_class": "facility"}]}, {"description": "LOPERAMIDE 2MG/15ML LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5315508", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 53.0, "discounted_cash": 39.75, "setting": "both", "billing_class": "facility"}]}, {"description": "LOPERAMIDE 2MG/15ML LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5315508", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 53.0, "discounted_cash": 39.75, "setting": "both", "billing_class": "facility"}]}, {"description": "LOPINAV/RITONA 200/50 TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5306731", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 148.0, "discounted_cash": 111.0, "setting": "both", "billing_class": "facility"}]}, {"description": "LOPINAV/RITONA 200/50 TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5306731", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 148.0, "discounted_cash": 111.0, "setting": "both", "billing_class": "facility"}]}, {"description": "LORATADINE 10MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5306740", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 66.0, "discounted_cash": 49.5, "setting": "both", "billing_class": "facility"}]}, {"description": "LORATADINE 10MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5306740", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 66.0, "discounted_cash": 49.5, "setting": "both", "billing_class": "facility"}]}, {"description": "LORATADINE 5MG/5ML LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5315544", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 47.0, "discounted_cash": 35.25, "setting": "both", "billing_class": "facility"}]}, {"description": "LORATADINE 5MG/5ML LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5315544", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 47.0, "discounted_cash": 35.25, "setting": "both", "billing_class": "facility"}]}, {"description": "LORAZEPAM .5MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5306749", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 77.0, "discounted_cash": 57.75, "setting": "both", "billing_class": "facility"}]}, {"description": "LORAZEPAM .5MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5306749", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 77.0, "discounted_cash": 57.75, "setting": "both", "billing_class": "facility"}]}, {"description": "LORAZEPAM 1MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5306752", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 78.0, "discounted_cash": 58.5, "setting": "both", "billing_class": "facility"}]}, {"description": "LORAZEPAM 1MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5306752", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 78.0, "discounted_cash": 58.5, "setting": "both", "billing_class": "facility"}]}, {"description": "LORAZEPAM PER 2MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J2060", "type": "HCPCS"}, {"code": "5321894", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 112.0, "discounted_cash": 84.0, "setting": "both", "billing_class": "facility"}]}, {"description": "LORAZEPAM PER 2MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J2060", "type": "HCPCS"}, {"code": "5321894", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 112.0, "discounted_cash": 84.0, "setting": "both", "billing_class": "facility"}]}, {"description": "LOSARTAN 25MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5306759", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 66.0, "discounted_cash": 49.5, "setting": "both", "billing_class": "facility"}]}, {"description": "LOSARTAN 25MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5306759", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 66.0, "discounted_cash": 49.5, "setting": "both", "billing_class": "facility"}]}, {"description": "LOSARTAN 50MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5306757", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 78.0, "discounted_cash": 58.5, "setting": "both", "billing_class": "facility"}]}, {"description": "LOSARTAN 50MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5306757", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 78.0, "discounted_cash": 58.5, "setting": "both", "billing_class": "facility"}]}, {"description": "LOSARTAN/HCTZ50/12.5 TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5306758", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 70.0, "discounted_cash": 52.5, "setting": "both", "billing_class": "facility"}]}, {"description": "LOSARTAN/HCTZ50/12.5 TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5306758", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 70.0, "discounted_cash": 52.5, "setting": "both", "billing_class": "facility"}]}, {"description": "LOTEPREDNOL .5% 5ML OS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5331415", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 1659.0, "discounted_cash": 1244.25, "setting": "both", "billing_class": "facility"}]}, {"description": "LOTEPREDNOL .5% 5ML OS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5331415", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 1659.0, "discounted_cash": 1244.25, "setting": "both", "billing_class": "facility"}]}, {"description": "LOWER EXT INFANT AP&LAT", "code_information": [{"code": "73592", "type": "CPT"}, {"code": "4903591", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 995.0, "discounted_cash": 746.25, "setting": "both", "billing_class": "facility"}]}, {"description": "LOWER EXT INFANT AP&LAT", "code_information": [{"code": "73592", "type": "CPT"}, {"code": "5113592", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 1761.0, "discounted_cash": 1320.75, "setting": "both", "billing_class": "facility"}]}, {"description": "LOXAPINE 25MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5306783", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 85.0, "discounted_cash": 63.75, "setting": "both", "billing_class": "facility"}]}, {"description": "LOXAPINE 25MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5306783", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 85.0, "discounted_cash": 63.75, "setting": "both", "billing_class": "facility"}]}, {"description": "LP-PLA2 (PLAC)", "code_information": [{"code": "83698", "type": "CPT"}, {"code": "7253643", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 287.0, "discounted_cash": 215.25, "setting": "both", "billing_class": "facility"}]}, {"description": "LUBIPROSTONE 24MCG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5306795", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 76.0, "discounted_cash": 57.0, "setting": "both", "billing_class": "facility"}]}, {"description": "LUBIPROSTONE 24MCG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5306795", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 76.0, "discounted_cash": 57.0, "setting": "both", "billing_class": "facility"}]}, {"description": "LUBIPROSTONE 8MCG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5306794", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 109.0, "discounted_cash": 81.75, "setting": "both", "billing_class": "facility"}]}, {"description": "LUBIPROSTONE 8MCG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5306794", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 109.0, "discounted_cash": 81.75, "setting": "both", "billing_class": "facility"}]}, {"description": "LUMB BENDNG 2 OR 3 VWS", "code_information": [{"code": "72120", "type": "CPT"}, {"code": "4902121", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 2467.0, "discounted_cash": 1850.25, "setting": "both", "billing_class": "facility"}]}, {"description": "LUMB BENDNG 2 OR 3 VWS", "code_information": [{"code": "72120", "type": "CPT"}, {"code": "5112123", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 2624.0, "discounted_cash": 1968.0, "setting": "both", "billing_class": "facility"}]}, {"description": "LUNG PERF PARTICULATE", "code_information": [{"code": "78580", "type": "CPT"}, {"code": "5208580", "type": "CDM"}, {"code": "341", "type": "RC"}], "standard_charges": [{"gross_charge": 3271.0, "discounted_cash": 2453.25, "setting": "both", "billing_class": "facility"}]}, {"description": "LUNG PERF&VENTILAT DIFF", "code_information": [{"code": "78598", "type": "CPT"}, {"code": "5208589", "type": "CDM"}, {"code": "341", "type": "RC"}], "standard_charges": [{"gross_charge": 7312.0, "discounted_cash": 5484.0, "setting": "both", "billing_class": "facility"}]}, {"description": "LUNG VENT&PERF IMAGING", "code_information": [{"code": "78582", "type": "CPT"}, {"code": "5208583", "type": "CDM"}, {"code": "341", "type": "RC"}], "standard_charges": [{"gross_charge": 5356.0, "discounted_cash": 4017.0, "setting": "both", "billing_class": "facility"}]}, {"description": "LUNG VENTILATION IMAGING", "code_information": [{"code": "78579", "type": "CPT"}, {"code": "5208579", "type": "CDM"}, {"code": "341", "type": "RC"}], "standard_charges": [{"gross_charge": 3805.0, "discounted_cash": 2853.75, "setting": "both", "billing_class": "facility"}]}, {"description": "LUNG VOL GAS DIL/WASHOUT", "code_information": [{"code": "94727", "type": "CPT"}, {"code": "5504727", "type": "CDM"}, {"code": "460", "type": "RC"}], "standard_charges": [{"gross_charge": 2354.0, "discounted_cash": 1765.5, "setting": "both", "billing_class": "facility"}]}, {"description": "LURASIDONE 20MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5306797", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 555.0, "discounted_cash": 416.25, "setting": "both", "billing_class": "facility"}]}, {"description": "LURASIDONE 20MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5306797", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 555.0, "discounted_cash": 416.25, "setting": "both", "billing_class": "facility"}]}, {"description": "LURASIDONE 40MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5306798", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 306.0, "discounted_cash": 229.5, "setting": "both", "billing_class": "facility"}]}, {"description": "LURASIDONE 40MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5306798", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 306.0, "discounted_cash": 229.5, "setting": "both", "billing_class": "facility"}]}, {"description": "LURASIDONE 60MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5306796", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 555.0, "discounted_cash": 416.25, "setting": "both", "billing_class": "facility"}]}, {"description": "LURASIDONE 60MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5306796", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 555.0, "discounted_cash": 416.25, "setting": "both", "billing_class": "facility"}]}, {"description": "LUTEINING HORMONE", "code_information": [{"code": "83002", "type": "CPT"}, {"code": "4103002", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 482.0, "discounted_cash": 361.5, "setting": "both", "billing_class": "facility"}]}, {"description": "LUTEINING HORMONE", "code_information": [{"code": "83002", "type": "CPT"}, {"code": "4173002", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 8.56, "discounted_cash": 6.42, "setting": "both", "billing_class": "facility"}]}, {"description": "LUTEINING HORMONE", "code_information": [{"code": "83002", "type": "CPT"}, {"code": "7253002", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 614.0, "discounted_cash": 460.5, "setting": "both", "billing_class": "facility"}]}, {"description": "LUTENIZING RELEASE FACTR", "code_information": [{"code": "83727", "type": "CPT"}, {"code": "7253727", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 443.0, "discounted_cash": 332.25, "setting": "both", "billing_class": "facility"}]}, {"description": "LYME AMP PROBE/2", "code_information": [{"code": "87476", "type": "CPT"}, {"code": "7257136", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 856.0, "discounted_cash": 642.0, "setting": "both", "billing_class": "facility"}]}, {"description": "LYME DISEASE AB", "code_information": [{"code": "86618", "type": "CPT"}, {"code": "4106257", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 1144.0, "discounted_cash": 858.0, "setting": "both", "billing_class": "facility"}]}, {"description": "LYME DISEASE AB", "code_information": [{"code": "86618", "type": "CPT"}, {"code": "7256257", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 83.0, "discounted_cash": 62.25, "setting": "both", "billing_class": "facility"}]}, {"description": "LYME DISEASE AB TEST", "code_information": [{"code": "86617", "type": "CPT"}, {"code": "7250225", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 216.0, "discounted_cash": 162.0, "setting": "both", "billing_class": "facility"}]}, {"description": "LYME DISEASE AB TEST/2", "code_information": [{"code": "86617", "type": "CPT"}, {"code": "7256308", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 110.0, "discounted_cash": 82.5, "setting": "both", "billing_class": "facility"}]}, {"description": "LYME DISEASE AB TEST/6", "code_information": [{"code": "86617", "type": "CPT"}, {"code": "7258617", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 190.0, "discounted_cash": 142.5, "setting": "both", "billing_class": "facility"}]}, {"description": "LYME DISEASE AB/2", "code_information": [{"code": "86618", "type": "CPT"}, {"code": "7256312", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 93.0, "discounted_cash": 69.75, "setting": "both", "billing_class": "facility"}]}, {"description": "LYME DISEASE AB/6", "code_information": [{"code": "86618", "type": "CPT"}, {"code": "7256624", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 65.0, "discounted_cash": 48.75, "setting": "both", "billing_class": "facility"}]}, {"description": "LYMPHATICS & LYMPH NODES", "code_information": [{"code": "78195", "type": "CPT"}, {"code": "5208195", "type": "CDM"}, {"code": "341", "type": "RC"}], "standard_charges": [{"gross_charge": 1960.0, "discounted_cash": 1470.0, "setting": "both", "billing_class": "facility"}]}, {"description": "LYMPHOCYTE TRANSF MITOGN", "code_information": [{"code": "86353", "type": "CPT"}, {"code": "7016357", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 1831.0, "discounted_cash": 1373.25, "setting": "both", "billing_class": "facility"}]}, {"description": "MAG SULF NEO PER 1ML IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5321983", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 92.0, "discounted_cash": 69.0, "setting": "both", "billing_class": "facility"}]}, {"description": "MAG SULF PED PER 1ML IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5321959", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 35.0, "discounted_cash": 26.25, "setting": "both", "billing_class": "facility"}]}, {"description": "MAG SULF PEDI DOSE IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3475", "type": "HCPCS"}, {"code": "5321957", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 113.0, "discounted_cash": 84.75, "setting": "both", "billing_class": "facility"}]}, {"description": "MAG SULF PEDI DOSE IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3475", "type": "HCPCS"}, {"code": "5321957", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 113.0, "discounted_cash": 84.75, "setting": "both", "billing_class": "facility"}]}, {"description": "MAG SULF PER 500MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3475", "type": "HCPCS"}, {"code": "5321953", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 100.0, "discounted_cash": 75.0, "setting": "both", "billing_class": "facility"}]}, {"description": "MAG SULF PER 500MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3475", "type": "HCPCS"}, {"code": "5321953", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 100.0, "discounted_cash": 75.0, "setting": "both", "billing_class": "facility"}]}, {"description": "MAG SULF PER 500MG PFSIJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3475", "type": "HCPCS"}, {"code": "5321954", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 39.0, "discounted_cash": 29.25, "setting": "both", "billing_class": "facility"}]}, {"description": "MAG SULF PER 500MG PFSIJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3475", "type": "HCPCS"}, {"code": "5321954", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 39.0, "discounted_cash": 29.25, "setting": "both", "billing_class": "facility"}]}, {"description": "MAG SULF PER 500MG PMXIJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3475", "type": "HCPCS"}, {"code": "5321956", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 14.0, "discounted_cash": 10.5, "setting": "both", "billing_class": "facility"}]}, {"description": "MAG SULF PER 500MG PMXIJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3475", "type": "HCPCS"}, {"code": "5321956", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 14.0, "discounted_cash": 10.5, "setting": "both", "billing_class": "facility"}]}, {"description": "MAG SULF PER 500MGIVPBIJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3475", "type": "HCPCS"}, {"code": "5321958", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 194.0, "discounted_cash": 145.5, "setting": "both", "billing_class": "facility"}]}, {"description": "MAG SULF PER 500MGIVPBIJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3475", "type": "HCPCS"}, {"code": "5321958", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 194.0, "discounted_cash": 145.5, "setting": "both", "billing_class": "facility"}]}, {"description": "MAGIC MOUTHWASH 1ML LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5315550", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 2.0, "discounted_cash": 1.5, "setting": "both", "billing_class": "facility"}]}, {"description": "MAGIC MOUTHWASH 1ML LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5315550", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 2.0, "discounted_cash": 1.5, "setting": "both", "billing_class": "facility"}]}, {"description": "MAGIC MOUTHWASH CMPD LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5315541", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 680.0, "discounted_cash": 510.0, "setting": "both", "billing_class": "facility"}]}, {"description": "MAGIC MOUTHWASH CMPD LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5315541", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 680.0, "discounted_cash": 510.0, "setting": "both", "billing_class": "facility"}]}, {"description": "MAGNESIUM", "code_information": [{"code": "83735", "type": "CPT"}, {"code": "4103735", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 704.0, "discounted_cash": 528.0, "setting": "both", "billing_class": "facility"}]}, {"description": "MAGNESIUM", "code_information": [{"code": "83735", "type": "CPT"}, {"code": "4173735", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 4.29, "discounted_cash": 3.22, "setting": "both", "billing_class": "facility"}]}, {"description": "MAGNESIUM OXIDE 400MG TB", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5306855", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 71.0, "discounted_cash": 53.25, "setting": "both", "billing_class": "facility"}]}, {"description": "MAGNESIUM OXIDE 400MG TB", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5306855", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 71.0, "discounted_cash": 53.25, "setting": "both", "billing_class": "facility"}]}, {"description": "MAGNESIUM/2", "code_information": [{"code": "83735", "type": "CPT"}, {"code": "7253737", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 256.0, "discounted_cash": 192.0, "setting": "both", "billing_class": "facility"}]}, {"description": "MAGNESIUM/4", "code_information": [{"code": "83735", "type": "CPT"}, {"code": "4103755", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 570.0, "discounted_cash": 427.5, "setting": "both", "billing_class": "facility"}]}, {"description": "MAGNESIUM/4", "code_information": [{"code": "83735", "type": "CPT"}, {"code": "7253755", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 14.0, "discounted_cash": 10.5, "setting": "both", "billing_class": "facility"}]}, {"description": "MAMMARY DUCT/GALACT SNG", "code_information": [{"code": "77053", "type": "CPT"}, {"code": "3070030", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 2139.0, "discounted_cash": 1604.25, "setting": "both", "billing_class": "facility"}]}, {"description": "MANDIBLE 4VW MIN", "code_information": [{"code": "70110", "type": "CPT"}, {"code": "4900110", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 1348.0, "discounted_cash": 1011.0, "setting": "both", "billing_class": "facility"}]}, {"description": "MANDIBLE < 4 VIEWS", "code_information": [{"code": "70100", "type": "CPT"}, {"code": "4900100", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 1497.0, "discounted_cash": 1122.75, "setting": "both", "billing_class": "facility"}]}, {"description": "MANDIBLE < 4 VIEWS", "code_information": [{"code": "70100", "type": "CPT"}, {"code": "5110100", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 2052.0, "discounted_cash": 1539.0, "setting": "both", "billing_class": "facility"}]}, {"description": "MANGANESE", "code_information": [{"code": "83785", "type": "CPT"}, {"code": "7253785", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 877.0, "discounted_cash": 657.75, "setting": "both", "billing_class": "facility"}]}, {"description": "MANNITOL 20% 500ML IVF", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5412585", "type": "CDM"}, {"code": "258", "type": "RC"}], "standard_charges": [{"gross_charge": 1172.0, "discounted_cash": 879.0, "setting": "both", "billing_class": "facility"}]}, {"description": "MANNITOL PER 250MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J2151", "type": "HCPCS"}, {"code": "5321962", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 1.84, "discounted_cash": 1.38, "setting": "both", "billing_class": "facility"}]}, {"description": "MANNITOL PER 250MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J2151", "type": "HCPCS"}, {"code": "5321962", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 1.84, "discounted_cash": 1.38, "setting": "both", "billing_class": "facility"}]}, {"description": "MANUAL BLOOD COUNT", "code_information": [{"code": "85032", "type": "CPT"}, {"code": "4175010", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 533.75, "discounted_cash": 400.31, "setting": "both", "billing_class": "facility"}]}, {"description": "MASS SPEC TNDM MS NES/6", "code_information": [{"code": "83789", "type": "CPT"}, {"code": "7258378", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 300.0, "discounted_cash": 225.0, "setting": "both", "billing_class": "facility"}]}, {"description": "MASTOIDS < 3V/SIDE", "code_information": [{"code": "70120", "type": "CPT"}, {"code": "4900120", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 1761.0, "discounted_cash": 1320.75, "setting": "both", "billing_class": "facility"}]}, {"description": "MASTOIDS < 3V/SIDE", "code_information": [{"code": "70120", "type": "CPT"}, {"code": "5110120", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 1761.0, "discounted_cash": 1320.75, "setting": "both", "billing_class": "facility"}]}, {"description": "MASTOIDS BI 3VWS PR SIDE", "code_information": [{"code": "70130", "type": "CPT"}, {"code": "4900130", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 3027.0, "discounted_cash": 2270.25, "setting": "both", "billing_class": "facility"}]}, {"description": "MASTOIDS BI 3VWS PR SIDE", "code_information": [{"code": "70130", "type": "CPT"}, {"code": "5110130", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 2349.0, "discounted_cash": 1761.75, "setting": "both", "billing_class": "facility"}]}, {"description": "MATRISTEM MICROMATRI 1MG", "code_information": [{"code": "Q4118", "type": "HCPCS"}, {"code": "4023911", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 28.0, "discounted_cash": 21.0, "setting": "both", "billing_class": "facility"}]}, {"description": "MATRISTEM MICROMATRI 1MG", "code_information": [{"code": "Q4118", "type": "HCPCS"}, {"code": "4023911", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 28.0, "discounted_cash": 21.0, "setting": "both", "billing_class": "facility"}]}, {"description": "MATRIX ACELLULAR HUMAN PLACNTL", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3590", "type": "HCPCS"}, {"code": "4023945", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 3790.0, "discounted_cash": 2842.5, "setting": "both", "billing_class": "facility"}]}, {"description": "MATRIX ACELLULAR HUMAN PLACNTL", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3590", "type": "HCPCS"}, {"code": "4023945", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 3790.0, "discounted_cash": 2842.5, "setting": "both", "billing_class": "facility"}]}, {"description": "MATRX BN CELL VIVIGN 5CC", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8132977", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 47285.0, "discounted_cash": 35463.75, "setting": "both", "billing_class": "facility"}]}, {"description": "MATRX COLLAGEN XENMATRIX", "code_information": [{"code": "C1781", "type": "HCPCS"}, {"code": "4023888", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 138795.0, "discounted_cash": 104096.25, "setting": "both", "billing_class": "facility"}]}, {"description": "MATRX NOVO DERML PER SQ CM", "code_information": [{"code": "A2006", "type": "HCPCS"}, {"code": "4023942", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 1242.0, "discounted_cash": 931.5, "setting": "both", "billing_class": "facility"}]}, {"description": "MATRX NOVO DERML PER SQ CM", "code_information": [{"code": "A2006", "type": "HCPCS"}, {"code": "4023942", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 1242.0, "discounted_cash": 931.5, "setting": "both", "billing_class": "facility"}]}, {"description": "MATRX OASIS 3-LYR SQ CM", "code_information": [{"code": "Q4124", "type": "HCPCS"}, {"code": "4023913", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 254.0, "discounted_cash": 190.5, "setting": "both", "billing_class": "facility"}]}, {"description": "MATRX OASIS 3-LYR SQ CM", "code_information": [{"code": "Q4124", "type": "HCPCS"}, {"code": "4023913", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 254.0, "discounted_cash": 190.5, "setting": "both", "billing_class": "facility"}]}, {"description": "MATRX OASIS 3X3.5CM PER SQ CM", "code_information": [{"code": "Q4124", "type": "HCPCS"}, {"code": "4023930", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 162.0, "discounted_cash": 121.5, "setting": "both", "billing_class": "facility"}]}, {"description": "MATRX OASIS 3X3.5CM PER SQ CM", "code_information": [{"code": "Q4124", "type": "HCPCS"}, {"code": "4023930", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 162.0, "discounted_cash": 121.5, "setting": "both", "billing_class": "facility"}]}, {"description": "MATRX TISSUE < 25 SQ CM", "code_information": [{"code": "Q4100", "type": "HCPCS"}, {"code": "4023883", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 690.0, "discounted_cash": 517.5, "setting": "both", "billing_class": "facility"}]}, {"description": "MATRX TISSUE < 25 SQ CM", "code_information": [{"code": "Q4100", "type": "HCPCS"}, {"code": "4023883", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 690.0, "discounted_cash": 517.5, "setting": "both", "billing_class": "facility"}]}, {"description": "MATRX WND ACEL PLST SURG", "code_information": [{"code": "Q4100", "type": "HCPCS"}, {"code": "4023909", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 16763.0, "discounted_cash": 12572.25, "setting": "both", "billing_class": "facility"}]}, {"description": "MATRX WND ACEL PLST SURG", "code_information": [{"code": "Q4100", "type": "HCPCS"}, {"code": "4023909", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 16763.0, "discounted_cash": 12572.25, "setting": "both", "billing_class": "facility"}]}, {"description": "MATRX WND FLOWABLE 1CC", "code_information": [{"code": "Q4114", "type": "HCPCS"}, {"code": "4023910", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 7837.0, "discounted_cash": 5877.75, "setting": "both", "billing_class": "facility"}]}, {"description": "MATRX WND FLOWABLE 1CC", "code_information": [{"code": "Q4114", "type": "HCPCS"}, {"code": "4023910", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 7837.0, "discounted_cash": 5877.75, "setting": "both", "billing_class": "facility"}]}, {"description": "MC PERF SPECT WM EF MULT", "code_information": [{"code": "78452", "type": "CPT"}, {"code": "5204301", "type": "CDM"}, {"code": "341", "type": "RC"}], "standard_charges": [{"gross_charge": 9293.0, "discounted_cash": 6969.75, "setting": "both", "billing_class": "facility"}]}, {"description": "MC PERF SPECT WM EF SNGL", "code_information": [{"code": "78451", "type": "CPT"}, {"code": "5204300", "type": "CDM"}, {"code": "341", "type": "RC"}], "standard_charges": [{"gross_charge": 4372.0, "discounted_cash": 3279.0, "setting": "both", "billing_class": "facility"}]}, {"description": "MCATH DELIVERY LANTERN", "code_information": [{"code": "C1887", "type": "HCPCS"}, {"code": "4033053", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 10356.0, "discounted_cash": 7767.0, "setting": "both", "billing_class": "facility"}]}, {"description": "MCATH DELIVERY VELOCITY", "code_information": [{"code": "C1887", "type": "HCPCS"}, {"code": "4033048", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 12210.0, "discounted_cash": 9157.5, "setting": "both", "billing_class": "facility"}]}, {"description": "MCATH FINECROSS", "code_information": [{"code": "C1887", "type": "HCPCS"}, {"code": "4033046", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 8566.0, "discounted_cash": 6424.5, "setting": "both", "billing_class": "facility"}]}, {"description": "MCATH HEADWAY PRESHAPE", "code_information": [{"code": "C1887", "type": "HCPCS"}, {"code": "8057013", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 16799.0, "discounted_cash": 12599.25, "setting": "both", "billing_class": "facility"}]}, {"description": "MCATH MARATHON", "code_information": [{"code": "C1887", "type": "HCPCS"}, {"code": "8240147", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 6613.0, "discounted_cash": 4959.75, "setting": "both", "billing_class": "facility"}]}, {"description": "MCATH PROWLER PLUS", "code_information": [{"code": "C1887", "type": "HCPCS"}, {"code": "8247775", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 1606.0, "discounted_cash": 1204.5, "setting": "both", "billing_class": "facility"}]}, {"description": "MCATH RENEGADE HI FLO", "code_information": [{"code": "C1887", "type": "HCPCS"}, {"code": "4033041", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 6611.0, "discounted_cash": 4958.25, "setting": "both", "billing_class": "facility"}]}, {"description": "MDI TREATMENT", "code_information": [{"code": "94640", "type": "CPT"}, {"code": "5502105", "type": "CDM"}, {"code": "410", "type": "RC"}], "standard_charges": [{"gross_charge": 820.0, "discounted_cash": 615.0, "setting": "both", "billing_class": "facility"}]}, {"description": "MEASLES/MUMPS/RUB VACCIJ", "code_information": [{"code": "90707", "type": "CPT"}, {"code": "5321992", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 1285.0, "discounted_cash": 963.75, "setting": "both", "billing_class": "facility"}]}, {"description": "MEASLES/MUMPS/RUB VACCIJ", "code_information": [{"code": "90707", "type": "CPT"}, {"code": "5321992", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 1285.0, "discounted_cash": 963.75, "setting": "both", "billing_class": "facility"}]}, {"description": "MECH THRMBCTMY VN RPEAT", "code_information": [{"code": "4617188", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 16425.0, "discounted_cash": 12318.75, "setting": "both", "billing_class": "facility"}]}, {"description": "MECLIZINE 12.5MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5306968", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 61.0, "discounted_cash": 45.75, "setting": "both", "billing_class": "facility"}]}, {"description": "MECLIZINE 12.5MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5306968", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 61.0, "discounted_cash": 45.75, "setting": "both", "billing_class": "facility"}]}, {"description": "MECLIZINE TAB 25MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5306972", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 126.0, "discounted_cash": 94.5, "setting": "both", "billing_class": "facility"}]}, {"description": "MECLIZINE TAB 25MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5306972", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 126.0, "discounted_cash": 94.5, "setting": "both", "billing_class": "facility"}]}, {"description": "MED NUTRTN TH INIT 15MIN", "code_information": [{"code": "97802", "type": "CPT"}, {"code": "6570036", "type": "CDM"}, {"code": "942", "type": "RC"}], "standard_charges": [{"gross_charge": 429.0, "discounted_cash": 321.75, "setting": "both", "billing_class": "facility"}]}, {"description": "MED NUTRTN TH INIT 15MIN", "code_information": [{"code": "97802", "type": "CPT"}, {"code": "6807802", "type": "CDM"}, {"code": "942", "type": "RC"}], "standard_charges": [{"gross_charge": 519.0, "discounted_cash": 389.25, "setting": "both", "billing_class": "facility"}]}, {"description": "MED NUTRTN TH REEVAL15MN", "code_information": [{"code": "97803", "type": "CPT"}, {"code": "6807803", "type": "CDM"}, {"code": "942", "type": "RC"}], "standard_charges": [{"gross_charge": 231.0, "discounted_cash": 173.25, "setting": "both", "billing_class": "facility"}]}, {"description": "MED/SURG WITH TELEMETRY", "code_information": [{"code": "1990008", "type": "CDM"}, {"code": "206", "type": "RC"}], "standard_charges": [{"gross_charge": 7376.0, "discounted_cash": 5532.0, "setting": "both", "billing_class": "facility"}]}, {"description": "MED/SURG WITH TELEMETRY", "code_information": [{"code": "2300008", "type": "CDM"}, {"code": "206", "type": "RC"}], "standard_charges": [{"gross_charge": 7376.0, "discounted_cash": 5532.0, "setting": "both", "billing_class": "facility"}]}, {"description": "MED/SURG WITH TELEMETRY", "code_information": [{"code": "2310008", "type": "CDM"}, {"code": "206", "type": "RC"}], "standard_charges": [{"gross_charge": 7376.0, "discounted_cash": 5532.0, "setting": "both", "billing_class": "facility"}]}, {"description": "MEDROXYPROGEST 10MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5307026", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 78.0, "discounted_cash": 58.5, "setting": "both", "billing_class": "facility"}]}, {"description": "MEDROXYPROGEST 10MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5307026", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 78.0, "discounted_cash": 58.5, "setting": "both", "billing_class": "facility"}]}, {"description": "MEDROXYPROGEST 2.5MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5307022", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 66.0, "discounted_cash": 49.5, "setting": "both", "billing_class": "facility"}]}, {"description": "MEDROXYPROGEST 2.5MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5307022", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 66.0, "discounted_cash": 49.5, "setting": "both", "billing_class": "facility"}]}, {"description": "MEDROXYPROGEST PER 1MGIJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J1050", "type": "HCPCS"}, {"code": "5322021", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 12.0, "discounted_cash": 9.0, "setting": "both", "billing_class": "facility"}]}, {"description": "MEDROXYPROGEST PER 1MGIJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J1050", "type": "HCPCS"}, {"code": "5322021", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 12.0, "discounted_cash": 9.0, "setting": "both", "billing_class": "facility"}]}, {"description": "MEGESTROL 40MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5307076", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 61.0, "discounted_cash": 45.75, "setting": "both", "billing_class": "facility"}]}, {"description": "MEGESTROL 40MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5307076", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 61.0, "discounted_cash": 45.75, "setting": "both", "billing_class": "facility"}]}, {"description": "MEGESTROL40MG/ML 10ML LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8999", "type": "HCPCS"}, {"code": "5315568", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 108.0, "discounted_cash": 81.0, "setting": "both", "billing_class": "facility"}]}, {"description": "MEGESTROL40MG/ML 10ML LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8999", "type": "HCPCS"}, {"code": "5315568", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 108.0, "discounted_cash": 81.0, "setting": "both", "billing_class": "facility"}]}, {"description": "MELOXICAM 7.5MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5307095", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 99.0, "discounted_cash": 74.25, "setting": "both", "billing_class": "facility"}]}, {"description": "MELOXICAM 7.5MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5307095", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 99.0, "discounted_cash": 74.25, "setting": "both", "billing_class": "facility"}]}, {"description": "MEMANTINE 5MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5307110", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 124.0, "discounted_cash": 93.0, "setting": "both", "billing_class": "facility"}]}, {"description": "MEMANTINE 5MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5307110", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 124.0, "discounted_cash": 93.0, "setting": "both", "billing_class": "facility"}]}, {"description": "MEMBRANE SURGICAL", "code_information": [{"code": "8143458", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 21197.0, "discounted_cash": 15897.75, "setting": "both", "billing_class": "facility"}]}, {"description": "MENINGO VAC IM RCMB LIPO PFSIJ", "code_information": [{"code": "90621", "type": "CPT"}, {"code": "5322054", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 2288.0, "discounted_cash": 1716.0, "setting": "both", "billing_class": "facility"}]}, {"description": "MENINGO VAC IM RCMB LIPO PFSIJ", "code_information": [{"code": "90621", "type": "CPT"}, {"code": "5322054", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 2288.0, "discounted_cash": 1716.0, "setting": "both", "billing_class": "facility"}]}, {"description": "MENINGOCOCCAL VAC IM IJ", "code_information": [{"code": "90734", "type": "CPT"}, {"code": "5322059", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 8170.0, "discounted_cash": 6127.5, "setting": "both", "billing_class": "facility"}]}, {"description": "MENINGOCOCCAL VAC IM IJ", "code_information": [{"code": "90734", "type": "CPT"}, {"code": "5322059", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 8170.0, "discounted_cash": 6127.5, "setting": "both", "billing_class": "facility"}]}, {"description": "MENINGOCOCCAL VAC SQ IJ", "code_information": [{"code": "90733", "type": "CPT"}, {"code": "5322058", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 2591.0, "discounted_cash": 1943.25, "setting": "both", "billing_class": "facility"}]}, {"description": "MENINGOCOCCAL VAC SQ IJ", "code_information": [{"code": "90733", "type": "CPT"}, {"code": "5322058", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 2591.0, "discounted_cash": 1943.25, "setting": "both", "billing_class": "facility"}]}, {"description": "MENINGOOCCAL-TT VAC IM IJ", "code_information": [{"code": "90619", "type": "CPT"}, {"code": "5322065", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 1865.0, "discounted_cash": 1398.75, "setting": "both", "billing_class": "facility"}]}, {"description": "MENINGOOCCAL-TT VAC IM IJ", "code_information": [{"code": "90619", "type": "CPT"}, {"code": "5322065", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 1865.0, "discounted_cash": 1398.75, "setting": "both", "billing_class": "facility"}]}, {"description": "MENTHOL/PHENOL LZ", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5302181", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 11.0, "discounted_cash": 8.25, "setting": "both", "billing_class": "facility"}]}, {"description": "MENTHOL/PHENOL LZ", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5302181", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 11.0, "discounted_cash": 8.25, "setting": "both", "billing_class": "facility"}]}, {"description": "MEPERIDINE 25MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5327650", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 113.0, "discounted_cash": 84.75, "setting": "both", "billing_class": "facility"}]}, {"description": "MEPERIDINE 50MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J2175", "type": "HCPCS"}, {"code": "5327621", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 113.0, "discounted_cash": 84.75, "setting": "both", "billing_class": "facility"}]}, {"description": "MEPERIDINE 50MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J2175", "type": "HCPCS"}, {"code": "5327621", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 113.0, "discounted_cash": 84.75, "setting": "both", "billing_class": "facility"}]}, {"description": "MEPERIDINE PER 100MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J2175", "type": "HCPCS"}, {"code": "5327637", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 113.0, "discounted_cash": 84.75, "setting": "both", "billing_class": "facility"}]}, {"description": "MEPERIDINE PER 100MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J2175", "type": "HCPCS"}, {"code": "5327637", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 113.0, "discounted_cash": 84.75, "setting": "both", "billing_class": "facility"}]}, {"description": "MEPERIDINE PER 100MG PCA", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J2175", "type": "HCPCS"}, {"code": "5327647", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 97.0, "discounted_cash": 72.75, "setting": "both", "billing_class": "facility"}]}, {"description": "MEPERIDINE PER 100MG PCA", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J2175", "type": "HCPCS"}, {"code": "5327647", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 97.0, "discounted_cash": 72.75, "setting": "both", "billing_class": "facility"}]}, {"description": "MEPIVACAIN 1% PER10ML IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0670", "type": "HCPCS"}, {"code": "5322101", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 110.0, "discounted_cash": 82.5, "setting": "both", "billing_class": "facility"}]}, {"description": "MEPIVACAIN 1% PER10ML IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0670", "type": "HCPCS"}, {"code": "5322101", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 110.0, "discounted_cash": 82.5, "setting": "both", "billing_class": "facility"}]}, {"description": "MEPIVACAIN 2% PER10ML IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0670", "type": "HCPCS"}, {"code": "5322100", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 201.0, "discounted_cash": 150.75, "setting": "both", "billing_class": "facility"}]}, {"description": "MEPIVACAIN 2% PER10ML IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0670", "type": "HCPCS"}, {"code": "5322100", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 201.0, "discounted_cash": 150.75, "setting": "both", "billing_class": "facility"}]}, {"description": "MEPIVACAINE1.5%PER10MLIJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0670", "type": "HCPCS"}, {"code": "5322099", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 146.0, "discounted_cash": 109.5, "setting": "both", "billing_class": "facility"}]}, {"description": "MEPIVACAINE1.5%PER10MLIJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0670", "type": "HCPCS"}, {"code": "5322099", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 146.0, "discounted_cash": 109.5, "setting": "both", "billing_class": "facility"}]}, {"description": "MERCURY QUANTITATIVE", "code_information": [{"code": "83825", "type": "CPT"}, {"code": "7253825", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 22.0, "discounted_cash": 16.5, "setting": "both", "billing_class": "facility"}]}, {"description": "MERCURY QUANTITATIVE/6", "code_information": [{"code": "83825", "type": "CPT"}, {"code": "7253830", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 50.0, "discounted_cash": 37.5, "setting": "both", "billing_class": "facility"}]}, {"description": "MEROPEN/VABORBACT 10MG/10MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J2186", "type": "HCPCS"}, {"code": "5322125", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 11.0, "discounted_cash": 8.25, "setting": "both", "billing_class": "facility"}]}, {"description": "MEROPEN/VABORBACT 10MG/10MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J2186", "type": "HCPCS"}, {"code": "5322125", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 11.0, "discounted_cash": 8.25, "setting": "both", "billing_class": "facility"}]}, {"description": "MEROPENEM PER 100MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J2185", "type": "HCPCS"}, {"code": "5322116", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 230.0, "discounted_cash": 172.5, "setting": "both", "billing_class": "facility"}]}, {"description": "MEROPENEM PER 100MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J2185", "type": "HCPCS"}, {"code": "5322116", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 230.0, "discounted_cash": 172.5, "setting": "both", "billing_class": "facility"}]}, {"description": "MESALAMINE 1.2GM EC TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5307282", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 181.0, "discounted_cash": 135.75, "setting": "both", "billing_class": "facility"}]}, {"description": "MESALAMINE 1.2GM EC TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5307282", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 181.0, "discounted_cash": 135.75, "setting": "both", "billing_class": "facility"}]}, {"description": "MESALAMINE 1000MG SU", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5338512", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 532.0, "discounted_cash": 399.0, "setting": "both", "billing_class": "facility"}]}, {"description": "MESALAMINE 1000MG SU", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5338512", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 532.0, "discounted_cash": 399.0, "setting": "both", "billing_class": "facility"}]}, {"description": "MESALAMINE 400MG EC TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5307280", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 86.0, "discounted_cash": 64.5, "setting": "both", "billing_class": "facility"}]}, {"description": "MESALAMINE 400MG EC TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5307280", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 86.0, "discounted_cash": 64.5, "setting": "both", "billing_class": "facility"}]}, {"description": "MESALAMINE 800MG XR TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5307284", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 144.0, "discounted_cash": 108.0, "setting": "both", "billing_class": "facility"}]}, {"description": "MESALAMINE 800MG XR TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5307284", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 144.0, "discounted_cash": 108.0, "setting": "both", "billing_class": "facility"}]}, {"description": "MESH 3D MAX MID ANATOMICAL", "code_information": [{"code": "C1781", "type": "HCPCS"}, {"code": "4021511", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 4259.0, "discounted_cash": 3194.25, "setting": "both", "billing_class": "facility"}]}, {"description": "MESH BARD 3DMAX LG", "code_information": [{"code": "C1781", "type": "HCPCS"}, {"code": "8242076", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 4344.0, "discounted_cash": 3258.0, "setting": "both", "billing_class": "facility"}]}, {"description": "MESH BARD 3DMAX MED", "code_information": [{"code": "C1781", "type": "HCPCS"}, {"code": "8242078", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 3332.0, "discounted_cash": 2499.0, "setting": "both", "billing_class": "facility"}]}, {"description": "MESH COMPOSIX E/X 10X13", "code_information": [{"code": "C1781", "type": "HCPCS"}, {"code": "8242094", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 22159.0, "discounted_cash": 16619.25, "setting": "both", "billing_class": "facility"}]}, {"description": "MESH COMPOSIX E/X 4X6", "code_information": [{"code": "C1781", "type": "HCPCS"}, {"code": "8242090", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 6020.0, "discounted_cash": 4515.0, "setting": "both", "billing_class": "facility"}]}, {"description": "MESH GENTRIX HIATAL", "code_information": [{"code": "C1763", "type": "HCPCS"}, {"code": "4024221", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 15129.0, "discounted_cash": 11346.75, "setting": "both", "billing_class": "facility"}]}, {"description": "MESH GRTX DUAL 884CM1OVL", "code_information": [{"code": "C1781", "type": "HCPCS"}, {"code": "8242110", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 29816.0, "discounted_cash": 22362.0, "setting": "both", "billing_class": "facility"}]}, {"description": "MESH GRTX DUAL+150CM1OVL", "code_information": [{"code": "C1781", "type": "HCPCS"}, {"code": "8242114", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 8549.0, "discounted_cash": 6411.75, "setting": "both", "billing_class": "facility"}]}, {"description": "MESH GRTX DUAL+285CM1OVL", "code_information": [{"code": "C1781", "type": "HCPCS"}, {"code": "8242118", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 17000.0, "discounted_cash": 12750.0, "setting": "both", "billing_class": "facility"}]}, {"description": "MESH H BARD COMPOSIX E/X", "code_information": [{"code": "C1781", "type": "HCPCS"}, {"code": "8247825", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 11660.0, "discounted_cash": 8745.0, "setting": "both", "billing_class": "facility"}]}, {"description": "MESH H PTCH BARDK SO8X12", "code_information": [{"code": "C1781", "type": "HCPCS"}, {"code": "8247848", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 8609.0, "discounted_cash": 6456.75, "setting": "both", "billing_class": "facility"}]}, {"description": "MESH HERNIA", "code_information": [{"code": "C1781", "type": "HCPCS"}, {"code": "4024078", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 9431.0, "discounted_cash": 7073.25, "setting": "both", "billing_class": "facility"}]}, {"description": "MESH HERNIA COMPOSIX 18", "code_information": [{"code": "C1781", "type": "HCPCS"}, {"code": "8242086", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 891.0, "discounted_cash": 668.25, "setting": "both", "billing_class": "facility"}]}, {"description": "MESH HERNIA VENT", "code_information": [{"code": "C1781", "type": "HCPCS"}, {"code": "8153510", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 14750.0, "discounted_cash": 11062.5, "setting": "both", "billing_class": "facility"}]}, {"description": "MESH HERNIA VENT 2", "code_information": [{"code": "C1781", "type": "HCPCS"}, {"code": "8153511", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 6105.0, "discounted_cash": 4578.75, "setting": "both", "billing_class": "facility"}]}, {"description": "MESH PANEL SM GRID RESRB", "code_information": [{"code": "C1781", "type": "HCPCS"}, {"code": "4024181", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 14573.0, "discounted_cash": 10929.75, "setting": "both", "billing_class": "facility"}]}, {"description": "MESH POLYPRO 10X14", "code_information": [{"code": "C1781", "type": "HCPCS"}, {"code": "4024194", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 2066.0, "discounted_cash": 1549.5, "setting": "both", "billing_class": "facility"}]}, {"description": "MESH POLYPRO FLAT 3X6", "code_information": [{"code": "C1781", "type": "HCPCS"}, {"code": "4024191", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 1354.0, "discounted_cash": 1015.5, "setting": "both", "billing_class": "facility"}]}, {"description": "MESH POLYPRO KEYHOLE", "code_information": [{"code": "C1781", "type": "HCPCS"}, {"code": "4024193", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 1223.0, "discounted_cash": 917.25, "setting": "both", "billing_class": "facility"}]}, {"description": "MESH PROCEED 15X20", "code_information": [{"code": "C1781", "type": "HCPCS"}, {"code": "4024207", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 17280.0, "discounted_cash": 12960.0, "setting": "both", "billing_class": "facility"}]}, {"description": "MESH PROCEED 20X30", "code_information": [{"code": "C1781", "type": "HCPCS"}, {"code": "4024208", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 30497.0, "discounted_cash": 22872.75, "setting": "both", "billing_class": "facility"}]}, {"description": "MESH PROCEED 4X6", "code_information": [{"code": "C1781", "type": "HCPCS"}, {"code": "4024202", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 11033.0, "discounted_cash": 8274.75, "setting": "both", "billing_class": "facility"}]}, {"description": "MESH PROLENE SOFT", "code_information": [{"code": "C1781", "type": "HCPCS"}, {"code": "8247865", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 3856.0, "discounted_cash": 2892.0, "setting": "both", "billing_class": "facility"}]}, {"description": "MESH SOFT TIS FULL RESRB", "code_information": [{"code": "C1781", "type": "HCPCS"}, {"code": "4024215", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 29322.0, "discounted_cash": 21991.5, "setting": "both", "billing_class": "facility"}]}, {"description": "MESH VICRYL", "code_information": [{"code": "C1781", "type": "HCPCS"}, {"code": "8142108", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 11982.0, "discounted_cash": 8986.5, "setting": "both", "billing_class": "facility"}]}, {"description": "METANEPHRINES", "code_information": [{"code": "83835", "type": "CPT"}, {"code": "7253836", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 694.0, "discounted_cash": 520.5, "setting": "both", "billing_class": "facility"}]}, {"description": "METANEPHRINES/2", "code_information": [{"code": "83835", "type": "CPT"}, {"code": "7253837", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 755.0, "discounted_cash": 566.25, "setting": "both", "billing_class": "facility"}]}, {"description": "METANEPHRINES/3", "code_information": [{"code": "83835", "type": "CPT"}, {"code": "7253838", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 201.0, "discounted_cash": 150.75, "setting": "both", "billing_class": "facility"}]}, {"description": "METFORMIN", "code_information": [{"code": "80375", "type": "CPT"}, {"code": "7252558", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 450.0, "discounted_cash": 337.5, "setting": "both", "billing_class": "facility"}]}, {"description": "METFORMIN 500MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5307360", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 71.0, "discounted_cash": 53.25, "setting": "both", "billing_class": "facility"}]}, {"description": "METFORMIN 500MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5307360", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 71.0, "discounted_cash": 53.25, "setting": "both", "billing_class": "facility"}]}, {"description": "METFORMIN 500MG XR TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5307362", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 63.0, "discounted_cash": 47.25, "setting": "both", "billing_class": "facility"}]}, {"description": "METFORMIN 500MG XR TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5307362", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 63.0, "discounted_cash": 47.25, "setting": "both", "billing_class": "facility"}]}, {"description": "METFORMIN 850MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5307361", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 66.0, "discounted_cash": 49.5, "setting": "both", "billing_class": "facility"}]}, {"description": "METFORMIN 850MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5307361", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 66.0, "discounted_cash": 49.5, "setting": "both", "billing_class": "facility"}]}, {"description": "METHADONE 10MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5327670", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 77.0, "discounted_cash": 57.75, "setting": "both", "billing_class": "facility"}]}, {"description": "METHADONE 10MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5327670", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 77.0, "discounted_cash": 57.75, "setting": "both", "billing_class": "facility"}]}, {"description": "METHADONE QUANT/2", "code_information": [{"code": "80358", "type": "CPT"}, {"code": "7253840", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 130.0, "discounted_cash": 97.5, "setting": "both", "billing_class": "facility"}]}, {"description": "METHAZOLAMIDE 50MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5307399", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 83.0, "discounted_cash": 62.25, "setting": "both", "billing_class": "facility"}]}, {"description": "METHAZOLAMIDE 50MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5307399", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 83.0, "discounted_cash": 62.25, "setting": "both", "billing_class": "facility"}]}, {"description": "METHIMAZOLE 5MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5307505", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 66.0, "discounted_cash": 49.5, "setting": "both", "billing_class": "facility"}]}, {"description": "METHIMAZOLE 5MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5307505", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 66.0, "discounted_cash": 49.5, "setting": "both", "billing_class": "facility"}]}, {"description": "METHOCARBAMOL 500MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5307530", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 66.0, "discounted_cash": 49.5, "setting": "both", "billing_class": "facility"}]}, {"description": "METHOCARBAMOL 500MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5307530", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 66.0, "discounted_cash": 49.5, "setting": "both", "billing_class": "facility"}]}, {"description": "METHOCARBAMOL UPTO10MLIJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J2800", "type": "HCPCS"}, {"code": "5322185", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 1836.0, "discounted_cash": 1377.0, "setting": "both", "billing_class": "facility"}]}, {"description": "METHOCARBAMOL UPTO10MLIJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J2800", "type": "HCPCS"}, {"code": "5322185", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 1836.0, "discounted_cash": 1377.0, "setting": "both", "billing_class": "facility"}]}, {"description": "METHOTREXATE 2.5MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8610", "type": "HCPCS"}, {"code": "5307561", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 109.0, "discounted_cash": 81.75, "setting": "both", "billing_class": "facility"}]}, {"description": "METHOTREXATE 2.5MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8610", "type": "HCPCS"}, {"code": "5307561", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 109.0, "discounted_cash": 81.75, "setting": "both", "billing_class": "facility"}]}, {"description": "METHOTREXATE PER 50MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J9260", "type": "HCPCS"}, {"code": "5318089", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 261.0, "discounted_cash": 195.75, "setting": "both", "billing_class": "facility"}]}, {"description": "METHOTREXATE PER 50MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J9260", "type": "HCPCS"}, {"code": "5318089", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 261.0, "discounted_cash": 195.75, "setting": "both", "billing_class": "facility"}]}, {"description": "METHOTREXATE QUANT", "code_information": [{"code": "80204", "type": "CPT"}, {"code": "7250378", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 77.0, "discounted_cash": 57.75, "setting": "both", "billing_class": "facility"}]}, {"description": "METHYL SAL MENTH 57GM CR", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5336473", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 72.0, "discounted_cash": 54.0, "setting": "both", "billing_class": "facility"}]}, {"description": "METHYL SAL MENTH 57GM CR", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5336473", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 72.0, "discounted_cash": 54.0, "setting": "both", "billing_class": "facility"}]}, {"description": "METHYL SALICY 90GM CR", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5336215", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 61.0, "discounted_cash": 45.75, "setting": "both", "billing_class": "facility"}]}, {"description": "METHYL SALICY 90GM CR", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5336215", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 61.0, "discounted_cash": 45.75, "setting": "both", "billing_class": "facility"}]}, {"description": "METHYLDOPA 250MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5307588", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 71.0, "discounted_cash": 53.25, "setting": "both", "billing_class": "facility"}]}, {"description": "METHYLDOPA 250MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5307588", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 71.0, "discounted_cash": 53.25, "setting": "both", "billing_class": "facility"}]}, {"description": "METHYLEN BLUE PER 1MG IJ", "code_information": [{"code": "Q9968", "type": "HCPCS"}, {"code": "5358207", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 405.0, "discounted_cash": 303.75, "setting": "both", "billing_class": "facility"}]}, {"description": "METHYLEN BLUE PER 1MG IJ", "code_information": [{"code": "Q9968", "type": "HCPCS"}, {"code": "5358207", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 405.0, "discounted_cash": 303.75, "setting": "both", "billing_class": "facility"}]}, {"description": "METHYLERGONOV UPTO.2MGIJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J2210", "type": "HCPCS"}, {"code": "5322269", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 412.0, "discounted_cash": 309.0, "setting": "both", "billing_class": "facility"}]}, {"description": "METHYLERGONOV UPTO.2MGIJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J2210", "type": "HCPCS"}, {"code": "5322269", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 412.0, "discounted_cash": 309.0, "setting": "both", "billing_class": "facility"}]}, {"description": "METHYLERGONOVIN .2MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5307631", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 149.0, "discounted_cash": 111.75, "setting": "both", "billing_class": "facility"}]}, {"description": "METHYLERGONOVIN .2MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5307631", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 149.0, "discounted_cash": 111.75, "setting": "both", "billing_class": "facility"}]}, {"description": "METHYLNALTREXONE 0.1MGIJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J2212", "type": "HCPCS"}, {"code": "5322276", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 17.0, "discounted_cash": 12.75, "setting": "both", "billing_class": "facility"}]}, {"description": "METHYLNALTREXONE 0.1MGIJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J2212", "type": "HCPCS"}, {"code": "5322276", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 17.0, "discounted_cash": 12.75, "setting": "both", "billing_class": "facility"}]}, {"description": "METHYLPHENIDATE 5MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5327695", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 61.0, "discounted_cash": 45.75, "setting": "both", "billing_class": "facility"}]}, {"description": "METHYLPHENIDATE 5MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5327695", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 61.0, "discounted_cash": 45.75, "setting": "both", "billing_class": "facility"}]}, {"description": "METHYLPHENIDATE QUANT", "code_information": [{"code": "80360", "type": "CPT"}, {"code": "7253856", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 60.0, "discounted_cash": 45.0, "setting": "both", "billing_class": "facility"}]}, {"description": "METHYLPRED 4MG 21 PK TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5307662", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 249.0, "discounted_cash": 186.75, "setting": "both", "billing_class": "facility"}]}, {"description": "METHYLPRED 4MG 21 PK TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5307662", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 249.0, "discounted_cash": 186.75, "setting": "both", "billing_class": "facility"}]}, {"description": "METHYLPRED 4MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5307658", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 65.0, "discounted_cash": 48.75, "setting": "both", "billing_class": "facility"}]}, {"description": "METHYLPRED 4MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5307658", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 65.0, "discounted_cash": 48.75, "setting": "both", "billing_class": "facility"}]}, {"description": "METHYLPRED A PER 1MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J1010", "type": "HCPCS"}, {"code": "5322296", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 5.0, "discounted_cash": 3.75, "setting": "both", "billing_class": "facility"}]}, {"description": "METHYLPRED A PER 1MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J1010", "type": "HCPCS"}, {"code": "5322296", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 5.0, "discounted_cash": 3.75, "setting": "both", "billing_class": "facility"}]}, {"description": "METHYLPRED SS PER 5MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J2919", "type": "HCPCS"}, {"code": "5322313", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 15.0, "discounted_cash": 11.25, "setting": "both", "billing_class": "facility"}]}, {"description": "METHYLPRED SS PER 5MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J2919", "type": "HCPCS"}, {"code": "5322313", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 15.0, "discounted_cash": 11.25, "setting": "both", "billing_class": "facility"}]}, {"description": "METOCLOPRAM NEO CMPD IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5322367", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 131.0, "discounted_cash": 98.25, "setting": "both", "billing_class": "facility"}]}, {"description": "METOCLOPRAM UPTO10MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J2765", "type": "HCPCS"}, {"code": "5322366", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 130.0, "discounted_cash": 97.5, "setting": "both", "billing_class": "facility"}]}, {"description": "METOCLOPRAM UPTO10MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J2765", "type": "HCPCS"}, {"code": "5322366", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 130.0, "discounted_cash": 97.5, "setting": "both", "billing_class": "facility"}]}, {"description": "METOCLOPRAM5/5 10ML LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5315668", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 61.0, "discounted_cash": 45.75, "setting": "both", "billing_class": "facility"}]}, {"description": "METOCLOPRAM5/5 10ML LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5315668", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 61.0, "discounted_cash": 45.75, "setting": "both", "billing_class": "facility"}]}, {"description": "METOCLOPRAMIDE 10MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5307731", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 68.0, "discounted_cash": 51.0, "setting": "both", "billing_class": "facility"}]}, {"description": "METOCLOPRAMIDE 10MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5307731", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 68.0, "discounted_cash": 51.0, "setting": "both", "billing_class": "facility"}]}, {"description": "METOLAZONE 2.5MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5307758", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 61.0, "discounted_cash": 45.75, "setting": "both", "billing_class": "facility"}]}, {"description": "METOLAZONE 2.5MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5307758", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 61.0, "discounted_cash": 45.75, "setting": "both", "billing_class": "facility"}]}, {"description": "METOLAZONE 5MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5307762", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 61.0, "discounted_cash": 45.75, "setting": "both", "billing_class": "facility"}]}, {"description": "METOLAZONE 5MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5307762", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 61.0, "discounted_cash": 45.75, "setting": "both", "billing_class": "facility"}]}, {"description": "METOPROLOL 100MG XR TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5307787", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 61.0, "discounted_cash": 45.75, "setting": "both", "billing_class": "facility"}]}, {"description": "METOPROLOL 100MG XR TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5307787", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 61.0, "discounted_cash": 45.75, "setting": "both", "billing_class": "facility"}]}, {"description": "METOPROLOL 12.5MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5307788", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 53.0, "discounted_cash": 39.75, "setting": "both", "billing_class": "facility"}]}, {"description": "METOPROLOL 12.5MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5307788", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 53.0, "discounted_cash": 39.75, "setting": "both", "billing_class": "facility"}]}, {"description": "METOPROLOL 25MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5307791", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 85.0, "discounted_cash": 63.75, "setting": "both", "billing_class": "facility"}]}, {"description": "METOPROLOL 25MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5307791", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 85.0, "discounted_cash": 63.75, "setting": "both", "billing_class": "facility"}]}, {"description": "METOPROLOL 25MG XR TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5307792", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 71.0, "discounted_cash": 53.25, "setting": "both", "billing_class": "facility"}]}, {"description": "METOPROLOL 25MG XR TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5307792", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 71.0, "discounted_cash": 53.25, "setting": "both", "billing_class": "facility"}]}, {"description": "METOPROLOL 50MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5307785", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 71.0, "discounted_cash": 53.25, "setting": "both", "billing_class": "facility"}]}, {"description": "METOPROLOL 50MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5307785", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 71.0, "discounted_cash": 53.25, "setting": "both", "billing_class": "facility"}]}, {"description": "METOPROLOL 50MG XR TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5307786", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 78.0, "discounted_cash": 58.5, "setting": "both", "billing_class": "facility"}]}, {"description": "METOPROLOL 50MG XR TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5307786", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 78.0, "discounted_cash": 58.5, "setting": "both", "billing_class": "facility"}]}, {"description": "METOPROLOL PER 1MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0616", "type": "HCPCS"}, {"code": "5322380", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 20.0, "discounted_cash": 15.0, "setting": "both", "billing_class": "facility"}]}, {"description": "METOPROLOL PER 1MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0616", "type": "HCPCS"}, {"code": "5322380", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 20.0, "discounted_cash": 15.0, "setting": "both", "billing_class": "facility"}]}, {"description": "METRONIDAZOL CMPD 1ML LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5315679", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 97.0, "discounted_cash": 72.75, "setting": "both", "billing_class": "facility"}]}, {"description": "METRONIDAZOL CMPD 1ML LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5315679", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 97.0, "discounted_cash": 72.75, "setting": "both", "billing_class": "facility"}]}, {"description": "METRONIDAZOLE 250MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5307812", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 61.0, "discounted_cash": 45.75, "setting": "both", "billing_class": "facility"}]}, {"description": "METRONIDAZOLE 250MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5307812", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 61.0, "discounted_cash": 45.75, "setting": "both", "billing_class": "facility"}]}, {"description": "METRONIDAZOLE 500MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5307815", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 77.0, "discounted_cash": 57.75, "setting": "both", "billing_class": "facility"}]}, {"description": "METRONIDAZOLE 500MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5307815", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 77.0, "discounted_cash": 57.75, "setting": "both", "billing_class": "facility"}]}, {"description": "METRONIDAZOLE PED IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5322384", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 3.0, "discounted_cash": 2.25, "setting": "both", "billing_class": "facility"}]}, {"description": "METRONIDAZOLE PER 10MG PMX IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J1836", "type": "HCPCS"}, {"code": "5322390", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 5.0, "discounted_cash": 3.75, "setting": "both", "billing_class": "facility"}]}, {"description": "METRONIDAZOLE PER 10MG PMX IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J1836", "type": "HCPCS"}, {"code": "5322390", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 5.0, "discounted_cash": 3.75, "setting": "both", "billing_class": "facility"}]}, {"description": "METRONIDAZOLE.75%45GM GL", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5336562", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 2064.0, "discounted_cash": 1548.0, "setting": "both", "billing_class": "facility"}]}, {"description": "METRONIDAZOLE.75%45GM GL", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5336562", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 2064.0, "discounted_cash": 1548.0, "setting": "both", "billing_class": "facility"}]}, {"description": "METRONIDAZOLE.75%70GMVGL", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5336560", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 1006.0, "discounted_cash": 754.5, "setting": "both", "billing_class": "facility"}]}, {"description": "METRONIDAZOLE.75%70GMVGL", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5336560", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 1006.0, "discounted_cash": 754.5, "setting": "both", "billing_class": "facility"}]}, {"description": "MEXILETINE 150MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5307836", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 71.0, "discounted_cash": 53.25, "setting": "both", "billing_class": "facility"}]}, {"description": "MEXILETINE 150MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5307836", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 71.0, "discounted_cash": 53.25, "setting": "both", "billing_class": "facility"}]}, {"description": "MEXILETINE/2", "code_information": [{"code": "80375", "type": "CPT"}, {"code": "7258309", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 118.0, "discounted_cash": 88.5, "setting": "both", "billing_class": "facility"}]}, {"description": "MG CL 64MG XR TB", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5306832", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 78.0, "discounted_cash": 58.5, "setting": "both", "billing_class": "facility"}]}, {"description": "MG CL 64MG XR TB", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5306832", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 78.0, "discounted_cash": 58.5, "setting": "both", "billing_class": "facility"}]}, {"description": "MG OH 8% 30ML LQ", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5315742", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 95.0, "discounted_cash": 71.25, "setting": "both", "billing_class": "facility"}]}, {"description": "MG OH 8% 30ML LQ", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5315742", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 95.0, "discounted_cash": 71.25, "setting": "both", "billing_class": "facility"}]}, {"description": "MICAFUNGIN PER 1MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J2248", "type": "HCPCS"}, {"code": "5322409", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 29.0, "discounted_cash": 21.75, "setting": "both", "billing_class": "facility"}]}, {"description": "MICAFUNGIN PER 1MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J2248", "type": "HCPCS"}, {"code": "5322409", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 29.0, "discounted_cash": 21.75, "setting": "both", "billing_class": "facility"}]}, {"description": "MICONAZOLE 100MG 7PK VSU", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5336580", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 152.0, "discounted_cash": 114.0, "setting": "both", "billing_class": "facility"}]}, {"description": "MICONAZOLE 100MG 7PK VSU", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5336580", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 152.0, "discounted_cash": 114.0, "setting": "both", "billing_class": "facility"}]}, {"description": "MICONAZOLE 100MG EA VSU", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5336579", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 149.0, "discounted_cash": 111.75, "setting": "both", "billing_class": "facility"}]}, {"description": "MICONAZOLE 100MG EA VSU", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5336579", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 149.0, "discounted_cash": 111.75, "setting": "both", "billing_class": "facility"}]}, {"description": "MICONAZOLE 2% 15GM CR", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5336593", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 124.0, "discounted_cash": 93.0, "setting": "both", "billing_class": "facility"}]}, {"description": "MICONAZOLE 2% 15GM CR", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5336593", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 124.0, "discounted_cash": 93.0, "setting": "both", "billing_class": "facility"}]}, {"description": "MICONAZOLE 2% 45GM VCR", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5336595", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 130.0, "discounted_cash": 97.5, "setting": "both", "billing_class": "facility"}]}, {"description": "MICONAZOLE 2% 45GM VCR", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5336595", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 130.0, "discounted_cash": 97.5, "setting": "both", "billing_class": "facility"}]}, {"description": "MICONAZOLE 200MG VSU", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5336581", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 269.0, "discounted_cash": 201.75, "setting": "both", "billing_class": "facility"}]}, {"description": "MICONAZOLE 200MG VSU", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5336581", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 269.0, "discounted_cash": 201.75, "setting": "both", "billing_class": "facility"}]}, {"description": "MICONAZOLE200MG3PK VSU", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5336582", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 666.0, "discounted_cash": 499.5, "setting": "both", "billing_class": "facility"}]}, {"description": "MICONAZOLE200MG3PK VSU", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5336582", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 666.0, "discounted_cash": 499.5, "setting": "both", "billing_class": "facility"}]}, {"description": "MICRO ALBUMIN URINE QNT", "code_information": [{"code": "82043", "type": "CPT"}, {"code": "4102042", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 607.0, "discounted_cash": 455.25, "setting": "both", "billing_class": "facility"}]}, {"description": "MICRO ALBUMIN URINE QNT", "code_information": [{"code": "82043", "type": "CPT"}, {"code": "4172042", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 7.14, "discounted_cash": 5.36, "setting": "both", "billing_class": "facility"}]}, {"description": "MICRO ALBUMIN URINE QNT", "code_information": [{"code": "82043", "type": "CPT"}, {"code": "7252043", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 60.0, "discounted_cash": 45.0, "setting": "both", "billing_class": "facility"}]}, {"description": "MICRODISSECTION MANUAL", "code_information": [{"code": "88381", "type": "CPT"}, {"code": "4308381", "type": "CDM"}, {"code": "310", "type": "RC"}], "standard_charges": [{"gross_charge": 275.0, "discounted_cash": 206.25, "setting": "both", "billing_class": "facility"}]}, {"description": "MICRODISSECTION MANUAL", "code_information": [{"code": "88381", "type": "CPT"}, {"code": "7068381", "type": "CDM"}, {"code": "310", "type": "RC"}], "standard_charges": [{"gross_charge": 494.0, "discounted_cash": 370.5, "setting": "both", "billing_class": "facility"}]}, {"description": "MICROMATRIX FLEX PER MG", "code_information": [{"code": "A2028", "type": "HCPCS"}, {"code": "4023964", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 11.0, "discounted_cash": 8.25, "setting": "both", "billing_class": "facility"}]}, {"description": "MICROMATRIX FLEX PER MG", "code_information": [{"code": "A2028", "type": "HCPCS"}, {"code": "4023964", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 11.0, "discounted_cash": 8.25, "setting": "both", "billing_class": "facility"}]}, {"description": "MICROSAT INSTABILITY ANL", "code_information": [{"code": "81301", "type": "CPT"}, {"code": "7061301", "type": "CDM"}, {"code": "310", "type": "RC"}], "standard_charges": [{"gross_charge": 576.0, "discounted_cash": 432.0, "setting": "both", "billing_class": "facility"}]}, {"description": "MICROSOMAL ANTIBODY EA", "code_information": [{"code": "86376", "type": "CPT"}, {"code": "7255559", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 361.0, "discounted_cash": 270.75, "setting": "both", "billing_class": "facility"}]}, {"description": "MICROSOMAL ANTIBODY EA/2", "code_information": [{"code": "86376", "type": "CPT"}, {"code": "7256374", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 222.0, "discounted_cash": 166.5, "setting": "both", "billing_class": "facility"}]}, {"description": "MICROSOMAL ANTIBODY EA/5", "code_information": [{"code": "86376", "type": "CPT"}, {"code": "7258640", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 300.0, "discounted_cash": 225.0, "setting": "both", "billing_class": "facility"}]}, {"description": "MIDAZOLAM 10MG/5ML LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5327730", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 143.0, "discounted_cash": 107.25, "setting": "both", "billing_class": "facility"}]}, {"description": "MIDAZOLAM 10MG/5ML LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5327730", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 143.0, "discounted_cash": 107.25, "setting": "both", "billing_class": "facility"}]}, {"description": "MIDAZOLAM NEO PER 1MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J2250", "type": "HCPCS"}, {"code": "5322460", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 78.0, "discounted_cash": 58.5, "setting": "both", "billing_class": "facility"}]}, {"description": "MIDAZOLAM NEO PER 1MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J2250", "type": "HCPCS"}, {"code": "5322460", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 78.0, "discounted_cash": 58.5, "setting": "both", "billing_class": "facility"}]}, {"description": "MIDAZOLAM PER 1MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J2250", "type": "HCPCS"}, {"code": "5322454", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 28.0, "discounted_cash": 21.0, "setting": "both", "billing_class": "facility"}]}, {"description": "MIDAZOLAM PER 1MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J2250", "type": "HCPCS"}, {"code": "5322454", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 28.0, "discounted_cash": 21.0, "setting": "both", "billing_class": "facility"}]}, {"description": "MIDAZOLAM PER 1MG PMX IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J2250", "type": "HCPCS"}, {"code": "5327721", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 5.0, "discounted_cash": 3.75, "setting": "both", "billing_class": "facility"}]}, {"description": "MIDAZOLAM PER 1MG PMX IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J2250", "type": "HCPCS"}, {"code": "5327721", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 5.0, "discounted_cash": 3.75, "setting": "both", "billing_class": "facility"}]}, {"description": "MIDLINE INSERTION 3+YRS", "code_information": [{"code": "5076410", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 1889.0, "discounted_cash": 1416.75, "setting": "both", "billing_class": "facility"}]}, {"description": "MIDODRINE 2.5MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5307841", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 85.0, "discounted_cash": 63.75, "setting": "both", "billing_class": "facility"}]}, {"description": "MIDODRINE 2.5MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5307841", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 85.0, "discounted_cash": 63.75, "setting": "both", "billing_class": "facility"}]}, {"description": "MIDODRINE 5MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5307842", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 64.0, "discounted_cash": 48.0, "setting": "both", "billing_class": "facility"}]}, {"description": "MIDODRINE 5MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5307842", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 64.0, "discounted_cash": 48.0, "setting": "both", "billing_class": "facility"}]}, {"description": "MILRINONE NEO PER 1MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5322459", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 21.0, "discounted_cash": 15.75, "setting": "both", "billing_class": "facility"}]}, {"description": "MILRINONE PER 5MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J2260", "type": "HCPCS"}, {"code": "5322447", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 440.0, "discounted_cash": 330.0, "setting": "both", "billing_class": "facility"}]}, {"description": "MILRINONE PER 5MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J2260", "type": "HCPCS"}, {"code": "5322447", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 440.0, "discounted_cash": 330.0, "setting": "both", "billing_class": "facility"}]}, {"description": "MILRINONE PER 5MG PMX IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J2260", "type": "HCPCS"}, {"code": "5322455", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 2263.0, "discounted_cash": 1697.25, "setting": "both", "billing_class": "facility"}]}, {"description": "MILRINONE PER 5MG PMX IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J2260", "type": "HCPCS"}, {"code": "5322455", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 2263.0, "discounted_cash": 1697.25, "setting": "both", "billing_class": "facility"}]}, {"description": "MINERAL OIL 133ML RE", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5338534", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 61.0, "discounted_cash": 45.75, "setting": "both", "billing_class": "facility"}]}, {"description": "MINERAL OIL 133ML RE", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5338534", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 61.0, "discounted_cash": 45.75, "setting": "both", "billing_class": "facility"}]}, {"description": "MINERAL OIL 30 ML LQ", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5315714", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 71.0, "discounted_cash": 53.25, "setting": "both", "billing_class": "facility"}]}, {"description": "MINERAL OIL 30 ML LQ", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5315714", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 71.0, "discounted_cash": 53.25, "setting": "both", "billing_class": "facility"}]}, {"description": "MINERAL OIL 480 ML LQ", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5315715", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 149.0, "discounted_cash": 111.75, "setting": "both", "billing_class": "facility"}]}, {"description": "MINERAL OIL 480 ML LQ", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5315715", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 149.0, "discounted_cash": 111.75, "setting": "both", "billing_class": "facility"}]}, {"description": "MINERAL OIL STER 10ML LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5336644", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 39.0, "discounted_cash": 29.25, "setting": "both", "billing_class": "facility"}]}, {"description": "MINOCYCLINE 100MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5307861", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 72.0, "discounted_cash": 54.0, "setting": "both", "billing_class": "facility"}]}, {"description": "MINOCYCLINE 100MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5307861", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 72.0, "discounted_cash": 54.0, "setting": "both", "billing_class": "facility"}]}, {"description": "MINOXIDIL 10MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5307889", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 61.0, "discounted_cash": 45.75, "setting": "both", "billing_class": "facility"}]}, {"description": "MINOXIDIL 10MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5307889", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 61.0, "discounted_cash": 45.75, "setting": "both", "billing_class": "facility"}]}, {"description": "MINOXIDIL 2.5MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5307881", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 61.0, "discounted_cash": 45.75, "setting": "both", "billing_class": "facility"}]}, {"description": "MINOXIDIL 2.5MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5307881", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 61.0, "discounted_cash": 45.75, "setting": "both", "billing_class": "facility"}]}, {"description": "MIRTAZAPINE 15MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5307880", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 84.0, "discounted_cash": 63.0, "setting": "both", "billing_class": "facility"}]}, {"description": "MIRTAZAPINE 15MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5307880", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 84.0, "discounted_cash": 63.0, "setting": "both", "billing_class": "facility"}]}, {"description": "MIRTAZAPINE 30MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5307879", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 68.0, "discounted_cash": 51.0, "setting": "both", "billing_class": "facility"}]}, {"description": "MIRTAZAPINE 30MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5307879", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 68.0, "discounted_cash": 51.0, "setting": "both", "billing_class": "facility"}]}, {"description": "MISOPROSTOL 100MCG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5307890", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 53.0, "discounted_cash": 39.75, "setting": "both", "billing_class": "facility"}]}, {"description": "MISOPROSTOL 100MCG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5307890", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 53.0, "discounted_cash": 39.75, "setting": "both", "billing_class": "facility"}]}, {"description": "MISOPROSTOL 200MCG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5307891", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 66.0, "discounted_cash": 49.5, "setting": "both", "billing_class": "facility"}]}, {"description": "MISOPROSTOL 200MCG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5307891", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 66.0, "discounted_cash": 49.5, "setting": "both", "billing_class": "facility"}]}, {"description": "MISOPROSTOL 25MCG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5307892", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 37.0, "discounted_cash": 27.75, "setting": "both", "billing_class": "facility"}]}, {"description": "MISOPROSTOL 25MCG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5307892", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 37.0, "discounted_cash": 27.75, "setting": "both", "billing_class": "facility"}]}, {"description": "MITCHONDRIAL ANTIBODY/2", "code_information": [{"code": "86381", "type": "CPT"}, {"code": "7253522", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 665.0, "discounted_cash": 498.75, "setting": "both", "billing_class": "facility"}]}, {"description": "MITOMYCIN 0.2MG KT OS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J7315", "type": "HCPCS"}, {"code": "5331484", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 167.0, "discounted_cash": 125.25, "setting": "both", "billing_class": "facility"}]}, {"description": "MITOMYCIN 0.2MG KT OS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J7315", "type": "HCPCS"}, {"code": "5331484", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 167.0, "discounted_cash": 125.25, "setting": "both", "billing_class": "facility"}]}, {"description": "MITOMYCIN CMPD OS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J7999", "type": "HCPCS"}, {"code": "5331493", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 337.0, "discounted_cash": 252.75, "setting": "both", "billing_class": "facility"}]}, {"description": "MITOMYCIN CMPD OS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J7999", "type": "HCPCS"}, {"code": "5331493", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 337.0, "discounted_cash": 252.75, "setting": "both", "billing_class": "facility"}]}, {"description": "MITOMYCIN PER 5MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J9280", "type": "HCPCS"}, {"code": "5322492", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 1917.0, "discounted_cash": 1437.75, "setting": "both", "billing_class": "facility"}]}, {"description": "MITOMYCIN PER 5MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J9280", "type": "HCPCS"}, {"code": "5322492", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 1917.0, "discounted_cash": 1437.75, "setting": "both", "billing_class": "facility"}]}, {"description": "MOD SED OTH EA ADD15", "code_information": [{"code": "99157", "type": "CPT"}, {"code": "4619157", "type": "CDM"}, {"code": "370", "type": "RC"}], "standard_charges": [{"gross_charge": 1172.0, "discounted_cash": 879.0, "setting": "both", "billing_class": "facility"}]}, {"description": "MOD SED OTH EA ADD15", "code_information": [{"code": "99157", "type": "CPT"}, {"code": "4919157", "type": "CDM"}, {"code": "370", "type": "RC"}], "standard_charges": [{"gross_charge": 1172.0, "discounted_cash": 879.0, "setting": "both", "billing_class": "facility"}]}, {"description": "MOD SED OTH EA ADD15", "code_information": [{"code": "99157", "type": "CPT"}, {"code": "6109157", "type": "CDM"}, {"code": "370", "type": "RC"}], "standard_charges": [{"gross_charge": 1172.0, "discounted_cash": 879.0, "setting": "both", "billing_class": "facility"}]}, {"description": "MOD SED OTH>5YRS INIT15", "code_information": [{"code": "99156", "type": "CPT"}, {"code": "4619156", "type": "CDM"}, {"code": "370", "type": "RC"}], "standard_charges": [{"gross_charge": 1172.0, "discounted_cash": 879.0, "setting": "both", "billing_class": "facility"}]}, {"description": "MOD SED OTH>5YRS INIT15", "code_information": [{"code": "99156", "type": "CPT"}, {"code": "4919156", "type": "CDM"}, {"code": "370", "type": "RC"}], "standard_charges": [{"gross_charge": 1172.0, "discounted_cash": 879.0, "setting": "both", "billing_class": "facility"}]}, {"description": "MOD SED OTH>5YRS INIT15", "code_information": [{"code": "99156", "type": "CPT"}, {"code": "6109156", "type": "CDM"}, {"code": "370", "type": "RC"}], "standard_charges": [{"gross_charge": 1172.0, "discounted_cash": 879.0, "setting": "both", "billing_class": "facility"}]}, {"description": "MOD SED SAME EA ADD15", "code_information": [{"code": "99153", "type": "CPT"}, {"code": "4619153", "type": "CDM"}, {"code": "370", "type": "RC"}], "standard_charges": [{"gross_charge": 2020.0, "discounted_cash": 1515.0, "setting": "both", "billing_class": "facility"}]}, {"description": "MOD SED SAME EA ADD15", "code_information": [{"code": "99153", "type": "CPT"}, {"code": "6109153", "type": "CDM"}, {"code": "370", "type": "RC"}], "standard_charges": [{"gross_charge": 439.0, "discounted_cash": 329.25, "setting": "both", "billing_class": "facility"}]}, {"description": "MOD SED SAME<5YRS INIT15", "code_information": [{"code": "99151", "type": "CPT"}, {"code": "6109151", "type": "CDM"}, {"code": "370", "type": "RC"}], "standard_charges": [{"gross_charge": 856.0, "discounted_cash": 642.0, "setting": "both", "billing_class": "facility"}]}, {"description": "MOD SED SAME>5YRS INIT15", "code_information": [{"code": "99152", "type": "CPT"}, {"code": "4619152", "type": "CDM"}, {"code": "370", "type": "RC"}], "standard_charges": [{"gross_charge": 3514.0, "discounted_cash": 2635.5, "setting": "both", "billing_class": "facility"}]}, {"description": "MOD SED SAME>5YRS INIT15", "code_information": [{"code": "99152", "type": "CPT"}, {"code": "6109152", "type": "CDM"}, {"code": "370", "type": "RC"}], "standard_charges": [{"gross_charge": 756.0, "discounted_cash": 567.0, "setting": "both", "billing_class": "facility"}]}, {"description": "MODAFINIL 100MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5307883", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 140.0, "discounted_cash": 105.0, "setting": "both", "billing_class": "facility"}]}, {"description": "MODAFINIL 100MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5307883", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 140.0, "discounted_cash": 105.0, "setting": "both", "billing_class": "facility"}]}, {"description": "MOLEC CYTOGEN CHRM 10-30", "code_information": [{"code": "88273", "type": "CPT"}, {"code": "7258254", "type": "CDM"}, {"code": "310", "type": "RC"}], "standard_charges": [{"gross_charge": 327.0, "discounted_cash": 245.25, "setting": "both", "billing_class": "facility"}]}, {"description": "MOLEC CYTOGEN INTPHS 100-300/5", "code_information": [{"code": "88275", "type": "CPT"}, {"code": "7258276", "type": "CDM"}, {"code": "310", "type": "RC"}], "standard_charges": [{"gross_charge": 327.0, "discounted_cash": 245.25, "setting": "both", "billing_class": "facility"}]}, {"description": "MOLEC CYTOGEN INTPHS 25-99/4", "code_information": [{"code": "88274", "type": "CPT"}, {"code": "7258275", "type": "CDM"}, {"code": "310", "type": "RC"}], "standard_charges": [{"gross_charge": 501.0, "discounted_cash": 375.75, "setting": "both", "billing_class": "facility"}]}, {"description": "MOLECULAR PATH LEVEL 2/3", "code_information": [{"code": "81401", "type": "CPT"}, {"code": "7251401", "type": "CDM"}, {"code": "310", "type": "RC"}], "standard_charges": [{"gross_charge": 724.0, "discounted_cash": 543.0, "setting": "both", "billing_class": "facility"}]}, {"description": "MOLECULAR PATH LEVEL 4", "code_information": [{"code": "81403", "type": "CPT"}, {"code": "7061402", "type": "CDM"}, {"code": "310", "type": "RC"}], "standard_charges": [{"gross_charge": 254.0, "discounted_cash": 190.5, "setting": "both", "billing_class": "facility"}]}, {"description": "MOLECULAR PATH LEVEL 5", "code_information": [{"code": "81404", "type": "CPT"}, {"code": "7061404", "type": "CDM"}, {"code": "310", "type": "RC"}], "standard_charges": [{"gross_charge": 254.0, "discounted_cash": 190.5, "setting": "both", "billing_class": "facility"}]}, {"description": "MOLECULAR PATH LEVEL 6", "code_information": [{"code": "81405", "type": "CPT"}, {"code": "7061405", "type": "CDM"}, {"code": "310", "type": "RC"}], "standard_charges": [{"gross_charge": 254.0, "discounted_cash": 190.5, "setting": "both", "billing_class": "facility"}]}, {"description": "MOLECULAR PATH LEVEL 7", "code_information": [{"code": "81406", "type": "CPT"}, {"code": "7061406", "type": "CDM"}, {"code": "310", "type": "RC"}], "standard_charges": [{"gross_charge": 6629.0, "discounted_cash": 4971.75, "setting": "both", "billing_class": "facility"}]}, {"description": "MOLECULR CYTO DNA PRB EA", "code_information": [{"code": "88271", "type": "CPT"}, {"code": "7258832", "type": "CDM"}, {"code": "310", "type": "RC"}], "standard_charges": [{"gross_charge": 501.0, "discounted_cash": 375.75, "setting": "both", "billing_class": "facility"}]}, {"description": "MOLECULR CYTO DNA PRB EA/2", "code_information": [{"code": "88271", "type": "CPT"}, {"code": "7258279", "type": "CDM"}, {"code": "310", "type": "RC"}], "standard_charges": [{"gross_charge": 501.0, "discounted_cash": 375.75, "setting": "both", "billing_class": "facility"}]}, {"description": "MOLECULR CYTO DNA PRB EA/3", "code_information": [{"code": "88271", "type": "CPT"}, {"code": "7258521", "type": "CDM"}, {"code": "310", "type": "RC"}], "standard_charges": [{"gross_charge": 89.0, "discounted_cash": 66.75, "setting": "both", "billing_class": "facility"}]}, {"description": "MOLECULR CYTO DNA PRB EA/4", "code_information": [{"code": "88271", "type": "CPT"}, {"code": "7258841", "type": "CDM"}, {"code": "310", "type": "RC"}], "standard_charges": [{"gross_charge": 112.0, "discounted_cash": 84.0, "setting": "both", "billing_class": "facility"}]}, {"description": "MOMETASONE .1% 15GM CR", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5336668", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 762.0, "discounted_cash": 571.5, "setting": "both", "billing_class": "facility"}]}, {"description": "MOMETASONE .1% 15GM CR", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5336668", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 762.0, "discounted_cash": 571.5, "setting": "both", "billing_class": "facility"}]}, {"description": "MOMETASONE .1% 15GM OI", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5336680", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 762.0, "discounted_cash": 571.5, "setting": "both", "billing_class": "facility"}]}, {"description": "MOMETASONE .1% 15GM OI", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5336680", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 762.0, "discounted_cash": 571.5, "setting": "both", "billing_class": "facility"}]}, {"description": "MONTELUKAST 10MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5307903", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 147.0, "discounted_cash": 110.25, "setting": "both", "billing_class": "facility"}]}, {"description": "MONTELUKAST 10MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5307903", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 147.0, "discounted_cash": 110.25, "setting": "both", "billing_class": "facility"}]}, {"description": "MONTELUKAST 4MG CTB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5307905", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 111.0, "discounted_cash": 83.25, "setting": "both", "billing_class": "facility"}]}, {"description": "MONTELUKAST 4MG CTB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5307905", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 111.0, "discounted_cash": 83.25, "setting": "both", "billing_class": "facility"}]}, {"description": "MONTELUKAST 5MG CTB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5307904", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 112.0, "discounted_cash": 84.0, "setting": "both", "billing_class": "facility"}]}, {"description": "MONTELUKAST 5MG CTB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5307904", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 112.0, "discounted_cash": 84.0, "setting": "both", "billing_class": "facility"}]}, {"description": "MORCLLTR LAP GYNCR XTRCT", "code_information": [{"code": "C1782", "type": "HCPCS"}, {"code": "8240032", "type": "CDM"}, {"code": "272", "type": "RC"}], "standard_charges": [{"gross_charge": 11878.0, "discounted_cash": 8908.5, "setting": "both", "billing_class": "facility"}]}, {"description": "MORPH PF EPI/INTR 10MGIJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J2274", "type": "HCPCS"}, {"code": "5327712", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 465.0, "discounted_cash": 348.75, "setting": "both", "billing_class": "facility"}]}, {"description": "MORPH PF EPI/INTR 10MGIJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J2274", "type": "HCPCS"}, {"code": "5327712", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 465.0, "discounted_cash": 348.75, "setting": "both", "billing_class": "facility"}]}, {"description": "MORPHINE 10MG/5ML LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5327749", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 70.0, "discounted_cash": 52.5, "setting": "both", "billing_class": "facility"}]}, {"description": "MORPHINE 10MG/5ML LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5327749", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 70.0, "discounted_cash": 52.5, "setting": "both", "billing_class": "facility"}]}, {"description": "MORPHINE 15MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5327777", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 85.0, "discounted_cash": 63.75, "setting": "both", "billing_class": "facility"}]}, {"description": "MORPHINE 15MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5327777", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 85.0, "discounted_cash": 63.75, "setting": "both", "billing_class": "facility"}]}, {"description": "MORPHINE 15MG XR TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5327780", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 92.0, "discounted_cash": 69.0, "setting": "both", "billing_class": "facility"}]}, {"description": "MORPHINE 15MG XR TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5327780", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 92.0, "discounted_cash": 69.0, "setting": "both", "billing_class": "facility"}]}, {"description": "MORPHINE 20MG/1ML LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5327755", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 77.0, "discounted_cash": 57.75, "setting": "both", "billing_class": "facility"}]}, {"description": "MORPHINE 20MG/1ML LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5327755", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 77.0, "discounted_cash": 57.75, "setting": "both", "billing_class": "facility"}]}, {"description": "MORPHINE 30MG XR TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5327782", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 71.0, "discounted_cash": 53.25, "setting": "both", "billing_class": "facility"}]}, {"description": "MORPHINE 30MG XR TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5327782", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 71.0, "discounted_cash": 53.25, "setting": "both", "billing_class": "facility"}]}, {"description": "MORPHINE 600MG/30ML LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5327801", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 85.0, "discounted_cash": 63.75, "setting": "both", "billing_class": "facility"}]}, {"description": "MORPHINE 600MG/30ML LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5327801", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 85.0, "discounted_cash": 63.75, "setting": "both", "billing_class": "facility"}]}, {"description": "MORPHINE NEO IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5322515", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 14.0, "discounted_cash": 10.5, "setting": "both", "billing_class": "facility"}]}, {"description": "MORPHINE NEO PER 1ML IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5322522", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 86.0, "discounted_cash": 64.5, "setting": "both", "billing_class": "facility"}]}, {"description": "MORPHINE ORAL PED DSE LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5327838", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 85.0, "discounted_cash": 63.75, "setting": "both", "billing_class": "facility"}]}, {"description": "MORPHINE ORAL PED DSE LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5327838", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 85.0, "discounted_cash": 63.75, "setting": "both", "billing_class": "facility"}]}, {"description": "MORPHINE PER 10MG PCA", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J2270", "type": "HCPCS"}, {"code": "5327836", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 166.0, "discounted_cash": 124.5, "setting": "both", "billing_class": "facility"}]}, {"description": "MORPHINE PER 10MG PCA", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J2270", "type": "HCPCS"}, {"code": "5327836", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 166.0, "discounted_cash": 124.5, "setting": "both", "billing_class": "facility"}]}, {"description": "MORPHINE UPTO 10MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J2270", "type": "HCPCS"}, {"code": "5327744", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 231.0, "discounted_cash": 173.25, "setting": "both", "billing_class": "facility"}]}, {"description": "MORPHINE UPTO 10MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J2270", "type": "HCPCS"}, {"code": "5327744", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 231.0, "discounted_cash": 173.25, "setting": "both", "billing_class": "facility"}]}, {"description": "MOXIFLOXACIN .5% 3ML OS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5331491", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 784.0, "discounted_cash": 588.0, "setting": "both", "billing_class": "facility"}]}, {"description": "MOXIFLOXACIN .5% 3ML OS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5331491", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 784.0, "discounted_cash": 588.0, "setting": "both", "billing_class": "facility"}]}, {"description": "MOXIFLOXACIN 400MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5307909", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 445.0, "discounted_cash": 333.75, "setting": "both", "billing_class": "facility"}]}, {"description": "MOXIFLOXACIN 400MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5307909", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 445.0, "discounted_cash": 333.75, "setting": "both", "billing_class": "facility"}]}, {"description": "MR CONTRAST GAD BASE 1ML", "code_information": [{"code": "A9579", "type": "HCPCS"}, {"code": "5358241", "type": "CDM"}, {"code": "255", "type": "RC"}], "standard_charges": [{"gross_charge": 14.0, "discounted_cash": 10.5, "setting": "both", "billing_class": "facility"}]}, {"description": "MR CONTRAST GAD BASE 1ML", "code_information": [{"code": "A9579", "type": "HCPCS"}, {"code": "5358241", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 14.0, "discounted_cash": 10.5, "setting": "both", "billing_class": "facility"}]}, {"description": "MRA ABDOMEN W/ CM", "code_information": [{"code": "74185", "type": "CPT"}, {"code": "5258899", "type": "CDM"}, {"code": "610", "type": "RC"}], "standard_charges": [{"gross_charge": 8589.0, "discounted_cash": 6441.75, "setting": "both", "billing_class": "facility"}]}, {"description": "MRA ABDOMEN W/O CM", "code_information": [{"code": "74185", "type": "CPT"}, {"code": "5258901", "type": "CDM"}, {"code": "610", "type": "RC"}], "standard_charges": [{"gross_charge": 9359.0, "discounted_cash": 7019.25, "setting": "both", "billing_class": "facility"}]}, {"description": "MRA ABDOMEN WO/W CM", "code_information": [{"code": "74185", "type": "CPT"}, {"code": "5258902", "type": "CDM"}, {"code": "610", "type": "RC"}], "standard_charges": [{"gross_charge": 14795.0, "discounted_cash": 11096.25, "setting": "both", "billing_class": "facility"}]}, {"description": "MRA CHEST WO/W CONTRAST", "code_information": [{"code": "71555", "type": "CPT"}, {"code": "5258911", "type": "CDM"}, {"code": "610", "type": "RC"}], "standard_charges": [{"gross_charge": 1897.0, "discounted_cash": 1422.75, "setting": "both", "billing_class": "facility"}]}, {"description": "MRA HEAD W/CONTRAST", "code_information": [{"code": "70545", "type": "CPT"}, {"code": "5250602", "type": "CDM"}, {"code": "615", "type": "RC"}], "standard_charges": [{"gross_charge": 10960.0, "discounted_cash": 8220.0, "setting": "both", "billing_class": "facility"}]}, {"description": "MRA HEAD W/O CONTRAST", "code_information": [{"code": "70544", "type": "CPT"}, {"code": "5110544", "type": "CDM"}, {"code": "615", "type": "RC"}], "standard_charges": [{"gross_charge": 7459.0, "discounted_cash": 5594.25, "setting": "both", "billing_class": "facility"}]}, {"description": "MRA HEAD W/O CONTRAST", "code_information": [{"code": "70544", "type": "CPT"}, {"code": "5250601", "type": "CDM"}, {"code": "615", "type": "RC"}], "standard_charges": [{"gross_charge": 9710.0, "discounted_cash": 7282.5, "setting": "both", "billing_class": "facility"}]}, {"description": "MRA HEAD WO/W CONTRAST", "code_information": [{"code": "70546", "type": "CPT"}, {"code": "5250603", "type": "CDM"}, {"code": "615", "type": "RC"}], "standard_charges": [{"gross_charge": 13166.0, "discounted_cash": 9874.5, "setting": "both", "billing_class": "facility"}]}, {"description": "MRA LOWR EXTRMTY W/ CM", "code_information": [{"code": "73725", "type": "CPT"}, {"code": "5258912", "type": "CDM"}, {"code": "616", "type": "RC"}], "standard_charges": [{"gross_charge": 11130.0, "discounted_cash": 8347.5, "setting": "both", "billing_class": "facility"}]}, {"description": "MRA LOWR EXTRMTY W/O CM", "code_information": [{"code": "73725", "type": "CPT"}, {"code": "5258913", "type": "CDM"}, {"code": "616", "type": "RC"}], "standard_charges": [{"gross_charge": 10607.0, "discounted_cash": 7955.25, "setting": "both", "billing_class": "facility"}]}, {"description": "MRA LOWR EXTRMTY WO/W CM", "code_information": [{"code": "73725", "type": "CPT"}, {"code": "5258914", "type": "CDM"}, {"code": "616", "type": "RC"}], "standard_charges": [{"gross_charge": 14260.0, "discounted_cash": 10695.0, "setting": "both", "billing_class": "facility"}]}, {"description": "MRA NECK W CONTRAST", "code_information": [{"code": "70548", "type": "CPT"}, {"code": "5250607", "type": "CDM"}, {"code": "615", "type": "RC"}], "standard_charges": [{"gross_charge": 8607.0, "discounted_cash": 6455.25, "setting": "both", "billing_class": "facility"}]}, {"description": "MRA NECK W/O CONTRAST", "code_information": [{"code": "70547", "type": "CPT"}, {"code": "5110606", "type": "CDM"}, {"code": "615", "type": "RC"}], "standard_charges": [{"gross_charge": 8791.0, "discounted_cash": 6593.25, "setting": "both", "billing_class": "facility"}]}, {"description": "MRA NECK W/O CONTRAST", "code_information": [{"code": "70547", "type": "CPT"}, {"code": "5250606", "type": "CDM"}, {"code": "615", "type": "RC"}], "standard_charges": [{"gross_charge": 7157.0, "discounted_cash": 5367.75, "setting": "both", "billing_class": "facility"}]}, {"description": "MRA NECK WO/W CONTRAST", "code_information": [{"code": "70549", "type": "CPT"}, {"code": "5110608", "type": "CDM"}, {"code": "615", "type": "RC"}], "standard_charges": [{"gross_charge": 15529.0, "discounted_cash": 11646.75, "setting": "both", "billing_class": "facility"}]}, {"description": "MRA NECK WO/W CONTRAST", "code_information": [{"code": "70549", "type": "CPT"}, {"code": "5250608", "type": "CDM"}, {"code": "615", "type": "RC"}], "standard_charges": [{"gross_charge": 11172.0, "discounted_cash": 8379.0, "setting": "both", "billing_class": "facility"}]}, {"description": "MRA PELVIS WO/W CONTRAST", "code_information": [{"code": "72198", "type": "CPT"}, {"code": "5258920", "type": "CDM"}, {"code": "610", "type": "RC"}], "standard_charges": [{"gross_charge": 14231.0, "discounted_cash": 10673.25, "setting": "both", "billing_class": "facility"}]}, {"description": "MRA SPINE WO/W CONTRAST", "code_information": [{"code": "72159", "type": "CPT"}, {"code": "5259584", "type": "CDM"}, {"code": "610", "type": "RC"}], "standard_charges": [{"gross_charge": 14599.0, "discounted_cash": 10949.25, "setting": "both", "billing_class": "facility"}]}, {"description": "MRI ABDOMEN W/ CM", "code_information": [{"code": "74182", "type": "CPT"}, {"code": "5250974", "type": "CDM"}, {"code": "610", "type": "RC"}], "standard_charges": [{"gross_charge": 7916.0, "discounted_cash": 5937.0, "setting": "both", "billing_class": "facility"}]}, {"description": "MRI ABDOMEN W/O CM", "code_information": [{"code": "74181", "type": "CPT"}, {"code": "5114181", "type": "CDM"}, {"code": "610", "type": "RC"}], "standard_charges": [{"gross_charge": 8052.0, "discounted_cash": 6039.0, "setting": "both", "billing_class": "facility"}]}, {"description": "MRI ABDOMEN W/O CM", "code_information": [{"code": "74181", "type": "CPT"}, {"code": "5251075", "type": "CDM"}, {"code": "610", "type": "RC"}], "standard_charges": [{"gross_charge": 8052.0, "discounted_cash": 6039.0, "setting": "both", "billing_class": "facility"}]}, {"description": "MRI ABDOMEN WO/W CM", "code_information": [{"code": "74183", "type": "CPT"}, {"code": "5114183", "type": "CDM"}, {"code": "610", "type": "RC"}], "standard_charges": [{"gross_charge": 11340.0, "discounted_cash": 8505.0, "setting": "both", "billing_class": "facility"}]}, {"description": "MRI ABDOMEN WO/W CM", "code_information": [{"code": "74183", "type": "CPT"}, {"code": "5251000", "type": "CDM"}, {"code": "610", "type": "RC"}], "standard_charges": [{"gross_charge": 14281.0, "discounted_cash": 10710.75, "setting": "both", "billing_class": "facility"}]}, {"description": "MRI BRAIN W/O CONTRAST", "code_information": [{"code": "70551", "type": "CPT"}, {"code": "5110551", "type": "CDM"}, {"code": "610", "type": "RC"}], "standard_charges": [{"gross_charge": 7157.0, "discounted_cash": 5367.75, "setting": "both", "billing_class": "facility"}]}, {"description": "MRI BRAIN W/O CONTRAST", "code_information": [{"code": "70551", "type": "CPT"}, {"code": "5250802", "type": "CDM"}, {"code": "610", "type": "RC"}], "standard_charges": [{"gross_charge": 10533.0, "discounted_cash": 7899.75, "setting": "both", "billing_class": "facility"}]}, {"description": "MRI BRAIN WITH CONTRAST", "code_information": [{"code": "70552", "type": "CPT"}, {"code": "5110552", "type": "CDM"}, {"code": "610", "type": "RC"}], "standard_charges": [{"gross_charge": 12438.0, "discounted_cash": 9328.5, "setting": "both", "billing_class": "facility"}]}, {"description": "MRI BRAIN WITH CONTRAST", "code_information": [{"code": "70552", "type": "CPT"}, {"code": "5250810", "type": "CDM"}, {"code": "610", "type": "RC"}], "standard_charges": [{"gross_charge": 9365.0, "discounted_cash": 7023.75, "setting": "both", "billing_class": "facility"}]}, {"description": "MRI BRAIN WO/W CONTRAST", "code_information": [{"code": "70553", "type": "CPT"}, {"code": "5110553", "type": "CDM"}, {"code": "610", "type": "RC"}], "standard_charges": [{"gross_charge": 11172.0, "discounted_cash": 8379.0, "setting": "both", "billing_class": "facility"}]}, {"description": "MRI BRAIN WO/W CONTRAST", "code_information": [{"code": "70553", "type": "CPT"}, {"code": "5250816", "type": "CDM"}, {"code": "610", "type": "RC"}], "standard_charges": [{"gross_charge": 14264.0, "discounted_cash": 10698.0, "setting": "both", "billing_class": "facility"}]}, {"description": "MRI BRST WO&W CM+CAD BI", "code_information": [{"code": "77049", "type": "CPT"}, {"code": "5117049", "type": "CDM"}, {"code": "610", "type": "RC"}], "standard_charges": [{"gross_charge": 17945.0, "discounted_cash": 13458.75, "setting": "both", "billing_class": "facility"}]}, {"description": "MRI BRST WO&W CM+CAD BI", "code_information": [{"code": "77049", "type": "CPT"}, {"code": "5257049", "type": "CDM"}, {"code": "610", "type": "RC"}], "standard_charges": [{"gross_charge": 17945.0, "discounted_cash": 13458.75, "setting": "both", "billing_class": "facility"}]}, {"description": "MRI BRST WO&W CM+CAD UNI", "code_information": [{"code": "77048", "type": "CPT"}, {"code": "5257048", "type": "CDM"}, {"code": "610", "type": "RC"}], "standard_charges": [{"gross_charge": 12818.0, "discounted_cash": 9613.5, "setting": "both", "billing_class": "facility"}]}, {"description": "MRI CHEST W/O CONTRAST", "code_information": [{"code": "71550", "type": "CPT"}, {"code": "5251040", "type": "CDM"}, {"code": "610", "type": "RC"}], "standard_charges": [{"gross_charge": 7379.0, "discounted_cash": 5534.25, "setting": "both", "billing_class": "facility"}]}, {"description": "MRI CHEST WO/W CONTRAST", "code_information": [{"code": "71552", "type": "CPT"}, {"code": "5110972", "type": "CDM"}, {"code": "610", "type": "RC"}], "standard_charges": [{"gross_charge": 13252.0, "discounted_cash": 9939.0, "setting": "both", "billing_class": "facility"}]}, {"description": "MRI CHEST WO/W CONTRAST", "code_information": [{"code": "71552", "type": "CPT"}, {"code": "5250972", "type": "CDM"}, {"code": "610", "type": "RC"}], "standard_charges": [{"gross_charge": 11470.0, "discounted_cash": 8602.5, "setting": "both", "billing_class": "facility"}]}, {"description": "MRI GDE PARENCHYM ABLAT", "code_information": [{"code": "77022", "type": "CPT"}, {"code": "5257022", "type": "CDM"}, {"code": "610", "type": "RC"}], "standard_charges": [{"gross_charge": 1918.0, "discounted_cash": 1438.5, "setting": "both", "billing_class": "facility"}]}, {"description": "MRI LE JNT WO/W CM", "code_information": [{"code": "73723", "type": "CPT"}, {"code": "5113723", "type": "CDM"}, {"code": "610", "type": "RC"}], "standard_charges": [{"gross_charge": 11551.0, "discounted_cash": 8663.25, "setting": "both", "billing_class": "facility"}]}, {"description": "MRI LE JNT WO/W CM", "code_information": [{"code": "73723", "type": "CPT"}, {"code": "5251007", "type": "CDM"}, {"code": "610", "type": "RC"}], "standard_charges": [{"gross_charge": 11551.0, "discounted_cash": 8663.25, "setting": "both", "billing_class": "facility"}]}, {"description": "MRI LE NONJNT W/CM", "code_information": [{"code": "73719", "type": "CPT"}, {"code": "5251003", "type": "CDM"}, {"code": "610", "type": "RC"}], "standard_charges": [{"gross_charge": 11559.0, "discounted_cash": 8669.25, "setting": "both", "billing_class": "facility"}]}, {"description": "MRI LE NONJNT W/O CM", "code_information": [{"code": "73718", "type": "CPT"}, {"code": "5113718", "type": "CDM"}, {"code": "610", "type": "RC"}], "standard_charges": [{"gross_charge": 8057.0, "discounted_cash": 6042.75, "setting": "both", "billing_class": "facility"}]}, {"description": "MRI LE NONJNT W/O CM", "code_information": [{"code": "73718", "type": "CPT"}, {"code": "5251004", "type": "CDM"}, {"code": "610", "type": "RC"}], "standard_charges": [{"gross_charge": 9311.0, "discounted_cash": 6983.25, "setting": "both", "billing_class": "facility"}]}, {"description": "MRI LE NONJNT WO/W CM", "code_information": [{"code": "73720", "type": "CPT"}, {"code": "5113720", "type": "CDM"}, {"code": "610", "type": "RC"}], "standard_charges": [{"gross_charge": 11551.0, "discounted_cash": 8663.25, "setting": "both", "billing_class": "facility"}]}, {"description": "MRI LE NONJNT WO/W CM", "code_information": [{"code": "73720", "type": "CPT"}, {"code": "5251065", "type": "CDM"}, {"code": "610", "type": "RC"}], "standard_charges": [{"gross_charge": 11551.0, "discounted_cash": 8663.25, "setting": "both", "billing_class": "facility"}]}, {"description": "MRI LOWR EXT JNT W/ CM", "code_information": [{"code": "73722", "type": "CPT"}, {"code": "5251006", "type": "CDM"}, {"code": "610", "type": "RC"}], "standard_charges": [{"gross_charge": 11734.0, "discounted_cash": 8800.5, "setting": "both", "billing_class": "facility"}]}, {"description": "MRI LOWR EXT JNT W/O CM", "code_information": [{"code": "73721", "type": "CPT"}, {"code": "5113721", "type": "CDM"}, {"code": "610", "type": "RC"}], "standard_charges": [{"gross_charge": 7992.0, "discounted_cash": 5994.0, "setting": "both", "billing_class": "facility"}]}, {"description": "MRI LOWR EXT JNT W/O CM", "code_information": [{"code": "73721", "type": "CPT"}, {"code": "5251070", "type": "CDM"}, {"code": "610", "type": "RC"}], "standard_charges": [{"gross_charge": 7332.0, "discounted_cash": 5499.0, "setting": "both", "billing_class": "facility"}]}, {"description": "MRI ORB/FACE/NECK W/CM", "code_information": [{"code": "70542", "type": "CPT"}, {"code": "5250821", "type": "CDM"}, {"code": "610", "type": "RC"}], "standard_charges": [{"gross_charge": 11746.0, "discounted_cash": 8809.5, "setting": "both", "billing_class": "facility"}]}, {"description": "MRI ORB/FACE/NECK WO CM", "code_information": [{"code": "70540", "type": "CPT"}, {"code": "5110540", "type": "CDM"}, {"code": "610", "type": "RC"}], "standard_charges": [{"gross_charge": 8549.0, "discounted_cash": 6411.75, "setting": "both", "billing_class": "facility"}]}, {"description": "MRI ORB/FACE/NECK WO CM", "code_information": [{"code": "70540", "type": "CPT"}, {"code": "5251025", "type": "CDM"}, {"code": "610", "type": "RC"}], "standard_charges": [{"gross_charge": 7937.0, "discounted_cash": 5952.75, "setting": "both", "billing_class": "facility"}]}, {"description": "MRI ORB/FACE/NECK WO/W C", "code_information": [{"code": "70543", "type": "CPT"}, {"code": "5110543", "type": "CDM"}, {"code": "610", "type": "RC"}], "standard_charges": [{"gross_charge": 11311.0, "discounted_cash": 8483.25, "setting": "both", "billing_class": "facility"}]}, {"description": "MRI ORB/FACE/NECK WO/W C", "code_information": [{"code": "70543", "type": "CPT"}, {"code": "5250822", "type": "CDM"}, {"code": "610", "type": "RC"}], "standard_charges": [{"gross_charge": 14264.0, "discounted_cash": 10698.0, "setting": "both", "billing_class": "facility"}]}, {"description": "MRI PELVIS W/ CONTRAST", "code_information": [{"code": "72196", "type": "CPT"}, {"code": "5251050", "type": "CDM"}, {"code": "610", "type": "RC"}], "standard_charges": [{"gross_charge": 10151.0, "discounted_cash": 7613.25, "setting": "both", "billing_class": "facility"}]}, {"description": "MRI PELVIS W/O CONTRAST", "code_information": [{"code": "72195", "type": "CPT"}, {"code": "5112195", "type": "CDM"}, {"code": "610", "type": "RC"}], "standard_charges": [{"gross_charge": 7360.0, "discounted_cash": 5520.0, "setting": "both", "billing_class": "facility"}]}, {"description": "MRI PELVIS W/O CONTRAST", "code_information": [{"code": "72195", "type": "CPT"}, {"code": "5250850", "type": "CDM"}, {"code": "610", "type": "RC"}], "standard_charges": [{"gross_charge": 7360.0, "discounted_cash": 5520.0, "setting": "both", "billing_class": "facility"}]}, {"description": "MRI PELVIS WO/W CONTRAST", "code_information": [{"code": "72197", "type": "CPT"}, {"code": "5112197", "type": "CDM"}, {"code": "610", "type": "RC"}], "standard_charges": [{"gross_charge": 11632.0, "discounted_cash": 8724.0, "setting": "both", "billing_class": "facility"}]}, {"description": "MRI PELVIS WO/W CONTRAST", "code_information": [{"code": "72197", "type": "CPT"}, {"code": "5250852", "type": "CDM"}, {"code": "610", "type": "RC"}], "standard_charges": [{"gross_charge": 11632.0, "discounted_cash": 8724.0, "setting": "both", "billing_class": "facility"}]}, {"description": "MRI SAFETY DETER PHYS/QHP", "code_information": [{"code": "76016", "type": "CPT"}, {"code": "5250096", "type": "CDM"}, {"code": "610", "type": "RC"}], "standard_charges": [{"gross_charge": 451.0, "discounted_cash": 338.25, "setting": "both", "billing_class": "facility"}]}, {"description": "MRI SAFETY IMPLANT ELEC PREPJ", "code_information": [{"code": "76018", "type": "CPT"}, {"code": "5250098", "type": "CDM"}, {"code": "610", "type": "RC"}], "standard_charges": [{"gross_charge": 470.0, "discounted_cash": 352.5, "setting": "both", "billing_class": "facility"}]}, {"description": "MRI SAFETY IMPLT POS&/IMMOBLJ", "code_information": [{"code": "76019", "type": "CPT"}, {"code": "5250099", "type": "CDM"}, {"code": "610", "type": "RC"}], "standard_charges": [{"gross_charge": 304.0, "discounted_cash": 228.0, "setting": "both", "billing_class": "facility"}]}, {"description": "MRI SFTY IMPLT&FB 1ST 15MIN", "code_information": [{"code": "76014", "type": "CPT"}, {"code": "5250094", "type": "CDM"}, {"code": "610", "type": "RC"}], "standard_charges": [{"gross_charge": 125.0, "discounted_cash": 93.75, "setting": "both", "billing_class": "facility"}]}, {"description": "MRI SFTY MED PHYSICS XM CSTMZ", "code_information": [{"code": "76017", "type": "CPT"}, {"code": "5250097", "type": "CDM"}, {"code": "610", "type": "RC"}], "standard_charges": [{"gross_charge": 1237.0, "discounted_cash": 927.75, "setting": "both", "billing_class": "facility"}]}, {"description": "MRI SFTY MPLT&FB ADD 30MIN", "code_information": [{"code": "76015", "type": "CPT"}, {"code": "5250095", "type": "CDM"}, {"code": "610", "type": "RC"}], "standard_charges": [{"gross_charge": 125.0, "discounted_cash": 93.75, "setting": "both", "billing_class": "facility"}]}, {"description": "MRI SPINE CERV WO/W CM", "code_information": [{"code": "72156", "type": "CPT"}, {"code": "5112156", "type": "CDM"}, {"code": "610", "type": "RC"}], "standard_charges": [{"gross_charge": 16467.0, "discounted_cash": 12350.25, "setting": "both", "billing_class": "facility"}]}, {"description": "MRI SPINE CERV WO/W CM", "code_information": [{"code": "72156", "type": "CPT"}, {"code": "5250230", "type": "CDM"}, {"code": "610", "type": "RC"}], "standard_charges": [{"gross_charge": 16467.0, "discounted_cash": 12350.25, "setting": "both", "billing_class": "facility"}]}, {"description": "MRI SPINE CERVICAL W/CM", "code_information": [{"code": "72142", "type": "CPT"}, {"code": "5112142", "type": "CDM"}, {"code": "610", "type": "RC"}], "standard_charges": [{"gross_charge": 17096.0, "discounted_cash": 12822.0, "setting": "both", "billing_class": "facility"}]}, {"description": "MRI SPINE CERVICAL W/CM", "code_information": [{"code": "72142", "type": "CPT"}, {"code": "5252142", "type": "CDM"}, {"code": "610", "type": "RC"}], "standard_charges": [{"gross_charge": 15684.0, "discounted_cash": 11763.0, "setting": "both", "billing_class": "facility"}]}, {"description": "MRI SPINE CERVICL W/O CM", "code_information": [{"code": "72141", "type": "CPT"}, {"code": "5112141", "type": "CDM"}, {"code": "610", "type": "RC"}], "standard_charges": [{"gross_charge": 10462.0, "discounted_cash": 7846.5, "setting": "both", "billing_class": "facility"}]}, {"description": "MRI SPINE CERVICL W/O CM", "code_information": [{"code": "72141", "type": "CPT"}, {"code": "5250662", "type": "CDM"}, {"code": "610", "type": "RC"}], "standard_charges": [{"gross_charge": 12428.0, "discounted_cash": 9321.0, "setting": "both", "billing_class": "facility"}]}, {"description": "MRI SPINE LUMBAR W/CM", "code_information": [{"code": "72149", "type": "CPT"}, {"code": "5252149", "type": "CDM"}, {"code": "610", "type": "RC"}], "standard_charges": [{"gross_charge": 11763.0, "discounted_cash": 8822.25, "setting": "both", "billing_class": "facility"}]}, {"description": "MRI SPINE LUMBAR W/O CM", "code_information": [{"code": "72148", "type": "CPT"}, {"code": "5112148", "type": "CDM"}, {"code": "610", "type": "RC"}], "standard_charges": [{"gross_charge": 10174.0, "discounted_cash": 7630.5, "setting": "both", "billing_class": "facility"}]}, {"description": "MRI SPINE LUMBAR W/O CM", "code_information": [{"code": "72148", "type": "CPT"}, {"code": "5250692", "type": "CDM"}, {"code": "610", "type": "RC"}], "standard_charges": [{"gross_charge": 12739.0, "discounted_cash": 9554.25, "setting": "both", "billing_class": "facility"}]}, {"description": "MRI SPINE LUMBAR WO/W CM", "code_information": [{"code": "72158", "type": "CPT"}, {"code": "5112158", "type": "CDM"}, {"code": "610", "type": "RC"}], "standard_charges": [{"gross_charge": 14209.0, "discounted_cash": 10656.75, "setting": "both", "billing_class": "facility"}]}, {"description": "MRI SPINE LUMBAR WO/W CM", "code_information": [{"code": "72158", "type": "CPT"}, {"code": "5250238", "type": "CDM"}, {"code": "610", "type": "RC"}], "standard_charges": [{"gross_charge": 16421.0, "discounted_cash": 12315.75, "setting": "both", "billing_class": "facility"}]}, {"description": "MRI SPINE THOR WO/W CM", "code_information": [{"code": "72157", "type": "CPT"}, {"code": "5112157", "type": "CDM"}, {"code": "610", "type": "RC"}], "standard_charges": [{"gross_charge": 13524.0, "discounted_cash": 10143.0, "setting": "both", "billing_class": "facility"}]}, {"description": "MRI SPINE THOR WO/W CM", "code_information": [{"code": "72157", "type": "CPT"}, {"code": "5250234", "type": "CDM"}, {"code": "610", "type": "RC"}], "standard_charges": [{"gross_charge": 15628.0, "discounted_cash": 11721.0, "setting": "both", "billing_class": "facility"}]}, {"description": "MRI SPINE THORAC W/O CM", "code_information": [{"code": "72146", "type": "CPT"}, {"code": "5112146", "type": "CDM"}, {"code": "610", "type": "RC"}], "standard_charges": [{"gross_charge": 8166.0, "discounted_cash": 6124.5, "setting": "both", "billing_class": "facility"}]}, {"description": "MRI SPINE THORAC W/O CM", "code_information": [{"code": "72146", "type": "CPT"}, {"code": "5250676", "type": "CDM"}, {"code": "610", "type": "RC"}], "standard_charges": [{"gross_charge": 9436.0, "discounted_cash": 7077.0, "setting": "both", "billing_class": "facility"}]}, {"description": "MRI SPINE THORACIC W/CM", "code_information": [{"code": "72147", "type": "CPT"}, {"code": "5112147", "type": "CDM"}, {"code": "610", "type": "RC"}], "standard_charges": [{"gross_charge": 14044.0, "discounted_cash": 10533.0, "setting": "both", "billing_class": "facility"}]}, {"description": "MRI SPINE THORACIC W/CM", "code_information": [{"code": "72147", "type": "CPT"}, {"code": "5252147", "type": "CDM"}, {"code": "610", "type": "RC"}], "standard_charges": [{"gross_charge": 10229.0, "discounted_cash": 7671.75, "setting": "both", "billing_class": "facility"}]}, {"description": "MRI TMJ", "code_information": [{"code": "70336", "type": "CPT"}, {"code": "5251035", "type": "CDM"}, {"code": "610", "type": "RC"}], "standard_charges": [{"gross_charge": 6321.0, "discounted_cash": 4740.75, "setting": "both", "billing_class": "facility"}]}, {"description": "MRI UP EXT JNT W/O CM", "code_information": [{"code": "73221", "type": "CPT"}, {"code": "5113221", "type": "CDM"}, {"code": "610", "type": "RC"}], "standard_charges": [{"gross_charge": 9124.0, "discounted_cash": 6843.0, "setting": "both", "billing_class": "facility"}]}, {"description": "MRI UP EXT JNT W/O CM", "code_information": [{"code": "73221", "type": "CPT"}, {"code": "5251060", "type": "CDM"}, {"code": "610", "type": "RC"}], "standard_charges": [{"gross_charge": 9124.0, "discounted_cash": 6843.0, "setting": "both", "billing_class": "facility"}]}, {"description": "MRI UP EXT JNT WO/W CM", "code_information": [{"code": "73223", "type": "CPT"}, {"code": "5113223", "type": "CDM"}, {"code": "610", "type": "RC"}], "standard_charges": [{"gross_charge": 12893.0, "discounted_cash": 9669.75, "setting": "both", "billing_class": "facility"}]}, {"description": "MRI UP EXT JNT WO/W CM", "code_information": [{"code": "73223", "type": "CPT"}, {"code": "5250846", "type": "CDM"}, {"code": "610", "type": "RC"}], "standard_charges": [{"gross_charge": 12893.0, "discounted_cash": 9669.75, "setting": "both", "billing_class": "facility"}]}, {"description": "MRI UP EXT NONJNT W/O CM", "code_information": [{"code": "73218", "type": "CPT"}, {"code": "5113218", "type": "CDM"}, {"code": "610", "type": "RC"}], "standard_charges": [{"gross_charge": 9194.0, "discounted_cash": 6895.5, "setting": "both", "billing_class": "facility"}]}, {"description": "MRI UP EXT NONJNT W/O CM", "code_information": [{"code": "73218", "type": "CPT"}, {"code": "5250840", "type": "CDM"}, {"code": "610", "type": "RC"}], "standard_charges": [{"gross_charge": 8433.0, "discounted_cash": 6324.75, "setting": "both", "billing_class": "facility"}]}, {"description": "MRI UP EXT NONJNT WO/WCM", "code_information": [{"code": "73220", "type": "CPT"}, {"code": "5113220", "type": "CDM"}, {"code": "610", "type": "RC"}], "standard_charges": [{"gross_charge": 19174.0, "discounted_cash": 14380.5, "setting": "both", "billing_class": "facility"}]}, {"description": "MRI UP EXT NONJNT WO/WCM", "code_information": [{"code": "73220", "type": "CPT"}, {"code": "5251055", "type": "CDM"}, {"code": "610", "type": "RC"}], "standard_charges": [{"gross_charge": 14051.0, "discounted_cash": 10538.25, "setting": "both", "billing_class": "facility"}]}, {"description": "MSH COMPOSIX E/X 10X14", "code_information": [{"code": "C1781", "type": "HCPCS"}, {"code": "4023999", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 25719.0, "discounted_cash": 19289.25, "setting": "both", "billing_class": "facility"}]}, {"description": "MSH COMPOSIX E/X 8X10", "code_information": [{"code": "C1781", "type": "HCPCS"}, {"code": "4024000", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 19326.0, "discounted_cash": 14494.5, "setting": "both", "billing_class": "facility"}]}, {"description": "MSH COMPOSIX KGEL 7X9", "code_information": [{"code": "C1781", "type": "HCPCS"}, {"code": "4024001", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 20403.0, "discounted_cash": 15302.25, "setting": "both", "billing_class": "facility"}]}, {"description": "MSH LAPAROSCOPIC SLF-FIX", "code_information": [{"code": "C1781", "type": "HCPCS"}, {"code": "4024095", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 13088.0, "discounted_cash": 9816.0, "setting": "both", "billing_class": "facility"}]}, {"description": "MSH MACRO-POROUS PP", "code_information": [{"code": "C1781", "type": "HCPCS"}, {"code": "4024097", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 1770.0, "discounted_cash": 1327.5, "setting": "both", "billing_class": "facility"}]}, {"description": "MSH PLVC FLR ANT PROLIFT", "code_information": [{"code": "C1781", "type": "HCPCS"}, {"code": "4021246", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 20458.0, "discounted_cash": 15343.5, "setting": "both", "billing_class": "facility"}]}, {"description": "MSH PLVC FLR REP PROLIFT", "code_information": [{"code": "C1781", "type": "HCPCS"}, {"code": "4024090", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 41695.0, "discounted_cash": 31271.25, "setting": "both", "billing_class": "facility"}]}, {"description": "MSH POLYPRO PLUG EXL", "code_information": [{"code": "C1781", "type": "HCPCS"}, {"code": "4024200", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 3485.0, "discounted_cash": 2613.75, "setting": "both", "billing_class": "facility"}]}, {"description": "MSH POLYPRO PLUG LG", "code_information": [{"code": "C1781", "type": "HCPCS"}, {"code": "4024199", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 2460.0, "discounted_cash": 1845.0, "setting": "both", "billing_class": "facility"}]}, {"description": "MSH POLYPRO PLUG M", "code_information": [{"code": "C1781", "type": "HCPCS"}, {"code": "4024201", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 3023.0, "discounted_cash": 2267.25, "setting": "both", "billing_class": "facility"}]}, {"description": "MSH POLYPRO PLUG S", "code_information": [{"code": "C1781", "type": "HCPCS"}, {"code": "4024198", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 2900.0, "discounted_cash": 2175.0, "setting": "both", "billing_class": "facility"}]}, {"description": "MSH VENTRALEX W STRP", "code_information": [{"code": "C1781", "type": "HCPCS"}, {"code": "4024250", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 8444.0, "discounted_cash": 6333.0, "setting": "both", "billing_class": "facility"}]}, {"description": "MSH Y UPSYLON", "code_information": [{"code": "C1763", "type": "HCPCS"}, {"code": "4024243", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 19448.0, "discounted_cash": 14586.0, "setting": "both", "billing_class": "facility"}]}, {"description": "MSH6 FAMILIAL SEQUENCE", "code_information": [{"code": "81299", "type": "CPT"}, {"code": "7251300", "type": "CDM"}, {"code": "310", "type": "RC"}], "standard_charges": [{"gross_charge": 3088.0, "discounted_cash": 2316.0, "setting": "both", "billing_class": "facility"}]}, {"description": "MTB AMP PROBE", "code_information": [{"code": "87556", "type": "CPT"}, {"code": "7257556", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 985.0, "discounted_cash": 738.75, "setting": "both", "billing_class": "facility"}]}, {"description": "MTHFR COMMON VARIANTS", "code_information": [{"code": "81291", "type": "CPT"}, {"code": "7259210", "type": "CDM"}, {"code": "310", "type": "RC"}], "standard_charges": [{"gross_charge": 367.0, "discounted_cash": 275.25, "setting": "both", "billing_class": "facility"}]}, {"description": "MUCOPOLYSAAC-ACID URN QN/2", "code_information": [{"code": "83864", "type": "CPT"}, {"code": "7253865", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 795.0, "discounted_cash": 596.25, "setting": "both", "billing_class": "facility"}]}, {"description": "MULT SLEEP LATENCY TEST", "code_information": [{"code": "95805", "type": "CPT"}, {"code": "6912115", "type": "CDM"}, {"code": "740", "type": "RC"}], "standard_charges": [{"gross_charge": 13296.0, "discounted_cash": 9972.0, "setting": "both", "billing_class": "facility"}]}, {"description": "MULTI ORGANISMS AMP PRB", "code_information": [{"code": "87801", "type": "CPT"}, {"code": "7257826", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 1030.0, "discounted_cash": 772.5, "setting": "both", "billing_class": "facility"}]}, {"description": "MULTI ORGANISMS AMP PRB/3", "code_information": [{"code": "87801", "type": "CPT"}, {"code": "7257816", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 746.0, "discounted_cash": 559.5, "setting": "both", "billing_class": "facility"}]}, {"description": "MUMPS AB", "code_information": [{"code": "86735", "type": "CPT"}, {"code": "4106180", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 199.0, "discounted_cash": 149.25, "setting": "both", "billing_class": "facility"}]}, {"description": "MUMPS AB", "code_information": [{"code": "86735", "type": "CPT"}, {"code": "4126180", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 37.0, "discounted_cash": 27.75, "setting": "both", "billing_class": "facility"}]}, {"description": "MUMPS AB", "code_information": [{"code": "86735", "type": "CPT"}, {"code": "4176180", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 85.63, "discounted_cash": 64.22, "setting": "both", "billing_class": "facility"}]}, {"description": "MUMPS AB", "code_information": [{"code": "86735", "type": "CPT"}, {"code": "7256712", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 135.0, "discounted_cash": 101.25, "setting": "both", "billing_class": "facility"}]}, {"description": "MUMPS AB/3", "code_information": [{"code": "86735", "type": "CPT"}, {"code": "7256735", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 1111.0, "discounted_cash": 833.25, "setting": "both", "billing_class": "facility"}]}, {"description": "MUPIROCIN 2% 15GM CR", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5336685", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 618.0, "discounted_cash": 463.5, "setting": "both", "billing_class": "facility"}]}, {"description": "MUPIROCIN 2% 15GM CR", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5336685", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 618.0, "discounted_cash": 463.5, "setting": "both", "billing_class": "facility"}]}, {"description": "MUPIROCIN 2% 1GM OI", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5336683", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 288.0, "discounted_cash": 216.0, "setting": "both", "billing_class": "facility"}]}, {"description": "MUPIROCIN 2% 1GM OI", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5336683", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 288.0, "discounted_cash": 216.0, "setting": "both", "billing_class": "facility"}]}, {"description": "MUPIROCIN 2% 22GM OI", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5331488", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 649.0, "discounted_cash": 486.75, "setting": "both", "billing_class": "facility"}]}, {"description": "MUPIROCIN 2% 22GM OI", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5331488", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 649.0, "discounted_cash": 486.75, "setting": "both", "billing_class": "facility"}]}, {"description": "MURAMIDASE", "code_information": [{"code": "85549", "type": "CPT"}, {"code": "7255546", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 1127.0, "discounted_cash": 845.25, "setting": "both", "billing_class": "facility"}]}, {"description": "MUSK ANTIBODY", "code_information": [{"code": "83516", "type": "CPT"}, {"code": "7250019", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 2957.0, "discounted_cash": 2217.75, "setting": "both", "billing_class": "facility"}]}, {"description": "MVI 10ML IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5322591", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 581.0, "discounted_cash": 435.75, "setting": "both", "billing_class": "facility"}]}, {"description": "MVI 5ML IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5322612", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 687.0, "discounted_cash": 515.25, "setting": "both", "billing_class": "facility"}]}, {"description": "MVI 5ML LQ", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5315807", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 77.0, "discounted_cash": 57.75, "setting": "both", "billing_class": "facility"}]}, {"description": "MVI 5ML LQ", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5315807", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 77.0, "discounted_cash": 57.75, "setting": "both", "billing_class": "facility"}]}, {"description": "MVI DROPS 50ML LQ", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5316645", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 135.0, "discounted_cash": 101.25, "setting": "both", "billing_class": "facility"}]}, {"description": "MVI DROPS 50ML LQ", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5316645", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 135.0, "discounted_cash": 101.25, "setting": "both", "billing_class": "facility"}]}, {"description": "MVI FE CP", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5307935", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 85.0, "discounted_cash": 63.75, "setting": "both", "billing_class": "facility"}]}, {"description": "MVI FE CP", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5307935", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 85.0, "discounted_cash": 63.75, "setting": "both", "billing_class": "facility"}]}, {"description": "MVI FE DROPS 50ML LQ", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5316649", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 124.0, "discounted_cash": 93.0, "setting": "both", "billing_class": "facility"}]}, {"description": "MVI FE DROPS 50ML LQ", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5316649", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 124.0, "discounted_cash": 93.0, "setting": "both", "billing_class": "facility"}]}, {"description": "MVI FE HEMATINIC TB", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5307911", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 85.0, "discounted_cash": 63.75, "setting": "both", "billing_class": "facility"}]}, {"description": "MVI FE HEMATINIC TB", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5307911", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 85.0, "discounted_cash": 63.75, "setting": "both", "billing_class": "facility"}]}, {"description": "MVI MIN ANTIOX OCULAR TB", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5307923", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 66.0, "discounted_cash": 49.5, "setting": "both", "billing_class": "facility"}]}, {"description": "MVI MIN ANTIOX OCULAR TB", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5307923", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 66.0, "discounted_cash": 49.5, "setting": "both", "billing_class": "facility"}]}, {"description": "MVI MIN CP", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5307939", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 85.0, "discounted_cash": 63.75, "setting": "both", "billing_class": "facility"}]}, {"description": "MVI MIN CP", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5307939", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 85.0, "discounted_cash": 63.75, "setting": "both", "billing_class": "facility"}]}, {"description": "MVI MIN TB", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5307943", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 61.0, "discounted_cash": 45.75, "setting": "both", "billing_class": "facility"}]}, {"description": "MVI MIN TB", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5307943", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 61.0, "discounted_cash": 45.75, "setting": "both", "billing_class": "facility"}]}, {"description": "MVI PEDI 10ML IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5322592", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 450.0, "discounted_cash": 337.5, "setting": "both", "billing_class": "facility"}]}, {"description": "MVI PEDI 5ML IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5322593", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 423.0, "discounted_cash": 317.25, "setting": "both", "billing_class": "facility"}]}, {"description": "MVI PRENTAL TB", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5309800", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 99.0, "discounted_cash": 74.25, "setting": "both", "billing_class": "facility"}]}, {"description": "MVI PRENTAL TB", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5309800", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 99.0, "discounted_cash": 74.25, "setting": "both", "billing_class": "facility"}]}, {"description": "MVI RENAL FORMULA TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5312435", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 92.0, "discounted_cash": 69.0, "setting": "both", "billing_class": "facility"}]}, {"description": "MVI RENAL FORMULA TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5312435", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 92.0, "discounted_cash": 69.0, "setting": "both", "billing_class": "facility"}]}, {"description": "MVI TB", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5307919", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 85.0, "discounted_cash": 63.75, "setting": "both", "billing_class": "facility"}]}, {"description": "MVI TB", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5307919", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 85.0, "discounted_cash": 63.75, "setting": "both", "billing_class": "facility"}]}, {"description": "MVI THERAP TB", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5307912", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 65.0, "discounted_cash": 48.75, "setting": "both", "billing_class": "facility"}]}, {"description": "MVI THERAP TB", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5307912", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 65.0, "discounted_cash": 48.75, "setting": "both", "billing_class": "facility"}]}, {"description": "MVI VIT B COMPLEX FA TB", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5312358", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 71.0, "discounted_cash": 53.25, "setting": "both", "billing_class": "facility"}]}, {"description": "MVI VIT B COMPLEX FA TB", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5312358", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 71.0, "discounted_cash": 53.25, "setting": "both", "billing_class": "facility"}]}, {"description": "MVI VIT B&C FA FE CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5306055", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 64.0, "discounted_cash": 48.0, "setting": "both", "billing_class": "facility"}]}, {"description": "MVI VIT B&C FA FE CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5306055", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 64.0, "discounted_cash": 48.0, "setting": "both", "billing_class": "facility"}]}, {"description": "MVI VIT B&C STRESS TB", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5310960", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 85.0, "discounted_cash": 63.75, "setting": "both", "billing_class": "facility"}]}, {"description": "MVI VIT B&C STRESS TB", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5310960", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 85.0, "discounted_cash": 63.75, "setting": "both", "billing_class": "facility"}]}, {"description": "MYCOPHENOLATE 250MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J7517", "type": "HCPCS"}, {"code": "5307956", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 110.0, "discounted_cash": 82.5, "setting": "both", "billing_class": "facility"}]}, {"description": "MYCOPHENOLATE 250MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J7517", "type": "HCPCS"}, {"code": "5307956", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 110.0, "discounted_cash": 82.5, "setting": "both", "billing_class": "facility"}]}, {"description": "MYCOPHENOLIC ACID", "code_information": [{"code": "80180", "type": "CPT"}, {"code": "7254055", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 258.0, "discounted_cash": 193.5, "setting": "both", "billing_class": "facility"}]}, {"description": "MYCOPLASMA AB/3", "code_information": [{"code": "86738", "type": "CPT"}, {"code": "7256739", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 761.0, "discounted_cash": 570.75, "setting": "both", "billing_class": "facility"}]}, {"description": "MYCOPLASMA AB/4", "code_information": [{"code": "86738", "type": "CPT"}, {"code": "7256740", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 761.0, "discounted_cash": 570.75, "setting": "both", "billing_class": "facility"}]}, {"description": "MYCOPLASMA AMP PROBE", "code_information": [{"code": "87581", "type": "CPT"}, {"code": "4103876", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 398.0, "discounted_cash": 298.5, "setting": "both", "billing_class": "facility"}]}, {"description": "MYCOPLASMA AMP PROBE/3", "code_information": [{"code": "87581", "type": "CPT"}, {"code": "7253876", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 526.0, "discounted_cash": 394.5, "setting": "both", "billing_class": "facility"}]}, {"description": "MYELIN AB", "code_information": [{"code": "86362", "type": "CPT"}, {"code": "7256073", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 1356.0, "discounted_cash": 1017.0, "setting": "both", "billing_class": "facility"}]}, {"description": "MYELIN BASIC PROTEIN CSF", "code_information": [{"code": "83873", "type": "CPT"}, {"code": "7253874", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 1235.0, "discounted_cash": 926.25, "setting": "both", "billing_class": "facility"}]}, {"description": "MYELOGRAM 2 OR> REGIONS", "code_information": [{"code": "72270", "type": "CPT"}, {"code": "4902271", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 1970.0, "discounted_cash": 1477.5, "setting": "both", "billing_class": "facility"}]}, {"description": "MYELOGRAM 2 OR> REGIONS", "code_information": [{"code": "72270", "type": "CPT"}, {"code": "4912271", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 5482.0, "discounted_cash": 4111.5, "setting": "both", "billing_class": "facility"}]}, {"description": "MYELOGRAM C/T/L LUMB INJ", "code_information": [{"code": "4902305", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 3332.0, "discounted_cash": 2499.0, "setting": "both", "billing_class": "facility"}]}, {"description": "MYELOGRAM C/T/L LUMB INJ", "code_information": [{"code": "4912305", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 5482.0, "discounted_cash": 4111.5, "setting": "both", "billing_class": "facility"}]}, {"description": "MYELOGRAM CERV S&I", "code_information": [{"code": "72240", "type": "CPT"}, {"code": "4902240", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 3673.0, "discounted_cash": 2754.75, "setting": "both", "billing_class": "facility"}]}, {"description": "MYELOGRAM CERV S&I", "code_information": [{"code": "72240", "type": "CPT"}, {"code": "4912240", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 4591.0, "discounted_cash": 3443.25, "setting": "both", "billing_class": "facility"}]}, {"description": "MYELOGRAM LUMBAR S&I", "code_information": [{"code": "72265", "type": "CPT"}, {"code": "4902250", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 3527.0, "discounted_cash": 2645.25, "setting": "both", "billing_class": "facility"}]}, {"description": "MYELOGRAM LUMBAR S&I", "code_information": [{"code": "72265", "type": "CPT"}, {"code": "4912250", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 4309.0, "discounted_cash": 3231.75, "setting": "both", "billing_class": "facility"}]}, {"description": "MYELOGRAM THORACIC S&I", "code_information": [{"code": "72255", "type": "CPT"}, {"code": "4902260", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 3616.0, "discounted_cash": 2712.0, "setting": "both", "billing_class": "facility"}]}, {"description": "MYELOGRAM THORACIC S&I", "code_information": [{"code": "72255", "type": "CPT"}, {"code": "4912260", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 4699.0, "discounted_cash": 3524.25, "setting": "both", "billing_class": "facility"}]}, {"description": "MYELOPEROXIDASE (MPO) AB", "code_information": [{"code": "83520", "type": "CPT"}, {"code": "7253567", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 49.0, "discounted_cash": 36.75, "setting": "both", "billing_class": "facility"}]}, {"description": "MYELOPEROXIDASE (MPO) AB", "code_information": [{"code": "83876", "type": "CPT"}, {"code": "7258352", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 43.0, "discounted_cash": 32.25, "setting": "both", "billing_class": "facility"}]}, {"description": "MYOCARDIAL STRAIN IMAGING", "code_information": [{"code": "93356", "type": "CPT"}, {"code": "4600399", "type": "CDM"}, {"code": "483", "type": "RC"}], "standard_charges": [{"gross_charge": 936.2, "discounted_cash": 702.15, "setting": "both", "billing_class": "facility"}]}, {"description": "MYOGLOBIN", "code_information": [{"code": "83874", "type": "CPT"}, {"code": "4103873", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 1095.0, "discounted_cash": 821.25, "setting": "both", "billing_class": "facility"}]}, {"description": "MYOGLOBIN", "code_information": [{"code": "83874", "type": "CPT"}, {"code": "7253873", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 1069.0, "discounted_cash": 801.75, "setting": "both", "billing_class": "facility"}]}, {"description": "MYOGLOBIN/2", "code_information": [{"code": "83874", "type": "CPT"}, {"code": "4103875", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 737.0, "discounted_cash": 552.75, "setting": "both", "billing_class": "facility"}]}, {"description": "MYOGLOBIN/2", "code_information": [{"code": "83874", "type": "CPT"}, {"code": "4173875", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 25.69, "discounted_cash": 19.27, "setting": "both", "billing_class": "facility"}]}, {"description": "MYOGLOBIN/2", "code_information": [{"code": "83874", "type": "CPT"}, {"code": "7253875", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 784.0, "discounted_cash": 588.0, "setting": "both", "billing_class": "facility"}]}, {"description": "MYRIAD MATRIX PER SQ CM", "code_information": [{"code": "A2032", "type": "HCPCS"}, {"code": "4023970", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 76.0, "discounted_cash": 57.0, "setting": "both", "billing_class": "facility"}]}, {"description": "MYRIAD MATRIX PER SQ CM", "code_information": [{"code": "A2032", "type": "HCPCS"}, {"code": "4023970", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 76.0, "discounted_cash": 57.0, "setting": "both", "billing_class": "facility"}]}, {"description": "MYRIAD MORCELLS 4MG", "code_information": [{"code": "A2033", "type": "HCPCS"}, {"code": "4023971", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 122.0, "discounted_cash": 91.5, "setting": "both", "billing_class": "facility"}]}, {"description": "N-ACETYL-PROCAINAMIDE", "code_information": [{"code": "80192", "type": "CPT"}, {"code": "7254143", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 1624.0, "discounted_cash": 1218.0, "setting": "both", "billing_class": "facility"}]}, {"description": "NA ACETATE 0.225%250MLIJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5322673", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 582.0, "discounted_cash": 436.5, "setting": "both", "billing_class": "facility"}]}, {"description": "NA ACETATE NEO CMPD LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5315837", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 85.0, "discounted_cash": 63.75, "setting": "both", "billing_class": "facility"}]}, {"description": "NA ACETATE NEO CMPD LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5315837", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 85.0, "discounted_cash": 63.75, "setting": "both", "billing_class": "facility"}]}, {"description": "NA ACETATE2MEQ/ML 20MLIJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5324130", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 156.0, "discounted_cash": 117.0, "setting": "both", "billing_class": "facility"}]}, {"description": "NA ACETATE2MEQ/ML 50MLIJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5324129", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 374.0, "discounted_cash": 280.5, "setting": "both", "billing_class": "facility"}]}, {"description": "NA BICARB 150MEQ 1L IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5324136", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 653.0, "discounted_cash": 489.75, "setting": "both", "billing_class": "facility"}]}, {"description": "NA BICARB 4.2% 5ML IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5324137", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 569.0, "discounted_cash": 426.75, "setting": "both", "billing_class": "facility"}]}, {"description": "NA BICARB 8.4%10ML PFSIJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5324150", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 483.0, "discounted_cash": 362.25, "setting": "both", "billing_class": "facility"}]}, {"description": "NA BICARB 8.4%50ML IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5324151", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 113.0, "discounted_cash": 84.75, "setting": "both", "billing_class": "facility"}]}, {"description": "NA BICARB 8.4%50ML PFSIJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5324154", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 196.0, "discounted_cash": 147.0, "setting": "both", "billing_class": "facility"}]}, {"description": "NA BICARB PED4.2% IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5324141", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 298.0, "discounted_cash": 223.5, "setting": "both", "billing_class": "facility"}]}, {"description": "NA BICARBONATE 650MG TB", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5310810", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 61.0, "discounted_cash": 45.75, "setting": "both", "billing_class": "facility"}]}, {"description": "NA BICARBONATE 650MG TB", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5310810", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 61.0, "discounted_cash": 45.75, "setting": "both", "billing_class": "facility"}]}, {"description": "NA BIPHOSPHATE ADULT RE", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5338726", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 78.0, "discounted_cash": 58.5, "setting": "both", "billing_class": "facility"}]}, {"description": "NA BIPHOSPHATE ADULT RE", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5338726", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 78.0, "discounted_cash": 58.5, "setting": "both", "billing_class": "facility"}]}, {"description": "NA BIPHOSPHATE PED RE", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5338730", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 66.0, "discounted_cash": 49.5, "setting": "both", "billing_class": "facility"}]}, {"description": "NA BIPHOSPHATE PED RE", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5338730", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 66.0, "discounted_cash": 49.5, "setting": "both", "billing_class": "facility"}]}, {"description": "NA CITRA/CITRC AC30ML LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5316355", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 61.0, "discounted_cash": 45.75, "setting": "both", "billing_class": "facility"}]}, {"description": "NA CITRA/CITRC AC30ML LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5316355", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 61.0, "discounted_cash": 45.75, "setting": "both", "billing_class": "facility"}]}, {"description": "NA CL 1GM TB", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5310833", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 61.0, "discounted_cash": 45.75, "setting": "both", "billing_class": "facility"}]}, {"description": "NA CL 1GM TB", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5310833", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 61.0, "discounted_cash": 45.75, "setting": "both", "billing_class": "facility"}]}, {"description": "NA FERR GLUC PER12.5MGIJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J2916", "type": "HCPCS"}, {"code": "5322669", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 193.0, "discounted_cash": 144.75, "setting": "both", "billing_class": "facility"}]}, {"description": "NA FERR GLUC PER12.5MGIJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J2916", "type": "HCPCS"}, {"code": "5322669", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 193.0, "discounted_cash": 144.75, "setting": "both", "billing_class": "facility"}]}, {"description": "NA HYPOCHL .25% 480ML TS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5337305", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 190.0, "discounted_cash": 142.5, "setting": "both", "billing_class": "facility"}]}, {"description": "NA HYPOCHL .5% 480ML TS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5334811", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 189.0, "discounted_cash": 141.75, "setting": "both", "billing_class": "facility"}]}, {"description": "NA HYPOCHL.125% 480ML TS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5337310", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 230.0, "discounted_cash": 172.5, "setting": "both", "billing_class": "facility"}]}, {"description": "NA PHOSPHATE PER 1ML IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5324255", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 113.0, "discounted_cash": 84.75, "setting": "both", "billing_class": "facility"}]}, {"description": "NA PHOSPHATE3MM/ML 5MLIJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5324256", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 109.0, "discounted_cash": 81.75, "setting": "both", "billing_class": "facility"}]}, {"description": "NA PHOSPHATE3MM/ML15MLIJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5324257", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 360.0, "discounted_cash": 270.0, "setting": "both", "billing_class": "facility"}]}, {"description": "NA THIOSULFATE PER 100MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0209", "type": "HCPCS"}, {"code": "5324298", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 10.0, "discounted_cash": 7.5, "setting": "both", "billing_class": "facility"}]}, {"description": "NA THIOSULFATE PER 100MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0209", "type": "HCPCS"}, {"code": "5324298", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 10.0, "discounted_cash": 7.5, "setting": "both", "billing_class": "facility"}]}, {"description": "NA/K PHOS 250/280/160 PK", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5307970", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 63.0, "discounted_cash": 47.25, "setting": "both", "billing_class": "facility"}]}, {"description": "NA/K PHOS 250/280/160 PK", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5307970", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 63.0, "discounted_cash": 47.25, "setting": "both", "billing_class": "facility"}]}, {"description": "NACL .65% 15ML NASL IS", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5332408", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 85.0, "discounted_cash": 63.75, "setting": "both", "billing_class": "facility"}]}, {"description": "NACL .65% 15ML NASL IS", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5332408", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 85.0, "discounted_cash": 63.75, "setting": "both", "billing_class": "facility"}]}, {"description": "NACL .65% 45ML NASAL SP", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5332385", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 61.0, "discounted_cash": 45.75, "setting": "both", "billing_class": "facility"}]}, {"description": "NACL .65% 45ML NASAL SP", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5332385", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 61.0, "discounted_cash": 45.75, "setting": "both", "billing_class": "facility"}]}, {"description": "NACL .65% 45ML NASL IS", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5332396", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 66.0, "discounted_cash": 49.5, "setting": "both", "billing_class": "facility"}]}, {"description": "NACL .65% 45ML NASL IS", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5332396", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 66.0, "discounted_cash": 49.5, "setting": "both", "billing_class": "facility"}]}, {"description": "NACL .9% 10ML IJ", "code_information": [{"code": "A4216", "type": "HCPCS"}, {"code": "5324194", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 97.0, "discounted_cash": 72.75, "setting": "both", "billing_class": "facility"}]}, {"description": "NACL .9% 10ML PFS IJ", "code_information": [{"code": "A4216", "type": "HCPCS"}, {"code": "5324200", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 100.0, "discounted_cash": 75.0, "setting": "both", "billing_class": "facility"}]}, {"description": "NACL .9% 20ML IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5324193", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 86.0, "discounted_cash": 64.5, "setting": "both", "billing_class": "facility"}]}, {"description": "NACL .9% 3ML PFS IJ", "code_information": [{"code": "A4216", "type": "HCPCS"}, {"code": "5324201", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 66.0, "discounted_cash": 49.5, "setting": "both", "billing_class": "facility"}]}, {"description": "NACL 0.20 250ML IVF", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5412626", "type": "CDM"}, {"code": "258", "type": "RC"}], "standard_charges": [{"gross_charge": 646.0, "discounted_cash": 484.5, "setting": "both", "billing_class": "facility"}]}, {"description": "NACL 0.45 1000ML IVF", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5412625", "type": "CDM"}, {"code": "258", "type": "RC"}], "standard_charges": [{"gross_charge": 485.0, "discounted_cash": 363.75, "setting": "both", "billing_class": "facility"}]}, {"description": "NACL 0.45 250ML IVF", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5412616", "type": "CDM"}, {"code": "258", "type": "RC"}], "standard_charges": [{"gross_charge": 642.0, "discounted_cash": 481.5, "setting": "both", "billing_class": "facility"}]}, {"description": "NACL 0.45 500ML IVF", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5412620", "type": "CDM"}, {"code": "258", "type": "RC"}], "standard_charges": [{"gross_charge": 447.0, "discounted_cash": 335.25, "setting": "both", "billing_class": "facility"}]}, {"description": "NACL 0.9 1000ML IVF", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J7030", "type": "HCPCS"}, {"code": "5412670", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 626.0, "discounted_cash": 469.5, "setting": "both", "billing_class": "facility"}]}, {"description": "NACL 0.9 1000ML IVF", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J7030", "type": "HCPCS"}, {"code": "5412670", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 626.0, "discounted_cash": 469.5, "setting": "both", "billing_class": "facility"}]}, {"description": "NACL 0.9 100ML IVF", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J7050", "type": "HCPCS"}, {"code": "5412640", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 654.0, "discounted_cash": 490.5, "setting": "both", "billing_class": "facility"}]}, {"description": "NACL 0.9 100ML IVF", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J7050", "type": "HCPCS"}, {"code": "5412640", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 654.0, "discounted_cash": 490.5, "setting": "both", "billing_class": "facility"}]}, {"description": "NACL 0.9 150ML IVF", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J7050", "type": "HCPCS"}, {"code": "5412650", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 520.0, "discounted_cash": 390.0, "setting": "both", "billing_class": "facility"}]}, {"description": "NACL 0.9 150ML IVF", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J7050", "type": "HCPCS"}, {"code": "5412650", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 520.0, "discounted_cash": 390.0, "setting": "both", "billing_class": "facility"}]}, {"description": "NACL 0.9 250ML IVF", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J7050", "type": "HCPCS"}, {"code": "5412655", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 652.0, "discounted_cash": 489.0, "setting": "both", "billing_class": "facility"}]}, {"description": "NACL 0.9 250ML IVF", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J7050", "type": "HCPCS"}, {"code": "5412655", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 652.0, "discounted_cash": 489.0, "setting": "both", "billing_class": "facility"}]}, {"description": "NACL 0.9 25ML IVF", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J7050", "type": "HCPCS"}, {"code": "5412630", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 588.0, "discounted_cash": 441.0, "setting": "both", "billing_class": "facility"}]}, {"description": "NACL 0.9 25ML IVF", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J7050", "type": "HCPCS"}, {"code": "5412630", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 588.0, "discounted_cash": 441.0, "setting": "both", "billing_class": "facility"}]}, {"description": "NACL 0.9 500ML IVF", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J7040", "type": "HCPCS"}, {"code": "5412665", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 687.0, "discounted_cash": 515.25, "setting": "both", "billing_class": "facility"}]}, {"description": "NACL 0.9 500ML IVF", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J7040", "type": "HCPCS"}, {"code": "5412665", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 687.0, "discounted_cash": 515.25, "setting": "both", "billing_class": "facility"}]}, {"description": "NACL 0.9 50ML IVF", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J7050", "type": "HCPCS"}, {"code": "5412635", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 654.0, "discounted_cash": 490.5, "setting": "both", "billing_class": "facility"}]}, {"description": "NACL 0.9 50ML IVF", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J7050", "type": "HCPCS"}, {"code": "5412635", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 654.0, "discounted_cash": 490.5, "setting": "both", "billing_class": "facility"}]}, {"description": "NACL 0.9 MB+ 100ML IVF", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J7050", "type": "HCPCS"}, {"code": "5412642", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 420.0, "discounted_cash": 315.0, "setting": "both", "billing_class": "facility"}]}, {"description": "NACL 0.9 MB+ 100ML IVF", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J7050", "type": "HCPCS"}, {"code": "5412642", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 420.0, "discounted_cash": 315.0, "setting": "both", "billing_class": "facility"}]}, {"description": "NACL 0.9 MB+ 50ML IVF", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J7050", "type": "HCPCS"}, {"code": "5412637", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 420.0, "discounted_cash": 315.0, "setting": "both", "billing_class": "facility"}]}, {"description": "NACL 0.9 MB+ 50ML IVF", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J7050", "type": "HCPCS"}, {"code": "5412637", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 420.0, "discounted_cash": 315.0, "setting": "both", "billing_class": "facility"}]}, {"description": "NACL 0.9% 5ML IS", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5332392", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 85.0, "discounted_cash": 63.75, "setting": "both", "billing_class": "facility"}]}, {"description": "NACL 0.9% 5ML IS", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5332392", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 85.0, "discounted_cash": 63.75, "setting": "both", "billing_class": "facility"}]}, {"description": "NACL 14.6% 20ML IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5324180", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 113.0, "discounted_cash": 84.75, "setting": "both", "billing_class": "facility"}]}, {"description": "NACL 23.4% 30ML IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5324178", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 1817.0, "discounted_cash": 1362.75, "setting": "both", "billing_class": "facility"}]}, {"description": "NACL 3% 4ML IS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5332407", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 61.0, "discounted_cash": 45.75, "setting": "both", "billing_class": "facility"}]}, {"description": "NACL 3% 500ML IVF", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5412690", "type": "CDM"}, {"code": "258", "type": "RC"}], "standard_charges": [{"gross_charge": 605.0, "discounted_cash": 453.75, "setting": "both", "billing_class": "facility"}]}, {"description": "NACL 4MEQ/ML 1ML IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5324182", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 85.0, "discounted_cash": 63.75, "setting": "both", "billing_class": "facility"}]}, {"description": "NACL 9% 3ML IS", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5332391", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 66.0, "discounted_cash": 49.5, "setting": "both", "billing_class": "facility"}]}, {"description": "NACL 9% 3ML IS", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5332391", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 66.0, "discounted_cash": 49.5, "setting": "both", "billing_class": "facility"}]}, {"description": "NACL BACT .9% 30ML IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5324199", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 113.0, "discounted_cash": 84.75, "setting": "both", "billing_class": "facility"}]}, {"description": "NACL HYPERTONIC5%15ML OS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5332403", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 252.0, "discounted_cash": 189.0, "setting": "both", "billing_class": "facility"}]}, {"description": "NACL PED DS LQ", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5316347", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 100.0, "discounted_cash": 75.0, "setting": "both", "billing_class": "facility"}]}, {"description": "NACL PED DS LQ", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5316347", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 100.0, "discounted_cash": 75.0, "setting": "both", "billing_class": "facility"}]}, {"description": "NACL.45 KCL20 1000ML IVF", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5412621", "type": "CDM"}, {"code": "258", "type": "RC"}], "standard_charges": [{"gross_charge": 616.0, "discounted_cash": 462.0, "setting": "both", "billing_class": "facility"}]}, {"description": "NACL.9 ARTH 3L IRR", "code_information": [{"code": "A4217", "type": "HCPCS"}, {"code": "5414185", "type": "CDM"}, {"code": "270", "type": "RC"}], "standard_charges": [{"gross_charge": 665.0, "discounted_cash": 498.75, "setting": "both", "billing_class": "facility"}]}, {"description": "NACL.9 KCL20 1000ML IVF", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5412680", "type": "CDM"}, {"code": "258", "type": "RC"}], "standard_charges": [{"gross_charge": 576.0, "discounted_cash": 432.0, "setting": "both", "billing_class": "facility"}]}, {"description": "NACL.9 KCL40 1000ML IVF", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5412685", "type": "CDM"}, {"code": "258", "type": "RC"}], "standard_charges": [{"gross_charge": 491.0, "discounted_cash": 368.25, "setting": "both", "billing_class": "facility"}]}, {"description": "NACL/ALOE.65%14GM NAS GL", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5337304", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 84.0, "discounted_cash": 63.0, "setting": "both", "billing_class": "facility"}]}, {"description": "NACL/ALOE.65%14GM NAS GL", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5337304", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 84.0, "discounted_cash": 63.0, "setting": "both", "billing_class": "facility"}]}, {"description": "NACL100MEQ/40ML IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5324176", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 85.0, "discounted_cash": 63.75, "setting": "both", "billing_class": "facility"}]}, {"description": "NADOLOL 40MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5307974", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 66.0, "discounted_cash": 49.5, "setting": "both", "billing_class": "facility"}]}, {"description": "NADOLOL 40MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5307974", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 66.0, "discounted_cash": 49.5, "setting": "both", "billing_class": "facility"}]}, {"description": "NAFCILLIN PED CMPD IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J7999", "type": "HCPCS"}, {"code": "5322665", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 90.0, "discounted_cash": 67.5, "setting": "both", "billing_class": "facility"}]}, {"description": "NAFCILLIN PED CMPD IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J7999", "type": "HCPCS"}, {"code": "5322665", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 90.0, "discounted_cash": 67.5, "setting": "both", "billing_class": "facility"}]}, {"description": "NAFCILLIN PER 20MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J2290", "type": "HCPCS"}, {"code": "5322653", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 5.0, "discounted_cash": 3.75, "setting": "both", "billing_class": "facility"}]}, {"description": "NAFCILLIN PER 20MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J2290", "type": "HCPCS"}, {"code": "5322653", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 5.0, "discounted_cash": 3.75, "setting": "both", "billing_class": "facility"}]}, {"description": "NAFCILLIN PER1ML CMPD IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J7999", "type": "HCPCS"}, {"code": "5322667", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 113.0, "discounted_cash": 84.75, "setting": "both", "billing_class": "facility"}]}, {"description": "NAFCILLIN PER1ML CMPD IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J7999", "type": "HCPCS"}, {"code": "5322667", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 113.0, "discounted_cash": 84.75, "setting": "both", "billing_class": "facility"}]}, {"description": "NAIL & SCREW SET", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8133072", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 16961.0, "discounted_cash": 12720.75, "setting": "both", "billing_class": "facility"}]}, {"description": "NAIL ANKLE ARTHRODESIS", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8132999", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 98546.0, "discounted_cash": 73909.5, "setting": "both", "billing_class": "facility"}]}, {"description": "NAIL BROOKERWIL", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8133000", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 18390.0, "discounted_cash": 13792.5, "setting": "both", "billing_class": "facility"}]}, {"description": "NAIL HUMERAL", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8133025", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 22369.0, "discounted_cash": 16776.75, "setting": "both", "billing_class": "facility"}]}, {"description": "NAIL INTRAMEDULLARY TYP1", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8133001", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 15441.0, "discounted_cash": 11580.75, "setting": "both", "billing_class": "facility"}]}, {"description": "NAIL INTRAMEDULLARY TYP2", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8133002", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 20804.0, "discounted_cash": 15603.0, "setting": "both", "billing_class": "facility"}]}, {"description": "NAIL INTRAMEDULLARY TYP5", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8133006", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 32431.0, "discounted_cash": 24323.25, "setting": "both", "billing_class": "facility"}]}, {"description": "NAIL TIBIA", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8133075", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 20949.0, "discounted_cash": 15711.75, "setting": "both", "billing_class": "facility"}]}, {"description": "NAIL TIBIA EXTE", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8133080", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 6676.0, "discounted_cash": 5007.0, "setting": "both", "billing_class": "facility"}]}, {"description": "NAIL TITANIUM ELASTIC", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8133081", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 5593.0, "discounted_cash": 4194.75, "setting": "both", "billing_class": "facility"}]}, {"description": "NALOXONE PER 0.01MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J2312", "type": "HCPCS"}, {"code": "5322718", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 0.96, "discounted_cash": 0.72, "setting": "both", "billing_class": "facility"}]}, {"description": "NALOXONE PER 0.01MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J2312", "type": "HCPCS"}, {"code": "5322718", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 0.96, "discounted_cash": 0.72, "setting": "both", "billing_class": "facility"}]}, {"description": "NALOXONE PER 1ML IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5322715", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 463.0, "discounted_cash": 347.25, "setting": "both", "billing_class": "facility"}]}, {"description": "NALTREXONE 50MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5308069", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 90.0, "discounted_cash": 67.5, "setting": "both", "billing_class": "facility"}]}, {"description": "NALTREXONE 50MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5308069", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 90.0, "discounted_cash": 67.5, "setting": "both", "billing_class": "facility"}]}, {"description": "NAPHAZOLINE .012%15ML OS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5331495", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 72.0, "discounted_cash": 54.0, "setting": "both", "billing_class": "facility"}]}, {"description": "NAPHAZOLINE .012%15ML OS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5331495", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 72.0, "discounted_cash": 54.0, "setting": "both", "billing_class": "facility"}]}, {"description": "NAPROXEN 220MG TB", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5308079", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 55.0, "discounted_cash": 41.25, "setting": "both", "billing_class": "facility"}]}, {"description": "NAPROXEN 220MG TB", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5308079", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 55.0, "discounted_cash": 41.25, "setting": "both", "billing_class": "facility"}]}, {"description": "NAPROXEN 250MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5308078", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 85.0, "discounted_cash": 63.75, "setting": "both", "billing_class": "facility"}]}, {"description": "NAPROXEN 250MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5308078", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 85.0, "discounted_cash": 63.75, "setting": "both", "billing_class": "facility"}]}, {"description": "NAPROXEN 275MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5308082", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 70.0, "discounted_cash": 52.5, "setting": "both", "billing_class": "facility"}]}, {"description": "NAPROXEN 275MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5308082", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 70.0, "discounted_cash": 52.5, "setting": "both", "billing_class": "facility"}]}, {"description": "NAPROXEN 375MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5308086", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 85.0, "discounted_cash": 63.75, "setting": "both", "billing_class": "facility"}]}, {"description": "NAPROXEN 375MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5308086", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 85.0, "discounted_cash": 63.75, "setting": "both", "billing_class": "facility"}]}, {"description": "NAPROXEN 500MG EC TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5308081", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 85.0, "discounted_cash": 63.75, "setting": "both", "billing_class": "facility"}]}, {"description": "NAPROXEN 500MG EC TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5308081", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 85.0, "discounted_cash": 63.75, "setting": "both", "billing_class": "facility"}]}, {"description": "NAPROXEN 500MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5308088", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 78.0, "discounted_cash": 58.5, "setting": "both", "billing_class": "facility"}]}, {"description": "NAPROXEN 500MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5308088", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 78.0, "discounted_cash": 58.5, "setting": "both", "billing_class": "facility"}]}, {"description": "NAPROXEN 550MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5308087", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 78.0, "discounted_cash": 58.5, "setting": "both", "billing_class": "facility"}]}, {"description": "NAPROXEN 550MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5308087", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 78.0, "discounted_cash": 58.5, "setting": "both", "billing_class": "facility"}]}, {"description": "NASAL BONES 3VW MIN", "code_information": [{"code": "70160", "type": "CPT"}, {"code": "4900160", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 837.0, "discounted_cash": 627.75, "setting": "both", "billing_class": "facility"}]}, {"description": "NASAL BONES 3VW MIN", "code_information": [{"code": "70160", "type": "CPT"}, {"code": "5110160", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 1056.0, "discounted_cash": 792.0, "setting": "both", "billing_class": "facility"}]}, {"description": "NASAL SMEAR EOSINOPHILES", "code_information": [{"code": "89190", "type": "CPT"}, {"code": "4109190", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 390.0, "discounted_cash": 292.5, "setting": "both", "billing_class": "facility"}]}, {"description": "NASAL SMEAR EOSINOPHILES", "code_information": [{"code": "89190", "type": "CPT"}, {"code": "4179190", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 8.56, "discounted_cash": 6.42, "setting": "both", "billing_class": "facility"}]}, {"description": "NAT KILLER CELL TOT CNT", "code_information": [{"code": "86357", "type": "CPT"}, {"code": "4108637", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 355.0, "discounted_cash": 266.25, "setting": "both", "billing_class": "facility"}]}, {"description": "NAT KILLER CELL TOT CNT", "code_information": [{"code": "86357", "type": "CPT"}, {"code": "7250018", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 76.0, "discounted_cash": 57.0, "setting": "both", "billing_class": "facility"}]}, {"description": "NATEGLINIDE 60MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5308092", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 85.0, "discounted_cash": 63.75, "setting": "both", "billing_class": "facility"}]}, {"description": "NATEGLINIDE 60MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5308092", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 85.0, "discounted_cash": 63.75, "setting": "both", "billing_class": "facility"}]}, {"description": "NC CONVALESCENT FFP", "code_information": [{"code": "P9017", "type": "HCPCS"}, {"code": "4500075", "type": "CDM"}, {"code": "399", "type": "RC"}], "standard_charges": [{"gross_charge": 0.01, "discounted_cash": 0.01, "setting": "both", "billing_class": "facility"}]}, {"description": "NC CONVALESCENT PATH REDCD FFP", "code_information": [{"code": "P9071", "type": "HCPCS"}, {"code": "4500076", "type": "CDM"}, {"code": "399", "type": "RC"}], "standard_charges": [{"gross_charge": 0.01, "discounted_cash": 0.01, "setting": "both", "billing_class": "facility"}]}, {"description": "NC CONVALESCNT FRSH LIQ PLASMA", "code_information": [{"code": "P9099", "type": "HCPCS"}, {"code": "4500077", "type": "CDM"}, {"code": "399", "type": "RC"}], "standard_charges": [{"gross_charge": 0.01, "discounted_cash": 0.01, "setting": "both", "billing_class": "facility"}]}, {"description": "NDL CRYOABLATION ICEFORCE", "code_information": [{"code": "C9809", "type": "HCPCS"}, {"code": "8178172", "type": "CDM"}, {"code": "272", "type": "RC"}], "standard_charges": [{"gross_charge": 29646.0, "discounted_cash": 22234.5, "setting": "both", "billing_class": "facility"}]}, {"description": "NECK FOR SOFT TISSUES", "code_information": [{"code": "70360", "type": "CPT"}, {"code": "4900360", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 1186.0, "discounted_cash": 889.5, "setting": "both", "billing_class": "facility"}]}, {"description": "NECK FOR SOFT TISSUES", "code_information": [{"code": "70360", "type": "CPT"}, {"code": "5110360", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 1410.0, "discounted_cash": 1057.5, "setting": "both", "billing_class": "facility"}]}, {"description": "NEG PRESS THRPY <=50CM", "code_information": [{"code": "97605", "type": "CPT"}, {"code": "6817605", "type": "CDM"}, {"code": "761", "type": "RC"}], "standard_charges": [{"gross_charge": 1849.0, "discounted_cash": 1386.75, "setting": "both", "billing_class": "facility"}]}, {"description": "NEG PRESS THRPY <=50CM", "code_information": [{"code": "97605", "type": "CPT"}, {"code": "6907608", "type": "CDM"}, {"code": "761", "type": "RC"}], "standard_charges": [{"gross_charge": 325.0, "discounted_cash": 243.75, "setting": "both", "billing_class": "facility"}]}, {"description": "NEG PRESS THRPY >50CM", "code_information": [{"code": "97606", "type": "CPT"}, {"code": "6817606", "type": "CDM"}, {"code": "761", "type": "RC"}], "standard_charges": [{"gross_charge": 1475.0, "discounted_cash": 1106.25, "setting": "both", "billing_class": "facility"}]}, {"description": "NEG PRESS THRPY >50CM", "code_information": [{"code": "97606", "type": "CPT"}, {"code": "6907609", "type": "CDM"}, {"code": "761", "type": "RC"}], "standard_charges": [{"gross_charge": 687.0, "discounted_cash": 515.25, "setting": "both", "billing_class": "facility"}]}, {"description": "NEG PRESS TX MPD <50CM", "code_information": [{"code": "97607", "type": "CPT"}, {"code": "6900456", "type": "CDM"}, {"code": "761", "type": "RC"}], "standard_charges": [{"gross_charge": 1465.0, "discounted_cash": 1098.75, "setting": "both", "billing_class": "facility"}]}, {"description": "NEG PRESS TX MPD >50CM", "code_information": [{"code": "97608", "type": "CPT"}, {"code": "6900457", "type": "CDM"}, {"code": "761", "type": "RC"}], "standard_charges": [{"gross_charge": 1465.0, "discounted_cash": 1098.75, "setting": "both", "billing_class": "facility"}]}, {"description": "NELFINAVIR 250MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5308099", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 124.0, "discounted_cash": 93.0, "setting": "both", "billing_class": "facility"}]}, {"description": "NELFINAVIR 250MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5308099", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 124.0, "discounted_cash": 93.0, "setting": "both", "billing_class": "facility"}]}, {"description": "NEO/BAC/POLYB 15GM OI", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5336776", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 120.0, "discounted_cash": 90.0, "setting": "both", "billing_class": "facility"}]}, {"description": "NEO/BAC/POLYB 15GM OI", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5336776", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 120.0, "discounted_cash": 90.0, "setting": "both", "billing_class": "facility"}]}, {"description": "NEO/BAC/POLYB 30GM OI", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5336775", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 197.0, "discounted_cash": 147.75, "setting": "both", "billing_class": "facility"}]}, {"description": "NEO/BAC/POLYB 30GM OI", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5336775", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 197.0, "discounted_cash": 147.75, "setting": "both", "billing_class": "facility"}]}, {"description": "NEO/BAC/POLYB.9GM OI", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5336777", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 77.0, "discounted_cash": 57.75, "setting": "both", "billing_class": "facility"}]}, {"description": "NEO/BAC/POLYB.9GM OI", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5336777", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 77.0, "discounted_cash": 57.75, "setting": "both", "billing_class": "facility"}]}, {"description": "NEO/POLY/BAC/HCTS3.5GMOO", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5331584", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 315.0, "discounted_cash": 236.25, "setting": "both", "billing_class": "facility"}]}, {"description": "NEO/POLY/BAC/HCTS3.5GMOO", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5331584", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 315.0, "discounted_cash": 236.25, "setting": "both", "billing_class": "facility"}]}, {"description": "NEOMY/POLY/BACIT3.5GM OO", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5331612", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 144.0, "discounted_cash": 108.0, "setting": "both", "billing_class": "facility"}]}, {"description": "NEOMY/POLY/BACIT3.5GM OO", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5331612", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 144.0, "discounted_cash": 108.0, "setting": "both", "billing_class": "facility"}]}, {"description": "NEOMY/POLY/GRAMICD10MLOS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5331605", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 641.0, "discounted_cash": 480.75, "setting": "both", "billing_class": "facility"}]}, {"description": "NEOMY/POLY/GRAMICD10MLOS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5331605", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 641.0, "discounted_cash": 480.75, "setting": "both", "billing_class": "facility"}]}, {"description": "NEOMY/POLY/HCTS 7.5ML OS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5331566", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 1597.0, "discounted_cash": 1197.75, "setting": "both", "billing_class": "facility"}]}, {"description": "NEOMY/POLY/HCTS 7.5ML OS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5331566", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 1597.0, "discounted_cash": 1197.75, "setting": "both", "billing_class": "facility"}]}, {"description": "NEOMYCIN 500MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5308105", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 61.0, "discounted_cash": 45.75, "setting": "both", "billing_class": "facility"}]}, {"description": "NEOMYCIN 500MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5308105", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 61.0, "discounted_cash": 45.75, "setting": "both", "billing_class": "facility"}]}, {"description": "NEOMYCIN/POLYMB IR 1MLTS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5336779", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 1118.0, "discounted_cash": 838.5, "setting": "both", "billing_class": "facility"}]}, {"description": "NEOSTIGMINE UPTO .5MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J2710", "type": "HCPCS"}, {"code": "5322810", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 4.0, "discounted_cash": 3.0, "setting": "both", "billing_class": "facility"}]}, {"description": "NEOSTIGMINE UPTO .5MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J2710", "type": "HCPCS"}, {"code": "5322810", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 4.0, "discounted_cash": 3.0, "setting": "both", "billing_class": "facility"}]}, {"description": "NEPHELOMETRY EA ANALYTE", "code_information": [{"code": "83883", "type": "CPT"}, {"code": "7258427", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 316.0, "discounted_cash": 237.0, "setting": "both", "billing_class": "facility"}]}, {"description": "NEURO CSF PRION PRTN QUAL", "code_information": [{"code": "35U", "type": "CPT"}, {"code": "7250037", "type": "CDM"}, {"code": "310", "type": "RC"}], "standard_charges": [{"gross_charge": 1007.0, "discounted_cash": 755.25, "setting": "both", "billing_class": "facility"}]}, {"description": "NEUROMYELITIS OPTICA", "code_information": [{"code": "83520", "type": "CPT"}, {"code": "7253501", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 1444.0, "discounted_cash": 1083.0, "setting": "both", "billing_class": "facility"}]}, {"description": "NEUROMYELITIS OPTICAL AB", "code_information": [{"code": "86255", "type": "CPT"}, {"code": "7256250", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 859.0, "discounted_cash": 644.25, "setting": "both", "billing_class": "facility"}]}, {"description": "NEUTRALIZATN TEST VIRAL", "code_information": [{"code": "86382", "type": "CPT"}, {"code": "7256387", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 216.0, "discounted_cash": 162.0, "setting": "both", "billing_class": "facility"}]}, {"description": "NEVIRAPINE 10MG/ML 5MLLQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5315842", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 95.0, "discounted_cash": 71.25, "setting": "both", "billing_class": "facility"}]}, {"description": "NEVIRAPINE 10MG/ML 5MLLQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5315842", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 95.0, "discounted_cash": 71.25, "setting": "both", "billing_class": "facility"}]}, {"description": "NEVIRAPINE 200MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5308130", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 174.0, "discounted_cash": 130.5, "setting": "both", "billing_class": "facility"}]}, {"description": "NEVIRAPINE 200MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5308130", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 174.0, "discounted_cash": 130.5, "setting": "both", "billing_class": "facility"}]}, {"description": "NEWBORN LEVEL I", "code_information": [{"code": "1990010", "type": "CDM"}, {"code": "171", "type": "RC"}], "standard_charges": [{"gross_charge": 1846.0, "discounted_cash": 1384.5, "setting": "both", "billing_class": "facility"}]}, {"description": "NEWBORN LEVEL I", "code_information": [{"code": "2550010", "type": "CDM"}, {"code": "171", "type": "RC"}], "standard_charges": [{"gross_charge": 1846.0, "discounted_cash": 1384.5, "setting": "both", "billing_class": "facility"}]}, {"description": "NEWBORN LEVEL II", "code_information": [{"code": "1990012", "type": "CDM"}, {"code": "172", "type": "RC"}], "standard_charges": [{"gross_charge": 5280.0, "discounted_cash": 3960.0, "setting": "both", "billing_class": "facility"}]}, {"description": "NEWBORN LEVEL II", "code_information": [{"code": "2210012", "type": "CDM"}, {"code": "172", "type": "RC"}], "standard_charges": [{"gross_charge": 5280.0, "discounted_cash": 3960.0, "setting": "both", "billing_class": "facility"}]}, {"description": "NEWBORN LEVEL II", "code_information": [{"code": "2550012", "type": "CDM"}, {"code": "172", "type": "RC"}], "standard_charges": [{"gross_charge": 5280.0, "discounted_cash": 3960.0, "setting": "both", "billing_class": "facility"}]}, {"description": "NEWBORN RESUSCITATION", "code_information": [{"code": "99465", "type": "CPT"}, {"code": "3110164", "type": "CDM"}, {"code": "410", "type": "RC"}], "standard_charges": [{"gross_charge": 1138.0, "discounted_cash": 853.5, "setting": "both", "billing_class": "facility"}]}, {"description": "NFCT DS CHRNC HCV 6 ASSAYS", "code_information": [{"code": "81596", "type": "CPT"}, {"code": "7251596", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 239.0, "discounted_cash": 179.25, "setting": "both", "billing_class": "facility"}]}, {"description": "NFCT DS DNA UNTRGT NGNRJ SEQ", "code_information": [{"code": "152U", "type": "CPT"}, {"code": "7250412", "type": "CDM"}, {"code": "310", "type": "RC"}], "standard_charges": [{"gross_charge": 4042.0, "discounted_cash": 3031.5, "setting": "both", "billing_class": "facility"}]}, {"description": "NIACIN 500MG TB", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5308247", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 85.0, "discounted_cash": 63.75, "setting": "both", "billing_class": "facility"}]}, {"description": "NIACIN 500MG TB", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5308247", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 85.0, "discounted_cash": 63.75, "setting": "both", "billing_class": "facility"}]}, {"description": "NIACIN 500MG XR TB", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5308248", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 66.0, "discounted_cash": 49.5, "setting": "both", "billing_class": "facility"}]}, {"description": "NIACIN 500MG XR TB", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5308248", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 66.0, "discounted_cash": 49.5, "setting": "both", "billing_class": "facility"}]}, {"description": "NICARDIPINE PER 0.1MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J2404", "type": "HCPCS"}, {"code": "5322851", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 2.0, "discounted_cash": 1.5, "setting": "both", "billing_class": "facility"}]}, {"description": "NICARDIPINE PER 0.1MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J2404", "type": "HCPCS"}, {"code": "5322851", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 2.0, "discounted_cash": 1.5, "setting": "both", "billing_class": "facility"}]}, {"description": "NICARDIPINE PER 0.1MG PMX IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J2404", "type": "HCPCS"}, {"code": "5322852", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 3.0, "discounted_cash": 2.25, "setting": "both", "billing_class": "facility"}]}, {"description": "NICARDIPINE PER 0.1MG PMX IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J2404", "type": "HCPCS"}, {"code": "5322852", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 3.0, "discounted_cash": 2.25, "setting": "both", "billing_class": "facility"}]}, {"description": "NICARDIPINE PER 1ML IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5322857", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 1988.0, "discounted_cash": 1491.0, "setting": "both", "billing_class": "facility"}]}, {"description": "NICOTINE 14MG TD", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5336811", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 71.0, "discounted_cash": 53.25, "setting": "both", "billing_class": "facility"}]}, {"description": "NICOTINE 14MG TD", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5336811", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 71.0, "discounted_cash": 53.25, "setting": "both", "billing_class": "facility"}]}, {"description": "NICOTINE 21MG TD", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5336812", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 61.0, "discounted_cash": 45.75, "setting": "both", "billing_class": "facility"}]}, {"description": "NICOTINE 21MG TD", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5336812", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 61.0, "discounted_cash": 45.75, "setting": "both", "billing_class": "facility"}]}, {"description": "NICOTINE 7MG TD", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5336810", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 126.0, "discounted_cash": 94.5, "setting": "both", "billing_class": "facility"}]}, {"description": "NICOTINE 7MG TD", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5336810", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 126.0, "discounted_cash": 94.5, "setting": "both", "billing_class": "facility"}]}, {"description": "NICOTINE GUM 2MG EA", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5308275", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 66.0, "discounted_cash": 49.5, "setting": "both", "billing_class": "facility"}]}, {"description": "NICOTINE GUM 2MG EA", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5308275", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 66.0, "discounted_cash": 49.5, "setting": "both", "billing_class": "facility"}]}, {"description": "NICU NB LVL III", "code_information": [{"code": "1990070", "type": "CDM"}, {"code": "173", "type": "RC"}], "standard_charges": [{"gross_charge": 10055.0, "discounted_cash": 7541.25, "setting": "both", "billing_class": "facility"}]}, {"description": "NICU NB LVL III", "code_information": [{"code": "2210070", "type": "CDM"}, {"code": "173", "type": "RC"}], "standard_charges": [{"gross_charge": 10055.0, "discounted_cash": 7541.25, "setting": "both", "billing_class": "facility"}]}, {"description": "NICU NB LVL IV", "code_information": [{"code": "1990020", "type": "CDM"}, {"code": "174", "type": "RC"}], "standard_charges": [{"gross_charge": 13132.0, "discounted_cash": 9849.0, "setting": "both", "billing_class": "facility"}]}, {"description": "NICU NB LVL IV", "code_information": [{"code": "2210020", "type": "CDM"}, {"code": "174", "type": "RC"}], "standard_charges": [{"gross_charge": 13132.0, "discounted_cash": 9849.0, "setting": "both", "billing_class": "facility"}]}, {"description": "NIFEDIPINE 10MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5308312", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 85.0, "discounted_cash": 63.75, "setting": "both", "billing_class": "facility"}]}, {"description": "NIFEDIPINE 10MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5308312", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 85.0, "discounted_cash": 63.75, "setting": "both", "billing_class": "facility"}]}, {"description": "NIFEDIPINE 30MG XR TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5308310", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 66.0, "discounted_cash": 49.5, "setting": "both", "billing_class": "facility"}]}, {"description": "NIFEDIPINE 30MG XR TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5308310", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 66.0, "discounted_cash": 49.5, "setting": "both", "billing_class": "facility"}]}, {"description": "NIFEDIPINE 60MG XR TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5308309", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 61.0, "discounted_cash": 45.75, "setting": "both", "billing_class": "facility"}]}, {"description": "NIFEDIPINE 60MG XR TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5308309", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 61.0, "discounted_cash": 45.75, "setting": "both", "billing_class": "facility"}]}, {"description": "NIFEDIPINE 90MG XR TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5308308", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 90.0, "discounted_cash": 67.5, "setting": "both", "billing_class": "facility"}]}, {"description": "NIFEDIPINE 90MG XR TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5308308", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 90.0, "discounted_cash": 67.5, "setting": "both", "billing_class": "facility"}]}, {"description": "NIMODIPINE 30MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5308320", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 233.0, "discounted_cash": 174.75, "setting": "both", "billing_class": "facility"}]}, {"description": "NIMODIPINE 30MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5308320", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 233.0, "discounted_cash": 174.75, "setting": "both", "billing_class": "facility"}]}, {"description": "NISOLDIPINE 8.5MG XR TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5308322", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 189.0, "discounted_cash": 141.75, "setting": "both", "billing_class": "facility"}]}, {"description": "NISOLDIPINE 8.5MG XR TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5308322", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 189.0, "discounted_cash": 141.75, "setting": "both", "billing_class": "facility"}]}, {"description": "NITAZOXANID100MG/5MLPWLQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5315862", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 640.0, "discounted_cash": 480.0, "setting": "both", "billing_class": "facility"}]}, {"description": "NITAZOXANID100MG/5MLPWLQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5315862", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 640.0, "discounted_cash": 480.0, "setting": "both", "billing_class": "facility"}]}, {"description": "NITAZOXANIDE 500MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5308395", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 894.0, "discounted_cash": 670.5, "setting": "both", "billing_class": "facility"}]}, {"description": "NITAZOXANIDE 500MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5308395", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 894.0, "discounted_cash": 670.5, "setting": "both", "billing_class": "facility"}]}, {"description": "NITRIC OXIDE PER DAY", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5503490", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 25345.0, "discounted_cash": 19008.75, "setting": "both", "billing_class": "facility"}]}, {"description": "NITROFURANTOIN 100MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5308337", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 66.0, "discounted_cash": 49.5, "setting": "both", "billing_class": "facility"}]}, {"description": "NITROFURANTOIN 100MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5308337", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 66.0, "discounted_cash": 49.5, "setting": "both", "billing_class": "facility"}]}, {"description": "NITROFURANTOIN 50MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5308335", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 61.0, "discounted_cash": 45.75, "setting": "both", "billing_class": "facility"}]}, {"description": "NITROFURANTOIN 50MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5308335", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 61.0, "discounted_cash": 45.75, "setting": "both", "billing_class": "facility"}]}, {"description": "NITROGLYCERIN .1MG/HR TD", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5336835", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 71.0, "discounted_cash": 53.25, "setting": "both", "billing_class": "facility"}]}, {"description": "NITROGLYCERIN .1MG/HR TD", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5336835", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 71.0, "discounted_cash": 53.25, "setting": "both", "billing_class": "facility"}]}, {"description": "NITROGLYCERIN .2MG/HR TD", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5336836", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 61.0, "discounted_cash": 45.75, "setting": "both", "billing_class": "facility"}]}, {"description": "NITROGLYCERIN .2MG/HR TD", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5336836", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 61.0, "discounted_cash": 45.75, "setting": "both", "billing_class": "facility"}]}, {"description": "NITROGLYCERIN .3MG/HR TD", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5336837", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 118.0, "discounted_cash": 88.5, "setting": "both", "billing_class": "facility"}]}, {"description": "NITROGLYCERIN .3MG/HR TD", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5336837", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 118.0, "discounted_cash": 88.5, "setting": "both", "billing_class": "facility"}]}, {"description": "NITROGLYCERIN .4MG SL TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5308378", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 85.0, "discounted_cash": 63.75, "setting": "both", "billing_class": "facility"}]}, {"description": "NITROGLYCERIN .4MG SL TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5308378", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 85.0, "discounted_cash": 63.75, "setting": "both", "billing_class": "facility"}]}, {"description": "NITROGLYCERIN .4MG/HR TD", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5336838", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 61.0, "discounted_cash": 45.75, "setting": "both", "billing_class": "facility"}]}, {"description": "NITROGLYCERIN .4MG/HR TD", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5336838", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 61.0, "discounted_cash": 45.75, "setting": "both", "billing_class": "facility"}]}, {"description": "NITROGLYCERIN .6MG/HR TD", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5336840", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 59.0, "discounted_cash": 44.25, "setting": "both", "billing_class": "facility"}]}, {"description": "NITROGLYCERIN .6MG/HR TD", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5336840", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 59.0, "discounted_cash": 44.25, "setting": "both", "billing_class": "facility"}]}, {"description": "NITROGLYCERIN PER 5MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J2305", "type": "HCPCS"}, {"code": "5322955", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 35.0, "discounted_cash": 26.25, "setting": "both", "billing_class": "facility"}]}, {"description": "NITROGLYCERIN PER 5MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J2305", "type": "HCPCS"}, {"code": "5322955", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 35.0, "discounted_cash": 26.25, "setting": "both", "billing_class": "facility"}]}, {"description": "NITROGLYCERIN PER 5MG PMX IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J2305", "type": "HCPCS"}, {"code": "5322956", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 56.0, "discounted_cash": 42.0, "setting": "both", "billing_class": "facility"}]}, {"description": "NITROGLYCERIN PER 5MG PMX IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J2305", "type": "HCPCS"}, {"code": "5322956", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 56.0, "discounted_cash": 42.0, "setting": "both", "billing_class": "facility"}]}, {"description": "NITROGLYCERIN.4MG4.9GMSP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5331624", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 788.0, "discounted_cash": 591.0, "setting": "both", "billing_class": "facility"}]}, {"description": "NITROGLYCERIN.4MG4.9GMSP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5331624", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 788.0, "discounted_cash": 591.0, "setting": "both", "billing_class": "facility"}]}, {"description": "NITROGLYCERIN.4MGSL 25TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5308379", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 255.0, "discounted_cash": 191.25, "setting": "both", "billing_class": "facility"}]}, {"description": "NITROGLYCERIN.4MGSL 25TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5308379", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 255.0, "discounted_cash": 191.25, "setting": "both", "billing_class": "facility"}]}, {"description": "NITROGLYCERIN2% 1GM OI", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5336888", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 85.0, "discounted_cash": 63.75, "setting": "both", "billing_class": "facility"}]}, {"description": "NITROGLYCERIN2% 1GM OI", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5336888", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 85.0, "discounted_cash": 63.75, "setting": "both", "billing_class": "facility"}]}, {"description": "NITROPRUSSIDE 50MG/2MLIJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5322926", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 3391.0, "discounted_cash": 2543.25, "setting": "both", "billing_class": "facility"}]}, {"description": "NOREPIN/D5W 4MG/250ML IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5322913", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 591.0, "discounted_cash": 443.25, "setting": "both", "billing_class": "facility"}]}, {"description": "NOREPINEPHR 16MG DRIP IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5322912", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 1106.0, "discounted_cash": 829.5, "setting": "both", "billing_class": "facility"}]}, {"description": "NOREPINEPHRINE 4MG/4MLIJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5321698", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 209.0, "discounted_cash": 156.75, "setting": "both", "billing_class": "facility"}]}, {"description": "NORTRIPTYLINE 10MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5308428", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 66.0, "discounted_cash": 49.5, "setting": "both", "billing_class": "facility"}]}, {"description": "NORTRIPTYLINE 10MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5308428", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 66.0, "discounted_cash": 49.5, "setting": "both", "billing_class": "facility"}]}, {"description": "NORTRIPTYLINE 25MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5308432", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 78.0, "discounted_cash": 58.5, "setting": "both", "billing_class": "facility"}]}, {"description": "NORTRIPTYLINE 25MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5308432", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 78.0, "discounted_cash": 58.5, "setting": "both", "billing_class": "facility"}]}, {"description": "NOS IMMUNOASSAY NON-RIA", "code_information": [{"code": "83520", "type": "CPT"}, {"code": "4102662", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 680.0, "discounted_cash": 510.0, "setting": "both", "billing_class": "facility"}]}, {"description": "NOS IMMUNOASSAY NON-RIA", "code_information": [{"code": "83520", "type": "CPT"}, {"code": "7253488", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 128.0, "discounted_cash": 96.0, "setting": "both", "billing_class": "facility"}]}, {"description": "NRAS VARIANT EXON 2-3", "code_information": [{"code": "81311", "type": "CPT"}, {"code": "7061311", "type": "CDM"}, {"code": "310", "type": "RC"}], "standard_charges": [{"gross_charge": 254.0, "discounted_cash": 190.5, "setting": "both", "billing_class": "facility"}]}, {"description": "NSEL DEB WNDS WO ANES", "code_information": [{"code": "97602", "type": "CPT"}, {"code": "6817602", "type": "CDM"}, {"code": "510", "type": "RC"}], "standard_charges": [{"gross_charge": 541.0, "discounted_cash": 405.75, "setting": "both", "billing_class": "facility"}]}, {"description": "NSEL DEB WNDS WO ANES", "code_information": [{"code": "97602", "type": "CPT"}, {"code": "6817602", "type": "CDM"}, {"code": "761", "type": "RC"}], "standard_charges": [{"gross_charge": 541.0, "discounted_cash": 405.75, "setting": "both", "billing_class": "facility"}]}, {"description": "NSEL DEB WNDS WO ANES B", "code_information": [{"code": "97602", "type": "CPT"}, {"code": "6907605", "type": "CDM"}, {"code": "510", "type": "RC"}], "standard_charges": [{"gross_charge": 767.0, "discounted_cash": 575.25, "setting": "both", "billing_class": "facility"}]}, {"description": "NSEL DEB WNDS WO ANES B", "code_information": [{"code": "97602", "type": "CPT"}, {"code": "6907605", "type": "CDM"}, {"code": "761", "type": "RC"}], "standard_charges": [{"gross_charge": 767.0, "discounted_cash": 575.25, "setting": "both", "billing_class": "facility"}]}, {"description": "NSEL DEB WNDS WO ANES C", "code_information": [{"code": "97602", "type": "CPT"}, {"code": "6907607", "type": "CDM"}, {"code": "510", "type": "RC"}], "standard_charges": [{"gross_charge": 658.0, "discounted_cash": 493.5, "setting": "both", "billing_class": "facility"}]}, {"description": "NSEL DEB WNDS WO ANES C", "code_information": [{"code": "97602", "type": "CPT"}, {"code": "6907607", "type": "CDM"}, {"code": "761", "type": "RC"}], "standard_charges": [{"gross_charge": 658.0, "discounted_cash": 493.5, "setting": "both", "billing_class": "facility"}]}, {"description": "NSEL DEB WNDS WO ANES I", "code_information": [{"code": "97602", "type": "CPT"}, {"code": "6907606", "type": "CDM"}, {"code": "510", "type": "RC"}], "standard_charges": [{"gross_charge": 1142.0, "discounted_cash": 856.5, "setting": "both", "billing_class": "facility"}]}, {"description": "NSEL DEB WNDS WO ANES I", "code_information": [{"code": "97602", "type": "CPT"}, {"code": "6907606", "type": "CDM"}, {"code": "761", "type": "RC"}], "standard_charges": [{"gross_charge": 1142.0, "discounted_cash": 856.5, "setting": "both", "billing_class": "facility"}]}, {"description": "NUCLEAR ANTIGEN AB", "code_information": [{"code": "86235", "type": "CPT"}, {"code": "7256214", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 128.0, "discounted_cash": 96.0, "setting": "both", "billing_class": "facility"}]}, {"description": "NUCLEAR ANTIGEN AB/11", "code_information": [{"code": "86235", "type": "CPT"}, {"code": "7256239", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 43.0, "discounted_cash": 32.25, "setting": "both", "billing_class": "facility"}]}, {"description": "NUCLEAR ANTIGEN AB/15", "code_information": [{"code": "86235", "type": "CPT"}, {"code": "7256271", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 65.0, "discounted_cash": 48.75, "setting": "both", "billing_class": "facility"}]}, {"description": "NUCLEAR ANTIGEN AB/17", "code_information": [{"code": "86235", "type": "CPT"}, {"code": "7256275", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 65.0, "discounted_cash": 48.75, "setting": "both", "billing_class": "facility"}]}, {"description": "NUCLEAR ANTIGEN AB/20", "code_information": [{"code": "86235", "type": "CPT"}, {"code": "7256378", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 610.0, "discounted_cash": 457.5, "setting": "both", "billing_class": "facility"}]}, {"description": "NUCLEAR ANTIGEN AB/22", "code_information": [{"code": "86235", "type": "CPT"}, {"code": "7258607", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 343.0, "discounted_cash": 257.25, "setting": "both", "billing_class": "facility"}]}, {"description": "NUCLEAR ANTIGEN AB/23", "code_information": [{"code": "86235", "type": "CPT"}, {"code": "7258623", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 93.0, "discounted_cash": 69.75, "setting": "both", "billing_class": "facility"}]}, {"description": "NUCLEAR ANTIGEN AB/24", "code_information": [{"code": "86235", "type": "CPT"}, {"code": "7258626", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 72.0, "discounted_cash": 54.0, "setting": "both", "billing_class": "facility"}]}, {"description": "NUCLEAR ANTIGEN AB/4", "code_information": [{"code": "86235", "type": "CPT"}, {"code": "7256224", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 109.0, "discounted_cash": 81.75, "setting": "both", "billing_class": "facility"}]}, {"description": "NUCLEAR ANTIGEN AB/5", "code_information": [{"code": "86235", "type": "CPT"}, {"code": "7256233", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 38.0, "discounted_cash": 28.5, "setting": "both", "billing_class": "facility"}]}, {"description": "NUCLEAR ANTIGEN AB/6", "code_information": [{"code": "86235", "type": "CPT"}, {"code": "7256234", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 92.0, "discounted_cash": 69.0, "setting": "both", "billing_class": "facility"}]}, {"description": "NUCLEAR ANTIGEN AB/9", "code_information": [{"code": "86235", "type": "CPT"}, {"code": "7256237", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 33.0, "discounted_cash": 24.75, "setting": "both", "billing_class": "facility"}]}, {"description": "NUCLEOTIDASE 5-", "code_information": [{"code": "83915", "type": "CPT"}, {"code": "7253905", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 59.0, "discounted_cash": 44.25, "setting": "both", "billing_class": "facility"}]}, {"description": "NUSHIELD 1.6CM DISC PER SQ CM", "code_information": [{"code": "Q4160", "type": "HCPCS"}, {"code": "4028554", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 1144.0, "discounted_cash": 858.0, "setting": "both", "billing_class": "facility"}]}, {"description": "NUSHIELD 1.6CM DISC PER SQ CM", "code_information": [{"code": "Q4160", "type": "HCPCS"}, {"code": "4028554", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 1144.0, "discounted_cash": 858.0, "setting": "both", "billing_class": "facility"}]}, {"description": "NUSHIELD 4X4 PER SQ CM", "code_information": [{"code": "Q4160", "type": "HCPCS"}, {"code": "4028561", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 857.0, "discounted_cash": 642.75, "setting": "both", "billing_class": "facility"}]}, {"description": "NUSHIELD 4X4 PER SQ CM", "code_information": [{"code": "Q4160", "type": "HCPCS"}, {"code": "4028561", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 857.0, "discounted_cash": 642.75, "setting": "both", "billing_class": "facility"}]}, {"description": "NUT", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8133260", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 2754.0, "discounted_cash": 2065.5, "setting": "both", "billing_class": "facility"}]}, {"description": "NV ORTHOPOX VIR DNA AMP PROBE", "code_information": [{"code": "87593", "type": "CPT"}, {"code": "7250413", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 204.0, "discounted_cash": 153.0, "setting": "both", "billing_class": "facility"}]}, {"description": "NYSTATIN 15GM CR", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5336909", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 70.0, "discounted_cash": 52.5, "setting": "both", "billing_class": "facility"}]}, {"description": "NYSTATIN 15GM CR", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5336909", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 70.0, "discounted_cash": 52.5, "setting": "both", "billing_class": "facility"}]}, {"description": "NYSTATIN 15GM OI", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5336924", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 102.0, "discounted_cash": 76.5, "setting": "both", "billing_class": "facility"}]}, {"description": "NYSTATIN 15GM OI", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5336924", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 102.0, "discounted_cash": 76.5, "setting": "both", "billing_class": "facility"}]}, {"description": "NYSTATIN 15GM PW", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5336919", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 470.0, "discounted_cash": 352.5, "setting": "both", "billing_class": "facility"}]}, {"description": "NYSTATIN 15GM PW", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5336919", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 470.0, "discounted_cash": 352.5, "setting": "both", "billing_class": "facility"}]}, {"description": "NYSTATIN 1ML LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5315883", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 85.0, "discounted_cash": 63.75, "setting": "both", "billing_class": "facility"}]}, {"description": "NYSTATIN 1ML LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5315883", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 85.0, "discounted_cash": 63.75, "setting": "both", "billing_class": "facility"}]}, {"description": "NYSTATIN 5ML LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5315881", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 61.0, "discounted_cash": 45.75, "setting": "both", "billing_class": "facility"}]}, {"description": "NYSTATIN 5ML LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5315881", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 61.0, "discounted_cash": 45.75, "setting": "both", "billing_class": "facility"}]}, {"description": "NYSTATIN 60ML LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5315884", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 304.0, "discounted_cash": 228.0, "setting": "both", "billing_class": "facility"}]}, {"description": "NYSTATIN 60ML LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5315884", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 304.0, "discounted_cash": 228.0, "setting": "both", "billing_class": "facility"}]}, {"description": "NYSTATIN/TRIAMCIN 15GMCR", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5337394", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 113.0, "discounted_cash": 84.75, "setting": "both", "billing_class": "facility"}]}, {"description": "NYSTATIN/TRIAMCIN 15GMCR", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5337394", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 113.0, "discounted_cash": 84.75, "setting": "both", "billing_class": "facility"}]}, {"description": "NYSTATIN/TRIAMCIN 15GMOI", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5337399", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 144.0, "discounted_cash": 108.0, "setting": "both", "billing_class": "facility"}]}, {"description": "NYSTATIN/TRIAMCIN 15GMOI", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5337399", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 144.0, "discounted_cash": 108.0, "setting": "both", "billing_class": "facility"}]}, {"description": "O2 UPTAKE REST INDRCT", "code_information": [{"code": "94690", "type": "CPT"}, {"code": "5501820", "type": "CDM"}, {"code": "460", "type": "RC"}], "standard_charges": [{"gross_charge": 1900.0, "discounted_cash": 1425.0, "setting": "both", "billing_class": "facility"}]}, {"description": "OASIS BURN MATRIX SQ CM", "code_information": [{"code": "Q4103", "type": "HCPCS"}, {"code": "4036000", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 153.0, "discounted_cash": 114.75, "setting": "both", "billing_class": "facility"}]}, {"description": "OASIS BURN MATRIX SQ CM", "code_information": [{"code": "Q4103", "type": "HCPCS"}, {"code": "4036000", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 153.0, "discounted_cash": 114.75, "setting": "both", "billing_class": "facility"}]}, {"description": "OASIS WND MATRIX SQ CM", "code_information": [{"code": "Q4102", "type": "HCPCS"}, {"code": "8247996", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 55.0, "discounted_cash": 41.25, "setting": "both", "billing_class": "facility"}]}, {"description": "OASIS WND MATRIX SQ CM", "code_information": [{"code": "Q4102", "type": "HCPCS"}, {"code": "8247996", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 55.0, "discounted_cash": 41.25, "setting": "both", "billing_class": "facility"}]}, {"description": "OATMEAL COLLD 1PK PW EA", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5334231", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 184.0, "discounted_cash": 138.0, "setting": "both", "billing_class": "facility"}]}, {"description": "OATMEAL COLLD 1PK PW EA", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5334231", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 184.0, "discounted_cash": 138.0, "setting": "both", "billing_class": "facility"}]}, {"description": "OB ER VISIT LVL I", "code_information": [{"code": "99281", "type": "CPT"}, {"code": "6169281", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 992.0, "discounted_cash": 744.0, "setting": "both", "billing_class": "facility"}]}, {"description": "OB ER VISIT LVL II", "code_information": [{"code": "99282", "type": "CPT"}, {"code": "6169282", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 2153.0, "discounted_cash": 1614.75, "setting": "both", "billing_class": "facility"}]}, {"description": "OB ER VISIT LVL III", "code_information": [{"code": "99283", "type": "CPT"}, {"code": "6169283", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 3546.0, "discounted_cash": 2659.5, "setting": "both", "billing_class": "facility"}]}, {"description": "OB ER VISIT LVL IV", "code_information": [{"code": "99284", "type": "CPT"}, {"code": "6169284", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 5606.0, "discounted_cash": 4204.5, "setting": "both", "billing_class": "facility"}]}, {"description": "OB ER VISIT LVL V", "code_information": [{"code": "99285", "type": "CPT"}, {"code": "6169285", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 7272.0, "discounted_cash": 5454.0, "setting": "both", "billing_class": "facility"}]}, {"description": "OBS 200 ICU 1/HR", "code_information": [{"code": "G0378", "type": "HCPCS"}, {"code": "6240406", "type": "CDM"}, {"code": "762", "type": "RC"}], "standard_charges": [{"gross_charge": 473.0, "discounted_cash": 354.75, "setting": "both", "billing_class": "facility"}]}, {"description": "OBS 200 ICU DIR ADM", "code_information": [{"code": "G0379", "type": "HCPCS"}, {"code": "6240408", "type": "CDM"}, {"code": "762", "type": "RC"}], "standard_charges": [{"gross_charge": 1481.0, "discounted_cash": 1110.75, "setting": "both", "billing_class": "facility"}]}, {"description": "OBS 201 ICC 1/HR", "code_information": [{"code": "G0378", "type": "HCPCS"}, {"code": "6240410", "type": "CDM"}, {"code": "762", "type": "RC"}], "standard_charges": [{"gross_charge": 433.0, "discounted_cash": 324.75, "setting": "both", "billing_class": "facility"}]}, {"description": "OBS 201 ICC DIR ADM", "code_information": [{"code": "G0379", "type": "HCPCS"}, {"code": "6240412", "type": "CDM"}, {"code": "762", "type": "RC"}], "standard_charges": [{"gross_charge": 1481.0, "discounted_cash": 1110.75, "setting": "both", "billing_class": "facility"}]}, {"description": "OBS 215 DOU 1/HR", "code_information": [{"code": "G0378", "type": "HCPCS"}, {"code": "6240652", "type": "CDM"}, {"code": "762", "type": "RC"}], "standard_charges": [{"gross_charge": 323.0, "discounted_cash": 242.25, "setting": "both", "billing_class": "facility"}]}, {"description": "OBS 215 DOU DIR ADM", "code_information": [{"code": "G0379", "type": "HCPCS"}, {"code": "6240654", "type": "CDM"}, {"code": "762", "type": "RC"}], "standard_charges": [{"gross_charge": 1558.0, "discounted_cash": 1168.5, "setting": "both", "billing_class": "facility"}]}, {"description": "OBS 230 M/S 1/HR", "code_information": [{"code": "G0378", "type": "HCPCS"}, {"code": "6240612", "type": "CDM"}, {"code": "762", "type": "RC"}], "standard_charges": [{"gross_charge": 175.0, "discounted_cash": 131.25, "setting": "both", "billing_class": "facility"}]}, {"description": "OBS 230 M/S DIR ADM", "code_information": [{"code": "G0379", "type": "HCPCS"}, {"code": "6241612", "type": "CDM"}, {"code": "762", "type": "RC"}], "standard_charges": [{"gross_charge": 1558.0, "discounted_cash": 1168.5, "setting": "both", "billing_class": "facility"}]}, {"description": "OBS 231 M/S 1/HR", "code_information": [{"code": "G0378", "type": "HCPCS"}, {"code": "6240614", "type": "CDM"}, {"code": "762", "type": "RC"}], "standard_charges": [{"gross_charge": 193.0, "discounted_cash": 144.75, "setting": "both", "billing_class": "facility"}]}, {"description": "OBS 231 M/S DIR ADM", "code_information": [{"code": "G0379", "type": "HCPCS"}, {"code": "6241614", "type": "CDM"}, {"code": "762", "type": "RC"}], "standard_charges": [{"gross_charge": 1558.0, "discounted_cash": 1168.5, "setting": "both", "billing_class": "facility"}]}, {"description": "OBS 232 M/S 1/HR", "code_information": [{"code": "G0378", "type": "HCPCS"}, {"code": "6240616", "type": "CDM"}, {"code": "762", "type": "RC"}], "standard_charges": [{"gross_charge": 142.0, "discounted_cash": 106.5, "setting": "both", "billing_class": "facility"}]}, {"description": "OBS 232 M/S DIR ADM", "code_information": [{"code": "G0379", "type": "HCPCS"}, {"code": "6241616", "type": "CDM"}, {"code": "762", "type": "RC"}], "standard_charges": [{"gross_charge": 1283.0, "discounted_cash": 962.25, "setting": "both", "billing_class": "facility"}]}, {"description": "OBS 240 PED 1/HR", "code_information": [{"code": "G0378", "type": "HCPCS"}, {"code": "6240800", "type": "CDM"}, {"code": "762", "type": "RC"}], "standard_charges": [{"gross_charge": 194.0, "discounted_cash": 145.5, "setting": "both", "billing_class": "facility"}]}, {"description": "OBS 240 PED DIR ADM", "code_information": [{"code": "G0379", "type": "HCPCS"}, {"code": "6240806", "type": "CDM"}, {"code": "762", "type": "RC"}], "standard_charges": [{"gross_charge": 1558.0, "discounted_cash": 1168.5, "setting": "both", "billing_class": "facility"}]}, {"description": "OBS 245 PSY 1/HR", "code_information": [{"code": "G0378", "type": "HCPCS"}, {"code": "6240700", "type": "CDM"}, {"code": "762", "type": "RC"}], "standard_charges": [{"gross_charge": 149.0, "discounted_cash": 111.75, "setting": "both", "billing_class": "facility"}]}, {"description": "OBS 245 PSY DIR ADM", "code_information": [{"code": "G0379", "type": "HCPCS"}, {"code": "6240706", "type": "CDM"}, {"code": "762", "type": "RC"}], "standard_charges": [{"gross_charge": 1481.0, "discounted_cash": 1110.75, "setting": "both", "billing_class": "facility"}]}, {"description": "OBS 250 OB 1/HR", "code_information": [{"code": "G0378", "type": "HCPCS"}, {"code": "6240620", "type": "CDM"}, {"code": "762", "type": "RC"}], "standard_charges": [{"gross_charge": 193.0, "discounted_cash": 144.75, "setting": "both", "billing_class": "facility"}]}, {"description": "OBS 250 OB DIR ADM", "code_information": [{"code": "G0379", "type": "HCPCS"}, {"code": "6241620", "type": "CDM"}, {"code": "762", "type": "RC"}], "standard_charges": [{"gross_charge": 1558.0, "discounted_cash": 1168.5, "setting": "both", "billing_class": "facility"}]}, {"description": "OBSTETRICS PROFILE", "code_information": [{"code": "80055", "type": "CPT"}, {"code": "4100215", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 3758.0, "discounted_cash": 2818.5, "setting": "both", "billing_class": "facility"}]}, {"description": "OCCLSN/EMBL CATH CNS", "code_information": [{"code": "4617795", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 6919.0, "discounted_cash": 5189.25, "setting": "both", "billing_class": "facility"}]}, {"description": "OCCLSN/EMBL CATH NON-CNS", "code_information": [{"code": "4617790", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 42442.0, "discounted_cash": 31831.5, "setting": "both", "billing_class": "facility"}]}, {"description": "OCCLSN/EMBL CATH NON-CNS", "code_information": [{"code": "4917790", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 39041.0, "discounted_cash": 29280.75, "setting": "both", "billing_class": "facility"}]}, {"description": "OCCULT BLD FECES ONE SPC", "code_information": [{"code": "82272", "type": "CPT"}, {"code": "4102272", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 261.0, "discounted_cash": 195.75, "setting": "both", "billing_class": "facility"}]}, {"description": "OCCULT BLD OTHR SOURCE/2", "code_information": [{"code": "82271", "type": "CPT"}, {"code": "4102275", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 191.0, "discounted_cash": 143.25, "setting": "both", "billing_class": "facility"}]}, {"description": "OCCULT BLD STL 1-3", "code_information": [{"code": "82270", "type": "CPT"}, {"code": "4102270", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 265.0, "discounted_cash": 198.75, "setting": "both", "billing_class": "facility"}]}, {"description": "OCCULT BLD STL 1-3", "code_information": [{"code": "82270", "type": "CPT"}, {"code": "4172270", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 5.71, "discounted_cash": 4.28, "setting": "both", "billing_class": "facility"}]}, {"description": "OCTREOTIDE PER 1ML INJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5322917", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 1026.0, "discounted_cash": 769.5, "setting": "both", "billing_class": "facility"}]}, {"description": "OCTREOTIDE PER 25MCG IV IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J2354", "type": "HCPCS"}, {"code": "5322920", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 175.0, "discounted_cash": 131.25, "setting": "both", "billing_class": "facility"}], "modifiers": "JA"}, {"description": "OCTREOTIDE PER 25MCG IV IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J2354", "type": "HCPCS"}, {"code": "5322920", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 175.0, "discounted_cash": 131.25, "setting": "both", "billing_class": "facility"}], "modifiers": "JA"}, {"description": "OCTREOTIDE PER 25MCG SQ IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J2354", "type": "HCPCS"}, {"code": "5322948", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 84.0, "discounted_cash": 63.0, "setting": "both", "billing_class": "facility"}], "modifiers": "JB"}, {"description": "OCTREOTIDE PER 25MCG SQ IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J2354", "type": "HCPCS"}, {"code": "5322948", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 84.0, "discounted_cash": 63.0, "setting": "both", "billing_class": "facility"}], "modifiers": "JB"}, {"description": "OCULAR IMP AQUA DRN DEV", "code_information": [{"code": "C1783", "type": "HCPCS"}, {"code": "8247990", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 16180.0, "discounted_cash": 12135.0, "setting": "both", "billing_class": "facility"}]}, {"description": "OCULAR LUB 1GM UD OO", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5331751", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 71.0, "discounted_cash": 53.25, "setting": "both", "billing_class": "facility"}]}, {"description": "OCULAR LUB 1GM UD OO", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5331751", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 71.0, "discounted_cash": 53.25, "setting": "both", "billing_class": "facility"}]}, {"description": "OCULAR LUB 3.5GM OO", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5331635", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 96.0, "discounted_cash": 72.0, "setting": "both", "billing_class": "facility"}]}, {"description": "OCULAR LUB 3.5GM OO", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5331635", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 96.0, "discounted_cash": 72.0, "setting": "both", "billing_class": "facility"}]}, {"description": "OCULAR LUB PF 15ML OS", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5330242", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 85.0, "discounted_cash": 63.75, "setting": "both", "billing_class": "facility"}]}, {"description": "OCULAR LUB PF 15ML OS", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5330242", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 85.0, "discounted_cash": 63.75, "setting": "both", "billing_class": "facility"}]}, {"description": "OCULAR LUB PF UD 1ML OS", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5331636", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 85.0, "discounted_cash": 63.75, "setting": "both", "billing_class": "facility"}]}, {"description": "OCULAR LUB PF UD 1ML OS", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5331636", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 85.0, "discounted_cash": 63.75, "setting": "both", "billing_class": "facility"}]}, {"description": "OCULAR LUB PF.4ML UD OS", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5332036", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 53.0, "discounted_cash": 39.75, "setting": "both", "billing_class": "facility"}]}, {"description": "OCULAR LUB PF.4ML UD OS", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5332036", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 53.0, "discounted_cash": 39.75, "setting": "both", "billing_class": "facility"}]}, {"description": "OCULAR LUB PF.9ML UD OS", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5331632", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 78.0, "discounted_cash": 58.5, "setting": "both", "billing_class": "facility"}]}, {"description": "OCULAR LUB PF.9ML UD OS", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5331632", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 78.0, "discounted_cash": 58.5, "setting": "both", "billing_class": "facility"}]}, {"description": "OCULAR LUB PRSRV 15ML OS", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5332130", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 118.0, "discounted_cash": 88.5, "setting": "both", "billing_class": "facility"}]}, {"description": "OCULAR LUB PRSRV 15ML OS", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5332130", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 118.0, "discounted_cash": 88.5, "setting": "both", "billing_class": "facility"}]}, {"description": "OFLOXACIN .3% 5ML OS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5331640", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 617.0, "discounted_cash": 462.75, "setting": "both", "billing_class": "facility"}]}, {"description": "OFLOXACIN .3% 5ML OS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5331640", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 617.0, "discounted_cash": 462.75, "setting": "both", "billing_class": "facility"}]}, {"description": "OFLOXACIN .3% 5ML OT", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5330944", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 706.0, "discounted_cash": 529.5, "setting": "both", "billing_class": "facility"}]}, {"description": "OFLOXACIN .3% 5ML OT", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5330944", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 706.0, "discounted_cash": 529.5, "setting": "both", "billing_class": "facility"}]}, {"description": "OFLOXACIN .3%10ML OS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5331641", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 569.0, "discounted_cash": 426.75, "setting": "both", "billing_class": "facility"}]}, {"description": "OFLOXACIN .3%10ML OS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5331641", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 569.0, "discounted_cash": 426.75, "setting": "both", "billing_class": "facility"}]}, {"description": "OH PATCH PERICARDL BOVIN", "code_information": [{"code": "C1768", "type": "HCPCS"}, {"code": "8175902", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 3056.0, "discounted_cash": 2292.0, "setting": "both", "billing_class": "facility"}]}, {"description": "OH PATCH PERICARDL TUTOP", "code_information": [{"code": "C1768", "type": "HCPCS"}, {"code": "8175903", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 9874.0, "discounted_cash": 7405.5, "setting": "both", "billing_class": "facility"}]}, {"description": "OH RING ANNULOPLASTY", "code_information": [{"code": "C1889", "type": "HCPCS"}, {"code": "8143498", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 46887.0, "discounted_cash": 35165.25, "setting": "both", "billing_class": "facility"}]}, {"description": "OH RING AORTIC", "code_information": [{"code": "C1889", "type": "HCPCS"}, {"code": "8143500", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 102344.0, "discounted_cash": 76758.0, "setting": "both", "billing_class": "facility"}]}, {"description": "OH SURG EA ADD 15MIN", "code_information": [{"code": "3303557", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 6016.0, "discounted_cash": 4512.0, "setting": "both", "billing_class": "facility"}]}, {"description": "OH SURG INT 30 MIN", "code_information": [{"code": "3303556", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 24050.0, "discounted_cash": 18037.5, "setting": "both", "billing_class": "facility"}]}, {"description": "OH VALVE AOR/MIT", "code_information": [{"code": "L8699", "type": "HCPCS"}, {"code": "8143510", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 92144.0, "discounted_cash": 69108.0, "setting": "both", "billing_class": "facility"}]}, {"description": "OH VALVE AORTIC", "code_information": [{"code": "L8699", "type": "HCPCS"}, {"code": "8143515", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 96125.0, "discounted_cash": 72093.75, "setting": "both", "billing_class": "facility"}]}, {"description": "OH VALVE MITRAL", "code_information": [{"code": "L8699", "type": "HCPCS"}, {"code": "8143525", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 71611.0, "discounted_cash": 53708.25, "setting": "both", "billing_class": "facility"}]}, {"description": "OH VALVE PERICARDIAL", "code_information": [{"code": "L8699", "type": "HCPCS"}, {"code": "8143526", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 129775.0, "discounted_cash": 97331.25, "setting": "both", "billing_class": "facility"}]}, {"description": "OH VALVE ST JUDE", "code_information": [{"code": "L8699", "type": "HCPCS"}, {"code": "8143529", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 92662.0, "discounted_cash": 69496.5, "setting": "both", "billing_class": "facility"}]}, {"description": "OLANZAPINE 10MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5308499", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 252.0, "discounted_cash": 189.0, "setting": "both", "billing_class": "facility"}]}, {"description": "OLANZAPINE 10MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5308499", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 252.0, "discounted_cash": 189.0, "setting": "both", "billing_class": "facility"}]}, {"description": "OLANZAPINE 2.5MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5308500", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 191.0, "discounted_cash": 143.25, "setting": "both", "billing_class": "facility"}]}, {"description": "OLANZAPINE 2.5MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5308500", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 191.0, "discounted_cash": 143.25, "setting": "both", "billing_class": "facility"}]}, {"description": "OLANZAPINE 5MG DT", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5308506", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 190.0, "discounted_cash": 142.5, "setting": "both", "billing_class": "facility"}]}, {"description": "OLANZAPINE 5MG DT", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5308506", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 190.0, "discounted_cash": 142.5, "setting": "both", "billing_class": "facility"}]}, {"description": "OLANZAPINE 5MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5308497", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 181.0, "discounted_cash": 135.75, "setting": "both", "billing_class": "facility"}]}, {"description": "OLANZAPINE 5MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5308497", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 181.0, "discounted_cash": 135.75, "setting": "both", "billing_class": "facility"}]}, {"description": "OLANZAPINE PER 0.5MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J2359", "type": "HCPCS"}, {"code": "5322958", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 40.0, "discounted_cash": 30.0, "setting": "both", "billing_class": "facility"}]}, {"description": "OLANZAPINE PER 0.5MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J2359", "type": "HCPCS"}, {"code": "5322958", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 40.0, "discounted_cash": 30.0, "setting": "both", "billing_class": "facility"}]}, {"description": "OLIGOCLONAL BANDS", "code_information": [{"code": "83916", "type": "CPT"}, {"code": "7253925", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 996.0, "discounted_cash": 747.0, "setting": "both", "billing_class": "facility"}]}, {"description": "OLMESARTAN 20MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5308520", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 125.0, "discounted_cash": 93.75, "setting": "both", "billing_class": "facility"}]}, {"description": "OLMESARTAN 20MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5308520", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 125.0, "discounted_cash": 93.75, "setting": "both", "billing_class": "facility"}]}, {"description": "OLOPATADINE .1% 5ML OS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5331645", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 1499.0, "discounted_cash": 1124.25, "setting": "both", "billing_class": "facility"}]}, {"description": "OLOPATADINE .1% 5ML OS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5331645", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 1499.0, "discounted_cash": 1124.25, "setting": "both", "billing_class": "facility"}]}, {"description": "OMEGA3 FISH OIL 1000MGCP", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5308530", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 70.0, "discounted_cash": 52.5, "setting": "both", "billing_class": "facility"}]}, {"description": "OMEGA3 FISH OIL 1000MGCP", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5308530", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 70.0, "discounted_cash": 52.5, "setting": "both", "billing_class": "facility"}]}, {"description": "ONDANSETRON 4MG DT", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5308492", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 505.0, "discounted_cash": 378.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ONDANSETRON 4MG DT", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5308492", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 505.0, "discounted_cash": 378.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ONDANSETRON 4MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5308495", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 536.0, "discounted_cash": 402.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ONDANSETRON 4MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5308495", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 536.0, "discounted_cash": 402.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ONDANSETRON PER 1MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J2405", "type": "HCPCS"}, {"code": "5322936", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 37.0, "discounted_cash": 27.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ONDANSETRON PER 1MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J2405", "type": "HCPCS"}, {"code": "5322936", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 37.0, "discounted_cash": 27.75, "setting": "both", "billing_class": "facility"}]}, {"description": "OPEN AXL/SUB DEL PRO INCIS UNI", "code_information": [{"code": "4614716", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 1540.0, "discounted_cash": 1155.0, "setting": "both", "billing_class": "facility"}]}, {"description": "OPEN/PERC PL ST 1ST AR", "code_information": [{"code": "4617236", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 41839.0, "discounted_cash": 31379.25, "setting": "both", "billing_class": "facility"}]}, {"description": "OPEN/PERC PL ST 1ST AR", "code_information": [{"code": "4917236", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 45605.0, "discounted_cash": 34203.75, "setting": "both", "billing_class": "facility"}]}, {"description": "OPEN/PERC PL ST 1ST VN", "code_information": [{"code": "4617238", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 39462.0, "discounted_cash": 29596.5, "setting": "both", "billing_class": "facility"}]}, {"description": "OPEN/PERC PL ST 1ST VN", "code_information": [{"code": "4917238", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 30663.0, "discounted_cash": 22997.25, "setting": "both", "billing_class": "facility"}]}, {"description": "OPEN/PERC PL ST E/ADD AR", "code_information": [{"code": "4617237", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 22056.0, "discounted_cash": 16542.0, "setting": "both", "billing_class": "facility"}]}, {"description": "OPEN/PERC PL ST E/ADD AR", "code_information": [{"code": "4917237", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 22056.0, "discounted_cash": 16542.0, "setting": "both", "billing_class": "facility"}]}, {"description": "OPEN/PERC PL ST E/ADD VN", "code_information": [{"code": "4617239", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 22056.0, "discounted_cash": 16542.0, "setting": "both", "billing_class": "facility"}]}, {"description": "OPEN/PERC PL ST E/ADD VN", "code_information": [{"code": "4917239", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 22056.0, "discounted_cash": 16542.0, "setting": "both", "billing_class": "facility"}]}, {"description": "OPRELVEKIN PER 5MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J2355", "type": "HCPCS"}, {"code": "5322821", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 10326.0, "discounted_cash": 7744.5, "setting": "both", "billing_class": "facility"}]}, {"description": "OPRELVEKIN PER 5MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J2355", "type": "HCPCS"}, {"code": "5322821", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 10326.0, "discounted_cash": 7744.5, "setting": "both", "billing_class": "facility"}]}, {"description": "OPTIFLOW HFOT INITIAL", "code_information": [{"code": "94799", "type": "CPT"}, {"code": "5500061", "type": "CDM"}, {"code": "460", "type": "RC"}], "standard_charges": [{"gross_charge": 912.0, "discounted_cash": 684.0, "setting": "both", "billing_class": "facility"}]}, {"description": "OPTIFLOW HFOT MANAGEMENT DLY", "code_information": [{"code": "94799", "type": "CPT"}, {"code": "5500062", "type": "CDM"}, {"code": "460", "type": "RC"}], "standard_charges": [{"gross_charge": 912.0, "discounted_cash": 684.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ORBITS 4VW MIN", "code_information": [{"code": "70200", "type": "CPT"}, {"code": "4900152", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 1146.0, "discounted_cash": 859.5, "setting": "both", "billing_class": "facility"}]}, {"description": "ORGANIC ACID SNG QNT", "code_information": [{"code": "83921", "type": "CPT"}, {"code": "7252125", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 177.0, "discounted_cash": 132.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ORGANIC ACID SNG QNT/3", "code_information": [{"code": "83921", "type": "CPT"}, {"code": "7254003", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 122.0, "discounted_cash": 91.5, "setting": "both", "billing_class": "facility"}]}, {"description": "ORGANIC ACID SNG QNT/4", "code_information": [{"code": "83921", "type": "CPT"}, {"code": "7258426", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 231.0, "discounted_cash": 173.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ORGANIC ACIDS QUAL", "code_information": [{"code": "83919", "type": "CPT"}, {"code": "7258391", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 1385.0, "discounted_cash": 1038.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ORPHENADRINE TO 60MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J2360", "type": "HCPCS"}, {"code": "5322946", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 606.0, "discounted_cash": 454.5, "setting": "both", "billing_class": "facility"}]}, {"description": "ORPHENADRINE TO 60MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J2360", "type": "HCPCS"}, {"code": "5322946", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 606.0, "discounted_cash": 454.5, "setting": "both", "billing_class": "facility"}]}, {"description": "ORTH COLLR CERV FLX FOAM", "code_information": [{"code": "L0120", "type": "HCPCS"}, {"code": "8133243", "type": "CDM"}, {"code": "274", "type": "RC"}], "standard_charges": [{"gross_charge": 70.0, "discounted_cash": 52.5, "setting": "both", "billing_class": "facility"}]}, {"description": "ORTH LO RGD A/P L1-L5", "code_information": [{"code": "L0627", "type": "HCPCS"}, {"code": "8130101", "type": "CDM"}, {"code": "274", "type": "RC"}], "standard_charges": [{"gross_charge": 5004.0, "discounted_cash": 3753.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ORTH TLSO FLX THOR/SAC", "code_information": [{"code": "L0456", "type": "HCPCS"}, {"code": "8133235", "type": "CDM"}, {"code": "274", "type": "RC"}], "standard_charges": [{"gross_charge": 9152.0, "discounted_cash": 6864.0, "setting": "both", "billing_class": "facility"}]}, {"description": "OS CALCIS 2 VIEWS", "code_information": [{"code": "73650", "type": "CPT"}, {"code": "4903650", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 997.0, "discounted_cash": 747.75, "setting": "both", "billing_class": "facility"}]}, {"description": "OS CALCIS 2 VIEWS", "code_information": [{"code": "73650", "type": "CPT"}, {"code": "5113650", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 997.0, "discounted_cash": 747.75, "setting": "both", "billing_class": "facility"}]}, {"description": "OSELTAMIVIR 6/1 1ML PWLQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5315907", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 71.0, "discounted_cash": 53.25, "setting": "both", "billing_class": "facility"}]}, {"description": "OSELTAMIVIR 6/1 1ML PWLQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5315907", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 71.0, "discounted_cash": 53.25, "setting": "both", "billing_class": "facility"}]}, {"description": "OSELTAMIVIR 6/1 5ML PWLQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5315904", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 230.0, "discounted_cash": 172.5, "setting": "both", "billing_class": "facility"}]}, {"description": "OSELTAMIVIR 6/1 5ML PWLQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5315904", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 230.0, "discounted_cash": 172.5, "setting": "both", "billing_class": "facility"}]}, {"description": "OSELTAMIVIR 75MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5308504", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 254.0, "discounted_cash": 190.5, "setting": "both", "billing_class": "facility"}]}, {"description": "OSELTAMIVIR 75MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5308504", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 254.0, "discounted_cash": 190.5, "setting": "both", "billing_class": "facility"}]}, {"description": "OSMOLALITY BLOOD", "code_information": [{"code": "83930", "type": "CPT"}, {"code": "4103930", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 377.0, "discounted_cash": 282.75, "setting": "both", "billing_class": "facility"}]}, {"description": "OSMOLALITY BLOOD", "code_information": [{"code": "83930", "type": "CPT"}, {"code": "4173930", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 9.98, "discounted_cash": 7.49, "setting": "both", "billing_class": "facility"}]}, {"description": "OSMOLALITY BLOOD", "code_information": [{"code": "83930", "type": "CPT"}, {"code": "7253930", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 479.0, "discounted_cash": 359.25, "setting": "both", "billing_class": "facility"}]}, {"description": "OSMOLALITY URINE", "code_information": [{"code": "83935", "type": "CPT"}, {"code": "4103935", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 413.0, "discounted_cash": 309.75, "setting": "both", "billing_class": "facility"}]}, {"description": "OSMOLALITY URINE", "code_information": [{"code": "83935", "type": "CPT"}, {"code": "4173935", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 9.98, "discounted_cash": 7.49, "setting": "both", "billing_class": "facility"}]}, {"description": "OSMOTIC FRAG RBC INC", "code_information": [{"code": "85557", "type": "CPT"}, {"code": "7255557", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 208.0, "discounted_cash": 156.0, "setting": "both", "billing_class": "facility"}]}, {"description": "OSMOTIC FRAG RBC UNINC", "code_information": [{"code": "85555", "type": "CPT"}, {"code": "7255555", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 208.0, "discounted_cash": 156.0, "setting": "both", "billing_class": "facility"}]}, {"description": "OT COG FUNC ACTIVITY INIT 15M", "code_information": [{"code": "97129", "type": "CPT"}, {"code": "5807129", "type": "CDM"}, {"code": "430", "type": "RC"}], "standard_charges": [{"gross_charge": 619.0, "discounted_cash": 464.25, "setting": "both", "billing_class": "facility"}], "modifiers": "GO"}, {"description": "OT COG FUNC ACTIVTY ADDL 15M", "code_information": [{"code": "97130", "type": "CPT"}, {"code": "5807130", "type": "CDM"}, {"code": "430", "type": "RC"}], "standard_charges": [{"gross_charge": 619.0, "discounted_cash": 464.25, "setting": "both", "billing_class": "facility"}], "modifiers": "GO"}, {"description": "OT E-STIM BASIC", "code_information": [{"code": "G0283", "type": "HCPCS"}, {"code": "5800283", "type": "CDM"}, {"code": "430", "type": "RC"}], "standard_charges": [{"gross_charge": 1194.0, "discounted_cash": 895.5, "setting": "both", "billing_class": "facility"}], "modifiers": "GO"}, {"description": "OT EVAL HIGH COMP", "code_information": [{"code": "97167", "type": "CPT"}, {"code": "5805205", "type": "CDM"}, {"code": "434", "type": "RC"}], "standard_charges": [{"gross_charge": 1405.0, "discounted_cash": 1053.75, "setting": "both", "billing_class": "facility"}], "modifiers": "GO"}, {"description": "OT EVAL LOW COMP", "code_information": [{"code": "97165", "type": "CPT"}, {"code": "5805201", "type": "CDM"}, {"code": "434", "type": "RC"}], "standard_charges": [{"gross_charge": 1988.0, "discounted_cash": 1491.0, "setting": "both", "billing_class": "facility"}], "modifiers": "GO"}, {"description": "OT EVAL MOD COMP", "code_information": [{"code": "97166", "type": "CPT"}, {"code": "5805203", "type": "CDM"}, {"code": "434", "type": "RC"}], "standard_charges": [{"gross_charge": 1142.0, "discounted_cash": 856.5, "setting": "both", "billing_class": "facility"}], "modifiers": "GO"}, {"description": "OT EVAL NEURDEV/PED HIGH", "code_information": [{"code": "97167", "type": "CPT"}, {"code": "5805415", "type": "CDM"}, {"code": "434", "type": "RC"}], "standard_charges": [{"gross_charge": 1405.0, "discounted_cash": 1053.75, "setting": "both", "billing_class": "facility"}], "modifiers": "GO"}, {"description": "OT MANUAL THERAPY EA 15M", "code_information": [{"code": "97140", "type": "CPT"}, {"code": "5805180", "type": "CDM"}, {"code": "430", "type": "RC"}], "standard_charges": [{"gross_charge": 616.0, "discounted_cash": 462.0, "setting": "both", "billing_class": "facility"}], "modifiers": "GO"}, {"description": "OT NEURODEV/PED EVAL LOW", "code_information": [{"code": "97165", "type": "CPT"}, {"code": "5805411", "type": "CDM"}, {"code": "434", "type": "RC"}], "standard_charges": [{"gross_charge": 1927.0, "discounted_cash": 1445.25, "setting": "both", "billing_class": "facility"}], "modifiers": "GO"}, {"description": "OT NEURODEV/PED EVAL MOD", "code_information": [{"code": "97166", "type": "CPT"}, {"code": "5805413", "type": "CDM"}, {"code": "434", "type": "RC"}], "standard_charges": [{"gross_charge": 1405.0, "discounted_cash": 1053.75, "setting": "both", "billing_class": "facility"}], "modifiers": "GO"}, {"description": "OT NEUROMUSC RE-EDUC EA15", "code_information": [{"code": "97112", "type": "CPT"}, {"code": "5805300", "type": "CDM"}, {"code": "430", "type": "RC"}], "standard_charges": [{"gross_charge": 548.0, "discounted_cash": 411.0, "setting": "both", "billing_class": "facility"}], "modifiers": "GO"}, {"description": "OT ORTHO MGMT INIT EA 15MIN", "code_information": [{"code": "97760", "type": "CPT"}, {"code": "5807760", "type": "CDM"}, {"code": "430", "type": "RC"}], "standard_charges": [{"gross_charge": 277.0, "discounted_cash": 207.75, "setting": "both", "billing_class": "facility"}], "modifiers": "GO"}, {"description": "OT PARAFFIN BATH BSC", "code_information": [{"code": "97018", "type": "CPT"}, {"code": "5805248", "type": "CDM"}, {"code": "430", "type": "RC"}], "standard_charges": [{"gross_charge": 241.0, "discounted_cash": 180.75, "setting": "both", "billing_class": "facility"}], "modifiers": "GO"}, {"description": "OT RE-EVAL", "code_information": [{"code": "97168", "type": "CPT"}, {"code": "5805221", "type": "CDM"}, {"code": "434", "type": "RC"}], "standard_charges": [{"gross_charge": 1437.0, "discounted_cash": 1077.75, "setting": "both", "billing_class": "facility"}], "modifiers": "GO"}, {"description": "OT RE-EVAL NEURODEV/PED", "code_information": [{"code": "97168", "type": "CPT"}, {"code": "5805421", "type": "CDM"}, {"code": "434", "type": "RC"}], "standard_charges": [{"gross_charge": 1637.0, "discounted_cash": 1227.75, "setting": "both", "billing_class": "facility"}], "modifiers": "GO"}, {"description": "OT SLF CARE HM MGMT EA15", "code_information": [{"code": "97535", "type": "CPT"}, {"code": "5805316", "type": "CDM"}, {"code": "430", "type": "RC"}], "standard_charges": [{"gross_charge": 256.0, "discounted_cash": 192.0, "setting": "both", "billing_class": "facility"}], "modifiers": "GO"}, {"description": "OT THERAPTC ACT EA 15", "code_information": [{"code": "97530", "type": "CPT"}, {"code": "5805312", "type": "CDM"}, {"code": "430", "type": "RC"}], "standard_charges": [{"gross_charge": 635.0, "discounted_cash": 476.25, "setting": "both", "billing_class": "facility"}], "modifiers": "GO"}, {"description": "OT THERAPTC EXER EA 15", "code_information": [{"code": "97110", "type": "CPT"}, {"code": "5805296", "type": "CDM"}, {"code": "430", "type": "RC"}], "standard_charges": [{"gross_charge": 670.0, "discounted_cash": 502.5, "setting": "both", "billing_class": "facility"}], "modifiers": "GO"}, {"description": "OT US EA 15 BASIC", "code_information": [{"code": "97035", "type": "CPT"}, {"code": "5805284", "type": "CDM"}, {"code": "430", "type": "RC"}], "standard_charges": [{"gross_charge": 470.0, "discounted_cash": 352.5, "setting": "both", "billing_class": "facility"}], "modifiers": "GO"}, {"description": "OT VASOPNEUM DVC BSC", "code_information": [{"code": "97016", "type": "CPT"}, {"code": "5807015", "type": "CDM"}, {"code": "430", "type": "RC"}], "standard_charges": [{"gross_charge": 761.0, "discounted_cash": 570.75, "setting": "both", "billing_class": "facility"}], "modifiers": "GO"}, {"description": "OT WHIRLPOOL BSC", "code_information": [{"code": "97022", "type": "CPT"}, {"code": "5805254", "type": "CDM"}, {"code": "430", "type": "RC"}], "standard_charges": [{"gross_charge": 576.0, "discounted_cash": 432.0, "setting": "both", "billing_class": "facility"}], "modifiers": "GO"}, {"description": "OTA COG FUNC ACTIVITY INIT 15M", "code_information": [{"code": "97129", "type": "CPT"}, {"code": "5807127", "type": "CDM"}, {"code": "430", "type": "RC"}], "standard_charges": [{"gross_charge": 619.0, "discounted_cash": 464.25, "setting": "both", "billing_class": "facility"}], "modifiers": "GO|CO"}, {"description": "OTA COG FUNC ACTIVTY ADDL 15M", "code_information": [{"code": "97130", "type": "CPT"}, {"code": "5807131", "type": "CDM"}, {"code": "430", "type": "RC"}], "standard_charges": [{"gross_charge": 619.0, "discounted_cash": 464.25, "setting": "both", "billing_class": "facility"}], "modifiers": "GO|CO"}, {"description": "OTA E-STIM BASIC", "code_information": [{"code": "G0283", "type": "HCPCS"}, {"code": "5800002", "type": "CDM"}, {"code": "430", "type": "RC"}], "standard_charges": [{"gross_charge": 1194.0, "discounted_cash": 895.5, "setting": "both", "billing_class": "facility"}], "modifiers": "GO|CO"}, {"description": "OTA MANUAL THERAPY EA 15M", "code_information": [{"code": "97140", "type": "CPT"}, {"code": "5800012", "type": "CDM"}, {"code": "430", "type": "RC"}], "standard_charges": [{"gross_charge": 616.0, "discounted_cash": 462.0, "setting": "both", "billing_class": "facility"}], "modifiers": "GO|CO"}, {"description": "OTA NEUROMUSC RE-EDUC EA1", "code_information": [{"code": "97112", "type": "CPT"}, {"code": "5800028", "type": "CDM"}, {"code": "430", "type": "RC"}], "standard_charges": [{"gross_charge": 548.0, "discounted_cash": 411.0, "setting": "both", "billing_class": "facility"}], "modifiers": "GO|CO"}, {"description": "OTA PARAFFIN BATH BSC", "code_information": [{"code": "97018", "type": "CPT"}, {"code": "5800017", "type": "CDM"}, {"code": "430", "type": "RC"}], "standard_charges": [{"gross_charge": 241.0, "discounted_cash": 180.75, "setting": "both", "billing_class": "facility"}], "modifiers": "GO|CO"}, {"description": "OTA SLF CARE HM MGMT EA15", "code_information": [{"code": "97535", "type": "CPT"}, {"code": "5800036", "type": "CDM"}, {"code": "430", "type": "RC"}], "standard_charges": [{"gross_charge": 256.0, "discounted_cash": 192.0, "setting": "both", "billing_class": "facility"}], "modifiers": "GO|CO"}, {"description": "OTA THERAPTC ACT EA 15", "code_information": [{"code": "97530", "type": "CPT"}, {"code": "5800034", "type": "CDM"}, {"code": "430", "type": "RC"}], "standard_charges": [{"gross_charge": 635.0, "discounted_cash": 476.25, "setting": "both", "billing_class": "facility"}], "modifiers": "GO|CO"}, {"description": "OTA THERAPTC EXER EA 15", "code_information": [{"code": "97110", "type": "CPT"}, {"code": "5800026", "type": "CDM"}, {"code": "430", "type": "RC"}], "standard_charges": [{"gross_charge": 670.0, "discounted_cash": 502.5, "setting": "both", "billing_class": "facility"}], "modifiers": "GO|CO"}, {"description": "OTA US EA 15 BASIC", "code_information": [{"code": "97035", "type": "CPT"}, {"code": "5800025", "type": "CDM"}, {"code": "430", "type": "RC"}], "standard_charges": [{"gross_charge": 470.0, "discounted_cash": 352.5, "setting": "both", "billing_class": "facility"}], "modifiers": "GO|CO"}, {"description": "OTA VASOPNEUM DVC BSC", "code_information": [{"code": "97016", "type": "CPT"}, {"code": "5800047", "type": "CDM"}, {"code": "430", "type": "RC"}], "standard_charges": [{"gross_charge": 761.0, "discounted_cash": 570.75, "setting": "both", "billing_class": "facility"}], "modifiers": "GO|CO"}, {"description": "OTA WHIRLPOOL BSC", "code_information": [{"code": "97022", "type": "CPT"}, {"code": "5800018", "type": "CDM"}, {"code": "430", "type": "RC"}], "standard_charges": [{"gross_charge": 576.0, "discounted_cash": 432.0, "setting": "both", "billing_class": "facility"}], "modifiers": "GO|CO"}, {"description": "OUTSIDE FEE FFP/PEDIATRC", "code_information": [{"code": "P9017", "type": "HCPCS"}, {"code": "4500068", "type": "CDM"}, {"code": "399", "type": "RC"}], "standard_charges": [{"gross_charge": 225.0, "discounted_cash": 168.75, "setting": "both", "billing_class": "facility"}]}, {"description": "OVA & PARASITES SMEARS", "code_information": [{"code": "87177", "type": "CPT"}, {"code": "4107177", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 796.0, "discounted_cash": 597.0, "setting": "both", "billing_class": "facility"}]}, {"description": "OVA & PARASITES SMEARS", "code_information": [{"code": "87177", "type": "CPT"}, {"code": "4177177", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 4.29, "discounted_cash": 3.22, "setting": "both", "billing_class": "facility"}]}, {"description": "OVA & PARASITES SMEARS/2", "code_information": [{"code": "87177", "type": "CPT"}, {"code": "7257177", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 33.0, "discounted_cash": 24.75, "setting": "both", "billing_class": "facility"}]}, {"description": "OXALATE", "code_information": [{"code": "83945", "type": "CPT"}, {"code": "7253945", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 531.0, "discounted_cash": 398.25, "setting": "both", "billing_class": "facility"}]}, {"description": "OXANDROLONE 2.5MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5327840", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 178.0, "discounted_cash": 133.5, "setting": "both", "billing_class": "facility"}]}, {"description": "OXANDROLONE 2.5MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5327840", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 178.0, "discounted_cash": 133.5, "setting": "both", "billing_class": "facility"}]}, {"description": "OXCARBAZEPINE 150MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5308570", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 61.0, "discounted_cash": 45.75, "setting": "both", "billing_class": "facility"}]}, {"description": "OXCARBAZEPINE 150MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5308570", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 61.0, "discounted_cash": 45.75, "setting": "both", "billing_class": "facility"}]}, {"description": "OXCARBAZEPINE 5ML LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5315901", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 84.0, "discounted_cash": 63.0, "setting": "both", "billing_class": "facility"}]}, {"description": "OXCARBAZEPINE 5ML LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5315901", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 84.0, "discounted_cash": 63.0, "setting": "both", "billing_class": "facility"}]}, {"description": "OXCARBAZEPINE/2", "code_information": [{"code": "80183", "type": "CPT"}, {"code": "7250317", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 28.0, "discounted_cash": 21.0, "setting": "both", "billing_class": "facility"}]}, {"description": "OXYBUTYNIN 5MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5308640", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 77.0, "discounted_cash": 57.75, "setting": "both", "billing_class": "facility"}]}, {"description": "OXYBUTYNIN 5MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5308640", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 77.0, "discounted_cash": 57.75, "setting": "both", "billing_class": "facility"}]}, {"description": "OXYBUTYNIN 5MG XR TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5308641", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 76.0, "discounted_cash": 57.0, "setting": "both", "billing_class": "facility"}]}, {"description": "OXYBUTYNIN 5MG XR TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5308641", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 76.0, "discounted_cash": 57.0, "setting": "both", "billing_class": "facility"}]}, {"description": "OXYCOD/APAP 5/325 TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5327847", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 97.0, "discounted_cash": 72.75, "setting": "both", "billing_class": "facility"}]}, {"description": "OXYCOD/APAP 5/325 TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5327847", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 97.0, "discounted_cash": 72.75, "setting": "both", "billing_class": "facility"}]}, {"description": "OXYCODONE 15MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5327851", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 47.0, "discounted_cash": 35.25, "setting": "both", "billing_class": "facility"}]}, {"description": "OXYCODONE 15MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5327851", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 47.0, "discounted_cash": 35.25, "setting": "both", "billing_class": "facility"}]}, {"description": "OXYCODONE 40MG XR TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5327859", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 174.0, "discounted_cash": 130.5, "setting": "both", "billing_class": "facility"}]}, {"description": "OXYCODONE 40MG XR TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5327859", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 174.0, "discounted_cash": 130.5, "setting": "both", "billing_class": "facility"}]}, {"description": "OXYMETAZOLN NS.05%30MLSP", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5331681", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 70.0, "discounted_cash": 52.5, "setting": "both", "billing_class": "facility"}]}, {"description": "OXYMETAZOLN NS.05%30MLSP", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5331681", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 70.0, "discounted_cash": 52.5, "setting": "both", "billing_class": "facility"}]}, {"description": "OXYTOCIN PER 10U LR IV", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J2590", "type": "HCPCS"}, {"code": "5323038", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 605.0, "discounted_cash": 453.75, "setting": "both", "billing_class": "facility"}]}, {"description": "OXYTOCIN PER 10U LR IV", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J2590", "type": "HCPCS"}, {"code": "5323038", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 605.0, "discounted_cash": 453.75, "setting": "both", "billing_class": "facility"}]}, {"description": "OXYTOCIN PER 10U NACL IV", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J2590", "type": "HCPCS"}, {"code": "5323036", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 203.0, "discounted_cash": 152.25, "setting": "both", "billing_class": "facility"}]}, {"description": "OXYTOCIN PER 10U NACL IV", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J2590", "type": "HCPCS"}, {"code": "5323036", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 203.0, "discounted_cash": 152.25, "setting": "both", "billing_class": "facility"}]}, {"description": "OXYTOCIN UPTO 10U IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J2590", "type": "HCPCS"}, {"code": "5323045", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 225.0, "discounted_cash": 168.75, "setting": "both", "billing_class": "facility"}]}, {"description": "OXYTOCIN UPTO 10U IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J2590", "type": "HCPCS"}, {"code": "5323045", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 225.0, "discounted_cash": 168.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PALIPERIDONE 3MG XR TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5308879", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 256.0, "discounted_cash": 192.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PALIPERIDONE 3MG XR TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5308879", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 256.0, "discounted_cash": 192.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PALIPERIDONE 6MG XR TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5308880", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 274.0, "discounted_cash": 205.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PALIPERIDONE 6MG XR TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5308880", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 274.0, "discounted_cash": 205.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PALIPERIDONE 9MG XR TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5308881", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 324.0, "discounted_cash": 243.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PALIPERIDONE 9MG XR TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5308881", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 324.0, "discounted_cash": 243.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PALIVIZUMAB PER 50MG IJ", "code_information": [{"code": "90378", "type": "CPT"}, {"code": "5323057", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 11991.0, "discounted_cash": 8993.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PALIVIZUMAB PER 50MG IJ", "code_information": [{"code": "90378", "type": "CPT"}, {"code": "5323057", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 11991.0, "discounted_cash": 8993.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PAMIDRONATE PER 30MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J2430", "type": "HCPCS"}, {"code": "5323060", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 4537.0, "discounted_cash": 3402.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PAMIDRONATE PER 30MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J2430", "type": "HCPCS"}, {"code": "5323060", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 4537.0, "discounted_cash": 3402.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PANCRELIP 5-17-24 XRCP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5306614", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 53.0, "discounted_cash": 39.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PANCRELIP 5-17-24 XRCP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5306614", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 53.0, "discounted_cash": 39.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PANCRELIP 5-17-27 XRCP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5306601", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 61.0, "discounted_cash": 45.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PANCRELIP 5-17-27 XRCP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5306601", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 61.0, "discounted_cash": 45.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PANCRTC POLYPEP (RIA)/2", "code_information": [{"code": "83519", "type": "CPT"}, {"code": "7253519", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 439.0, "discounted_cash": 329.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PANCURONIUM 10MG/10ML IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5323066", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 272.0, "discounted_cash": 204.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PANCURONIUM NEO CMPD IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J7999", "type": "HCPCS"}, {"code": "5323065", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 113.0, "discounted_cash": 84.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PANCURONIUM NEO CMPD IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J7999", "type": "HCPCS"}, {"code": "5323065", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 113.0, "discounted_cash": 84.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PANTOPRAZOLE 40MG EC TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5308870", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 148.0, "discounted_cash": 111.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PANTOPRAZOLE 40MG EC TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5308870", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 148.0, "discounted_cash": 111.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PANTOPRAZOLE PER40MGIJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J2470", "type": "HCPCS"}, {"code": "5323070", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 440.0, "discounted_cash": 330.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PANTOPRAZOLE PER40MGIJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J2470", "type": "HCPCS"}, {"code": "5323070", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 440.0, "discounted_cash": 330.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PAPAVERINE UPTO 60MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J2440", "type": "HCPCS"}, {"code": "5323077", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 85.0, "discounted_cash": 63.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PAPAVERINE UPTO 60MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J2440", "type": "HCPCS"}, {"code": "5323077", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 85.0, "discounted_cash": 63.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PAPILLOTOME W GW", "code_information": [{"code": "C1769", "type": "HCPCS"}, {"code": "8082625", "type": "CDM"}, {"code": "272", "type": "RC"}], "standard_charges": [{"gross_charge": 1258.0, "discounted_cash": 943.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PARAINFLUENZA DFA", "code_information": [{"code": "87279", "type": "CPT"}, {"code": "4107279", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 43.0, "discounted_cash": 32.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PARATHORMONE (PTH)", "code_information": [{"code": "83970", "type": "CPT"}, {"code": "4173972", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 15.71, "discounted_cash": 11.78, "setting": "both", "billing_class": "facility"}]}, {"description": "PARATHORMONE (PTH)", "code_information": [{"code": "83970", "type": "CPT"}, {"code": "7253902", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 53.0, "discounted_cash": 39.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PARATHORMONE (PTH)/2", "code_information": [{"code": "83970", "type": "CPT"}, {"code": "4103972", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 1386.0, "discounted_cash": 1039.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PARATHYROID IMAGING", "code_information": [{"code": "78070", "type": "CPT"}, {"code": "5208031", "type": "CDM"}, {"code": "341", "type": "RC"}], "standard_charges": [{"gross_charge": 3028.0, "discounted_cash": 2271.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PARIETAL CELL AB", "code_information": [{"code": "83516", "type": "CPT"}, {"code": "7258658", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 55.0, "discounted_cash": 41.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PAROXETINE 10MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5308949", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 108.0, "discounted_cash": 81.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PAROXETINE 10MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5308949", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 108.0, "discounted_cash": 81.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PAROXETINE 12.5MG XR TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5308953", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 124.0, "discounted_cash": 93.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PAROXETINE 12.5MG XR TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5308953", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 124.0, "discounted_cash": 93.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PAROXETINE 20MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5308950", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 72.0, "discounted_cash": 54.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PAROXETINE 20MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5308950", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 72.0, "discounted_cash": 54.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PARTICLE AGGLUT AB EA/12", "code_information": [{"code": "86403", "type": "CPT"}, {"code": "4106415", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 674.0, "discounted_cash": 505.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PARTICLE AGGLUT AB EA/5", "code_information": [{"code": "86403", "type": "CPT"}, {"code": "4176415", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 21.41, "discounted_cash": 16.06, "setting": "both", "billing_class": "facility"}]}, {"description": "PARTICLE AGGLUT AB EA/6", "code_information": [{"code": "86403", "type": "CPT"}, {"code": "4106403", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 895.0, "discounted_cash": 671.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PARTICLE AGGLUT TITER EA", "code_information": [{"code": "86406", "type": "CPT"}, {"code": "7256406", "type": "CDM"}, {"code": "310", "type": "RC"}], "standard_charges": [{"gross_charge": 716.0, "discounted_cash": 537.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PARVOVIRUS AB", "code_information": [{"code": "86747", "type": "CPT"}, {"code": "7256248", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 2507.0, "discounted_cash": 1880.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PARVOVIRUS AB/3", "code_information": [{"code": "86747", "type": "CPT"}, {"code": "7256748", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 2507.0, "discounted_cash": 1880.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PATELLA ALL POLY GLOBUS CL", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "4013243", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 7736.0, "discounted_cash": 5802.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PATELLA ATTUNE POLY DEPUY CL", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "4012822", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 7426.0, "discounted_cash": 5569.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PATELLA KNEE POLY DJO CL", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "4013409", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 4118.0, "discounted_cash": 3088.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PATELLA METAL/POLY/JRNY SN CL", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "4012916", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 3093.0, "discounted_cash": 2319.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PATELLA PFJ ARTHROSURFACE CL", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "4013298", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 4298.0, "discounted_cash": 3223.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PATELLA POLY RP DEPUY CL", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "4012824", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 6497.0, "discounted_cash": 4872.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PATELLA TM METAL STRYKER CL", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "4013065", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 4054.0, "discounted_cash": 3040.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PDGFRA MUTATION ANALYSIS", "code_information": [{"code": "81314", "type": "CPT"}, {"code": "7061314", "type": "CDM"}, {"code": "310", "type": "RC"}], "standard_charges": [{"gross_charge": 254.0, "discounted_cash": 190.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PE 10% 5ML OS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5331822", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 171.0, "discounted_cash": 128.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PE 2.5% 15ML OS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5331829", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 892.0, "discounted_cash": 669.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PE 2.5% 15ML OS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5331829", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 892.0, "discounted_cash": 669.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PE 2.5% 2ML OS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5331828", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 258.0, "discounted_cash": 193.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PE 2.5% 3ML OS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5331830", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 530.0, "discounted_cash": 397.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PE NAS .125% 15ML DR IS", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5331779", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 87.0, "discounted_cash": 65.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PE NAS .125% 15ML DR IS", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5331779", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 87.0, "discounted_cash": 65.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PE NASAL .25% 15ML SP", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5331794", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 95.0, "discounted_cash": 71.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PE NASAL .25% 15ML SP", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5331794", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 95.0, "discounted_cash": 71.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PE NASAL .5% 15ML SP", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5331808", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 95.0, "discounted_cash": 71.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PE NASAL .5% 15ML SP", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5331808", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 95.0, "discounted_cash": 71.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PE NASAL 1% 30ML DR IS", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5331814", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 108.0, "discounted_cash": 81.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PE NASAL 1% 30ML DR IS", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5331814", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 108.0, "discounted_cash": 81.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PE/CYCLOPENT 1-.2%2ML OS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5331842", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 407.0, "discounted_cash": 305.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PE/CYCLOPENT1-.2% 5ML OS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5331843", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 356.0, "discounted_cash": 267.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PEG LOCKING IMP", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8134001", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 2421.0, "discounted_cash": 1815.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PELVIS 1 VIEW", "code_information": [{"code": "72170", "type": "CPT"}, {"code": "4902170", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 1695.0, "discounted_cash": 1271.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PELVIS 1 VIEW", "code_information": [{"code": "72170", "type": "CPT"}, {"code": "5112170", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 1030.0, "discounted_cash": 772.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PELVIS MIN 3 VWS", "code_information": [{"code": "72190", "type": "CPT"}, {"code": "4902190", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 487.0, "discounted_cash": 365.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PELVIS MIN 3 VWS", "code_information": [{"code": "72190", "type": "CPT"}, {"code": "5112190", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 487.0, "discounted_cash": 365.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PEN G BENZ PER 100KU IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0561", "type": "HCPCS"}, {"code": "5323121", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 130.0, "discounted_cash": 97.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PEN G BENZ PER 100KU IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0561", "type": "HCPCS"}, {"code": "5323121", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 130.0, "discounted_cash": 97.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PEN G K UPTO 600KU IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J2540", "type": "HCPCS"}, {"code": "5323151", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 353.0, "discounted_cash": 264.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PEN G K UPTO 600KU IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J2540", "type": "HCPCS"}, {"code": "5323151", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 353.0, "discounted_cash": 264.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PENICILLIN G K PED IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5323149", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 104.0, "discounted_cash": 78.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PENICILLIN VK125M/5MPWLQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5315987", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 47.0, "discounted_cash": 35.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PENICILLIN VK125M/5MPWLQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5315987", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 47.0, "discounted_cash": 35.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PENTOSN POLYSLF 100MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5309065", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 125.0, "discounted_cash": 93.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PENTOSN POLYSLF 100MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5309065", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 125.0, "discounted_cash": 93.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PENTOXIFYLLN 400MG XR TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5309066", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 63.0, "discounted_cash": 47.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PENTOXIFYLLN 400MG XR TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5309066", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 63.0, "discounted_cash": 47.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PER COR REVAS CABG ADDL", "code_information": [{"code": "C9605", "type": "HCPCS"}, {"code": "4619605", "type": "CDM"}, {"code": "480", "type": "RC"}], "standard_charges": [{"gross_charge": 70607.0, "discounted_cash": 52955.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PER COR REVAS CABG ADDL", "code_information": [{"code": "C9605", "type": "HCPCS"}, {"code": "4619605", "type": "CDM"}, {"code": "481", "type": "RC"}], "standard_charges": [{"gross_charge": 70607.0, "discounted_cash": 52955.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PER COR REVAS CHRONC SNG", "code_information": [{"code": "C9607", "type": "HCPCS"}, {"code": "4619607", "type": "CDM"}, {"code": "480", "type": "RC"}], "standard_charges": [{"gross_charge": 64779.0, "discounted_cash": 48584.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PER COR REVAS CHRONC SNG", "code_information": [{"code": "C9607", "type": "HCPCS"}, {"code": "4619607", "type": "CDM"}, {"code": "481", "type": "RC"}], "standard_charges": [{"gross_charge": 64779.0, "discounted_cash": 48584.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PER COR REVAS D-E ADDL", "code_information": [{"code": "C9608", "type": "HCPCS"}, {"code": "4619608", "type": "CDM"}, {"code": "480", "type": "RC"}], "standard_charges": [{"gross_charge": 69944.0, "discounted_cash": 52458.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PER COR REVAS D-E ADDL", "code_information": [{"code": "C9608", "type": "HCPCS"}, {"code": "4619608", "type": "CDM"}, {"code": "481", "type": "RC"}], "standard_charges": [{"gross_charge": 69944.0, "discounted_cash": 52458.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PER COR REVAS D-E W/AMI", "code_information": [{"code": "C9606", "type": "HCPCS"}, {"code": "4619606", "type": "CDM"}, {"code": "480", "type": "RC"}], "standard_charges": [{"gross_charge": 60092.0, "discounted_cash": 45069.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PER COR REVAS D-E W/AMI", "code_information": [{"code": "C9606", "type": "HCPCS"}, {"code": "4619606", "type": "CDM"}, {"code": "481", "type": "RC"}], "standard_charges": [{"gross_charge": 60092.0, "discounted_cash": 45069.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PERC ACCES+DEL GFT+US/UNI", "code_information": [{"code": "4614713", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 81923.0, "discounted_cash": 61442.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PERC AUG 1 BD LUMB/IMG", "code_information": [{"code": "4919720", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 78732.0, "discounted_cash": 59049.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PERC AUG 1 BD THOR/IMG", "code_information": [{"code": "4919718", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 85818.0, "discounted_cash": 64363.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PERC BILIARY BRUSH BIOPS", "code_information": [{"code": "4914306", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 12046.0, "discounted_cash": 9034.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PERC BIOPSY LYMPH NODE", "code_information": [{"code": "4918500", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 7911.0, "discounted_cash": 5933.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PERC BIOPSY LYMPH NODE", "code_information": [{"code": "5057516", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 9664.0, "discounted_cash": 7248.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PERC BIOPSY LYMPH NODE", "code_information": [{"code": "5068505", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 7083.0, "discounted_cash": 5312.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PERC CATH PORTAL VEIN", "code_information": [{"code": "4910163", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 15017.0, "discounted_cash": 11262.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PERC CHOLECYSTOSTOMY", "code_information": [{"code": "4917600", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 11767.0, "discounted_cash": 8825.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PERC COR ATH D-E STNT", "code_information": [{"code": "C9602", "type": "HCPCS"}, {"code": "4619602", "type": "CDM"}, {"code": "480", "type": "RC"}], "standard_charges": [{"gross_charge": 55702.0, "discounted_cash": 41776.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PERC COR ATH D-E STNT", "code_information": [{"code": "C9602", "type": "HCPCS"}, {"code": "4619602", "type": "CDM"}, {"code": "481", "type": "RC"}], "standard_charges": [{"gross_charge": 55702.0, "discounted_cash": 41776.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PERC COR ATHER STNT ADD", "code_information": [{"code": "C9603", "type": "HCPCS"}, {"code": "4619603", "type": "CDM"}, {"code": "480", "type": "RC"}], "standard_charges": [{"gross_charge": 70607.0, "discounted_cash": 52955.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PERC COR ATHER STNT ADD", "code_information": [{"code": "C9603", "type": "HCPCS"}, {"code": "4619603", "type": "CDM"}, {"code": "481", "type": "RC"}], "standard_charges": [{"gross_charge": 70607.0, "discounted_cash": 52955.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PERC COR DRUG-ELUT STNT", "code_information": [{"code": "C9600", "type": "HCPCS"}, {"code": "4619600", "type": "CDM"}, {"code": "480", "type": "RC"}], "standard_charges": [{"gross_charge": 67563.0, "discounted_cash": 50672.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PERC COR DRUG-ELUT STNT", "code_information": [{"code": "C9600", "type": "HCPCS"}, {"code": "4619600", "type": "CDM"}, {"code": "481", "type": "RC"}], "standard_charges": [{"gross_charge": 67563.0, "discounted_cash": 50672.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PERC COR REVASC D-E CABG", "code_information": [{"code": "C9604", "type": "HCPCS"}, {"code": "4619604", "type": "CDM"}, {"code": "480", "type": "RC"}], "standard_charges": [{"gross_charge": 64779.0, "discounted_cash": 48584.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PERC COR REVASC D-E CABG", "code_information": [{"code": "C9604", "type": "HCPCS"}, {"code": "4619604", "type": "CDM"}, {"code": "481", "type": "RC"}], "standard_charges": [{"gross_charge": 64779.0, "discounted_cash": 48584.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PERC CORON THROMBECT", "code_information": [{"code": "92973", "type": "CPT"}, {"code": "4612973", "type": "CDM"}, {"code": "480", "type": "RC"}], "standard_charges": [{"gross_charge": 14419.0, "discounted_cash": 10814.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PERC CRY ABLAT LIVR TUMR", "code_information": [{"code": "4917383", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 31054.0, "discounted_cash": 23290.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PERC DEVC BRST 1ST MAMMO", "code_information": [{"code": "3079281", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 994.0, "discounted_cash": 745.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PERC DEVC BRST 1ST STRTC", "code_information": [{"code": "3079283", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 962.0, "discounted_cash": 721.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PERC DEVC BRST 1ST US", "code_information": [{"code": "3079285", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 994.0, "discounted_cash": 745.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PERC DEVC BRST ADD MAM", "code_information": [{"code": "3079282", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 444.0, "discounted_cash": 333.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PERC DEVC BRST ADD STRTC", "code_information": [{"code": "3079284", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 480.0, "discounted_cash": 360.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PERC DEVC BRST ADD US", "code_information": [{"code": "3079286", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 440.0, "discounted_cash": 330.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PERC DRAIN W CATH PLC", "code_information": [{"code": "75989", "type": "CPT"}, {"code": "4915990", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 4056.0, "discounted_cash": 3042.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PERC DRAIN W CATH PLC", "code_information": [{"code": "75989", "type": "CPT"}, {"code": "5055990", "type": "CDM"}, {"code": "350", "type": "RC"}], "standard_charges": [{"gross_charge": 4686.0, "discounted_cash": 3514.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PERC DRAIN W CATH PLC", "code_information": [{"code": "75989", "type": "CPT"}, {"code": "5067630", "type": "CDM"}, {"code": "402", "type": "RC"}], "standard_charges": [{"gross_charge": 5109.0, "discounted_cash": 3831.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PERC DRUG-ELUT STNT ADDL", "code_information": [{"code": "C9601", "type": "HCPCS"}, {"code": "4619601", "type": "CDM"}, {"code": "480", "type": "RC"}], "standard_charges": [{"gross_charge": 55702.0, "discounted_cash": 41776.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PERC DRUG-ELUT STNT ADDL", "code_information": [{"code": "C9601", "type": "HCPCS"}, {"code": "4619601", "type": "CDM"}, {"code": "481", "type": "RC"}], "standard_charges": [{"gross_charge": 55702.0, "discounted_cash": 41776.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PERC INSERT IABP DEV", "code_information": [{"code": "4613967", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 7215.0, "discounted_cash": 5411.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PERC MECH THROMBECTMY VN", "code_information": [{"code": "4617187", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 17070.0, "discounted_cash": 12802.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PERC MECH THROMBECTMY VN", "code_information": [{"code": "4914104", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 9701.0, "discounted_cash": 7275.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PERC MECH THROMBUS ART", "code_information": [{"code": "4611645", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 28094.0, "discounted_cash": 21070.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PERC NEPH/PYELO 0-2CM", "code_information": [{"code": "4915008", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 17290.0, "discounted_cash": 12967.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PERC RF ABLATE BONE TUMR", "code_information": [{"code": "4912098", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 104449.0, "discounted_cash": 78336.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PERC RF ABLATE BONE TUMR", "code_information": [{"code": "5050982", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 95825.0, "discounted_cash": 71868.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PERC RF ABLATE LIVR TUMR", "code_information": [{"code": "5057382", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 70368.0, "discounted_cash": 52776.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PERC RF ABLATE PULM TUMR+IMG", "code_information": [{"code": "5052998", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 86359.0, "discounted_cash": 64769.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PERC RF ABLATE RENL TUMR", "code_information": [{"code": "5050592", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 110675.0, "discounted_cash": 83006.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PERC SACRL AUGMENT BILAT", "code_information": [{"code": "5052898", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 13300.0, "discounted_cash": 9975.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PERC SACRL AUGMENT UNIL", "code_information": [{"code": "5052899", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 13300.0, "discounted_cash": 9975.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PERC TRNSHEP PORT W/EVL", "code_information": [{"code": "75885", "type": "CPT"}, {"code": "4915886", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 11264.0, "discounted_cash": 8448.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PERC VALVULOPLSTY AORTIC", "code_information": [{"code": "92986", "type": "CPT"}, {"code": "4610500", "type": "CDM"}, {"code": "480", "type": "RC"}], "standard_charges": [{"gross_charge": 35051.0, "discounted_cash": 26288.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PERC VERT 1 BD LSAC/IMG", "code_information": [{"code": "4914479", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 19914.0, "discounted_cash": 14935.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PERC VERT 1BD CTHOR/IMG", "code_information": [{"code": "4914478", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 19914.0, "discounted_cash": 14935.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PERFLUORON PER 5ML IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5331745", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 6322.0, "discounted_cash": 4741.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PERFLUTREN LIP MICRO 1ML", "code_information": [{"code": "Q9957", "type": "HCPCS"}, {"code": "5358247", "type": "CDM"}, {"code": "255", "type": "RC"}], "standard_charges": [{"gross_charge": 800.0, "discounted_cash": 600.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PERFLUTREN LIP MICRO 1ML", "code_information": [{"code": "Q9957", "type": "HCPCS"}, {"code": "5358247", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 800.0, "discounted_cash": 600.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PERI DIAL ACUTE RNL FAIL", "code_information": [{"code": "90945", "type": "CPT"}, {"code": "5600962", "type": "CDM"}, {"code": "802", "type": "RC"}], "standard_charges": [{"gross_charge": 3529.0, "discounted_cash": 2646.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PERICARDIOCENTESIS W/IMG GUIDE", "code_information": [{"code": "4613016", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 6901.0, "discounted_cash": 5175.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PERINDOPRIL 4MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5309096", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 85.0, "discounted_cash": 63.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PERINDOPRIL 4MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5309096", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 85.0, "discounted_cash": 63.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PERIT DIALYSIS SNGL EVAL", "code_information": [{"code": "90945", "type": "CPT"}, {"code": "5600159", "type": "CDM"}, {"code": "851", "type": "RC"}], "standard_charges": [{"gross_charge": 3529.0, "discounted_cash": 2646.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PERMETHRIN 1% 60ML TS", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5336996", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 194.0, "discounted_cash": 145.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PERMETHRIN 1% 60ML TS", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5336996", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 194.0, "discounted_cash": 145.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PERMETHRIN 5% 60GM CR", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5336998", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 553.0, "discounted_cash": 414.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PERMETHRIN 5% 60GM CR", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5336998", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 553.0, "discounted_cash": 414.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PERPHENAZINE 2MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5309106", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 85.0, "discounted_cash": 63.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PERPHENAZINE 2MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5309106", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 85.0, "discounted_cash": 63.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PERPHENAZINE 4MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5309107", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 85.0, "discounted_cash": 63.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PERPHENAZINE 4MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5309107", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 85.0, "discounted_cash": 63.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PERQ TRANSLUM CORONARY LITHOTR", "code_information": [{"code": "92972", "type": "CPT"}, {"code": "4610715", "type": "CDM"}, {"code": "480", "type": "RC"}], "standard_charges": [{"gross_charge": 19737.0, "discounted_cash": 14802.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PETROLATUM 30GM OI", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5337018", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 51.0, "discounted_cash": 38.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PETROLATUM 30GM OI", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5337018", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 51.0, "discounted_cash": 38.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PETROLATUM 52GM OI", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5337011", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 71.0, "discounted_cash": 53.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PETROLATUM 52GM OI", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5337011", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 71.0, "discounted_cash": 53.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PETROLATUM AQUA 52GM OI", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5334210", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 131.0, "discounted_cash": 98.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PETROLATUM AQUA 52GM OI", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5334210", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 131.0, "discounted_cash": 98.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PH BODY FLUID NOS", "code_information": [{"code": "83986", "type": "CPT"}, {"code": "4103980", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 318.0, "discounted_cash": 238.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PH BODY FLUID NOS", "code_information": [{"code": "83986", "type": "CPT"}, {"code": "4173980", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 19.98, "discounted_cash": 14.99, "setting": "both", "billing_class": "facility"}]}, {"description": "PHARYNGL EVAL CINEVIDEO", "code_information": [{"code": "70371", "type": "CPT"}, {"code": "4900368", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 1894.0, "discounted_cash": 1420.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PHENAZOPYRIDINE 100MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5309145", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 85.0, "discounted_cash": 63.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PHENAZOPYRIDINE 100MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5309145", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 85.0, "discounted_cash": 63.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PHENAZOPYRIDINE 200MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5309149", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 78.0, "discounted_cash": 58.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PHENAZOPYRIDINE 200MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5309149", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 78.0, "discounted_cash": 58.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PHENELZINE 15MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5309172", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 85.0, "discounted_cash": 63.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PHENELZINE 15MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5309172", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 85.0, "discounted_cash": 63.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PHENOBARB NEO IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J7999", "type": "HCPCS"}, {"code": "5323247", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 404.0, "discounted_cash": 303.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PHENOBARB NEO IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J7999", "type": "HCPCS"}, {"code": "5323247", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 404.0, "discounted_cash": 303.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PHENOBARB UPTO 120MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J2560", "type": "HCPCS"}, {"code": "5327941", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 95.0, "discounted_cash": 71.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PHENOBARB UPTO 120MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J2560", "type": "HCPCS"}, {"code": "5327941", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 95.0, "discounted_cash": 71.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PHENOBARBIT 20MG/5ML LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5327947", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 61.0, "discounted_cash": 45.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PHENOBARBIT 20MG/5ML LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5327947", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 61.0, "discounted_cash": 45.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PHENOBARBITAL", "code_information": [{"code": "80184", "type": "CPT"}, {"code": "4104020", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 1020.0, "discounted_cash": 765.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PHENOBARBITAL", "code_information": [{"code": "80184", "type": "CPT"}, {"code": "4174020", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 8.56, "discounted_cash": 6.42, "setting": "both", "billing_class": "facility"}]}, {"description": "PHENOBARBITAL 32.4MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5327936", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 61.0, "discounted_cash": 45.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PHENOBARBITAL 32.4MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5327936", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 61.0, "discounted_cash": 45.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PHENOBARBITAL/2", "code_information": [{"code": "80184", "type": "CPT"}, {"code": "7254020", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 1111.0, "discounted_cash": 833.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PHENOL 1.4% 180ML SP", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5314597", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 109.0, "discounted_cash": 81.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PHENOL 1.4% 180ML SP", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5314597", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 109.0, "discounted_cash": 81.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PHENOL 8% CMPD TS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J7999", "type": "HCPCS"}, {"code": "5337035", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 101.0, "discounted_cash": 75.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PHENOL 8% CMPD TS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J7999", "type": "HCPCS"}, {"code": "5337035", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 101.0, "discounted_cash": 75.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PHENOL 89% 5ML TS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5337036", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 110.0, "discounted_cash": 82.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PHENOL/NA PHENOL180ML SP", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5316020", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 120.0, "discounted_cash": 90.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PHENOL/NA PHENOL180ML SP", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5316020", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 120.0, "discounted_cash": 90.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PHENTOLAMINE UPTO 5MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J2760", "type": "HCPCS"}, {"code": "5323267", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 3556.0, "discounted_cash": 2667.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PHENTOLAMINE UPTO 5MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J2760", "type": "HCPCS"}, {"code": "5323267", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 3556.0, "discounted_cash": 2667.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PHENYLEPHRINE 50MG PMX IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5323296", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 711.0, "discounted_cash": 533.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PHENYLEPHRINE HEMOR SU", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5338555", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 85.0, "discounted_cash": 63.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PHENYLEPHRINE HEMOR SU", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5338555", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 85.0, "discounted_cash": 63.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PHENYLEPHRINE PER 20MCG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J2371", "type": "HCPCS"}, {"code": "5323281", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 0.13, "discounted_cash": 0.1, "setting": "both", "billing_class": "facility"}]}, {"description": "PHENYLEPHRINE PER 20MCG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J2371", "type": "HCPCS"}, {"code": "5323281", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 0.13, "discounted_cash": 0.1, "setting": "both", "billing_class": "facility"}]}, {"description": "PHENYLEPHRINE PER 20MCG PFS IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J2371", "type": "HCPCS"}, {"code": "5323283", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 2.0, "discounted_cash": 1.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PHENYLEPHRINE PER 20MCG PFS IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J2371", "type": "HCPCS"}, {"code": "5323283", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 2.0, "discounted_cash": 1.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PHENYTOIN 100MG XR CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5309438", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 77.0, "discounted_cash": 57.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PHENYTOIN 100MG XR CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5309438", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 77.0, "discounted_cash": 57.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PHENYTOIN 100MG/4ML LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5316059", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 61.0, "discounted_cash": 45.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PHENYTOIN 100MG/4ML LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5316059", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 61.0, "discounted_cash": 45.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PHENYTOIN 125MG/5ML LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5316056", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 85.0, "discounted_cash": 63.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PHENYTOIN 125MG/5ML LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5316056", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 85.0, "discounted_cash": 63.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PHENYTOIN 50MG CTB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5309434", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 72.0, "discounted_cash": 54.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PHENYTOIN 50MG CTB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5309434", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 72.0, "discounted_cash": 54.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PHENYTOIN FREE", "code_information": [{"code": "80186", "type": "CPT"}, {"code": "4100186", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 547.0, "discounted_cash": 410.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PHENYTOIN FREE", "code_information": [{"code": "80186", "type": "CPT"}, {"code": "7254045", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 29.0, "discounted_cash": 21.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PHENYTOIN PER 50MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J1165", "type": "HCPCS"}, {"code": "5323320", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 22.0, "discounted_cash": 16.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PHENYTOIN PER 50MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J1165", "type": "HCPCS"}, {"code": "5323320", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 22.0, "discounted_cash": 16.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PHENYTOIN PER50MG SG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J1165", "type": "HCPCS"}, {"code": "5323321", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 113.0, "discounted_cash": 84.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PHENYTOIN PER50MG SG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J1165", "type": "HCPCS"}, {"code": "5323321", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 113.0, "discounted_cash": 84.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PHENYTOIN TOTAL", "code_information": [{"code": "80185", "type": "CPT"}, {"code": "4102655", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 1207.0, "discounted_cash": 905.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PHENYTOIN TOTAL", "code_information": [{"code": "80185", "type": "CPT"}, {"code": "4172655", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 8.56, "discounted_cash": 6.42, "setting": "both", "billing_class": "facility"}]}, {"description": "PHLEBOT THERAP", "code_information": [{"code": "99195", "type": "CPT"}, {"code": "4502276", "type": "CDM"}, {"code": "940", "type": "RC"}], "standard_charges": [{"gross_charge": 744.0, "discounted_cash": 558.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PHLEBOTOMY THERAPEUTIC", "code_information": [{"code": "99195", "type": "CPT"}, {"code": "3609195", "type": "CDM"}, {"code": "940", "type": "RC"}], "standard_charges": [{"gross_charge": 938.0, "discounted_cash": 703.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PHLEBOTOMY/THERAPEUTIC", "code_information": [{"code": "99195", "type": "CPT"}, {"code": "4209013", "type": "CDM"}, {"code": "940", "type": "RC"}], "standard_charges": [{"gross_charge": 1107.0, "discounted_cash": 830.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PHOSPHATASE ACID TOTAL", "code_information": [{"code": "84060", "type": "CPT"}, {"code": "7254060", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 229.0, "discounted_cash": 171.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PHOSPHATASE ALKALINE", "code_information": [{"code": "84075", "type": "CPT"}, {"code": "4104075", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 413.0, "discounted_cash": 309.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PHOSPHATASE ALKALINE", "code_information": [{"code": "84075", "type": "CPT"}, {"code": "4174075", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 2.86, "discounted_cash": 2.15, "setting": "both", "billing_class": "facility"}]}, {"description": "PHOSPHATASE ALKALINE", "code_information": [{"code": "84075", "type": "CPT"}, {"code": "7254075", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 501.0, "discounted_cash": 375.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PHOSPHATASE ISO ALK", "code_information": [{"code": "84080", "type": "CPT"}, {"code": "7254080", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 613.0, "discounted_cash": 459.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PHOSPHATIDYL/7", "code_information": [{"code": "83520", "type": "CPT"}, {"code": "7253617", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 86.0, "discounted_cash": 64.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PHOSPHATIDYLGYCEROL", "code_information": [{"code": "84081", "type": "CPT"}, {"code": "4174081", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 59.94, "discounted_cash": 44.96, "setting": "both", "billing_class": "facility"}]}, {"description": "PHOSPHATIDYLGYCEROL", "code_information": [{"code": "84081", "type": "CPT"}, {"code": "7254081", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 1731.0, "discounted_cash": 1298.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PHOSPHATSE PROSTATIC", "code_information": [{"code": "84066", "type": "CPT"}, {"code": "7254066", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 298.0, "discounted_cash": 223.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PHOSPHOLIP NEUT PLATELET", "code_information": [{"code": "85597", "type": "CPT"}, {"code": "4105597", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 662.0, "discounted_cash": 496.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PHOSPHOLIP NEUT PLATELET", "code_information": [{"code": "85597", "type": "CPT"}, {"code": "7255597", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 219.0, "discounted_cash": 164.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PHOSPHOLP NEUT HEXAGONAL", "code_information": [{"code": "85598", "type": "CPT"}, {"code": "7255598", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 99.0, "discounted_cash": 74.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PHOSPHOLP NEUT HEXAGONAL/2", "code_information": [{"code": "85598", "type": "CPT"}, {"code": "7255599", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 128.0, "discounted_cash": 96.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PHOSPHORUS", "code_information": [{"code": "84100", "type": "CPT"}, {"code": "4104100", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 462.0, "discounted_cash": 346.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PHOSPHORUS", "code_information": [{"code": "84100", "type": "CPT"}, {"code": "4174100", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 1.12, "discounted_cash": 0.84, "setting": "both", "billing_class": "facility"}]}, {"description": "PHOSPHORUS URINE", "code_information": [{"code": "84105", "type": "CPT"}, {"code": "4104102", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 376.0, "discounted_cash": 282.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PHOSPHORUS URINE", "code_information": [{"code": "84105", "type": "CPT"}, {"code": "4174102", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 15.71, "discounted_cash": 11.78, "setting": "both", "billing_class": "facility"}]}, {"description": "PHYSOSTIGM 1MG/ML 2ML IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5323345", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 275.0, "discounted_cash": 206.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PHYTONADIONE 5MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5309461", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 85.0, "discounted_cash": 63.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PHYTONADIONE 5MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5309461", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 85.0, "discounted_cash": 63.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PHYTONADIONE PER 1MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3430", "type": "HCPCS"}, {"code": "5323366", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 63.0, "discounted_cash": 47.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PHYTONADIONE PER 1MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3430", "type": "HCPCS"}, {"code": "5323366", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 63.0, "discounted_cash": 47.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PHYTONADN PED PER 1MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3430", "type": "HCPCS"}, {"code": "5323365", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 215.0, "discounted_cash": 161.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PHYTONADN PED PER 1MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3430", "type": "HCPCS"}, {"code": "5323365", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 215.0, "discounted_cash": 161.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PILOCARPINE 1% 15ML OS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5331906", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 142.0, "discounted_cash": 106.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PILOCARPINE 1% 15ML OS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5331906", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 142.0, "discounted_cash": 106.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PILOCARPINE 2% 15ML OS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5331927", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 727.0, "discounted_cash": 545.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PILOCARPINE 2% 15ML OS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5331927", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 727.0, "discounted_cash": 545.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PILOCARPINE 4% 15ML OS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5331948", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 1130.0, "discounted_cash": 847.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PILOCARPINE 4% 15ML OS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5331948", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 1130.0, "discounted_cash": 847.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PIMECROLIMUS 1% 30GM CR", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5337046", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 2700.0, "discounted_cash": 2025.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PIMECROLIMUS 1% 30GM CR", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5337046", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 2700.0, "discounted_cash": 2025.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PIN HALF THREAD", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8133546", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 4970.0, "discounted_cash": 3727.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PIN HOFMAN TRNFX", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8133570", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 1318.0, "discounted_cash": 988.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PIN MLT FIXATN", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8133595", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 1899.0, "discounted_cash": 1424.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PIN STEINMAN PL", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8133635", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 569.0, "discounted_cash": 426.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PIN STEINMAN THR", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8133640", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 140.0, "discounted_cash": 105.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PIN TYPE I", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8133638", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 1785.0, "discounted_cash": 1338.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PIN TYPE II", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8133636", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 1874.0, "discounted_cash": 1405.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PINDOLOL 5MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5309484", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 85.0, "discounted_cash": 63.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PINDOLOL 5MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5309484", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 85.0, "discounted_cash": 63.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PINS LG EXT FIX", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8133645", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 4980.0, "discounted_cash": 3735.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PINWORM EXAM", "code_information": [{"code": "87172", "type": "CPT"}, {"code": "4107144", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 465.0, "discounted_cash": 348.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PINWORM EXAM", "code_information": [{"code": "87172", "type": "CPT"}, {"code": "4177173", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 5.71, "discounted_cash": 4.28, "setting": "both", "billing_class": "facility"}]}, {"description": "PIOGLITAZONE 15MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5309500", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 124.0, "discounted_cash": 93.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PIOGLITAZONE 15MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5309500", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 124.0, "discounted_cash": 93.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PIPER/TAZ PED PER1ML IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5323415", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 16.0, "discounted_cash": 12.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PIPER/TAZ PER1.125GM IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J2543", "type": "HCPCS"}, {"code": "5323412", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 290.0, "discounted_cash": 217.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PIPER/TAZ PER1.125GM IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J2543", "type": "HCPCS"}, {"code": "5323412", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 290.0, "discounted_cash": 217.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PIPER/TAZ PER1.125GMPBIJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J2543", "type": "HCPCS"}, {"code": "5323413", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 141.0, "discounted_cash": 105.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PIPER/TAZ PER1.125GMPBIJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J2543", "type": "HCPCS"}, {"code": "5323413", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 141.0, "discounted_cash": 105.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PKNG NASAL MEROGEL", "code_information": [{"code": "C1763", "type": "HCPCS"}, {"code": "8240277", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 1662.0, "discounted_cash": 1246.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PL CECOSTOMY TUBE PERC", "code_information": [{"code": "5059442", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 8607.0, "discounted_cash": 6455.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PL GASTRO TUBE W/FLUORO", "code_information": [{"code": "4919440", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 3737.0, "discounted_cash": 2802.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PL JEJUNOSTMYTBE WFLUORO", "code_information": [{"code": "4919442", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 6774.0, "discounted_cash": 5080.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PL STNT BIL EXIS ACCESS", "code_information": [{"code": "4917538", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 22865.0, "discounted_cash": 17148.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PL STNT BIL W/O DRN", "code_information": [{"code": "4917539", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 22865.0, "discounted_cash": 17148.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PL STNT INT/EXT BILE DRN", "code_information": [{"code": "4917540", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 22865.0, "discounted_cash": 17148.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PLACENTAL A1 MICRO DIR", "code_information": [{"code": "84112", "type": "CPT"}, {"code": "4103507", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 423.0, "discounted_cash": 317.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PLACENTAL A1 MICRO DIR/2", "code_information": [{"code": "84112", "type": "CPT"}, {"code": "4104112", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 423.0, "discounted_cash": 317.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PLASMALYTE A 1000ML IVF", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5412720", "type": "CDM"}, {"code": "258", "type": "RC"}], "standard_charges": [{"gross_charge": 606.0, "discounted_cash": 454.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PLATE AO SPECIAL TYP2", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8133651", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 4436.0, "discounted_cash": 3327.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PLATE AO SPECIAL TYP3", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8133652", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 9827.0, "discounted_cash": 7370.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PLATE AO SPECIAL TYP5", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8133654", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 7562.0, "discounted_cash": 5671.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PLATE OTHER", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8133843", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 6944.0, "discounted_cash": 5208.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PLATE ULNAR", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8133186", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 30629.0, "discounted_cash": 22971.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PLATELET AB", "code_information": [{"code": "86022", "type": "CPT"}, {"code": "4106022", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 1206.0, "discounted_cash": 904.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PLATELET AB", "code_information": [{"code": "86022", "type": "CPT"}, {"code": "7016009", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 870.0, "discounted_cash": 652.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PLATELET AB/2", "code_information": [{"code": "86022", "type": "CPT"}, {"code": "4106030", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 1206.0, "discounted_cash": 904.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PLATELET AB/2", "code_information": [{"code": "86022", "type": "CPT"}, {"code": "7256017", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 526.0, "discounted_cash": 394.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PLATELET AB/3", "code_information": [{"code": "86022", "type": "CPT"}, {"code": "7016017", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 870.0, "discounted_cash": 652.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PLATELET AB/3", "code_information": [{"code": "86022", "type": "CPT"}, {"code": "7256022", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 59.0, "discounted_cash": 44.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PLATELET AB/4", "code_information": [{"code": "86022", "type": "CPT"}, {"code": "7016029", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 870.0, "discounted_cash": 652.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PLATELET AB/5", "code_information": [{"code": "86022", "type": "CPT"}, {"code": "7256025", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 499.0, "discounted_cash": 374.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PLATELET AB/6", "code_information": [{"code": "86022", "type": "CPT"}, {"code": "7256027", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 688.0, "discounted_cash": 516.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PLATELET AUTO", "code_information": [{"code": "85049", "type": "CPT"}, {"code": "4105595", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 424.0, "discounted_cash": 318.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PLATELET AUTO", "code_information": [{"code": "85049", "type": "CPT"}, {"code": "4175595", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 5.71, "discounted_cash": 4.28, "setting": "both", "billing_class": "facility"}]}, {"description": "PLATELET RICH PLASMA", "code_information": [{"code": "P9020", "type": "HCPCS"}, {"code": "4509026", "type": "CDM"}, {"code": "399", "type": "RC"}], "standard_charges": [{"gross_charge": 764.0, "discounted_cash": 573.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PLC CATH AORTA", "code_information": [{"code": "4617800", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 262.0, "discounted_cash": 196.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PLC CATH AORTA", "code_information": [{"code": "4917800", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 329.0, "discounted_cash": 246.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PLC CATH ART 1ST ORDR", "code_information": [{"code": "4617835", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 2664.0, "discounted_cash": 1998.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PLC CATH ART 1ST ORDR", "code_information": [{"code": "4917835", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 3550.0, "discounted_cash": 2662.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PLC CATH ART 2ND ORDR", "code_information": [{"code": "4617840", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 2906.0, "discounted_cash": 2179.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PLC CATH ART 3RD ORDR", "code_information": [{"code": "4617845", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 4150.0, "discounted_cash": 3112.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PLC CATH ART ABD 1ST", "code_information": [{"code": "4617815", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 4383.0, "discounted_cash": 3287.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PLC CATH ART ABD 1ST", "code_information": [{"code": "4917815", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 3740.0, "discounted_cash": 2805.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PLC CATH ART ABD 2ND", "code_information": [{"code": "4617820", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 3862.0, "discounted_cash": 2896.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PLC CATH ART ABD 2ND", "code_information": [{"code": "4917820", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 3862.0, "discounted_cash": 2896.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PLC CATH ART ABD 3RD", "code_information": [{"code": "4617825", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 4509.0, "discounted_cash": 3381.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PLC CATH ART ABD 3RD", "code_information": [{"code": "4917825", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 4449.0, "discounted_cash": 3336.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PLC CATH EXTRM ARTERY", "code_information": [{"code": "4617860", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 414.0, "discounted_cash": 310.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PLC CATH EXTRM ARTERY", "code_information": [{"code": "4917865", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 308.0, "discounted_cash": 231.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PLC CATH RT HRT/PULM ART", "code_information": [{"code": "4616013", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 349.0, "discounted_cash": 261.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PLC CATH VEIN 1ST ORDR", "code_information": [{"code": "4616011", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 2285.0, "discounted_cash": 1713.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PLC CATH VEIN 1ST ORDR", "code_information": [{"code": "4917885", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 1905.0, "discounted_cash": 1428.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PLC CATH VEIN 2ND ORDR", "code_information": [{"code": "4616012", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 339.0, "discounted_cash": 254.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PLC CATH VEIN 2ND ORDR", "code_information": [{"code": "4917890", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 308.0, "discounted_cash": 231.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PLC CATH VENACAVA", "code_information": [{"code": "4617870", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 4485.0, "discounted_cash": 3363.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PLC CATH VENACAVA", "code_information": [{"code": "4907870", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 385.0, "discounted_cash": 288.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PLC CATH VENACAVA", "code_information": [{"code": "4917870", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 3268.0, "discounted_cash": 2451.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PLC CERV CAROTD W/PRD", "code_information": [{"code": "4617215", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 37486.0, "discounted_cash": 28114.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PLC EXT PROS RPR FOR ANEUR+S&I", "code_information": [{"code": "4614709", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 30565.0, "discounted_cash": 22923.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PLC NDL/CATH CAR/VERT AR", "code_information": [{"code": "4916100", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 339.0, "discounted_cash": 254.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PLC NEPHROSTOMY CATH", "code_information": [{"code": "4917770", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 7739.0, "discounted_cash": 5804.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PLC NEPHROSTOMY CATH", "code_information": [{"code": "5050392", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 8594.0, "discounted_cash": 6445.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PLC NEPHROURETERAL CATH", "code_information": [{"code": "4914334", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 7722.0, "discounted_cash": 5791.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PLC NG TUBE W FLUORO", "code_information": [{"code": "4903752", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 523.0, "discounted_cash": 392.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PLC NG TUBE W FLUORO", "code_information": [{"code": "4913752", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 535.0, "discounted_cash": 401.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PLC STNT NEW DX W/CATH", "code_information": [{"code": "4910695", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 12458.0, "discounted_cash": 9343.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PLC STNT NEW DX WO/CATH", "code_information": [{"code": "4910694", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 12458.0, "discounted_cash": 9343.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PLC STNT W/DX NEPHRO", "code_information": [{"code": "4910693", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 9948.0, "discounted_cash": 7461.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PLEURAL DRAINAGE PERC", "code_information": [{"code": "4912557", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 1961.0, "discounted_cash": 1470.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PLEURAL DRAINAGE PERC", "code_information": [{"code": "5052557", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 2265.0, "discounted_cash": 1698.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PLEURAL DRAINAGE PERC", "code_information": [{"code": "5062557", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 2455.0, "discounted_cash": 1841.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PLT 1/4 TUBULAR", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8133681", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 4895.0, "discounted_cash": 3671.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PLT ADAPTION LCP", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8133661", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 10121.0, "discounted_cash": 7590.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PLT AGGREGATION EA AGENT", "code_information": [{"code": "85576", "type": "CPT"}, {"code": "4105576", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 218.0, "discounted_cash": 163.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PLT AGGREGATION EA AGENT", "code_information": [{"code": "85576", "type": "CPT"}, {"code": "4175576", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 142.72, "discounted_cash": 107.04, "setting": "both", "billing_class": "facility"}]}, {"description": "PLT AGGREGATION EA AGENT/2", "code_information": [{"code": "85576", "type": "CPT"}, {"code": "4105577", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 661.0, "discounted_cash": 495.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PLT AGGREGATION EA AGENT/4", "code_information": [{"code": "85576", "type": "CPT"}, {"code": "4105579", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 238.0, "discounted_cash": 178.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PLT ANT TT HI TALAR NK", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8137819", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 18921.0, "discounted_cash": 14190.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PLT BAR SHEAR STERNUM", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8137651", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 3417.0, "discounted_cash": 2562.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PLT BN HEAVY", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8133665", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 2606.0, "discounted_cash": 1954.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PLT BN MED", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8133675", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 8296.0, "discounted_cash": 6222.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PLT BN SMALL", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8133680", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 7928.0, "discounted_cash": 5946.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PLT BURR HOLE", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8133664", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 3840.0, "discounted_cash": 2880.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PLT CABLE", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8137820", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 15238.0, "discounted_cash": 11428.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PLT CALCANEAL", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8133683", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 12497.0, "discounted_cash": 9372.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PLT CERV SPINE", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8133685", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 13750.0, "discounted_cash": 10312.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PLT CERV SPINE 2", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8133686", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 5055.0, "discounted_cash": 3791.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PLT CLAVICLE HOOK", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8133687", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 15855.0, "discounted_cash": 11891.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PLT COMP HIP", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8133690", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 6284.0, "discounted_cash": 4713.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PLT COMP LCP", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8133699", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 7269.0, "discounted_cash": 5451.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PLT COMPRESSION", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8133700", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 9277.0, "discounted_cash": 6957.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PLT COMPRESSION 2", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8133701", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 5281.0, "discounted_cash": 3960.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PLT CRANI", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8133702", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 2226.0, "discounted_cash": 1669.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PLT DISTAL LATERAL FEMUR", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8133712", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 15277.0, "discounted_cash": 11457.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PLT DISTL FEMUR LCKNG", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8133711", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 18820.0, "discounted_cash": 14115.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PLT E 1/3 TUBE", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8133825", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 3403.0, "discounted_cash": 2552.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PLT E CLOVLEAF", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8133715", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 8609.0, "discounted_cash": 6456.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PLT E COMP BRD", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8133720", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 6503.0, "discounted_cash": 4877.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PLT E COMP DCP", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8133725", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 6807.0, "discounted_cash": 5105.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PLT E COMP NRW", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8133735", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 3791.0, "discounted_cash": 2843.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PLT E COMP SPN", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8133740", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 8744.0, "discounted_cash": 6558.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PLT E CONDYLR", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8133750", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 22128.0, "discounted_cash": 16596.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PLT E L BUTRES", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8133760", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 6368.0, "discounted_cash": 4776.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PLT E MINI", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8133765", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 4812.0, "discounted_cash": 3609.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PLT E MINI DC", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8133770", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 2487.0, "discounted_cash": 1865.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PLT E MINI T/L", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8133775", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 2829.0, "discounted_cash": 2121.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PLT E SEM TUBE", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8133785", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 3920.0, "discounted_cash": 2940.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PLT E SM STRAT", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8133790", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 5329.0, "discounted_cash": 3996.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PLT E T SMALL L", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8133815", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 1356.0, "discounted_cash": 1017.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PLT FACIAL", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8137825", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 3048.0, "discounted_cash": 2286.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PLT FEM PROX ANGLED", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8133828", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 6569.0, "discounted_cash": 4926.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PLT FIBULA COMPOSITE", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8133829", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 9046.0, "discounted_cash": 6784.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PLT FIBULA COMPOSITE", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8133852", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 15514.0, "discounted_cash": 11635.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PLT FIBULA DISTL LATERL", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8137653", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 9004.0, "discounted_cash": 6753.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PLT GLENOID REVERS SHLDR", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8137826", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 19315.0, "discounted_cash": 14486.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PLT HIP COMP", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8133835", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 6320.0, "discounted_cash": 4740.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PLT HUMERUS DSTL LAT", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8137823", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 19843.0, "discounted_cash": 14882.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PLT HUMERUS MEDIAL", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8177817", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 31213.0, "discounted_cash": 23409.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PLT L/R CMV IRR", "code_information": [{"code": "P9053", "type": "HCPCS"}, {"code": "4509053", "type": "CDM"}, {"code": "399", "type": "RC"}], "standard_charges": [{"gross_charge": 2878.0, "discounted_cash": 2158.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PLT LC CLAVICLE TIT", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8133896", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 15256.0, "discounted_cash": 11442.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PLT LC COMP METAPHYSEAL", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8133830", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 12251.0, "discounted_cash": 9188.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PLT LC DISTAL FEMUR", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "4014304", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 19484.0, "discounted_cash": 14613.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PLT LC LAT PROX HUMERAL", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8133897", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 12515.0, "discounted_cash": 9386.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PLT LC MED DISTL HUMERUS", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "4014313", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 15198.0, "discounted_cash": 11398.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PLT LC MEDIAL DISTAL TIB", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "4014312", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 20056.0, "discounted_cash": 15042.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PLT LC PROX TIBIAL", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "4014311", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 18045.0, "discounted_cash": 13533.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PLT LCK STERNAL", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8137830", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 9059.0, "discounted_cash": 6794.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PLT LCP CLAVICLE", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8137821", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 13112.0, "discounted_cash": 9834.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PLT LCP MED PROX TIBIA", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8137822", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 20514.0, "discounted_cash": 15385.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PLT LEUKO REDUC EA UNIT", "code_information": [{"code": "P9031", "type": "HCPCS"}, {"code": "4500035", "type": "CDM"}, {"code": "399", "type": "RC"}], "standard_charges": [{"gross_charge": 465.0, "discounted_cash": 348.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PLT LOCK MEDIAL HOOK", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8137829", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 12825.0, "discounted_cash": 9618.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PLT MAX FACL", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8154030", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 9749.0, "discounted_cash": 7311.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PLT MED DSTL TIB LOW BND", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8137832", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 18797.0, "discounted_cash": 14097.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PLT METATARSAL LP FLAT", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8137831", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 12691.0, "discounted_cash": 9518.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PLT MICRO", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8133637", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 6108.0, "discounted_cash": 4581.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PLT MICRO", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8133836", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 2018.0, "discounted_cash": 1513.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PLT MINI FRAG", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8133840", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 3540.0, "discounted_cash": 2655.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PLT MTP", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8133838", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 9491.0, "discounted_cash": 7118.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PLT NEURO", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8133783", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 4073.0, "discounted_cash": 3054.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PLT OLECRANON", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8133841", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 16771.0, "discounted_cash": 12578.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PLT ORBITAL", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8137842", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 3645.0, "discounted_cash": 2733.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PLT PHER L/R CMV NEG", "code_information": [{"code": "P9055", "type": "HCPCS"}, {"code": "4509055", "type": "CDM"}, {"code": "399", "type": "RC"}], "standard_charges": [{"gross_charge": 2617.0, "discounted_cash": 1962.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PLT PHER LEUKO PED", "code_information": [{"code": "P9035", "type": "HCPCS"}, {"code": "4505309", "type": "CDM"}, {"code": "399", "type": "RC"}], "standard_charges": [{"gross_charge": 2153.0, "discounted_cash": 1614.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PLT PHER LEUKORED IRRAD", "code_information": [{"code": "P9037", "type": "HCPCS"}, {"code": "4505588", "type": "CDM"}, {"code": "399", "type": "RC"}], "standard_charges": [{"gross_charge": 2214.0, "discounted_cash": 1660.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PLT PROX HUMERAL", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8133898", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 18086.0, "discounted_cash": 13564.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PLT PROX LAT TIB", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8133851", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 26835.0, "discounted_cash": 20126.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PLT RATCHET WHEEL", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8137652", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 5369.0, "discounted_cash": 4026.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PLT RECON MAND", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8133848", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 2521.0, "discounted_cash": 1890.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PLT RECONSTRCT II", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8133846", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 16216.0, "discounted_cash": 12162.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PLT RECONTSRCT", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8133845", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 8062.0, "discounted_cash": 6046.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PLT SM FRAG AO", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8133860", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 15233.0, "discounted_cash": 11424.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PLT V STERNAL", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8134008", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 5828.0, "discounted_cash": 4371.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PLT VOLAR DISTAL RADIUS", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8133899", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 12316.0, "discounted_cash": 9237.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PLT VOLAR LCP", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8130133", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 15797.0, "discounted_cash": 11847.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PLT VOLAR RADIUS", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8133888", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 14118.0, "discounted_cash": 10588.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PLT WEDGE FOOT OPEN", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8134036", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 19764.0, "discounted_cash": 14823.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PLT WRIST FUSION LCP", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8134034", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 22922.0, "discounted_cash": 17191.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PLT WRIST LCKNG", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8133891", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 32543.0, "discounted_cash": 24407.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PLT X FOOT FIXATION", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8133893", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 10956.0, "discounted_cash": 8217.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PLT X STERNAL", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8133892", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 8816.0, "discounted_cash": 6612.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PLT Y DBL", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8133889", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 2835.0, "discounted_cash": 2126.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PLT/TUBE E COM", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8134000", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 1222.0, "discounted_cash": 916.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PLUG VASCULAR AMPLATZER", "code_information": [{"code": "C1889", "type": "HCPCS"}, {"code": "4024606", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 16288.0, "discounted_cash": 12216.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PM ADVISA DR MRI A2DR01", "code_information": [{"code": "C1785", "type": "HCPCS"}, {"code": "4004098", "type": "CDM"}, {"code": "275", "type": "RC"}], "standard_charges": [{"gross_charge": 72884.0, "discounted_cash": 54663.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PM ALLURE QUADRA 3242", "code_information": [{"code": "C2621", "type": "HCPCS"}, {"code": "4000458", "type": "CDM"}, {"code": "275", "type": "RC"}], "standard_charges": [{"gross_charge": 104141.0, "discounted_cash": 78105.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PM ALLURE RF PM3222", "code_information": [{"code": "C2621", "type": "HCPCS"}, {"code": "4004114", "type": "CDM"}, {"code": "275", "type": "RC"}], "standard_charges": [{"gross_charge": 83116.0, "discounted_cash": 62337.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PM ALTRUA SSIR SC S201", "code_information": [{"code": "C1786", "type": "HCPCS"}, {"code": "4004110", "type": "CDM"}, {"code": "275", "type": "RC"}], "standard_charges": [{"gross_charge": 77935.0, "discounted_cash": 58451.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PM ASSURITY DR-RF PM2240", "code_information": [{"code": "C1785", "type": "HCPCS"}, {"code": "4000429", "type": "CDM"}, {"code": "275", "type": "RC"}], "standard_charges": [{"gross_charge": 65886.0, "discounted_cash": 49414.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PM ASSURITY MRI PM2272", "code_information": [{"code": "C1785", "type": "HCPCS"}, {"code": "4000433", "type": "CDM"}, {"code": "275", "type": "RC"}], "standard_charges": [{"gross_charge": 60939.0, "discounted_cash": 45704.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PM DC ACCENT DR PM2110", "code_information": [{"code": "C1785", "type": "HCPCS"}, {"code": "4004125", "type": "CDM"}, {"code": "275", "type": "RC"}], "standard_charges": [{"gross_charge": 69469.0, "discounted_cash": 52101.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PM DC ESTELLA DRT 371207", "code_information": [{"code": "C1785", "type": "HCPCS"}, {"code": "4000478", "type": "CDM"}, {"code": "275", "type": "RC"}], "standard_charges": [{"gross_charge": 66244.0, "discounted_cash": 49683.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PM DC EVIA DR CLS 359524", "code_information": [{"code": "C1785", "type": "HCPCS"}, {"code": "4000477", "type": "CDM"}, {"code": "275", "type": "RC"}], "standard_charges": [{"gross_charge": 65465.0, "discounted_cash": 49098.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PM DC EVIA DR-T 359529", "code_information": [{"code": "C1785", "type": "HCPCS"}, {"code": "4000476", "type": "CDM"}, {"code": "275", "type": "RC"}], "standard_charges": [{"gross_charge": 69361.0, "discounted_cash": 52020.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PM DC RR ADAPTA ADDRS1", "code_information": [{"code": "C1785", "type": "HCPCS"}, {"code": "4000493", "type": "CDM"}, {"code": "275", "type": "RC"}], "standard_charges": [{"gross_charge": 68583.0, "discounted_cash": 51437.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PM DC RR ZEPHYR 5826", "code_information": [{"code": "C1785", "type": "HCPCS"}, {"code": "4000641", "type": "CDM"}, {"code": "275", "type": "RC"}], "standard_charges": [{"gross_charge": 87786.0, "discounted_cash": 65839.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PM EDORA PROMRI 407157", "code_information": [{"code": "C1786", "type": "HCPCS"}, {"code": "4004137", "type": "CDM"}, {"code": "275", "type": "RC"}], "standard_charges": [{"gross_charge": 51053.0, "discounted_cash": 38289.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PM ENDURITY DR PM2160", "code_information": [{"code": "C1785", "type": "HCPCS"}, {"code": "4000466", "type": "CDM"}, {"code": "275", "type": "RC"}], "standard_charges": [{"gross_charge": 59152.0, "discounted_cash": 44364.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PM ENDURITY INDCT PM1160", "code_information": [{"code": "C1786", "type": "HCPCS"}, {"code": "4000465", "type": "CDM"}, {"code": "275", "type": "RC"}], "standard_charges": [{"gross_charge": 50298.0, "discounted_cash": 37723.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PM ENTOVIS PROMRI 371992", "code_information": [{"code": "C1785", "type": "HCPCS"}, {"code": "4004131", "type": "CDM"}, {"code": "275", "type": "RC"}], "standard_charges": [{"gross_charge": 85905.0, "discounted_cash": 64428.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PM EVIA DR-T CLS/HM GSM", "code_information": [{"code": "C1785", "type": "HCPCS"}, {"code": "4004126", "type": "CDM"}, {"code": "275", "type": "RC"}], "standard_charges": [{"gross_charge": 73257.0, "discounted_cash": 54942.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PM EVIA SR-T CLS/HM MOB", "code_information": [{"code": "C1786", "type": "HCPCS"}, {"code": "4004127", "type": "CDM"}, {"code": "275", "type": "RC"}], "standard_charges": [{"gross_charge": 65465.0, "discounted_cash": 49098.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PM INSYNC III 8042", "code_information": [{"code": "C2621", "type": "HCPCS"}, {"code": "4000700", "type": "CDM"}, {"code": "275", "type": "RC"}], "standard_charges": [{"gross_charge": 44891.0, "discounted_cash": 33668.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PM SC EVIA SR 359531", "code_information": [{"code": "C1786", "type": "HCPCS"}, {"code": "4000918", "type": "CDM"}, {"code": "275", "type": "RC"}], "standard_charges": [{"gross_charge": 60788.0, "discounted_cash": 45591.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PM SC EVIA SR-T 359533", "code_information": [{"code": "C1786", "type": "HCPCS"}, {"code": "4000920", "type": "CDM"}, {"code": "275", "type": "RC"}], "standard_charges": [{"gross_charge": 62346.0, "discounted_cash": 46759.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PM SC RR ADAPTA ADSR01", "code_information": [{"code": "C1786", "type": "HCPCS"}, {"code": "4001046", "type": "CDM"}, {"code": "275", "type": "RC"}], "standard_charges": [{"gross_charge": 76375.0, "discounted_cash": 57281.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PM SC RR SENSIA SESR01", "code_information": [{"code": "C1786", "type": "HCPCS"}, {"code": "4001165", "type": "CDM"}, {"code": "275", "type": "RC"}], "standard_charges": [{"gross_charge": 56112.0, "discounted_cash": 42084.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PM STRATOS LV 338200", "code_information": [{"code": "C2621", "type": "HCPCS"}, {"code": "4004190", "type": "CDM"}, {"code": "275", "type": "RC"}], "standard_charges": [{"gross_charge": 93989.0, "discounted_cash": 70491.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PNEUMOCOC 13 VAL VACC IJ", "code_information": [{"code": "90670", "type": "CPT"}, {"code": "5323447", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 2931.0, "discounted_cash": 2198.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PNEUMOCOC23 VAL VACC IJ", "code_information": [{"code": "90732", "type": "CPT"}, {"code": "5323449", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 2244.0, "discounted_cash": 1683.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PNEUMOCOCCAL 20-VALENT VACCINE", "code_information": [{"code": "90677", "type": "CPT"}, {"code": "5323451", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 2360.0, "discounted_cash": 1770.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PNEUMOCOCCAL VACC ADMIN", "code_information": [{"code": "G0009", "type": "HCPCS"}, {"code": "6100009", "type": "CDM"}, {"code": "771", "type": "RC"}], "standard_charges": [{"gross_charge": 280.0, "discounted_cash": 210.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PNEUMOCOCCAL VACC ADMIN", "code_information": [{"code": "G0009", "type": "HCPCS"}, {"code": "6160009", "type": "CDM"}, {"code": "771", "type": "RC"}], "standard_charges": [{"gross_charge": 287.0, "discounted_cash": 215.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PNEUMOCOCCAL VACC ADMIN", "code_information": [{"code": "G0009", "type": "HCPCS"}, {"code": "6290009", "type": "CDM"}, {"code": "771", "type": "RC"}], "standard_charges": [{"gross_charge": 287.0, "discounted_cash": 215.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PNEUMOCYST CARIN DFA", "code_information": [{"code": "87281", "type": "CPT"}, {"code": "4107281", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 90.0, "discounted_cash": 67.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PNEUMOCYST CARIN DFA", "code_information": [{"code": "87281", "type": "CPT"}, {"code": "7257281", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 149.0, "discounted_cash": 111.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PNEUMOGRAM", "code_information": [{"code": "94772", "type": "CPT"}, {"code": "5504765", "type": "CDM"}, {"code": "460", "type": "RC"}], "standard_charges": [{"gross_charge": 9578.0, "discounted_cash": 7183.5, "setting": "both", "billing_class": "facility"}]}, {"description": "POD SURG PROC LEVEL I", "code_information": [{"code": "6810400", "type": "CDM"}, {"code": "510", "type": "RC"}], "standard_charges": [{"gross_charge": 355.0, "discounted_cash": 266.25, "setting": "both", "billing_class": "facility"}]}, {"description": "POD SURG PROC LEVEL I", "code_information": [{"code": "6810400", "type": "CDM"}, {"code": "761", "type": "RC"}], "standard_charges": [{"gross_charge": 355.0, "discounted_cash": 266.25, "setting": "both", "billing_class": "facility"}]}, {"description": "POD SURG PROC LEVEL II", "code_information": [{"code": "6810402", "type": "CDM"}, {"code": "510", "type": "RC"}], "standard_charges": [{"gross_charge": 1144.0, "discounted_cash": 858.0, "setting": "both", "billing_class": "facility"}]}, {"description": "POD SURG PROC LEVEL II", "code_information": [{"code": "6810402", "type": "CDM"}, {"code": "761", "type": "RC"}], "standard_charges": [{"gross_charge": 1144.0, "discounted_cash": 858.0, "setting": "both", "billing_class": "facility"}]}, {"description": "POD SURG PROC LEVEL III", "code_information": [{"code": "6810404", "type": "CDM"}, {"code": "510", "type": "RC"}], "standard_charges": [{"gross_charge": 2099.0, "discounted_cash": 1574.25, "setting": "both", "billing_class": "facility"}]}, {"description": "POD SURG PROC LEVEL III", "code_information": [{"code": "6810404", "type": "CDM"}, {"code": "761", "type": "RC"}], "standard_charges": [{"gross_charge": 2099.0, "discounted_cash": 1574.25, "setting": "both", "billing_class": "facility"}]}, {"description": "POD SURG PROC LEVEL IV", "code_information": [{"code": "6810406", "type": "CDM"}, {"code": "510", "type": "RC"}], "standard_charges": [{"gross_charge": 6020.0, "discounted_cash": 4515.0, "setting": "both", "billing_class": "facility"}]}, {"description": "POD SURG PROC LEVEL IV", "code_information": [{"code": "6810406", "type": "CDM"}, {"code": "761", "type": "RC"}], "standard_charges": [{"gross_charge": 6020.0, "discounted_cash": 4515.0, "setting": "both", "billing_class": "facility"}]}, {"description": "POD SURG PROC LEVEL V", "code_information": [{"code": "6810408", "type": "CDM"}, {"code": "510", "type": "RC"}], "standard_charges": [{"gross_charge": 7446.0, "discounted_cash": 5584.5, "setting": "both", "billing_class": "facility"}]}, {"description": "POD SURG PROC LEVEL V", "code_information": [{"code": "6810408", "type": "CDM"}, {"code": "761", "type": "RC"}], "standard_charges": [{"gross_charge": 7446.0, "discounted_cash": 5584.5, "setting": "both", "billing_class": "facility"}]}, {"description": "POD SURG PROC LEVEL VI", "code_information": [{"code": "6810410", "type": "CDM"}, {"code": "510", "type": "RC"}], "standard_charges": [{"gross_charge": 13393.0, "discounted_cash": 10044.75, "setting": "both", "billing_class": "facility"}]}, {"description": "POD SURG PROC LEVEL VI", "code_information": [{"code": "6810410", "type": "CDM"}, {"code": "761", "type": "RC"}], "standard_charges": [{"gross_charge": 13393.0, "discounted_cash": 10044.75, "setting": "both", "billing_class": "facility"}]}, {"description": "POLY PATELLA AESCULAP CL", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "4013348", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 7838.0, "discounted_cash": 5878.5, "setting": "both", "billing_class": "facility"}]}, {"description": "POLY/NEO/HCTS 10ML OT", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5332095", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 508.0, "discounted_cash": 381.0, "setting": "both", "billing_class": "facility"}]}, {"description": "POLY/NEO/HCTS 10ML OT", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5332095", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 508.0, "discounted_cash": 381.0, "setting": "both", "billing_class": "facility"}]}, {"description": "POLYCARBOPHIL 625MG TB", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5301901", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 85.0, "discounted_cash": 63.75, "setting": "both", "billing_class": "facility"}]}, {"description": "POLYCARBOPHIL 625MG TB", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5301901", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 85.0, "discounted_cash": 63.75, "setting": "both", "billing_class": "facility"}]}, {"description": "POLYETHYLE GLYCOL 17GMPW", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5316072", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 617.0, "discounted_cash": 462.75, "setting": "both", "billing_class": "facility"}]}, {"description": "POLYETHYLE GLYCOL 17GMPW", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5316072", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 617.0, "discounted_cash": 462.75, "setting": "both", "billing_class": "facility"}]}, {"description": "POLYMYXIN B 500MU IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5323491", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 341.0, "discounted_cash": 255.75, "setting": "both", "billing_class": "facility"}]}, {"description": "POLYSOMN <6 YRS W CPAP", "code_information": [{"code": "95783", "type": "CPT"}, {"code": "6915783", "type": "CDM"}, {"code": "740", "type": "RC"}], "standard_charges": [{"gross_charge": 8044.0, "discounted_cash": 6033.0, "setting": "both", "billing_class": "facility"}]}, {"description": "POLYSOMNOGRAPHY", "code_information": [{"code": "95810", "type": "CPT"}, {"code": "6912105", "type": "CDM"}, {"code": "740", "type": "RC"}], "standard_charges": [{"gross_charge": 14047.0, "discounted_cash": 10535.25, "setting": "both", "billing_class": "facility"}]}, {"description": "POLYSOMNOGRAPHY <6 YRS", "code_information": [{"code": "95782", "type": "CPT"}, {"code": "6915782", "type": "CDM"}, {"code": "740", "type": "RC"}], "standard_charges": [{"gross_charge": 8703.0, "discounted_cash": 6527.25, "setting": "both", "billing_class": "facility"}]}, {"description": "POLYSOMNOGRAPHY CPAP 4", "code_information": [{"code": "95811", "type": "CPT"}, {"code": "6912102", "type": "CDM"}, {"code": "740", "type": "RC"}], "standard_charges": [{"gross_charge": 13926.0, "discounted_cash": 10444.5, "setting": "both", "billing_class": "facility"}]}, {"description": "POLYSTYRENE 15GM PWLQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5316064", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 51.0, "discounted_cash": 38.25, "setting": "both", "billing_class": "facility"}]}, {"description": "POLYSTYRENE 15GM PWLQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5316064", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 51.0, "discounted_cash": 38.25, "setting": "both", "billing_class": "facility"}]}, {"description": "POLYSTYRENE 60ML LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5316075", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 179.0, "discounted_cash": 134.25, "setting": "both", "billing_class": "facility"}]}, {"description": "POLYSTYRENE 60ML LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5316075", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 179.0, "discounted_cash": 134.25, "setting": "both", "billing_class": "facility"}]}, {"description": "POOLING PLT/OTH BLD PROD", "code_information": [{"code": "86965", "type": "CPT"}, {"code": "4202030", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 933.0, "discounted_cash": 699.75, "setting": "both", "billing_class": "facility"}]}, {"description": "POOLING PLT/OTH BLD PROD/2", "code_information": [{"code": "86965", "type": "CPT"}, {"code": "4202031", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 933.0, "discounted_cash": 699.75, "setting": "both", "billing_class": "facility"}]}, {"description": "POOLING PLT/OTH BLD PROD/3", "code_information": [{"code": "86965", "type": "CPT"}, {"code": "4206965", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 933.0, "discounted_cash": 699.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PORACTANT 120MG/1.5ML IS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5332140", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 3451.0, "discounted_cash": 2588.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PORACTANT 240MG/3ML IS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5332141", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 6681.0, "discounted_cash": 5010.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PORPHOBILINOGEN URINE QL", "code_information": [{"code": "84106", "type": "CPT"}, {"code": "7254106", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 657.0, "discounted_cash": 492.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PORPHOBILINOGEN URINE QN", "code_information": [{"code": "84110", "type": "CPT"}, {"code": "7254110", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 53.0, "discounted_cash": 39.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PORPHYRINS", "code_information": [{"code": "84311", "type": "CPT"}, {"code": "7254321", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 196.0, "discounted_cash": 147.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PORPHYRINS FECES QN", "code_information": [{"code": "84126", "type": "CPT"}, {"code": "7254125", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 753.0, "discounted_cash": 564.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PORPHYRINS URINE QN/FRACT/2", "code_information": [{"code": "84120", "type": "CPT"}, {"code": "7254121", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 68.0, "discounted_cash": 51.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PORPHYRN URINE QUAL", "code_information": [{"code": "84119", "type": "CPT"}, {"code": "7254119", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 992.0, "discounted_cash": 744.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PORT GASTRIC BAND INJ", "code_information": [{"code": "4024610", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 14266.0, "discounted_cash": 10699.5, "setting": "both", "billing_class": "facility"}]}, {"description": "POST TAPER", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8134003", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 5030.0, "discounted_cash": 3772.5, "setting": "both", "billing_class": "facility"}]}, {"description": "POST TAPR UNI KN PFJ ARTHRO CL", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "4013301", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 5157.0, "discounted_cash": 3867.75, "setting": "both", "billing_class": "facility"}]}, {"description": "POTASSIUM", "code_information": [{"code": "84132", "type": "CPT"}, {"code": "4104132", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 520.0, "discounted_cash": 390.0, "setting": "both", "billing_class": "facility"}]}, {"description": "POTASSIUM", "code_information": [{"code": "84132", "type": "CPT"}, {"code": "4174132", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 1.12, "discounted_cash": 0.84, "setting": "both", "billing_class": "facility"}]}, {"description": "POTASSIUM", "code_information": [{"code": "84999", "type": "CPT"}, {"code": "4104135", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 530.0, "discounted_cash": 397.5, "setting": "both", "billing_class": "facility"}]}, {"description": "POTASSIUM", "code_information": [{"code": "84999", "type": "CPT"}, {"code": "4174135", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 5.71, "discounted_cash": 4.28, "setting": "both", "billing_class": "facility"}]}, {"description": "POTASSIUM BICARB25MEQTB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5309640", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 71.0, "discounted_cash": 53.25, "setting": "both", "billing_class": "facility"}]}, {"description": "POTASSIUM BICARB25MEQTB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5309640", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 71.0, "discounted_cash": 53.25, "setting": "both", "billing_class": "facility"}]}, {"description": "POTASSIUM CL 10MEQ XR CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5309657", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 71.0, "discounted_cash": 53.25, "setting": "both", "billing_class": "facility"}]}, {"description": "POTASSIUM CL 10MEQ XR CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5309657", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 71.0, "discounted_cash": 53.25, "setting": "both", "billing_class": "facility"}]}, {"description": "POTASSIUM CL 10MEQ XR TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5309660", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 85.0, "discounted_cash": 63.75, "setting": "both", "billing_class": "facility"}]}, {"description": "POTASSIUM CL 10MEQ XR TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5309660", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 85.0, "discounted_cash": 63.75, "setting": "both", "billing_class": "facility"}]}, {"description": "POTASSIUM CL 20MEQ XR TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5309658", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 85.0, "discounted_cash": 63.75, "setting": "both", "billing_class": "facility"}]}, {"description": "POTASSIUM CL 20MEQ XR TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5309658", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 85.0, "discounted_cash": 63.75, "setting": "both", "billing_class": "facility"}]}, {"description": "POTASSIUM URINE", "code_information": [{"code": "84133", "type": "CPT"}, {"code": "4104133", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 435.0, "discounted_cash": 326.25, "setting": "both", "billing_class": "facility"}]}, {"description": "POTASSIUM URINE", "code_information": [{"code": "84133", "type": "CPT"}, {"code": "4174133", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 1.32, "discounted_cash": 0.99, "setting": "both", "billing_class": "facility"}]}, {"description": "POTASSIUM URINE/2", "code_information": [{"code": "84133", "type": "CPT"}, {"code": "4104134", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 377.0, "discounted_cash": 282.75, "setting": "both", "billing_class": "facility"}]}, {"description": "POTASSIUM URINE/2", "code_information": [{"code": "84133", "type": "CPT"}, {"code": "4174134", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 18.55, "discounted_cash": 13.91, "setting": "both", "billing_class": "facility"}]}, {"description": "POVIDONE IODINE5%30ML OS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5332145", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 214.0, "discounted_cash": 160.5, "setting": "both", "billing_class": "facility"}]}, {"description": "POVIDONE-IODINE10%30GMOI", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5337107", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 136.0, "discounted_cash": 102.0, "setting": "both", "billing_class": "facility"}]}, {"description": "POVIDONE-IODINE10%30GMOI", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5337107", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 136.0, "discounted_cash": 102.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PRALIDOXIME UPTO1GM IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J2730", "type": "HCPCS"}, {"code": "5323574", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 1905.0, "discounted_cash": 1428.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PRALIDOXIME UPTO1GM IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J2730", "type": "HCPCS"}, {"code": "5323574", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 1905.0, "discounted_cash": 1428.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PRAMIPEXOLE .125MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5309693", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 70.0, "discounted_cash": 52.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PRAMIPEXOLE .125MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5309693", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 70.0, "discounted_cash": 52.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PRAMIPEXOLE .25MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5309692", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 83.0, "discounted_cash": 62.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PRAMIPEXOLE .25MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5309692", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 83.0, "discounted_cash": 62.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PRAMIPEXOLE .5MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5309706", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 70.0, "discounted_cash": 52.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PRAMIPEXOLE .5MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5309706", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 70.0, "discounted_cash": 52.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PRAMOXINE 1% 15GM R FM", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5338580", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 462.0, "discounted_cash": 346.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PRAMOXINE 1% 15GM R FM", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5338580", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 462.0, "discounted_cash": 346.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PRAMOXINE HC 1%30GM TCR", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5337139", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 694.0, "discounted_cash": 520.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PRAMOXINE HC 1%30GM TCR", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5337139", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 694.0, "discounted_cash": 520.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PRAMOXINE PE 26GM RCR", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5338583", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 144.0, "discounted_cash": 108.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PRAMOXINE PE 26GM RCR", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5338583", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 144.0, "discounted_cash": 108.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PRASUGREL 10MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5309703", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 173.0, "discounted_cash": 129.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PRASUGREL 10MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5309703", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 173.0, "discounted_cash": 129.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PRAVASTATIN 10MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5309690", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 86.0, "discounted_cash": 64.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PRAVASTATIN 10MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5309690", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 86.0, "discounted_cash": 64.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PRAVASTATIN 20MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5309691", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 92.0, "discounted_cash": 69.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PRAVASTATIN 20MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5309691", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 92.0, "discounted_cash": 69.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PRAZIQUANTEL 600MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5309716", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 528.0, "discounted_cash": 396.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PRAZIQUANTEL 600MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5309716", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 528.0, "discounted_cash": 396.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PRAZOSIN 1MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5309723", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 61.0, "discounted_cash": 45.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PRAZOSIN 1MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5309723", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 61.0, "discounted_cash": 45.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PRAZOSIN 5MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5309731", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 78.0, "discounted_cash": 58.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PRAZOSIN 5MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5309731", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 78.0, "discounted_cash": 58.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PRE-ALBUMIN", "code_information": [{"code": "84134", "type": "CPT"}, {"code": "4104176", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 146.0, "discounted_cash": 109.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PRE-ALBUMIN", "code_information": [{"code": "84134", "type": "CPT"}, {"code": "4174176", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 7.14, "discounted_cash": 5.36, "setting": "both", "billing_class": "facility"}]}, {"description": "PREDNISOLONE 1% 10ML OS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5332200", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 655.0, "discounted_cash": 491.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PREDNISOLONE 1% 10ML OS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5332200", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 655.0, "discounted_cash": 491.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PREDNISOLONE 1% 1ML OS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5332192", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 197.0, "discounted_cash": 147.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PREDNISOLONE 1% 1ML OS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5332192", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 197.0, "discounted_cash": 147.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PREDNISOLONE 1% 5ML OS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5332193", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 300.0, "discounted_cash": 225.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PREDNISOLONE 1% 5ML OS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5332193", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 300.0, "discounted_cash": 225.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PREDNISOLONE 15/5 5ML LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5316123", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 66.0, "discounted_cash": 49.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PREDNISOLONE 15/5 5ML LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5316123", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 66.0, "discounted_cash": 49.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PREDNISONE 10MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J7512", "type": "HCPCS"}, {"code": "5309789", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 85.0, "discounted_cash": 63.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PREDNISONE 10MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J7512", "type": "HCPCS"}, {"code": "5309789", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 85.0, "discounted_cash": 63.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PREDNISONE 1MG/ML 5ML LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5316120", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 61.0, "discounted_cash": 45.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PREDNISONE 1MG/ML 5ML LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5316120", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 61.0, "discounted_cash": 45.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PREDNISONE 20MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J7512", "type": "HCPCS"}, {"code": "5309793", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 85.0, "discounted_cash": 63.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PREDNISONE 20MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J7512", "type": "HCPCS"}, {"code": "5309793", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 85.0, "discounted_cash": 63.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PREDNISONE PER 1MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J7512", "type": "HCPCS"}, {"code": "5309777", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 4.0, "discounted_cash": 3.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PREDNISONE PER 1MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J7512", "type": "HCPCS"}, {"code": "5309777", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 4.0, "discounted_cash": 3.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PREDNISONE PER 5MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J7512", "type": "HCPCS"}, {"code": "5309785", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 78.0, "discounted_cash": 58.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PREDNISONE PER 5MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J7512", "type": "HCPCS"}, {"code": "5309785", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 78.0, "discounted_cash": 58.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PREGABALIN 25MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5309795", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 78.0, "discounted_cash": 58.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PREGABALIN 25MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5309795", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 78.0, "discounted_cash": 58.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PREGABALIN 50MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5309796", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 78.0, "discounted_cash": 58.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PREGABALIN 50MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5309796", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 78.0, "discounted_cash": 58.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PREGABALIN 75MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5309799", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 140.0, "discounted_cash": 105.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PREGABALIN 75MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5309799", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 140.0, "discounted_cash": 105.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PREGNENOLONE", "code_information": [{"code": "84140", "type": "CPT"}, {"code": "7254140", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 158.0, "discounted_cash": 118.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PRESBYOPIA FUNCTION IOL", "code_information": [{"code": "V2788", "type": "HCPCS"}, {"code": "8122173", "type": "CDM"}, {"code": "276", "type": "RC"}], "standard_charges": [{"gross_charge": 1061.0, "discounted_cash": 795.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PRETX RBC EA ABSRP", "code_information": [{"code": "86978", "type": "CPT"}, {"code": "4106013", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 535.0, "discounted_cash": 401.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PRETX RBC EA ABSRP", "code_information": [{"code": "86978", "type": "CPT"}, {"code": "4176978", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 5.71, "discounted_cash": 4.28, "setting": "both", "billing_class": "facility"}]}, {"description": "PRETX RBC EA ABSRP", "code_information": [{"code": "86978", "type": "CPT"}, {"code": "7016012", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 561.0, "discounted_cash": 420.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PRETX RBC S W/INHIB EA", "code_information": [{"code": "86977", "type": "CPT"}, {"code": "7016977", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 582.0, "discounted_cash": 436.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PRIMAQUINE 26.3MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5309809", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 85.0, "discounted_cash": 63.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PRIMAQUINE 26.3MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5309809", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 85.0, "discounted_cash": 63.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PRIMATRIX 10X12 SQ CM", "code_information": [{"code": "Q4110", "type": "HCPCS"}, {"code": "4024612", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 770.0, "discounted_cash": 577.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PRIMATRIX 10X12 SQ CM", "code_information": [{"code": "Q4110", "type": "HCPCS"}, {"code": "4024612", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 770.0, "discounted_cash": 577.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PRIMATRIX 10X25 PER SQCM", "code_information": [{"code": "Q4110", "type": "HCPCS"}, {"code": "4024262", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 344.0, "discounted_cash": 258.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PRIMATRIX 10X25 PER SQCM", "code_information": [{"code": "Q4110", "type": "HCPCS"}, {"code": "4024262", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 344.0, "discounted_cash": 258.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PRIMATRIX 4X4 PER SQ CM", "code_information": [{"code": "Q4110", "type": "HCPCS"}, {"code": "8242810", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 680.0, "discounted_cash": 510.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PRIMATRIX 4X4 PER SQ CM", "code_information": [{"code": "Q4110", "type": "HCPCS"}, {"code": "8242810", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 680.0, "discounted_cash": 510.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PRIMATRIX 6X6 PER SQ CM", "code_information": [{"code": "Q4110", "type": "HCPCS"}, {"code": "8242814", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 505.0, "discounted_cash": 378.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PRIMATRIX 6X6 PER SQ CM", "code_information": [{"code": "Q4110", "type": "HCPCS"}, {"code": "8242814", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 505.0, "discounted_cash": 378.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PRIMATRIX 8X12 PER SQ CM", "code_information": [{"code": "Q4110", "type": "HCPCS"}, {"code": "8242812", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 508.0, "discounted_cash": 381.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PRIMATRIX 8X12 PER SQ CM", "code_information": [{"code": "Q4110", "type": "HCPCS"}, {"code": "8242812", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 508.0, "discounted_cash": 381.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PRIMATRIX 8X8 PER SQ CM", "code_information": [{"code": "Q4110", "type": "HCPCS"}, {"code": "8242811", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 502.0, "discounted_cash": 376.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PRIMATRIX 8X8 PER SQ CM", "code_information": [{"code": "Q4110", "type": "HCPCS"}, {"code": "8242811", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 502.0, "discounted_cash": 376.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PRIMATRIX PER SQ CM", "code_information": [{"code": "Q4110", "type": "HCPCS"}, {"code": "4024611", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 165.0, "discounted_cash": 123.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PRIMATRIX PER SQ CM", "code_information": [{"code": "Q4110", "type": "HCPCS"}, {"code": "4024611", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 165.0, "discounted_cash": 123.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PRIMIDONE", "code_information": [{"code": "80188", "type": "CPT"}, {"code": "7250188", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 76.0, "discounted_cash": 57.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PRIMIDONE 250MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5309824", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 77.0, "discounted_cash": 57.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PRIMIDONE 250MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5309824", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 77.0, "discounted_cash": 57.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PRIMIDONE 50MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5309820", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 61.0, "discounted_cash": 45.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PRIMIDONE 50MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5309820", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 61.0, "discounted_cash": 45.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PRIV ISOLATION", "code_information": [{"code": "1990005", "type": "CDM"}, {"code": "111", "type": "RC"}], "standard_charges": [{"gross_charge": 4056.0, "discounted_cash": 3042.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PRIV ISOLATION", "code_information": [{"code": "2000005", "type": "CDM"}, {"code": "111", "type": "RC"}], "standard_charges": [{"gross_charge": 4056.0, "discounted_cash": 3042.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PRIV ISOLATION", "code_information": [{"code": "2010005", "type": "CDM"}, {"code": "111", "type": "RC"}], "standard_charges": [{"gross_charge": 4056.0, "discounted_cash": 3042.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PRIV ISOLATION", "code_information": [{"code": "2120005", "type": "CDM"}, {"code": "111", "type": "RC"}], "standard_charges": [{"gross_charge": 4056.0, "discounted_cash": 3042.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PRIV ISOLATION", "code_information": [{"code": "2150005", "type": "CDM"}, {"code": "111", "type": "RC"}], "standard_charges": [{"gross_charge": 4056.0, "discounted_cash": 3042.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PRIV ISOLATION", "code_information": [{"code": "2300005", "type": "CDM"}, {"code": "111", "type": "RC"}], "standard_charges": [{"gross_charge": 4056.0, "discounted_cash": 3042.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PRIV ISOLATION", "code_information": [{"code": "2310005", "type": "CDM"}, {"code": "111", "type": "RC"}], "standard_charges": [{"gross_charge": 4056.0, "discounted_cash": 3042.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PRIV ISOLATION", "code_information": [{"code": "2400005", "type": "CDM"}, {"code": "111", "type": "RC"}], "standard_charges": [{"gross_charge": 4056.0, "discounted_cash": 3042.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PRIVATE OBSTETRICS", "code_information": [{"code": "1990043", "type": "CDM"}, {"code": "112", "type": "RC"}], "standard_charges": [{"gross_charge": 3689.0, "discounted_cash": 2766.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PRIVATE OBSTETRICS", "code_information": [{"code": "2500043", "type": "CDM"}, {"code": "112", "type": "RC"}], "standard_charges": [{"gross_charge": 3689.0, "discounted_cash": 2766.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PRIVATE PEDIATRICS", "code_information": [{"code": "1990048", "type": "CDM"}, {"code": "113", "type": "RC"}], "standard_charges": [{"gross_charge": 3689.0, "discounted_cash": 2766.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PRIVATE PEDIATRICS", "code_information": [{"code": "2400048", "type": "CDM"}, {"code": "113", "type": "RC"}], "standard_charges": [{"gross_charge": 3689.0, "discounted_cash": 2766.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PRIVATE ROOM", "code_information": [{"code": "1990001", "type": "CDM"}, {"code": "111", "type": "RC"}], "standard_charges": [{"gross_charge": 3689.0, "discounted_cash": 2766.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PRIVATE ROOM", "code_information": [{"code": "2000001", "type": "CDM"}, {"code": "111", "type": "RC"}], "standard_charges": [{"gross_charge": 3689.0, "discounted_cash": 2766.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PRIVATE ROOM", "code_information": [{"code": "2010001", "type": "CDM"}, {"code": "111", "type": "RC"}], "standard_charges": [{"gross_charge": 3689.0, "discounted_cash": 2766.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PRIVATE ROOM", "code_information": [{"code": "2120001", "type": "CDM"}, {"code": "111", "type": "RC"}], "standard_charges": [{"gross_charge": 3689.0, "discounted_cash": 2766.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PRIVATE ROOM", "code_information": [{"code": "2150001", "type": "CDM"}, {"code": "111", "type": "RC"}], "standard_charges": [{"gross_charge": 3689.0, "discounted_cash": 2766.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PRIVATE ROOM", "code_information": [{"code": "2300001", "type": "CDM"}, {"code": "111", "type": "RC"}], "standard_charges": [{"gross_charge": 3689.0, "discounted_cash": 2766.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PRIVATE ROOM", "code_information": [{"code": "2310001", "type": "CDM"}, {"code": "111", "type": "RC"}], "standard_charges": [{"gross_charge": 3689.0, "discounted_cash": 2766.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PRIVATE ROOM", "code_information": [{"code": "2320001", "type": "CDM"}, {"code": "111", "type": "RC"}], "standard_charges": [{"gross_charge": 3689.0, "discounted_cash": 2766.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PRIVATE ROOM", "code_information": [{"code": "2400001", "type": "CDM"}, {"code": "111", "type": "RC"}], "standard_charges": [{"gross_charge": 3689.0, "discounted_cash": 2766.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PRIVATE ROOM", "code_information": [{"code": "2500001", "type": "CDM"}, {"code": "111", "type": "RC"}], "standard_charges": [{"gross_charge": 3689.0, "discounted_cash": 2766.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PRO-INSULIN", "code_information": [{"code": "84206", "type": "CPT"}, {"code": "7253526", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 520.0, "discounted_cash": 390.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PROCAINAMIDE UPTO 1GM IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J2690", "type": "HCPCS"}, {"code": "5323678", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 1810.0, "discounted_cash": 1357.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PROCAINAMIDE UPTO 1GM IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J2690", "type": "HCPCS"}, {"code": "5323678", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 1810.0, "discounted_cash": 1357.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PROCALCITONIN", "code_information": [{"code": "84145", "type": "CPT"}, {"code": "4108374", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 905.0, "discounted_cash": 678.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PROCALCITONIN", "code_information": [{"code": "84145", "type": "CPT"}, {"code": "7258374", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 724.0, "discounted_cash": 543.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PROCHLORPERAZ 10MG PFSIJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0780", "type": "HCPCS"}, {"code": "5323725", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 439.0, "discounted_cash": 329.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PROCHLORPERAZ 10MG PFSIJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0780", "type": "HCPCS"}, {"code": "5323725", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 439.0, "discounted_cash": 329.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PROCHLORPERAZINE 10MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0780", "type": "HCPCS"}, {"code": "5323720", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 177.0, "discounted_cash": 132.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PROCHLORPERAZINE 10MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0780", "type": "HCPCS"}, {"code": "5323720", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 177.0, "discounted_cash": 132.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PROCHLORPERAZINE 10MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5309983", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 66.0, "discounted_cash": 49.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PROCHLORPERAZINE 10MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5309983", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 66.0, "discounted_cash": 49.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PROCHLORPERAZINE 25MG SU", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5338613", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 279.0, "discounted_cash": 209.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PROCHLORPERAZINE 25MG SU", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5338613", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 279.0, "discounted_cash": 209.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PROCHLORPERAZINE 5MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5309979", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 64.0, "discounted_cash": 48.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PROCHLORPERAZINE 5MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5309979", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 64.0, "discounted_cash": 48.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PROGESTERONE", "code_information": [{"code": "84144", "type": "CPT"}, {"code": "4104144", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 1041.0, "discounted_cash": 780.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PROGESTERONE", "code_information": [{"code": "84144", "type": "CPT"}, {"code": "7254144", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 763.0, "discounted_cash": 572.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PROGRAMMER PT NEUROSTIM", "code_information": [{"code": "C1787", "type": "HCPCS"}, {"code": "8240357", "type": "CDM"}, {"code": "270", "type": "RC"}], "standard_charges": [{"gross_charge": 11407.0, "discounted_cash": 8555.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PROGRAMMER PT NSTIM 2", "code_information": [{"code": "C1787", "type": "HCPCS"}, {"code": "8242820", "type": "CDM"}, {"code": "270", "type": "RC"}], "standard_charges": [{"gross_charge": 14424.0, "discounted_cash": 10818.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PROGRMR SYNERGY EZ PT", "code_information": [{"code": "C1787", "type": "HCPCS"}, {"code": "8240358", "type": "CDM"}, {"code": "270", "type": "RC"}], "standard_charges": [{"gross_charge": 14265.0, "discounted_cash": 10698.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PROLACT+4 HMF 20ML", "code_information": [{"code": "8030896", "type": "CDM"}, {"code": "272", "type": "RC"}], "standard_charges": [{"gross_charge": 1362.0, "discounted_cash": 1021.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PROLACT+6 HMF 15ML", "code_information": [{"code": "8030900", "type": "CDM"}, {"code": "272", "type": "RC"}], "standard_charges": [{"gross_charge": 1101.0, "discounted_cash": 825.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PROLACT+6 HMF 30ML", "code_information": [{"code": "8030897", "type": "CDM"}, {"code": "272", "type": "RC"}], "standard_charges": [{"gross_charge": 2040.0, "discounted_cash": 1530.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PROLACT+8 HMF 40ML", "code_information": [{"code": "8030898", "type": "CDM"}, {"code": "272", "type": "RC"}], "standard_charges": [{"gross_charge": 1353.0, "discounted_cash": 1014.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PROLACTA CR 10ML", "code_information": [{"code": "8030890", "type": "CDM"}, {"code": "272", "type": "RC"}], "standard_charges": [{"gross_charge": 502.0, "discounted_cash": 376.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PROLACTIN", "code_information": [{"code": "84146", "type": "CPT"}, {"code": "4104146", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 706.0, "discounted_cash": 529.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PROLACTIN", "code_information": [{"code": "84146", "type": "CPT"}, {"code": "4174146", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 8.56, "discounted_cash": 6.42, "setting": "both", "billing_class": "facility"}]}, {"description": "PROLACTIN", "code_information": [{"code": "84146", "type": "CPT"}, {"code": "7254146", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 831.0, "discounted_cash": 623.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PROMETHAZ 6.25MG/5ML LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5316155", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 61.0, "discounted_cash": 45.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PROMETHAZ 6.25MG/5ML LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5316155", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 61.0, "discounted_cash": 45.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PROMETHAZINE 12.5MG SU", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5338634", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 96.0, "discounted_cash": 72.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PROMETHAZINE 12.5MG SU", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5338634", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 96.0, "discounted_cash": 72.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PROMETHAZINE 1ML LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5316157", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 85.0, "discounted_cash": 63.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PROMETHAZINE 1ML LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5316157", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 85.0, "discounted_cash": 63.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PROMETHAZINE 25MG SU", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5338638", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 102.0, "discounted_cash": 76.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PROMETHAZINE 25MG SU", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5338638", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 102.0, "discounted_cash": 76.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PROMETHAZINE 25MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5310068", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 85.0, "discounted_cash": 63.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PROMETHAZINE 25MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5310068", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 85.0, "discounted_cash": 63.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PROMETHAZINE 50MG SU", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5338642", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 777.0, "discounted_cash": 582.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PROMETHAZINE 50MG SU", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5338642", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 777.0, "discounted_cash": 582.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PROMETHAZINE UPTO50MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J2550", "type": "HCPCS"}, {"code": "5323798", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 112.0, "discounted_cash": 84.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PROMETHAZINE UPTO50MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J2550", "type": "HCPCS"}, {"code": "5323798", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 112.0, "discounted_cash": 84.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PROPAFENONE 150MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5310090", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 85.0, "discounted_cash": 63.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PROPAFENONE 150MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5310090", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 85.0, "discounted_cash": 63.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PROPAFENONE 225MG XR CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5310093", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 171.0, "discounted_cash": 128.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PROPAFENONE 225MG XR CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5310093", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 171.0, "discounted_cash": 128.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PROPOFOL PER 10MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J2704", "type": "HCPCS"}, {"code": "5323852", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 14.0, "discounted_cash": 10.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PROPOFOL PER 10MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J2704", "type": "HCPCS"}, {"code": "5323852", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 14.0, "discounted_cash": 10.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PROPRANOLOL 10MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5310199", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 71.0, "discounted_cash": 53.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PROPRANOLOL 10MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5310199", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 71.0, "discounted_cash": 53.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PROPRANOLOL 20MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5310201", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 61.0, "discounted_cash": 45.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PROPRANOLOL 20MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5310201", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 61.0, "discounted_cash": 45.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PROPRANOLOL 20MG/5ML LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5316172", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 63.0, "discounted_cash": 47.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PROPRANOLOL 20MG/5ML LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5316172", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 63.0, "discounted_cash": 47.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PROPRANOLOL 60MG XR CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5310208", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 85.0, "discounted_cash": 63.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PROPRANOLOL 60MG XR CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5310208", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 85.0, "discounted_cash": 63.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PROPRANOLOL NEO CMPD IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J7999", "type": "HCPCS"}, {"code": "5323822", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 431.0, "discounted_cash": 323.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PROPRANOLOL NEO CMPD IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J7999", "type": "HCPCS"}, {"code": "5323822", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 431.0, "discounted_cash": 323.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PROPYLTHIOURACIL 50MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5310216", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 72.0, "discounted_cash": 54.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PROPYLTHIOURACIL 50MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5310216", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 72.0, "discounted_cash": 54.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PROS ARTICULAR SURFACE", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "8134150", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 30947.0, "discounted_cash": 23210.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PROS CARPAL STEM", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "8130129", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 12459.0, "discounted_cash": 9344.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PROS DURA SUBST", "code_information": [{"code": "C1763", "type": "HCPCS"}, {"code": "8154095", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 6162.0, "discounted_cash": 4621.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PROS EAR TORP", "code_information": [{"code": "L8613", "type": "HCPCS"}, {"code": "8122174", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 5804.0, "discounted_cash": 4353.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PROS EAR TUBE", "code_information": [{"code": "L8613", "type": "HCPCS"}, {"code": "8093155", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 536.0, "discounted_cash": 402.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PROS ELBOW", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "8134269", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 55164.0, "discounted_cash": 41373.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PROS FEMORAL HEAD", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "8134204", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 16009.0, "discounted_cash": 12006.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PROS FEMORAL MODULE", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "8134200", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 29421.0, "discounted_cash": 22065.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PROS FINGER JNT", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "8134280", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 15277.0, "discounted_cash": 11457.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PROS GLENOSPH UNIV REVRS", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "8134282", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 16252.0, "discounted_cash": 12189.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PROS HIP", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "8134290", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 8615.0, "discounted_cash": 6461.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PROS HIP ACET INSERT", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "8134299", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 16080.0, "discounted_cash": 12060.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PROS HIP ACTBCU", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "8134300", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 15561.0, "discounted_cash": 11670.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PROS HIP BEARIN", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "8134305", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 14356.0, "discounted_cash": 10767.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PROS HIP CENTRA", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "8134310", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 2509.0, "discounted_cash": 1881.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PROS HIP FEMSTE", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "8134315", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 40492.0, "discounted_cash": 30369.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PROS HIP FEMSTE", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "8134320", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 30876.0, "discounted_cash": 23157.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PROS HIP FEMSTE", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "8134325", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 52747.0, "discounted_cash": 39560.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PROS HIP FENSTE", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "8134330", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 14591.0, "discounted_cash": 10943.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PROS HIP HD/NEC", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "8134335", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 9050.0, "discounted_cash": 6787.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PROS HIP LINER", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "8134338", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 11137.0, "discounted_cash": 8352.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PROS HIP/FEMSTE", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "8134345", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 26186.0, "discounted_cash": 19639.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PROS HIP/FEMSTE", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "8134350", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 19511.0, "discounted_cash": 14633.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PROS HUMERAL COMPONENT", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "8134353", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 25552.0, "discounted_cash": 19164.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PROS HUMERAL HD", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "8134352", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 18579.0, "discounted_cash": 13934.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PROS HUMERAL STEM", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "8134354", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 29938.0, "discounted_cash": 22453.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PROS KNE/FEMORA", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "8134365", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 30173.0, "discounted_cash": 22629.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PROS KNE/FEMORA", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "8134375", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 19722.0, "discounted_cash": 14791.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PROS KNE/INSERT", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "8134380", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 15414.0, "discounted_cash": 11560.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PROS KNE/PATELA", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "8134385", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 12217.0, "discounted_cash": 9162.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PROS KNE/PATELA", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "8134390", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 8805.0, "discounted_cash": 6603.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PROS KNE/TIBIAL", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "8134400", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 16879.0, "discounted_cash": 12659.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PROS KNE/TIBIAL", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "8134405", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 11620.0, "discounted_cash": 8715.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PROS KNE/TIBIAL", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "8134415", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 24174.0, "discounted_cash": 18130.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PROS METACARPOPHALANGEAL", "code_information": [{"code": "L8630", "type": "HCPCS"}, {"code": "8134433", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 11270.0, "discounted_cash": 8452.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PROS PENILE AMS 700", "code_information": [{"code": "C1813", "type": "HCPCS"}, {"code": "8240360", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 100061.0, "discounted_cash": 75045.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PROS PENILE INHIBIZONE/PRECONN", "code_information": [{"code": "C1813", "type": "HCPCS"}, {"code": "8240363", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 12379.0, "discounted_cash": 9284.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PROS PENILE MALLEABLE TACTRA", "code_information": [{"code": "C2622", "type": "HCPCS"}, {"code": "8154146", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 131224.0, "discounted_cash": 98418.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PROS PENILE PUM", "code_information": [{"code": "C1813", "type": "HCPCS"}, {"code": "8154155", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 231169.0, "discounted_cash": 173376.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PROS RADIAL HEAD", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "8134435", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 43817.0, "discounted_cash": 32862.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PROS RADIAL STEM", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "8130236", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 23333.0, "discounted_cash": 17499.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PROS SHOULDER", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "8134450", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 11553.0, "discounted_cash": 8664.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PROS STEM EXTENDER", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "8134453", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 4506.0, "discounted_cash": 3379.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PROS TIB BEARING", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "8134472", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 13457.0, "discounted_cash": 10092.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PROS TIB STEM", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "8134480", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 10877.0, "discounted_cash": 8157.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PROS TIBIAL TRAY", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "8133305", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 25072.0, "discounted_cash": 18804.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PROS TOE GREAT", "code_information": [{"code": "L8641", "type": "HCPCS"}, {"code": "8134490", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 16263.0, "discounted_cash": 12197.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PROS TOE HAMMER", "code_information": [{"code": "L8641", "type": "HCPCS"}, {"code": "8134495", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 6814.0, "discounted_cash": 5110.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PROS ULNAR ASSEMBLY", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "8134509", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 44531.0, "discounted_cash": 33398.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PROS ULNAR STEM", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "8130237", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 101329.0, "discounted_cash": 75996.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PROSTATE CANCER SCREEN", "code_information": [{"code": "G0103", "type": "HCPCS"}, {"code": "4100080", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 55.0, "discounted_cash": 41.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PROSTATE CANCER SCREEN", "code_information": [{"code": "G0103", "type": "HCPCS"}, {"code": "4170080", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 7.14, "discounted_cash": 5.36, "setting": "both", "billing_class": "facility"}]}, {"description": "PROTAMINE PER 10MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J2720", "type": "HCPCS"}, {"code": "5323870", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 122.0, "discounted_cash": 91.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PROTAMINE PER 10MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J2720", "type": "HCPCS"}, {"code": "5323870", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 122.0, "discounted_cash": 91.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PROTEIN C ACTIVITY", "code_information": [{"code": "85303", "type": "CPT"}, {"code": "7255303", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 129.0, "discounted_cash": 96.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PROTEIN C ANTIGEN", "code_information": [{"code": "85302", "type": "CPT"}, {"code": "4105302", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 1581.0, "discounted_cash": 1185.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PROTEIN C ANTIGEN", "code_information": [{"code": "85302", "type": "CPT"}, {"code": "7255302", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 1177.0, "discounted_cash": 882.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PROTEIN C RESIST", "code_information": [{"code": "85307", "type": "CPT"}, {"code": "7255307", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 136.0, "discounted_cash": 102.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PROTEIN ELCTRO OTHER FLUIDS", "code_information": [{"code": "84166", "type": "CPT"}, {"code": "7254167", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 83.0, "discounted_cash": 62.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PROTEIN ELCTRO OTHER FLUIDS/2", "code_information": [{"code": "84166", "type": "CPT"}, {"code": "4104175", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 361.0, "discounted_cash": 270.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PROTEIN ELCTRO OTHER FLUIDS/2", "code_information": [{"code": "84166", "type": "CPT"}, {"code": "7254168", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 66.0, "discounted_cash": 49.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PROTEIN ELCTRO SERUM", "code_information": [{"code": "84165", "type": "CPT"}, {"code": "4104165", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 97.0, "discounted_cash": 72.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PROTEIN ELCTRO SERUM", "code_information": [{"code": "84165", "type": "CPT"}, {"code": "7254165", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 37.0, "discounted_cash": 27.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PROTEIN S FREE/2", "code_information": [{"code": "85306", "type": "CPT"}, {"code": "4106898", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 177.0, "discounted_cash": 132.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PROTEIN S FREE/2", "code_information": [{"code": "85306", "type": "CPT"}, {"code": "7255306", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 143.0, "discounted_cash": 107.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PROTEIN S FREE/3", "code_information": [{"code": "85306", "type": "CPT"}, {"code": "7255308", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 52.0, "discounted_cash": 39.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PROTEIN S FREE/4", "code_information": [{"code": "85306", "type": "CPT"}, {"code": "7256898", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 129.0, "discounted_cash": 96.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PROTEIN S TOTAL", "code_information": [{"code": "85305", "type": "CPT"}, {"code": "4105305", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 149.0, "discounted_cash": 111.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PROTEIN S TOTAL", "code_information": [{"code": "85305", "type": "CPT"}, {"code": "7255305", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 124.0, "discounted_cash": 93.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PROTEIN TOTAL", "code_information": [{"code": "84155", "type": "CPT"}, {"code": "4104155", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 416.0, "discounted_cash": 312.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PROTEIN TOTAL", "code_information": [{"code": "84155", "type": "CPT"}, {"code": "4174155", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 1.12, "discounted_cash": 0.84, "setting": "both", "billing_class": "facility"}]}, {"description": "PROTEIN TOTAL", "code_information": [{"code": "84155", "type": "CPT"}, {"code": "7254155", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 37.0, "discounted_cash": 27.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PROTEIN TOTAL OTHER SOURCE", "code_information": [{"code": "84157", "type": "CPT"}, {"code": "4104154", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 401.0, "discounted_cash": 300.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PROTEIN TOTAL OTHER SOURCE", "code_information": [{"code": "84157", "type": "CPT"}, {"code": "4174154", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 7.14, "discounted_cash": 5.36, "setting": "both", "billing_class": "facility"}]}, {"description": "PROTEIN TOTAL OTHER SOURCE", "code_information": [{"code": "84157", "type": "CPT"}, {"code": "7254154", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 11.0, "discounted_cash": 8.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PROTEIN TOTAL OTHER SOURCE/2", "code_information": [{"code": "84157", "type": "CPT"}, {"code": "4174196", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 5.71, "discounted_cash": 4.28, "setting": "both", "billing_class": "facility"}]}, {"description": "PROTEIN TOTAL OTHER SOURCE/3", "code_information": [{"code": "84157", "type": "CPT"}, {"code": "4104196", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 372.0, "discounted_cash": 279.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PROTEIN TOTAL OTHER SOURCE/3", "code_information": [{"code": "84157", "type": "CPT"}, {"code": "7254195", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 325.0, "discounted_cash": 243.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PROTEIN URINE", "code_information": [{"code": "84156", "type": "CPT"}, {"code": "4104156", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 416.0, "discounted_cash": 312.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PROTEIN URINE", "code_information": [{"code": "84156", "type": "CPT"}, {"code": "4174156", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 8.56, "discounted_cash": 6.42, "setting": "both", "billing_class": "facility"}]}, {"description": "PROTEIN URINE/2", "code_information": [{"code": "84156", "type": "CPT"}, {"code": "4174180", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 4.29, "discounted_cash": 3.22, "setting": "both", "billing_class": "facility"}]}, {"description": "PROTEIN URINE/2", "code_information": [{"code": "84156", "type": "CPT"}, {"code": "7254157", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 60.0, "discounted_cash": 45.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PROTEIN URINE/3", "code_information": [{"code": "84156", "type": "CPT"}, {"code": "4104180", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 341.0, "discounted_cash": 255.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PROTEIN URINE/4", "code_information": [{"code": "84156", "type": "CPT"}, {"code": "7254180", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 83.0, "discounted_cash": 62.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PROTHROM COMPLX BALFAXAR 1U IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J7165", "type": "HCPCS"}, {"code": "5323877", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 15.0, "discounted_cash": 11.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PROTHROM COMPLX BALFAXAR 1U IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J7165", "type": "HCPCS"}, {"code": "5323877", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 15.0, "discounted_cash": 11.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PROTHROM COMPLX KCENTRA 1U IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J7168", "type": "HCPCS"}, {"code": "5323876", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 102.0, "discounted_cash": 76.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PROTHROM COMPLX KCENTRA 1U IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J7168", "type": "HCPCS"}, {"code": "5323876", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 102.0, "discounted_cash": 76.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PROTHROMBIN TIME", "code_information": [{"code": "85610", "type": "CPT"}, {"code": "4105610", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 341.0, "discounted_cash": 255.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PROTHROMBIN TIME", "code_information": [{"code": "85610", "type": "CPT"}, {"code": "4175610", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 5.71, "discounted_cash": 4.28, "setting": "both", "billing_class": "facility"}]}, {"description": "PROTHROMBIN TIME", "code_information": [{"code": "85610", "type": "CPT"}, {"code": "7255610", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 7.0, "discounted_cash": 5.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PROTOPORPHYRIN RBC QN", "code_information": [{"code": "84202", "type": "CPT"}, {"code": "7254128", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 461.0, "discounted_cash": 345.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PROTOZOA AB NES/7", "code_information": [{"code": "86753", "type": "CPT"}, {"code": "7256718", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 159.0, "discounted_cash": 119.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PROTOZOA AB NES/8", "code_information": [{"code": "86753", "type": "CPT"}, {"code": "7256753", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 393.0, "discounted_cash": 294.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PRQ REVASC BYP GRAFT ADDL", "code_information": [{"code": "92938", "type": "CPT"}, {"code": "4612938", "type": "CDM"}, {"code": "480", "type": "RC"}], "standard_charges": [{"gross_charge": 47708.0, "discounted_cash": 35781.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PRQ TCAT THER RX NTRAC BALLN", "code_information": [{"code": "4610913", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 5701.52, "discounted_cash": 4276.14, "setting": "both", "billing_class": "facility"}]}, {"description": "PSA FREE", "code_information": [{"code": "84154", "type": "CPT"}, {"code": "4108415", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 114.0, "discounted_cash": 85.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PSA FREE", "code_information": [{"code": "84154", "type": "CPT"}, {"code": "7254200", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 109.0, "discounted_cash": 81.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PSA TOTAL", "code_information": [{"code": "84153", "type": "CPT"}, {"code": "4106316", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 778.0, "discounted_cash": 583.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PSA TOTAL", "code_information": [{"code": "84153", "type": "CPT"}, {"code": "4176316", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 7.14, "discounted_cash": 5.36, "setting": "both", "billing_class": "facility"}]}, {"description": "PSA TOTAL", "code_information": [{"code": "84153", "type": "CPT"}, {"code": "7256316", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 66.0, "discounted_cash": 49.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PSA TOTAL/2", "code_information": [{"code": "84153", "type": "CPT"}, {"code": "7254153", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 97.0, "discounted_cash": 72.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PSEUDOEPHED 120MG XR TB", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5310262", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 61.0, "discounted_cash": 45.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PSEUDOEPHED 120MG XR TB", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5310262", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 61.0, "discounted_cash": 45.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PSEUDOEPHED 30MG TB", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5310266", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 61.0, "discounted_cash": 45.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PSEUDOEPHED 30MG TB", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5310266", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 61.0, "discounted_cash": 45.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PST TEF VCL CHD", "code_information": [{"code": "C1878", "type": "HCPCS"}, {"code": "8033761", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 10604.0, "discounted_cash": 7953.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PSY THRPY 30 MIN PT", "code_information": [{"code": "90832", "type": "CPT"}, {"code": "6400832", "type": "CDM"}, {"code": "914", "type": "RC"}], "standard_charges": [{"gross_charge": 607.0, "discounted_cash": 455.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PSY THRPY 45MIN PT", "code_information": [{"code": "90834", "type": "CPT"}, {"code": "6400834", "type": "CDM"}, {"code": "914", "type": "RC"}], "standard_charges": [{"gross_charge": 1335.0, "discounted_cash": 1001.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PSYLLIUM PK", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5316205", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 61.0, "discounted_cash": 45.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PSYLLIUM PK", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5316205", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 61.0, "discounted_cash": 45.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PT COG FUNC ACTIVITY ADDL 15M", "code_information": [{"code": "97130", "type": "CPT"}, {"code": "5707130", "type": "CDM"}, {"code": "420", "type": "RC"}], "standard_charges": [{"gross_charge": 619.0, "discounted_cash": 464.25, "setting": "both", "billing_class": "facility"}], "modifiers": "GP"}, {"description": "PT COG FUNC ACTIVITY INIT 15M", "code_information": [{"code": "97129", "type": "CPT"}, {"code": "5707129", "type": "CDM"}, {"code": "420", "type": "RC"}], "standard_charges": [{"gross_charge": 619.0, "discounted_cash": 464.25, "setting": "both", "billing_class": "facility"}], "modifiers": "GP"}, {"description": "PT E-STIM BASIC", "code_information": [{"code": "G0283", "type": "HCPCS"}, {"code": "5700283", "type": "CDM"}, {"code": "420", "type": "RC"}], "standard_charges": [{"gross_charge": 1038.0, "discounted_cash": 778.5, "setting": "both", "billing_class": "facility"}], "modifiers": "GP"}, {"description": "PT EVAL HIGH COMP", "code_information": [{"code": "97163", "type": "CPT"}, {"code": "5705205", "type": "CDM"}, {"code": "424", "type": "RC"}], "standard_charges": [{"gross_charge": 2360.0, "discounted_cash": 1770.0, "setting": "both", "billing_class": "facility"}], "modifiers": "GP"}, {"description": "PT EVAL LOW COMP", "code_information": [{"code": "97161", "type": "CPT"}, {"code": "5705201", "type": "CDM"}, {"code": "424", "type": "RC"}], "standard_charges": [{"gross_charge": 2322.0, "discounted_cash": 1741.5, "setting": "both", "billing_class": "facility"}], "modifiers": "GP"}, {"description": "PT EVAL MOD COMP", "code_information": [{"code": "97162", "type": "CPT"}, {"code": "5705203", "type": "CDM"}, {"code": "424", "type": "RC"}], "standard_charges": [{"gross_charge": 2143.0, "discounted_cash": 1607.25, "setting": "both", "billing_class": "facility"}], "modifiers": "GP"}, {"description": "PT EVAL NEUR/PED HIGH", "code_information": [{"code": "97163", "type": "CPT"}, {"code": "5705417", "type": "CDM"}, {"code": "424", "type": "RC"}], "standard_charges": [{"gross_charge": 2500.0, "discounted_cash": 1875.0, "setting": "both", "billing_class": "facility"}], "modifiers": "GP"}, {"description": "PT EVAL NEUR/PED LOW", "code_information": [{"code": "97161", "type": "CPT"}, {"code": "5705413", "type": "CDM"}, {"code": "424", "type": "RC"}], "standard_charges": [{"gross_charge": 2249.0, "discounted_cash": 1686.75, "setting": "both", "billing_class": "facility"}], "modifiers": "GP"}, {"description": "PT EVAL NEUR/PED MOD", "code_information": [{"code": "97162", "type": "CPT"}, {"code": "5705415", "type": "CDM"}, {"code": "424", "type": "RC"}], "standard_charges": [{"gross_charge": 2294.0, "discounted_cash": 1720.5, "setting": "both", "billing_class": "facility"}], "modifiers": "GP"}, {"description": "PT EVAL WND CARE HIGH", "code_information": [{"code": "97163", "type": "CPT"}, {"code": "5707208", "type": "CDM"}, {"code": "424", "type": "RC"}], "standard_charges": [{"gross_charge": 2585.0, "discounted_cash": 1938.75, "setting": "both", "billing_class": "facility"}], "modifiers": "GP"}, {"description": "PT EVAL WND CARE LOW", "code_information": [{"code": "97161", "type": "CPT"}, {"code": "5707201", "type": "CDM"}, {"code": "424", "type": "RC"}], "standard_charges": [{"gross_charge": 2143.0, "discounted_cash": 1607.25, "setting": "both", "billing_class": "facility"}], "modifiers": "GP"}, {"description": "PT EVAL WND CARE MOD", "code_information": [{"code": "97162", "type": "CPT"}, {"code": "5707207", "type": "CDM"}, {"code": "424", "type": "RC"}], "standard_charges": [{"gross_charge": 2143.0, "discounted_cash": 1607.25, "setting": "both", "billing_class": "facility"}], "modifiers": "GP"}, {"description": "PT GAIT/STR TRN EA 15", "code_information": [{"code": "97116", "type": "CPT"}, {"code": "5705656", "type": "CDM"}, {"code": "420", "type": "RC"}], "standard_charges": [{"gross_charge": 618.0, "discounted_cash": 463.5, "setting": "both", "billing_class": "facility"}], "modifiers": "GP"}, {"description": "PT INFRARED BSC", "code_information": [{"code": "97026", "type": "CPT"}, {"code": "5705632", "type": "CDM"}, {"code": "420", "type": "RC"}], "standard_charges": [{"gross_charge": 184.0, "discounted_cash": 138.0, "setting": "both", "billing_class": "facility"}], "modifiers": "GP"}, {"description": "PT INFRARED EXTNSV", "code_information": [{"code": "97026", "type": "CPT"}, {"code": "5705631", "type": "CDM"}, {"code": "420", "type": "RC"}], "standard_charges": [{"gross_charge": 467.0, "discounted_cash": 350.25, "setting": "both", "billing_class": "facility"}], "modifiers": "GP"}, {"description": "PT INTRARED CMPLX", "code_information": [{"code": "97026", "type": "CPT"}, {"code": "5705630", "type": "CDM"}, {"code": "420", "type": "RC"}], "standard_charges": [{"gross_charge": 374.0, "discounted_cash": 280.5, "setting": "both", "billing_class": "facility"}], "modifiers": "GP"}, {"description": "PT INTRARED INTERM", "code_information": [{"code": "97026", "type": "CPT"}, {"code": "5705629", "type": "CDM"}, {"code": "420", "type": "RC"}], "standard_charges": [{"gross_charge": 279.0, "discounted_cash": 209.25, "setting": "both", "billing_class": "facility"}], "modifiers": "GP"}, {"description": "PT IONTOPHORESIS 15 BSC", "code_information": [{"code": "97033", "type": "CPT"}, {"code": "5705272", "type": "CDM"}, {"code": "420", "type": "RC"}], "standard_charges": [{"gross_charge": 591.0, "discounted_cash": 443.25, "setting": "both", "billing_class": "facility"}], "modifiers": "GP"}, {"description": "PT MANUAL THERAPY EA 15M", "code_information": [{"code": "97140", "type": "CPT"}, {"code": "5705178", "type": "CDM"}, {"code": "420", "type": "RC"}], "standard_charges": [{"gross_charge": 730.0, "discounted_cash": 547.5, "setting": "both", "billing_class": "facility"}], "modifiers": "GP"}, {"description": "PT MECH TRACTION BSC", "code_information": [{"code": "97012", "type": "CPT"}, {"code": "5705600", "type": "CDM"}, {"code": "420", "type": "RC"}], "standard_charges": [{"gross_charge": 483.0, "discounted_cash": 362.25, "setting": "both", "billing_class": "facility"}], "modifiers": "GP"}, {"description": "PT NEG PRESS <=50CM", "code_information": [{"code": "97605", "type": "CPT"}, {"code": "5707614", "type": "CDM"}, {"code": "420", "type": "RC"}], "standard_charges": [{"gross_charge": 1597.0, "discounted_cash": 1197.75, "setting": "both", "billing_class": "facility"}], "modifiers": "GP"}, {"description": "PT NEG PRESS >50CM", "code_information": [{"code": "97606", "type": "CPT"}, {"code": "5707613", "type": "CDM"}, {"code": "420", "type": "RC"}], "standard_charges": [{"gross_charge": 1080.0, "discounted_cash": 810.0, "setting": "both", "billing_class": "facility"}], "modifiers": "GP"}, {"description": "PT NEUR/PED RE-EVAL", "code_information": [{"code": "97164", "type": "CPT"}, {"code": "5705423", "type": "CDM"}, {"code": "424", "type": "RC"}], "standard_charges": [{"gross_charge": 1134.0, "discounted_cash": 850.5, "setting": "both", "billing_class": "facility"}], "modifiers": "GP"}, {"description": "PT NEUROMUSC RE-ED EA15", "code_information": [{"code": "97112", "type": "CPT"}, {"code": "5705300", "type": "CDM"}, {"code": "420", "type": "RC"}], "standard_charges": [{"gross_charge": 704.0, "discounted_cash": 528.0, "setting": "both", "billing_class": "facility"}], "modifiers": "GP"}, {"description": "PT NSL WD/S DEB WO AN BS", "code_information": [{"code": "97602", "type": "CPT"}, {"code": "5707605", "type": "CDM"}, {"code": "420", "type": "RC"}], "standard_charges": [{"gross_charge": 658.0, "discounted_cash": 493.5, "setting": "both", "billing_class": "facility"}], "modifiers": "GP"}, {"description": "PT NSL WD/S DEB WO AN CO", "code_information": [{"code": "97602", "type": "CPT"}, {"code": "5707607", "type": "CDM"}, {"code": "420", "type": "RC"}], "standard_charges": [{"gross_charge": 658.0, "discounted_cash": 493.5, "setting": "both", "billing_class": "facility"}], "modifiers": "GP"}, {"description": "PT NSL WD/S DEB WO AN IN", "code_information": [{"code": "97602", "type": "CPT"}, {"code": "5707606", "type": "CDM"}, {"code": "420", "type": "RC"}], "standard_charges": [{"gross_charge": 1142.0, "discounted_cash": 856.5, "setting": "both", "billing_class": "facility"}], "modifiers": "GP"}, {"description": "PT ORTHO MGMT INIT EA 15MIN", "code_information": [{"code": "97760", "type": "CPT"}, {"code": "5707760", "type": "CDM"}, {"code": "420", "type": "RC"}], "standard_charges": [{"gross_charge": 391.0, "discounted_cash": 293.25, "setting": "both", "billing_class": "facility"}], "modifiers": "GP"}, {"description": "PT PARAFFIN BATH BSC", "code_information": [{"code": "97018", "type": "CPT"}, {"code": "5705248", "type": "CDM"}, {"code": "420", "type": "RC"}], "standard_charges": [{"gross_charge": 262.0, "discounted_cash": 196.5, "setting": "both", "billing_class": "facility"}], "modifiers": "GP"}, {"description": "PT PROSTH TRN INIT EA 15MIN", "code_information": [{"code": "97761", "type": "CPT"}, {"code": "5707762", "type": "CDM"}, {"code": "420", "type": "RC"}], "standard_charges": [{"gross_charge": 921.0, "discounted_cash": 690.75, "setting": "both", "billing_class": "facility"}], "modifiers": "GP"}, {"description": "PT RE-EVAL", "code_information": [{"code": "97164", "type": "CPT"}, {"code": "5705209", "type": "CDM"}, {"code": "424", "type": "RC"}], "standard_charges": [{"gross_charge": 1134.0, "discounted_cash": 850.5, "setting": "both", "billing_class": "facility"}], "modifiers": "GP"}, {"description": "PT SEL DEB 1ST 20CM OR LESS", "code_information": [{"code": "97597", "type": "CPT"}, {"code": "5707591", "type": "CDM"}, {"code": "420", "type": "RC"}], "standard_charges": [{"gross_charge": 1596.0, "discounted_cash": 1197.0, "setting": "both", "billing_class": "facility"}], "modifiers": "GP"}, {"description": "PT SEL DEB EA ADD UP TO 20CM", "code_information": [{"code": "97598", "type": "CPT"}, {"code": "5707592", "type": "CDM"}, {"code": "420", "type": "RC"}], "standard_charges": [{"gross_charge": 1525.0, "discounted_cash": 1143.75, "setting": "both", "billing_class": "facility"}], "modifiers": "GP"}, {"description": "PT SLF CR/HM MGMT EA 15", "code_information": [{"code": "97535", "type": "CPT"}, {"code": "5705316", "type": "CDM"}, {"code": "420", "type": "RC"}], "standard_charges": [{"gross_charge": 256.0, "discounted_cash": 192.0, "setting": "both", "billing_class": "facility"}], "modifiers": "GP"}, {"description": "PT SUBST PLSMA FRCT EA", "code_information": [{"code": "85611", "type": "CPT"}, {"code": "4104200", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 287.0, "discounted_cash": 215.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PT SUBST PLSMA FRCT EA", "code_information": [{"code": "85611", "type": "CPT"}, {"code": "4175611", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 31.39, "discounted_cash": 23.54, "setting": "both", "billing_class": "facility"}]}, {"description": "PT THER EX EA 15", "code_information": [{"code": "97110", "type": "CPT"}, {"code": "5705296", "type": "CDM"}, {"code": "420", "type": "RC"}], "standard_charges": [{"gross_charge": 795.0, "discounted_cash": 596.25, "setting": "both", "billing_class": "facility"}], "modifiers": "GP"}, {"description": "PT THERAPEUTC ACT EA 15", "code_information": [{"code": "97530", "type": "CPT"}, {"code": "5705312", "type": "CDM"}, {"code": "420", "type": "RC"}], "standard_charges": [{"gross_charge": 708.0, "discounted_cash": 531.0, "setting": "both", "billing_class": "facility"}], "modifiers": "GP"}, {"description": "PT THERAPEUTC MASSG EA15", "code_information": [{"code": "97124", "type": "CPT"}, {"code": "5705308", "type": "CDM"}, {"code": "420", "type": "RC"}], "standard_charges": [{"gross_charge": 493.0, "discounted_cash": 369.75, "setting": "both", "billing_class": "facility"}], "modifiers": "GP"}, {"description": "PT US EA 15 BSC", "code_information": [{"code": "97035", "type": "CPT"}, {"code": "5705284", "type": "CDM"}, {"code": "420", "type": "RC"}], "standard_charges": [{"gross_charge": 438.0, "discounted_cash": 328.5, "setting": "both", "billing_class": "facility"}], "modifiers": "GP"}, {"description": "PT WHIRLPOOL BSC", "code_information": [{"code": "97022", "type": "CPT"}, {"code": "5705254", "type": "CDM"}, {"code": "420", "type": "RC"}], "standard_charges": [{"gross_charge": 576.0, "discounted_cash": 432.0, "setting": "both", "billing_class": "facility"}], "modifiers": "GP"}, {"description": "PTA COG FUNC ACTIVITY INIT 15M", "code_information": [{"code": "97129", "type": "CPT"}, {"code": "5707127", "type": "CDM"}, {"code": "420", "type": "RC"}], "standard_charges": [{"gross_charge": 619.0, "discounted_cash": 464.25, "setting": "both", "billing_class": "facility"}], "modifiers": "GP|CQ"}, {"description": "PTA COG FUNC ACTIVTY ADDL 15M", "code_information": [{"code": "97130", "type": "CPT"}, {"code": "5707131", "type": "CDM"}, {"code": "420", "type": "RC"}], "standard_charges": [{"gross_charge": 619.0, "discounted_cash": 464.25, "setting": "both", "billing_class": "facility"}], "modifiers": "GP|CQ"}, {"description": "PTA E-STIM BASIC", "code_information": [{"code": "G0283", "type": "HCPCS"}, {"code": "5700023", "type": "CDM"}, {"code": "420", "type": "RC"}], "standard_charges": [{"gross_charge": 1038.0, "discounted_cash": 778.5, "setting": "both", "billing_class": "facility"}], "modifiers": "GP|CQ"}, {"description": "PTA GAIT/STR TRN EA 15", "code_information": [{"code": "97116", "type": "CPT"}, {"code": "5700053", "type": "CDM"}, {"code": "420", "type": "RC"}], "standard_charges": [{"gross_charge": 618.0, "discounted_cash": 463.5, "setting": "both", "billing_class": "facility"}], "modifiers": "GP|CQ"}, {"description": "PTA INFRARED BSC", "code_information": [{"code": "97026", "type": "CPT"}, {"code": "5700036", "type": "CDM"}, {"code": "420", "type": "RC"}], "standard_charges": [{"gross_charge": 184.0, "discounted_cash": 138.0, "setting": "both", "billing_class": "facility"}], "modifiers": "GP|CQ"}, {"description": "PTA INFRARED CMPLX", "code_information": [{"code": "97026", "type": "CPT"}, {"code": "5700034", "type": "CDM"}, {"code": "420", "type": "RC"}], "standard_charges": [{"gross_charge": 374.0, "discounted_cash": 280.5, "setting": "both", "billing_class": "facility"}], "modifiers": "GP|CQ"}, {"description": "PTA INFRARED EXTNSV", "code_information": [{"code": "97026", "type": "CPT"}, {"code": "5700035", "type": "CDM"}, {"code": "420", "type": "RC"}], "standard_charges": [{"gross_charge": 467.0, "discounted_cash": 350.25, "setting": "both", "billing_class": "facility"}], "modifiers": "GP|CQ"}, {"description": "PTA INFRARED INTERM", "code_information": [{"code": "97026", "type": "CPT"}, {"code": "5700033", "type": "CDM"}, {"code": "420", "type": "RC"}], "standard_charges": [{"gross_charge": 279.0, "discounted_cash": 209.25, "setting": "both", "billing_class": "facility"}], "modifiers": "GP|CQ"}, {"description": "PTA IONTOPHORESIS 15 BSC", "code_information": [{"code": "97033", "type": "CPT"}, {"code": "5700038", "type": "CDM"}, {"code": "420", "type": "RC"}], "standard_charges": [{"gross_charge": 591.0, "discounted_cash": 443.25, "setting": "both", "billing_class": "facility"}], "modifiers": "GP|CQ"}, {"description": "PTA MANUAL THRPY EA 15MIN", "code_information": [{"code": "97140", "type": "CPT"}, {"code": "5700057", "type": "CDM"}, {"code": "420", "type": "RC"}], "standard_charges": [{"gross_charge": 730.0, "discounted_cash": 547.5, "setting": "both", "billing_class": "facility"}], "modifiers": "GP|CQ"}, {"description": "PTA MECH TRACTION BSC", "code_information": [{"code": "97012", "type": "CPT"}, {"code": "5700025", "type": "CDM"}, {"code": "420", "type": "RC"}], "standard_charges": [{"gross_charge": 483.0, "discounted_cash": 362.25, "setting": "both", "billing_class": "facility"}], "modifiers": "GP|CQ"}, {"description": "PTA NEG PRESS <=50CM", "code_information": [{"code": "97605", "type": "CPT"}, {"code": "5707615", "type": "CDM"}, {"code": "420", "type": "RC"}], "standard_charges": [{"gross_charge": 1597.0, "discounted_cash": 1197.75, "setting": "both", "billing_class": "facility"}], "modifiers": "GP|CQ"}, {"description": "PTA NEG PRESS >50CM", "code_information": [{"code": "97606", "type": "CPT"}, {"code": "5707616", "type": "CDM"}, {"code": "420", "type": "RC"}], "standard_charges": [{"gross_charge": 1080.0, "discounted_cash": 810.0, "setting": "both", "billing_class": "facility"}], "modifiers": "GP|CQ"}, {"description": "PTA NEUROMUSC RE-ED EA15MIN", "code_information": [{"code": "97112", "type": "CPT"}, {"code": "5700048", "type": "CDM"}, {"code": "420", "type": "RC"}], "standard_charges": [{"gross_charge": 704.0, "discounted_cash": 528.0, "setting": "both", "billing_class": "facility"}], "modifiers": "GP|CQ"}, {"description": "PTA NSL WD/S DEB WO AN IN", "code_information": [{"code": "97602", "type": "CPT"}, {"code": "5707612", "type": "CDM"}, {"code": "420", "type": "RC"}], "standard_charges": [{"gross_charge": 1142.0, "discounted_cash": 856.5, "setting": "both", "billing_class": "facility"}], "modifiers": "GP|CQ"}, {"description": "PTA PARAFFIN BATH BSC", "code_information": [{"code": "97018", "type": "CPT"}, {"code": "5700028", "type": "CDM"}, {"code": "420", "type": "RC"}], "standard_charges": [{"gross_charge": 262.0, "discounted_cash": 196.5, "setting": "both", "billing_class": "facility"}], "modifiers": "GP|CQ"}, {"description": "PTA SLF CR/HM MGMT EA 15MIN", "code_information": [{"code": "97535", "type": "CPT"}, {"code": "5700068", "type": "CDM"}, {"code": "420", "type": "RC"}], "standard_charges": [{"gross_charge": 256.0, "discounted_cash": 192.0, "setting": "both", "billing_class": "facility"}], "modifiers": "GP|CQ"}, {"description": "PTA THER EX EA 15MIN", "code_information": [{"code": "97110", "type": "CPT"}, {"code": "5700045", "type": "CDM"}, {"code": "420", "type": "RC"}], "standard_charges": [{"gross_charge": 795.0, "discounted_cash": 596.25, "setting": "both", "billing_class": "facility"}], "modifiers": "GP|CQ"}, {"description": "PTA THERAPEUTC ACT EA 15MIN", "code_information": [{"code": "97530", "type": "CPT"}, {"code": "5700063", "type": "CDM"}, {"code": "420", "type": "RC"}], "standard_charges": [{"gross_charge": 708.0, "discounted_cash": 531.0, "setting": "both", "billing_class": "facility"}], "modifiers": "GP|CQ"}, {"description": "PTA THERAPUTC MASSG EA15MIN", "code_information": [{"code": "97124", "type": "CPT"}, {"code": "5700055", "type": "CDM"}, {"code": "420", "type": "RC"}], "standard_charges": [{"gross_charge": 493.0, "discounted_cash": 369.75, "setting": "both", "billing_class": "facility"}], "modifiers": "GP|CQ"}, {"description": "PTA US EA 15 BASIC", "code_information": [{"code": "97035", "type": "CPT"}, {"code": "5700040", "type": "CDM"}, {"code": "420", "type": "RC"}], "standard_charges": [{"gross_charge": 438.0, "discounted_cash": 328.5, "setting": "both", "billing_class": "facility"}], "modifiers": "GP|CQ"}, {"description": "PTA WHIRLPOOL BSC", "code_information": [{"code": "97022", "type": "CPT"}, {"code": "5700030", "type": "CDM"}, {"code": "420", "type": "RC"}], "standard_charges": [{"gross_charge": 576.0, "discounted_cash": 432.0, "setting": "both", "billing_class": "facility"}], "modifiers": "GP|CQ"}, {"description": "PTCH H VENTRIO MED OVAL", "code_information": [{"code": "C1781", "type": "HCPCS"}, {"code": "4024616", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 22950.0, "discounted_cash": 17212.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PTCH H VENTRIO ST MIDLN", "code_information": [{"code": "C1781", "type": "HCPCS"}, {"code": "4024622", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 42282.0, "discounted_cash": 31711.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PTT", "code_information": [{"code": "85730", "type": "CPT"}, {"code": "4105700", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 755.0, "discounted_cash": 566.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PTT", "code_information": [{"code": "85730", "type": "CPT"}, {"code": "4175700", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 5.71, "discounted_cash": 4.28, "setting": "both", "billing_class": "facility"}]}, {"description": "PTT", "code_information": [{"code": "85730", "type": "CPT"}, {"code": "7255730", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 9.0, "discounted_cash": 6.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PTT SUB EA FRACTION", "code_information": [{"code": "85732", "type": "CPT"}, {"code": "4105732", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 621.0, "discounted_cash": 465.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PTT SUB EA FRACTION", "code_information": [{"code": "85732", "type": "CPT"}, {"code": "4175732", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 25.69, "discounted_cash": 19.27, "setting": "both", "billing_class": "facility"}]}, {"description": "PTT SUB EA FRACTION", "code_information": [{"code": "85732", "type": "CPT"}, {"code": "7255732", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 162.0, "discounted_cash": 121.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PTT SUB EA FRACTION/3", "code_information": [{"code": "85732", "type": "CPT"}, {"code": "7255617", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 128.0, "discounted_cash": 96.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PTT SUB EA FRACTION/5", "code_information": [{"code": "85732", "type": "CPT"}, {"code": "7257542", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 43.0, "discounted_cash": 32.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PULSE OX SINGLE", "code_information": [{"code": "94760", "type": "CPT"}, {"code": "5502205", "type": "CDM"}, {"code": "460", "type": "RC"}], "standard_charges": [{"gross_charge": 272.0, "discounted_cash": 204.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PULSE OXIM MULT DETRM", "code_information": [{"code": "94761", "type": "CPT"}, {"code": "5504761", "type": "CDM"}, {"code": "460", "type": "RC"}], "standard_charges": [{"gross_charge": 407.0, "discounted_cash": 305.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PULSE OXIMTRY CONTINUOUS", "code_information": [{"code": "94762", "type": "CPT"}, {"code": "5504762", "type": "CDM"}, {"code": "460", "type": "RC"}], "standard_charges": [{"gross_charge": 714.0, "discounted_cash": 535.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PUNCH BX SKIN SINGLE LESION", "code_information": [{"code": "6901104", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 1230.0, "discounted_cash": 922.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PUNCH BX SKIN SINGLE LESION", "code_information": [{"code": "6901104", "type": "CDM"}, {"code": "361", "type": "RC"}], "standard_charges": [{"gross_charge": 1230.0, "discounted_cash": 922.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PUNTURE ASP ABSCESS/CYST", "code_information": [{"code": "10160", "type": "CPT"}, {"code": "5763104", "type": "CDM"}, {"code": "983", "type": "RC"}], "standard_charges": [{"gross_charge": 681.0, "discounted_cash": 510.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PURAPLY AM PER SQ CM", "code_information": [{"code": "Q4196", "type": "HCPCS"}, {"code": "4024264", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 1870.0, "discounted_cash": 1402.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PURAPLY AM PER SQ CM", "code_information": [{"code": "Q4196", "type": "HCPCS"}, {"code": "4024264", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 1870.0, "discounted_cash": 1402.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PUTTY OP-1 BMP7", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "4014499", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 476.0, "discounted_cash": 357.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PYRANTEL 50MG/ML 30ML LQ", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5316208", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 162.0, "discounted_cash": 121.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PYRANTEL 50MG/ML 30ML LQ", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5316208", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 162.0, "discounted_cash": 121.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PYRAZINAMIDE 500MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5310295", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 61.0, "discounted_cash": 45.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PYRAZINAMIDE 500MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5310295", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 61.0, "discounted_cash": 45.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PYRIDOSTIGMINE 60MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5310297", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 66.0, "discounted_cash": 49.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PYRIDOSTIGMINE 60MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5310297", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 66.0, "discounted_cash": 49.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PYRIDOXINE 50MG TB", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5310328", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 61.0, "discounted_cash": 45.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PYRIDOXINE 50MG TB", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5310328", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 61.0, "discounted_cash": 45.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PYRIDOXINE PER 100MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3415", "type": "HCPCS"}, {"code": "5323929", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 412.0, "discounted_cash": 309.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PYRIDOXINE PER 100MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3415", "type": "HCPCS"}, {"code": "5323929", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 412.0, "discounted_cash": 309.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PYRIDOXL PHOSPH VIT B6", "code_information": [{"code": "84207", "type": "CPT"}, {"code": "7254207", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 1243.0, "discounted_cash": 932.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PYRUVATE", "code_information": [{"code": "84210", "type": "CPT"}, {"code": "7254210", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 265.0, "discounted_cash": 198.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PYRUVATE KINASE", "code_information": [{"code": "84220", "type": "CPT"}, {"code": "7254220", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 965.0, "discounted_cash": 723.75, "setting": "both", "billing_class": "facility"}]}, {"description": "Q FEVER AB", "code_information": [{"code": "86638", "type": "CPT"}, {"code": "7256541", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 104.0, "discounted_cash": 78.0, "setting": "both", "billing_class": "facility"}]}, {"description": "Q FEVER AB/3", "code_information": [{"code": "86638", "type": "CPT"}, {"code": "7256639", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 239.0, "discounted_cash": 179.25, "setting": "both", "billing_class": "facility"}]}, {"description": "QUANT OF DRUG NES", "code_information": [{"code": "80299", "type": "CPT"}, {"code": "4100094", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 171.0, "discounted_cash": 128.25, "setting": "both", "billing_class": "facility"}]}, {"description": "QUANT OF DRUG NES", "code_information": [{"code": "80299", "type": "CPT"}, {"code": "7250299", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 585.0, "discounted_cash": 438.75, "setting": "both", "billing_class": "facility"}]}, {"description": "QUANT OF DRUG NES", "code_information": [{"code": "80299", "type": "CPT"}, {"code": "7250315", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 183.0, "discounted_cash": 137.25, "setting": "both", "billing_class": "facility"}]}, {"description": "QUETIAPINE 100MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5310371", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 114.0, "discounted_cash": 85.5, "setting": "both", "billing_class": "facility"}]}, {"description": "QUETIAPINE 100MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5310371", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 114.0, "discounted_cash": 85.5, "setting": "both", "billing_class": "facility"}]}, {"description": "QUETIAPINE 150MG XR TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5310379", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 313.0, "discounted_cash": 234.75, "setting": "both", "billing_class": "facility"}]}, {"description": "QUETIAPINE 150MG XR TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5310379", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 313.0, "discounted_cash": 234.75, "setting": "both", "billing_class": "facility"}]}, {"description": "QUETIAPINE 200MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5310372", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 201.0, "discounted_cash": 150.75, "setting": "both", "billing_class": "facility"}]}, {"description": "QUETIAPINE 200MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5310372", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 201.0, "discounted_cash": 150.75, "setting": "both", "billing_class": "facility"}]}, {"description": "QUETIAPINE 200MG XR TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5310376", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 203.0, "discounted_cash": 152.25, "setting": "both", "billing_class": "facility"}]}, {"description": "QUETIAPINE 200MG XR TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5310376", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 203.0, "discounted_cash": 152.25, "setting": "both", "billing_class": "facility"}]}, {"description": "QUETIAPINE 25MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5310370", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 66.0, "discounted_cash": 49.5, "setting": "both", "billing_class": "facility"}]}, {"description": "QUETIAPINE 25MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5310370", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 66.0, "discounted_cash": 49.5, "setting": "both", "billing_class": "facility"}]}, {"description": "QUETIAPINE 300MG XR TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5310377", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 256.0, "discounted_cash": 192.0, "setting": "both", "billing_class": "facility"}]}, {"description": "QUETIAPINE 300MG XR TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5310377", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 256.0, "discounted_cash": 192.0, "setting": "both", "billing_class": "facility"}]}, {"description": "QUETIAPINE 400MG XR TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5310378", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 313.0, "discounted_cash": 234.75, "setting": "both", "billing_class": "facility"}]}, {"description": "QUETIAPINE 400MG XR TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5310378", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 313.0, "discounted_cash": 234.75, "setting": "both", "billing_class": "facility"}]}, {"description": "QUETIAPINE 50MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5310373", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 125.0, "discounted_cash": 93.75, "setting": "both", "billing_class": "facility"}]}, {"description": "QUETIAPINE 50MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5310373", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 125.0, "discounted_cash": 93.75, "setting": "both", "billing_class": "facility"}]}, {"description": "QUETIAPINE 50MG XR TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5310368", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 166.0, "discounted_cash": 124.5, "setting": "both", "billing_class": "facility"}]}, {"description": "QUETIAPINE 50MG XR TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5310368", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 166.0, "discounted_cash": 124.5, "setting": "both", "billing_class": "facility"}]}, {"description": "QUINAPRIL 20MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5310399", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 85.0, "discounted_cash": 63.75, "setting": "both", "billing_class": "facility"}]}, {"description": "QUINAPRIL 20MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5310399", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 85.0, "discounted_cash": 63.75, "setting": "both", "billing_class": "facility"}]}, {"description": "QUINAPRIL 5MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5310397", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 85.0, "discounted_cash": 63.75, "setting": "both", "billing_class": "facility"}]}, {"description": "QUINAPRIL 5MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5310397", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 85.0, "discounted_cash": 63.75, "setting": "both", "billing_class": "facility"}]}, {"description": "QUINIDIN GLUC324MG XR TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5310459", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 85.0, "discounted_cash": 63.75, "setting": "both", "billing_class": "facility"}]}, {"description": "QUINIDIN GLUC324MG XR TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5310459", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 85.0, "discounted_cash": 63.75, "setting": "both", "billing_class": "facility"}]}, {"description": "QUINIDINE", "code_information": [{"code": "80194", "type": "CPT"}, {"code": "7254230", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 532.0, "discounted_cash": 399.0, "setting": "both", "billing_class": "facility"}]}, {"description": "QUINIDINE 300MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5310451", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 85.0, "discounted_cash": 63.75, "setting": "both", "billing_class": "facility"}]}, {"description": "QUINIDINE 300MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5310451", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 85.0, "discounted_cash": 63.75, "setting": "both", "billing_class": "facility"}]}, {"description": "QUININE 324MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5310483", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 183.0, "discounted_cash": 137.25, "setting": "both", "billing_class": "facility"}]}, {"description": "QUININE 324MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5310483", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 183.0, "discounted_cash": 137.25, "setting": "both", "billing_class": "facility"}]}, {"description": "QUINUPR/DALFOPR 500MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J2770", "type": "HCPCS"}, {"code": "5324419", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 5211.0, "discounted_cash": 3908.25, "setting": "both", "billing_class": "facility"}]}, {"description": "QUINUPR/DALFOPR 500MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J2770", "type": "HCPCS"}, {"code": "5324419", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 5211.0, "discounted_cash": 3908.25, "setting": "both", "billing_class": "facility"}]}, {"description": "RABIES IG HT PER150U IJ", "code_information": [{"code": "90376", "type": "CPT"}, {"code": "5323979", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 4846.0, "discounted_cash": 3634.5, "setting": "both", "billing_class": "facility"}]}, {"description": "RABIES IG HT PER150U IJ", "code_information": [{"code": "90376", "type": "CPT"}, {"code": "5323979", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 4846.0, "discounted_cash": 3634.5, "setting": "both", "billing_class": "facility"}]}, {"description": "RABIES IG IM/SC 150U IJ", "code_information": [{"code": "90375", "type": "CPT"}, {"code": "5323970", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 4846.0, "discounted_cash": 3634.5, "setting": "both", "billing_class": "facility"}]}, {"description": "RABIES IG IM/SC 150U IJ", "code_information": [{"code": "90375", "type": "CPT"}, {"code": "5323970", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 4846.0, "discounted_cash": 3634.5, "setting": "both", "billing_class": "facility"}]}, {"description": "RABIES VACCINE IM IJ", "code_information": [{"code": "90675", "type": "CPT"}, {"code": "5323974", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 4624.0, "discounted_cash": 3468.0, "setting": "both", "billing_class": "facility"}]}, {"description": "RABIES VACCINE IM IJ", "code_information": [{"code": "90675", "type": "CPT"}, {"code": "5323974", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 4624.0, "discounted_cash": 3468.0, "setting": "both", "billing_class": "facility"}]}, {"description": "RADIOPHARM TO INPATIENT", "code_information": [{"code": "C9898", "type": "HCPCS"}, {"code": "5199898", "type": "CDM"}, {"code": "343", "type": "RC"}], "standard_charges": [{"gross_charge": 2.0, "discounted_cash": 1.5, "setting": "both", "billing_class": "facility"}]}, {"description": "RADPHARM TX ORAL", "code_information": [{"code": "79005", "type": "CPT"}, {"code": "5209005", "type": "CDM"}, {"code": "342", "type": "RC"}], "standard_charges": [{"gross_charge": 8676.0, "discounted_cash": 6507.0, "setting": "both", "billing_class": "facility"}]}, {"description": "RALOXIFENE 60MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5310487", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 120.0, "discounted_cash": 90.0, "setting": "both", "billing_class": "facility"}]}, {"description": "RALOXIFENE 60MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5310487", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 120.0, "discounted_cash": 90.0, "setting": "both", "billing_class": "facility"}]}, {"description": "RAMELTEON 8MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5310488", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 110.0, "discounted_cash": 82.5, "setting": "both", "billing_class": "facility"}]}, {"description": "RAMELTEON 8MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5310488", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 110.0, "discounted_cash": 82.5, "setting": "both", "billing_class": "facility"}]}, {"description": "RAMIPRIL 2.5MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5310490", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 85.0, "discounted_cash": 63.75, "setting": "both", "billing_class": "facility"}]}, {"description": "RAMIPRIL 2.5MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5310490", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 85.0, "discounted_cash": 63.75, "setting": "both", "billing_class": "facility"}]}, {"description": "RAMIPRIL 5MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5310491", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 85.0, "discounted_cash": 63.75, "setting": "both", "billing_class": "facility"}]}, {"description": "RAMIPRIL 5MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5310491", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 85.0, "discounted_cash": 63.75, "setting": "both", "billing_class": "facility"}]}, {"description": "RANITIDINE 150MG/10ML LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5316245", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 203.0, "discounted_cash": 152.25, "setting": "both", "billing_class": "facility"}]}, {"description": "RANITIDINE 150MG/10ML LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5316245", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 203.0, "discounted_cash": 152.25, "setting": "both", "billing_class": "facility"}]}, {"description": "RANITIDINE 15MG/ML 1MLLQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5316239", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 66.0, "discounted_cash": 49.5, "setting": "both", "billing_class": "facility"}]}, {"description": "RANITIDINE 15MG/ML 1MLLQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5316239", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 66.0, "discounted_cash": 49.5, "setting": "both", "billing_class": "facility"}]}, {"description": "RANITIDINE PED PER1ML IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5323962", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 77.0, "discounted_cash": 57.75, "setting": "both", "billing_class": "facility"}]}, {"description": "RANOLAZINE 500MG XR TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5310520", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 111.0, "discounted_cash": 83.25, "setting": "both", "billing_class": "facility"}]}, {"description": "RANOLAZINE 500MG XR TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5310520", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 111.0, "discounted_cash": 83.25, "setting": "both", "billing_class": "facility"}]}, {"description": "RATE ADJUSTMENT - ATB", "code_information": [{"code": "9970001", "type": "CDM"}, {"code": "990", "type": "RC"}], "standard_charges": [{"gross_charge": 0.01, "discounted_cash": 0.01, "setting": "both", "billing_class": "facility"}]}, {"description": "RATE ADJUSTMENT - OTHER", "code_information": [{"code": "9970002", "type": "CDM"}, {"code": "990", "type": "RC"}], "standard_charges": [{"gross_charge": 0.01, "discounted_cash": 0.01, "setting": "both", "billing_class": "facility"}]}, {"description": "RBC AG EXCPT ABO/RHO EA", "code_information": [{"code": "86905", "type": "CPT"}, {"code": "4106095", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 552.0, "discounted_cash": 414.0, "setting": "both", "billing_class": "facility"}]}, {"description": "RBC AG EXCPT ABO/RHO EA/2", "code_information": [{"code": "86905", "type": "CPT"}, {"code": "4176905", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 51.37, "discounted_cash": 38.53, "setting": "both", "billing_class": "facility"}]}, {"description": "RBC ANTIBDY ELUTION EACH", "code_information": [{"code": "86860", "type": "CPT"}, {"code": "4106019", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 428.0, "discounted_cash": 321.0, "setting": "both", "billing_class": "facility"}]}, {"description": "RBC ANTIBDY ELUTION EACH", "code_information": [{"code": "86860", "type": "CPT"}, {"code": "4176019", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 27.11, "discounted_cash": 20.33, "setting": "both", "billing_class": "facility"}]}, {"description": "RBC ANTIBDY ELUTION EACH", "code_information": [{"code": "86860", "type": "CPT"}, {"code": "7016019", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 329.0, "discounted_cash": 246.75, "setting": "both", "billing_class": "facility"}]}, {"description": "RBC ANTIBODIES SCREEN", "code_information": [{"code": "86850", "type": "CPT"}, {"code": "4106016", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 626.0, "discounted_cash": 469.5, "setting": "both", "billing_class": "facility"}]}, {"description": "RBC ANTIBODIES SCREEN", "code_information": [{"code": "86850", "type": "CPT"}, {"code": "4176016", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 7.79, "discounted_cash": 5.84, "setting": "both", "billing_class": "facility"}]}, {"description": "RBC ANTIBODIES SCREEN", "code_information": [{"code": "86850", "type": "CPT"}, {"code": "7016016", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 336.0, "discounted_cash": 252.0, "setting": "both", "billing_class": "facility"}]}, {"description": "RBC AUTO", "code_information": [{"code": "85041", "type": "CPT"}, {"code": "7255041", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 60.0, "discounted_cash": 45.0, "setting": "both", "billing_class": "facility"}]}, {"description": "RBC LEUKO RED CMV NEG EA", "code_information": [{"code": "P9051", "type": "HCPCS"}, {"code": "4509051", "type": "CDM"}, {"code": "399", "type": "RC"}], "standard_charges": [{"gross_charge": 1099.0, "discounted_cash": 824.25, "setting": "both", "billing_class": "facility"}]}, {"description": "RBC LEUKORED IRRAD", "code_information": [{"code": "P9040", "type": "HCPCS"}, {"code": "4506023", "type": "CDM"}, {"code": "399", "type": "RC"}], "standard_charges": [{"gross_charge": 1086.0, "discounted_cash": 814.5, "setting": "both", "billing_class": "facility"}]}, {"description": "RBC LEUKORED IRRAD PED", "code_information": [{"code": "P9040", "type": "HCPCS"}, {"code": "4509042", "type": "CDM"}, {"code": "399", "type": "RC"}], "standard_charges": [{"gross_charge": 1086.0, "discounted_cash": 814.5, "setting": "both", "billing_class": "facility"}]}, {"description": "RBC LEUKOREDUCED PED", "code_information": [{"code": "P9016", "type": "HCPCS"}, {"code": "4509025", "type": "CDM"}, {"code": "399", "type": "RC"}], "standard_charges": [{"gross_charge": 942.0, "discounted_cash": 706.5, "setting": "both", "billing_class": "facility"}]}, {"description": "RBTCS DAVN LVL II EA 15 MIN", "code_information": [{"code": "3213573", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 5620.0, "discounted_cash": 4215.0, "setting": "both", "billing_class": "facility"}]}, {"description": "RBTCS DAVN LVL II INT 30 MIN", "code_information": [{"code": "3213572", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 13648.0, "discounted_cash": 10236.0, "setting": "both", "billing_class": "facility"}]}, {"description": "RBTCS DAVN LVL III EA 15 MIN", "code_information": [{"code": "3213575", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 6063.0, "discounted_cash": 4547.25, "setting": "both", "billing_class": "facility"}]}, {"description": "RBTCS DAVN LVL III INT 30 MIN", "code_information": [{"code": "3213574", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 14780.0, "discounted_cash": 11085.0, "setting": "both", "billing_class": "facility"}]}, {"description": "RBTCS DAVN LVL IV EA 15 MIN", "code_information": [{"code": "3213577", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 6925.0, "discounted_cash": 5193.75, "setting": "both", "billing_class": "facility"}]}, {"description": "RBTCS DAVN LVL IV INT 30 MIN", "code_information": [{"code": "3213576", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 15760.0, "discounted_cash": 11820.0, "setting": "both", "billing_class": "facility"}]}, {"description": "RD CARBON", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8135003", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 4176.0, "discounted_cash": 3132.0, "setting": "both", "billing_class": "facility"}]}, {"description": "RD CARBON", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8135004", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 2112.0, "discounted_cash": 1584.0, "setting": "both", "billing_class": "facility"}]}, {"description": "RD SPINAL", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8135030", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 3922.0, "discounted_cash": 2941.5, "setting": "both", "billing_class": "facility"}]}, {"description": "RD SPINAL 1", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8135035", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 6359.0, "discounted_cash": 4769.25, "setting": "both", "billing_class": "facility"}]}, {"description": "RD TYPE I", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8135002", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 977.0, "discounted_cash": 732.75, "setting": "both", "billing_class": "facility"}]}, {"description": "RD TYPE II", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8135001", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 19077.0, "discounted_cash": 14307.75, "setting": "both", "billing_class": "facility"}]}, {"description": "RD TYPE IV", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8135008", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 19608.0, "discounted_cash": 14706.0, "setting": "both", "billing_class": "facility"}]}, {"description": "RECEPT ASSAY NON-ENDOCRN/2", "code_information": [{"code": "84238", "type": "CPT"}, {"code": "4104467", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 3626.0, "discounted_cash": 2719.5, "setting": "both", "billing_class": "facility"}]}, {"description": "RECEPT ASSAY NON-ENDOCRN/7", "code_information": [{"code": "84238", "type": "CPT"}, {"code": "7258443", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 483.0, "discounted_cash": 362.25, "setting": "both", "billing_class": "facility"}]}, {"description": "RECOVERY EA ADD 15 MIN", "code_information": [{"code": "3203400", "type": "CDM"}, {"code": "710", "type": "RC"}], "standard_charges": [{"gross_charge": 1666.0, "discounted_cash": 1249.5, "setting": "both", "billing_class": "facility"}]}, {"description": "RECOVERY EA ADDL 15 MIN", "code_information": [{"code": "3223571", "type": "CDM"}, {"code": "710", "type": "RC"}], "standard_charges": [{"gross_charge": 1369.0, "discounted_cash": 1026.75, "setting": "both", "billing_class": "facility"}]}, {"description": "RECOVERY INIT 30 MIN", "code_information": [{"code": "3203450", "type": "CDM"}, {"code": "710", "type": "RC"}], "standard_charges": [{"gross_charge": 2710.0, "discounted_cash": 2032.5, "setting": "both", "billing_class": "facility"}]}, {"description": "RECOVERY INIT 30 MIN", "code_information": [{"code": "3223570", "type": "CDM"}, {"code": "710", "type": "RC"}], "standard_charges": [{"gross_charge": 3739.0, "discounted_cash": 2804.25, "setting": "both", "billing_class": "facility"}]}, {"description": "RECTAL MOTILITY", "code_information": [{"code": "91122", "type": "CPT"}, {"code": "5071008", "type": "CDM"}, {"code": "750", "type": "RC"}], "standard_charges": [{"gross_charge": 5620.0, "discounted_cash": 4215.0, "setting": "both", "billing_class": "facility"}]}, {"description": "REGADENOSON PER 0.1MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J2785", "type": "HCPCS"}, {"code": "5323992", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 1114.0, "discounted_cash": 835.5, "setting": "both", "billing_class": "facility"}]}, {"description": "REGADENOSON PER 0.1MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J2785", "type": "HCPCS"}, {"code": "5323992", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 1114.0, "discounted_cash": 835.5, "setting": "both", "billing_class": "facility"}]}, {"description": "RELOCATE SKIN PKT AICD", "code_information": [{"code": "4613223", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 10751.0, "discounted_cash": 8063.25, "setting": "both", "billing_class": "facility"}]}, {"description": "REM AICD LDS TRANSVEN", "code_information": [{"code": "4613243", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 9990.0, "discounted_cash": 7492.5, "setting": "both", "billing_class": "facility"}]}, {"description": "REM AICD PULS GEN", "code_information": [{"code": "4613241", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 12813.0, "discounted_cash": 9609.75, "setting": "both", "billing_class": "facility"}]}, {"description": "REM ENDO VENA CAVA FILTR", "code_information": [{"code": "4617193", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 25245.0, "discounted_cash": 18933.75, "setting": "both", "billing_class": "facility"}]}, {"description": "REM ENDO VENA CAVA FILTR", "code_information": [{"code": "4917193", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 25245.0, "discounted_cash": 18933.75, "setting": "both", "billing_class": "facility"}]}, {"description": "REM INTRLMNL OBST CV CTH", "code_information": [{"code": "4916537", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 5475.0, "discounted_cash": 4106.25, "setting": "both", "billing_class": "facility"}]}, {"description": "REM INTRLMNL OBST CV CTH", "code_information": [{"code": "75902", "type": "CPT"}, {"code": "4915902", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 1430.0, "discounted_cash": 1072.5, "setting": "both", "billing_class": "facility"}]}, {"description": "REM PCMKR PULS GEN ONLY", "code_information": [{"code": "4612503", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 9970.0, "discounted_cash": 7477.5, "setting": "both", "billing_class": "facility"}]}, {"description": "REM PCMKR TRAN ELCT DUAL", "code_information": [{"code": "4612500", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 19546.0, "discounted_cash": 14659.5, "setting": "both", "billing_class": "facility"}]}, {"description": "REM PERICTH OBST CV CATH", "code_information": [{"code": "4916536", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 11309.0, "discounted_cash": 8481.75, "setting": "both", "billing_class": "facility"}]}, {"description": "REM PERICTH OBST CV CATH", "code_information": [{"code": "75901", "type": "CPT"}, {"code": "4915901", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 2324.0, "discounted_cash": 1743.0, "setting": "both", "billing_class": "facility"}]}, {"description": "REM PPM LDLES VENTR", "code_information": [{"code": "4610388", "type": "CDM"}, {"code": "480", "type": "RC"}], "standard_charges": [{"gross_charge": 17516.0, "discounted_cash": 13137.0, "setting": "both", "billing_class": "facility"}]}, {"description": "REM PPM LDLES VENTR", "code_information": [{"code": "4610388", "type": "CDM"}, {"code": "481", "type": "RC"}], "standard_charges": [{"gross_charge": 17516.0, "discounted_cash": 13137.0, "setting": "both", "billing_class": "facility"}]}, {"description": "REM TRANSV PM ELCTD SNGL", "code_information": [{"code": "4612515", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 22841.0, "discounted_cash": 17130.75, "setting": "both", "billing_class": "facility"}]}, {"description": "REM TUNNLD INTRAPER CATH", "code_information": [{"code": "4919422", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 17498.0, "discounted_cash": 13123.5, "setting": "both", "billing_class": "facility"}]}, {"description": "REM TUNNLD PLEURL CATH", "code_information": [{"code": "4910025", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 4674.0, "discounted_cash": 3505.5, "setting": "both", "billing_class": "facility"}]}, {"description": "REM/REPL AICD DUAL LD", "code_information": [{"code": "4616263", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 173626.0, "discounted_cash": 130219.5, "setting": "both", "billing_class": "facility"}]}, {"description": "REM/REPL AICD MULT LD", "code_information": [{"code": "4616264", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 178406.0, "discounted_cash": 133804.5, "setting": "both", "billing_class": "facility"}]}, {"description": "REM/REPL AICD SINGL LD", "code_information": [{"code": "4613262", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 178406.0, "discounted_cash": 133804.5, "setting": "both", "billing_class": "facility"}]}, {"description": "REM/REPL PM GEN DUAL LD", "code_information": [{"code": "4613228", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 47448.0, "discounted_cash": 35586.0, "setting": "both", "billing_class": "facility"}]}, {"description": "REM/REPL PM GEN SGL LD", "code_information": [{"code": "4613227", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 47189.0, "discounted_cash": 35391.75, "setting": "both", "billing_class": "facility"}]}, {"description": "REM/REPL PM MULT LDS", "code_information": [{"code": "4613229", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 54829.0, "discounted_cash": 41121.75, "setting": "both", "billing_class": "facility"}]}, {"description": "REMDESIVIR PER 1MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0248", "type": "HCPCS"}, {"code": "5324000", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 26.31, "discounted_cash": 19.73, "setting": "both", "billing_class": "facility"}]}, {"description": "REMDESIVIR PER 1MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0248", "type": "HCPCS"}, {"code": "5324000", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 26.31, "discounted_cash": 19.73, "setting": "both", "billing_class": "facility"}]}, {"description": "REMOVAL FOREIGN BODY SQ", "code_information": [{"code": "10120", "type": "CPT"}, {"code": "5763101", "type": "CDM"}, {"code": "983", "type": "RC"}], "standard_charges": [{"gross_charge": 3266.0, "discounted_cash": 2449.5, "setting": "both", "billing_class": "facility"}]}, {"description": "REMOVE BILI DRAIN CATH", "code_information": [{"code": "4917537", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 2810.0, "discounted_cash": 2107.5, "setting": "both", "billing_class": "facility"}]}, {"description": "REMOVE FOREIGN BODY COMPLEX", "code_information": [{"code": "6900121", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 11470.0, "discounted_cash": 8602.5, "setting": "both", "billing_class": "facility"}]}, {"description": "REMOVE FOREIGN BODY COMPLEX", "code_information": [{"code": "6900121", "type": "CDM"}, {"code": "361", "type": "RC"}], "standard_charges": [{"gross_charge": 11470.0, "discounted_cash": 8602.5, "setting": "both", "billing_class": "facility"}]}, {"description": "REMOVE PERC LEFT HEART VAD", "code_information": [{"code": "4613992", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 4289.0, "discounted_cash": 3216.75, "setting": "both", "billing_class": "facility"}]}, {"description": "REMOVE SINGLE NAIL PLATE", "code_information": [{"code": "6900033", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 787.0, "discounted_cash": 590.25, "setting": "both", "billing_class": "facility"}]}, {"description": "REMOVE SINGLE NAIL PLATE", "code_information": [{"code": "6900033", "type": "CDM"}, {"code": "361", "type": "RC"}], "standard_charges": [{"gross_charge": 787.0, "discounted_cash": 590.25, "setting": "both", "billing_class": "facility"}]}, {"description": "REMV TUNL CVC WO PMP/PRT", "code_information": [{"code": "4916589", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 5404.0, "discounted_cash": 4053.0, "setting": "both", "billing_class": "facility"}]}, {"description": "REMVE RENL TUBE W/FLUORO", "code_information": [{"code": "4914238", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 1697.0, "discounted_cash": 1272.75, "setting": "both", "billing_class": "facility"}]}, {"description": "RENAL FUNCTION PANEL", "code_information": [{"code": "80069", "type": "CPT"}, {"code": "4100069", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 694.0, "discounted_cash": 520.5, "setting": "both", "billing_class": "facility"}]}, {"description": "RENAL FUNCTION PANEL", "code_information": [{"code": "80069", "type": "CPT"}, {"code": "4170069", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 5.71, "discounted_cash": 4.28, "setting": "both", "billing_class": "facility"}]}, {"description": "RENIN", "code_information": [{"code": "84244", "type": "CPT"}, {"code": "7258424", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 1487.0, "discounted_cash": 1115.25, "setting": "both", "billing_class": "facility"}]}, {"description": "REPAGLINIDE 0.5MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5310552", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 78.0, "discounted_cash": 58.5, "setting": "both", "billing_class": "facility"}]}, {"description": "REPAGLINIDE 0.5MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5310552", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 78.0, "discounted_cash": 58.5, "setting": "both", "billing_class": "facility"}]}, {"description": "REPAGLINIDE 1MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5310553", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 78.0, "discounted_cash": 58.5, "setting": "both", "billing_class": "facility"}]}, {"description": "REPAGLINIDE 1MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5310553", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 78.0, "discounted_cash": 58.5, "setting": "both", "billing_class": "facility"}]}, {"description": "REPAGLINIDE 2MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5310554", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 183.0, "discounted_cash": 137.25, "setting": "both", "billing_class": "facility"}]}, {"description": "REPAGLINIDE 2MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5310554", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 183.0, "discounted_cash": 137.25, "setting": "both", "billing_class": "facility"}]}, {"description": "REPAIR CV CATH WO SQ PMP", "code_information": [{"code": "4916575", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 9048.0, "discounted_cash": 6786.0, "setting": "both", "billing_class": "facility"}]}, {"description": "REPL GASTRO TUBE W/FLUOR", "code_information": [{"code": "4919450", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 2188.0, "discounted_cash": 1641.0, "setting": "both", "billing_class": "facility"}]}, {"description": "REPL GJ TUBE W/FLUOR", "code_information": [{"code": "4919453", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 2528.0, "discounted_cash": 1896.0, "setting": "both", "billing_class": "facility"}]}, {"description": "REPL J-TUBE W/FLUOR", "code_information": [{"code": "4919452", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 2654.0, "discounted_cash": 1990.5, "setting": "both", "billing_class": "facility"}]}, {"description": "REPLACE TUNNELED CV CATH", "code_information": [{"code": "4916581", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 9287.0, "discounted_cash": 6965.25, "setting": "both", "billing_class": "facility"}]}, {"description": "REPLC COMP CVAD W SQ PRT", "code_information": [{"code": "4916585", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 18966.0, "discounted_cash": 14224.5, "setting": "both", "billing_class": "facility"}]}, {"description": "REPLCE CATH ONLY CVAD", "code_information": [{"code": "4916578", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 12749.0, "discounted_cash": 9561.75, "setting": "both", "billing_class": "facility"}]}, {"description": "REPLCE NON-TUNNL CV CATH", "code_information": [{"code": "4916580", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 5065.0, "discounted_cash": 3798.75, "setting": "both", "billing_class": "facility"}]}, {"description": "REPOS ENDO VENACAVA FILT", "code_information": [{"code": "4917192", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 24092.0, "discounted_cash": 18069.0, "setting": "both", "billing_class": "facility"}]}, {"description": "REPOS VAD PERC W/IMAGING", "code_information": [{"code": "4613993", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 3098.0, "discounted_cash": 2323.5, "setting": "both", "billing_class": "facility"}]}, {"description": "REPOSITN CV CATH W/FLURO", "code_information": [{"code": "4914240", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 3313.0, "discounted_cash": 2484.75, "setting": "both", "billing_class": "facility"}]}, {"description": "REPS PREV LD VEN LTVENT", "code_information": [{"code": "4613226", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 17070.0, "discounted_cash": 12802.5, "setting": "both", "billing_class": "facility"}]}, {"description": "REPS TRNSV LD RT ATR/VNT", "code_information": [{"code": "4613215", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 10106.0, "discounted_cash": 7579.5, "setting": "both", "billing_class": "facility"}]}, {"description": "REPTILASE TEST", "code_information": [{"code": "85635", "type": "CPT"}, {"code": "7255635", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 112.0, "discounted_cash": 84.0, "setting": "both", "billing_class": "facility"}]}, {"description": "RESER OMAYA", "code_information": [{"code": "C1729", "type": "HCPCS"}, {"code": "8144175", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 4135.0, "discounted_cash": 3101.25, "setting": "both", "billing_class": "facility"}]}, {"description": "RESER OMAYA", "code_information": [{"code": "C1729", "type": "HCPCS"}, {"code": "8155032", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 5808.0, "discounted_cash": 4356.0, "setting": "both", "billing_class": "facility"}]}, {"description": "RESERV PENL PROSTH FLAT", "code_information": [{"code": "C1813", "type": "HCPCS"}, {"code": "8155034", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 27994.0, "discounted_cash": 20995.5, "setting": "both", "billing_class": "facility"}]}, {"description": "RESP VIRUS 12-25 AMP PROBE", "code_information": [{"code": "87633", "type": "CPT"}, {"code": "4107633", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 1179.0, "discounted_cash": 884.25, "setting": "both", "billing_class": "facility"}]}, {"description": "RESP VIRUS 12-25 AMP PROBE", "code_information": [{"code": "87633", "type": "CPT"}, {"code": "7257633", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 420.0, "discounted_cash": 315.0, "setting": "both", "billing_class": "facility"}]}, {"description": "RESPI SYNC VIRUS DIR OPT", "code_information": [{"code": "87807", "type": "CPT"}, {"code": "4100025", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 1020.0, "discounted_cash": 765.0, "setting": "both", "billing_class": "facility"}]}, {"description": "RESPI SYNCTIAL VIRUS AB", "code_information": [{"code": "86756", "type": "CPT"}, {"code": "7256756", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 889.0, "discounted_cash": 666.75, "setting": "both", "billing_class": "facility"}]}, {"description": "RETICULIN AB/2", "code_information": [{"code": "86255", "type": "CPT"}, {"code": "7258670", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 113.0, "discounted_cash": 84.75, "setting": "both", "billing_class": "facility"}]}, {"description": "RETICULOCYTE COUNT AUTO", "code_information": [{"code": "85045", "type": "CPT"}, {"code": "4105045", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 550.0, "discounted_cash": 412.5, "setting": "both", "billing_class": "facility"}]}, {"description": "RETICULOCYTE COUNT AUTO", "code_information": [{"code": "85045", "type": "CPT"}, {"code": "4175045", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 9.98, "discounted_cash": 7.49, "setting": "both", "billing_class": "facility"}]}, {"description": "REVAS PERC TRANS OCC ADD", "code_information": [{"code": "92944", "type": "CPT"}, {"code": "4612944", "type": "CDM"}, {"code": "480", "type": "RC"}], "standard_charges": [{"gross_charge": 47708.0, "discounted_cash": 35781.0, "setting": "both", "billing_class": "facility"}]}, {"description": "REVAS PERC TRANS OCCL MI", "code_information": [{"code": "92941", "type": "CPT"}, {"code": "4612941", "type": "CDM"}, {"code": "480", "type": "RC"}], "standard_charges": [{"gross_charge": 46916.0, "discounted_cash": 35187.0, "setting": "both", "billing_class": "facility"}]}, {"description": "REVAS PERC TRANS SGL VES", "code_information": [{"code": "92937", "type": "CPT"}, {"code": "4612937", "type": "CDM"}, {"code": "480", "type": "RC"}], "standard_charges": [{"gross_charge": 47359.0, "discounted_cash": 35519.25, "setting": "both", "billing_class": "facility"}]}, {"description": "REVAS PERC TRANS TOT OCC", "code_information": [{"code": "92943", "type": "CPT"}, {"code": "4612943", "type": "CDM"}, {"code": "480", "type": "RC"}], "standard_charges": [{"gross_charge": 47359.0, "discounted_cash": 35519.25, "setting": "both", "billing_class": "facility"}]}, {"description": "REVASC FEMPOP STNT ATHER", "code_information": [{"code": "4610235", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 123838.0, "discounted_cash": 92878.5, "setting": "both", "billing_class": "facility"}]}, {"description": "REVASC FEMPOP STNT ATHER", "code_information": [{"code": "4918182", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 136987.0, "discounted_cash": 102740.25, "setting": "both", "billing_class": "facility"}]}, {"description": "REVASC FEMPOP W/ATHER", "code_information": [{"code": "4610233", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 53177.0, "discounted_cash": 39882.75, "setting": "both", "billing_class": "facility"}]}, {"description": "REVASC FEMPOP W/STENT", "code_information": [{"code": "4610231", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 46359.0, "discounted_cash": 34769.25, "setting": "both", "billing_class": "facility"}]}, {"description": "REVASC FEMPOP W/STENT", "code_information": [{"code": "4918178", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 68949.0, "discounted_cash": 51711.75, "setting": "both", "billing_class": "facility"}]}, {"description": "REVASC FEMPOP W/TLA", "code_information": [{"code": "4610229", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 23767.0, "discounted_cash": 17825.25, "setting": "both", "billing_class": "facility"}]}, {"description": "REVASC FEMPOP W/TLA", "code_information": [{"code": "4918176", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 32486.0, "discounted_cash": 24364.5, "setting": "both", "billing_class": "facility"}]}, {"description": "REVASC ILI W/STENT ADD/O", "code_information": [{"code": "4610227", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 32247.0, "discounted_cash": 24185.25, "setting": "both", "billing_class": "facility"}]}, {"description": "REVASC ILIAC ADD ON", "code_information": [{"code": "4610223", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 37264.0, "discounted_cash": 27948.0, "setting": "both", "billing_class": "facility"}]}, {"description": "REVASC ILIAC INITIAL", "code_information": [{"code": "4610221", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 25790.0, "discounted_cash": 19342.5, "setting": "both", "billing_class": "facility"}]}, {"description": "REVASC ILIAC INITIAL", "code_information": [{"code": "4918168", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 32486.0, "discounted_cash": 24364.5, "setting": "both", "billing_class": "facility"}]}, {"description": "REVASC ILIAC W/STENT", "code_information": [{"code": "4610225", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 23767.0, "discounted_cash": 17825.25, "setting": "both", "billing_class": "facility"}]}, {"description": "REVASC ILIAC W/STENT", "code_information": [{"code": "4918172", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 32486.0, "discounted_cash": 24364.5, "setting": "both", "billing_class": "facility"}]}, {"description": "REVASC INTRAVASC LITHO+ATHER", "code_information": [{"code": "4619766", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 50809.0, "discounted_cash": 38106.75, "setting": "both", "billing_class": "facility"}]}, {"description": "REVASC INTRAVASC LITHO+ATHER", "code_information": [{"code": "4619774", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 50809.0, "discounted_cash": 38106.75, "setting": "both", "billing_class": "facility"}]}, {"description": "REVASC INTRAVASC LITHO+PLASTY", "code_information": [{"code": "4619772", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 31399.0, "discounted_cash": 23549.25, "setting": "both", "billing_class": "facility"}]}, {"description": "REVASC INTRAVASC LITHO+STENT", "code_information": [{"code": "4619765", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 50809.0, "discounted_cash": 38106.75, "setting": "both", "billing_class": "facility"}]}, {"description": "REVASC INTRAVASC LITHO+STNT", "code_information": [{"code": "4619773", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 50809.0, "discounted_cash": 38106.75, "setting": "both", "billing_class": "facility"}]}, {"description": "REVASC INTRAVASC LITHOTRIP", "code_information": [{"code": "4619764", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 31399.0, "discounted_cash": 23549.25, "setting": "both", "billing_class": "facility"}]}, {"description": "REVASC INTVASC LITH+STNT+ATHER", "code_information": [{"code": "4619767", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 50809.0, "discounted_cash": 38106.75, "setting": "both", "billing_class": "facility"}]}, {"description": "REVASC INTVASC LITH+STNT+ATHER", "code_information": [{"code": "4619775", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 50809.0, "discounted_cash": 38106.75, "setting": "both", "billing_class": "facility"}]}, {"description": "REVASC TIB PER ADD ON", "code_information": [{"code": "4610239", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 27310.0, "discounted_cash": 20482.5, "setting": "both", "billing_class": "facility"}]}, {"description": "REVASC TIB PER ATH ADD/O", "code_information": [{"code": "4610243", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 72560.0, "discounted_cash": 54420.0, "setting": "both", "billing_class": "facility"}]}, {"description": "REVASC TIB PER ATH ADD/O", "code_information": [{"code": "4918190", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 79091.0, "discounted_cash": 59318.25, "setting": "both", "billing_class": "facility"}]}, {"description": "REVASC TIBPER ST ATH ADD", "code_information": [{"code": "4610251", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 38525.0, "discounted_cash": 28893.75, "setting": "both", "billing_class": "facility"}]}, {"description": "REVASC TIBPER STNT ATHER", "code_information": [{"code": "4610249", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 115298.0, "discounted_cash": 86473.5, "setting": "both", "billing_class": "facility"}]}, {"description": "REVASC TIBPER STNT ATHER", "code_information": [{"code": "4918196", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 136987.0, "discounted_cash": 102740.25, "setting": "both", "billing_class": "facility"}]}, {"description": "REVASC TIBPER W/ATHER", "code_information": [{"code": "4610241", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 77936.0, "discounted_cash": 58452.0, "setting": "both", "billing_class": "facility"}]}, {"description": "REVASC TIBPER W/STENT", "code_information": [{"code": "4610245", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 58034.0, "discounted_cash": 43525.5, "setting": "both", "billing_class": "facility"}]}, {"description": "REVASC TIBPER W/STENT", "code_information": [{"code": "4918192", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 68949.0, "discounted_cash": 51711.75, "setting": "both", "billing_class": "facility"}]}, {"description": "REVASC TIBPER W/TLA", "code_information": [{"code": "4610237", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 27108.0, "discounted_cash": 20331.0, "setting": "both", "billing_class": "facility"}]}, {"description": "REVASC TIBPER W/TLA", "code_information": [{"code": "4918184", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 32486.0, "discounted_cash": 24364.5, "setting": "both", "billing_class": "facility"}]}, {"description": "REVASC TIBPER WSTENTADD", "code_information": [{"code": "4610247", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 37264.0, "discounted_cash": 27948.0, "setting": "both", "billing_class": "facility"}]}, {"description": "REVASC TIBPER WSTENTADD", "code_information": [{"code": "4918194", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 37264.0, "discounted_cash": 27948.0, "setting": "both", "billing_class": "facility"}]}, {"description": "REVERSE T3", "code_information": [{"code": "84482", "type": "CPT"}, {"code": "7254905", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 2013.0, "discounted_cash": 1509.75, "setting": "both", "billing_class": "facility"}]}, {"description": "REVSN INTRHEP PORTO SHNT", "code_information": [{"code": "4917183", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 58764.0, "discounted_cash": 44073.0, "setting": "both", "billing_class": "facility"}]}, {"description": "REVSN/RELOC PM SKN POCKT", "code_information": [{"code": "4613222", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 10260.0, "discounted_cash": 7695.0, "setting": "both", "billing_class": "facility"}]}, {"description": "RHEUM ARTHRITIS 14.3.3", "code_information": [{"code": "83520", "type": "CPT"}, {"code": "7253612", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 78.0, "discounted_cash": 58.5, "setting": "both", "billing_class": "facility"}]}, {"description": "RHEUMATOID FACTOR QUAL", "code_information": [{"code": "86430", "type": "CPT"}, {"code": "4106431", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 678.0, "discounted_cash": 508.5, "setting": "both", "billing_class": "facility"}]}, {"description": "RHEUMATOID FACTOR QUAL", "code_information": [{"code": "86430", "type": "CPT"}, {"code": "4176431", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 7.14, "discounted_cash": 5.36, "setting": "both", "billing_class": "facility"}]}, {"description": "RHEUMATOID FACTOR QUANT", "code_information": [{"code": "86431", "type": "CPT"}, {"code": "4106432", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 95.0, "discounted_cash": 71.25, "setting": "both", "billing_class": "facility"}]}, {"description": "RHEUMATOID FACTOR QUANT", "code_information": [{"code": "86431", "type": "CPT"}, {"code": "4176432", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 32.83, "discounted_cash": 24.62, "setting": "both", "billing_class": "facility"}]}, {"description": "RHEUMATOID FACTOR QUANT", "code_information": [{"code": "86431", "type": "CPT"}, {"code": "7256432", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 13.0, "discounted_cash": 9.75, "setting": "both", "billing_class": "facility"}]}, {"description": "RHO(D) IG PER 300MCG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J2790", "type": "HCPCS"}, {"code": "5324010", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 783.0, "discounted_cash": 587.25, "setting": "both", "billing_class": "facility"}]}, {"description": "RHO(D) IG PER 300MCG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J2790", "type": "HCPCS"}, {"code": "5324010", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 783.0, "discounted_cash": 587.25, "setting": "both", "billing_class": "facility"}]}, {"description": "RHOPHYLAC IV/IMPER100UIJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J2791", "type": "HCPCS"}, {"code": "5324005", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 239.0, "discounted_cash": 179.25, "setting": "both", "billing_class": "facility"}]}, {"description": "RHOPHYLAC IV/IMPER100UIJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J2791", "type": "HCPCS"}, {"code": "5324005", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 239.0, "discounted_cash": 179.25, "setting": "both", "billing_class": "facility"}]}, {"description": "RHYTHM EKG", "code_information": [{"code": "93041", "type": "CPT"}, {"code": "4603040", "type": "CDM"}, {"code": "730", "type": "RC"}], "standard_charges": [{"gross_charge": 1276.0, "discounted_cash": 957.0, "setting": "both", "billing_class": "facility"}]}, {"description": "RIBOFLAVIN(VITAMIN B2)", "code_information": [{"code": "84252", "type": "CPT"}, {"code": "7254252", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 283.0, "discounted_cash": 212.25, "setting": "both", "billing_class": "facility"}]}, {"description": "RIBONUCLEIC ACID AB", "code_information": [{"code": "83520", "type": "CPT"}, {"code": "7258470", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 197.0, "discounted_cash": 147.75, "setting": "both", "billing_class": "facility"}]}, {"description": "RIBOSOMAL P AB", "code_information": [{"code": "83516", "type": "CPT"}, {"code": "7253959", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 102.0, "discounted_cash": 76.5, "setting": "both", "billing_class": "facility"}]}, {"description": "RIBS BI 4V MIN W/PA CXR", "code_information": [{"code": "71111", "type": "CPT"}, {"code": "4901111", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 2442.0, "discounted_cash": 1831.5, "setting": "both", "billing_class": "facility"}]}, {"description": "RIBS BILAT 3VW MIN", "code_information": [{"code": "71110", "type": "CPT"}, {"code": "4901110", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 1616.0, "discounted_cash": 1212.0, "setting": "both", "billing_class": "facility"}]}, {"description": "RIBS BILAT 3VW MIN", "code_information": [{"code": "71110", "type": "CPT"}, {"code": "5111110", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 1616.0, "discounted_cash": 1212.0, "setting": "both", "billing_class": "facility"}]}, {"description": "RIBS UNI 3V MIN W/PA CXR", "code_information": [{"code": "71101", "type": "CPT"}, {"code": "4901101", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 1874.0, "discounted_cash": 1405.5, "setting": "both", "billing_class": "facility"}]}, {"description": "RIBS UNI 3V MIN W/PA CXR", "code_information": [{"code": "71101", "type": "CPT"}, {"code": "5111101", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 1902.0, "discounted_cash": 1426.5, "setting": "both", "billing_class": "facility"}]}, {"description": "RIBS UNILAT 2VW", "code_information": [{"code": "71100", "type": "CPT"}, {"code": "4901100", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 1965.0, "discounted_cash": 1473.75, "setting": "both", "billing_class": "facility"}]}, {"description": "RIBS UNILAT 2VW", "code_information": [{"code": "71100", "type": "CPT"}, {"code": "5111100", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 1616.0, "discounted_cash": 1212.0, "setting": "both", "billing_class": "facility"}]}, {"description": "RICKETTSIA AB", "code_information": [{"code": "86757", "type": "CPT"}, {"code": "7256742", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 87.0, "discounted_cash": 65.25, "setting": "both", "billing_class": "facility"}]}, {"description": "RICKETTSIA AB/2", "code_information": [{"code": "86757", "type": "CPT"}, {"code": "7256437", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 66.0, "discounted_cash": 49.5, "setting": "both", "billing_class": "facility"}]}, {"description": "RICKETTSIA AB/3", "code_information": [{"code": "86757", "type": "CPT"}, {"code": "7256439", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 66.0, "discounted_cash": 49.5, "setting": "both", "billing_class": "facility"}]}, {"description": "RICKETTSIA AB/4", "code_information": [{"code": "86757", "type": "CPT"}, {"code": "7256440", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 64.0, "discounted_cash": 48.0, "setting": "both", "billing_class": "facility"}]}, {"description": "RICKETTSIA AB/5", "code_information": [{"code": "86757", "type": "CPT"}, {"code": "7256441", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 70.0, "discounted_cash": 52.5, "setting": "both", "billing_class": "facility"}]}, {"description": "RICKETTSIA AB/8", "code_information": [{"code": "86757", "type": "CPT"}, {"code": "7256757", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 184.0, "discounted_cash": 138.0, "setting": "both", "billing_class": "facility"}]}, {"description": "RIFABUTIN 150MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5310620", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 190.0, "discounted_cash": 142.5, "setting": "both", "billing_class": "facility"}]}, {"description": "RIFABUTIN 150MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5310620", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 190.0, "discounted_cash": 142.5, "setting": "both", "billing_class": "facility"}]}, {"description": "RIFAMPIN", "code_information": [{"code": "80375", "type": "CPT"}, {"code": "7258306", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 196.0, "discounted_cash": 147.0, "setting": "both", "billing_class": "facility"}]}, {"description": "RIFAMPIN 150MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5310636", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 85.0, "discounted_cash": 63.75, "setting": "both", "billing_class": "facility"}]}, {"description": "RIFAMPIN 150MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5310636", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 85.0, "discounted_cash": 63.75, "setting": "both", "billing_class": "facility"}]}, {"description": "RIFAMPIN 1ML CMPD LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5316237", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 16.0, "discounted_cash": 12.0, "setting": "both", "billing_class": "facility"}]}, {"description": "RIFAMPIN 1ML CMPD LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5316237", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 16.0, "discounted_cash": 12.0, "setting": "both", "billing_class": "facility"}]}, {"description": "RIFAMPIN 300MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5310637", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 66.0, "discounted_cash": 49.5, "setting": "both", "billing_class": "facility"}]}, {"description": "RIFAMPIN 300MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5310637", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 66.0, "discounted_cash": 49.5, "setting": "both", "billing_class": "facility"}]}, {"description": "RIFAMPIN PER 1MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J2804", "type": "HCPCS"}, {"code": "5324073", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 2.0, "discounted_cash": 1.5, "setting": "both", "billing_class": "facility"}]}, {"description": "RIFAMPIN PER 1MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J2804", "type": "HCPCS"}, {"code": "5324073", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 2.0, "discounted_cash": 1.5, "setting": "both", "billing_class": "facility"}]}, {"description": "RIFAMPIN SUSP CMPD LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5316247", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 2.0, "discounted_cash": 1.5, "setting": "both", "billing_class": "facility"}]}, {"description": "RIFAMPIN SUSP CMPD LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5316247", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 2.0, "discounted_cash": 1.5, "setting": "both", "billing_class": "facility"}]}, {"description": "RIFAXIMIN 200MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5310625", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 134.0, "discounted_cash": 100.5, "setting": "both", "billing_class": "facility"}]}, {"description": "RIFAXIMIN 200MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5310625", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 134.0, "discounted_cash": 100.5, "setting": "both", "billing_class": "facility"}]}, {"description": "RIFAXIMIN 550 MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5310626", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 641.0, "discounted_cash": 480.75, "setting": "both", "billing_class": "facility"}]}, {"description": "RIFAXIMIN 550 MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5310626", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 641.0, "discounted_cash": 480.75, "setting": "both", "billing_class": "facility"}]}, {"description": "RIGHT CARE RIGHT PLACE", "code_information": [{"code": "99281", "type": "CPT"}, {"code": "6100498", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 50.0, "discounted_cash": 37.5, "setting": "both", "billing_class": "facility"}]}, {"description": "RIMEXOLONE 1% 5ML OS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5332275", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 840.0, "discounted_cash": 630.0, "setting": "both", "billing_class": "facility"}]}, {"description": "RIMEXOLONE 1% 5ML OS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5332275", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 840.0, "discounted_cash": 630.0, "setting": "both", "billing_class": "facility"}]}, {"description": "RING FALOPIAN", "code_information": [{"code": "A4264", "type": "HCPCS"}, {"code": "8155040", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 2326.0, "discounted_cash": 1744.5, "setting": "both", "billing_class": "facility"}]}, {"description": "RISEDRONATE 35MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5310648", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 843.0, "discounted_cash": 632.25, "setting": "both", "billing_class": "facility"}]}, {"description": "RISEDRONATE 35MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5310648", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 843.0, "discounted_cash": 632.25, "setting": "both", "billing_class": "facility"}]}, {"description": "RISPERIDONE 0.25MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5300648", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 148.0, "discounted_cash": 111.0, "setting": "both", "billing_class": "facility"}]}, {"description": "RISPERIDONE 0.25MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5300648", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 148.0, "discounted_cash": 111.0, "setting": "both", "billing_class": "facility"}]}, {"description": "RISPERIDONE 0.5MG DT", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5310633", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 183.0, "discounted_cash": 137.25, "setting": "both", "billing_class": "facility"}]}, {"description": "RISPERIDONE 0.5MG DT", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5310633", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 183.0, "discounted_cash": 137.25, "setting": "both", "billing_class": "facility"}]}, {"description": "RISPERIDONE 0.5MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5300649", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 97.0, "discounted_cash": 72.75, "setting": "both", "billing_class": "facility"}]}, {"description": "RISPERIDONE 0.5MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5300649", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 97.0, "discounted_cash": 72.75, "setting": "both", "billing_class": "facility"}]}, {"description": "RISPERIDONE 1M/M 1ML LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5316236", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 100.0, "discounted_cash": 75.0, "setting": "both", "billing_class": "facility"}]}, {"description": "RISPERIDONE 1M/M 1ML LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5316236", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 100.0, "discounted_cash": 75.0, "setting": "both", "billing_class": "facility"}]}, {"description": "RISPERIDONE 1M/M 30ML LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5316255", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 124.0, "discounted_cash": 93.0, "setting": "both", "billing_class": "facility"}]}, {"description": "RISPERIDONE 1M/M 30ML LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5316255", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 124.0, "discounted_cash": 93.0, "setting": "both", "billing_class": "facility"}]}, {"description": "RISPERIDONE 1MG DT", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5310634", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 178.0, "discounted_cash": 133.5, "setting": "both", "billing_class": "facility"}]}, {"description": "RISPERIDONE 1MG DT", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5310634", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 178.0, "discounted_cash": 133.5, "setting": "both", "billing_class": "facility"}]}, {"description": "RISPERIDONE 1MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5310651", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 125.0, "discounted_cash": 93.75, "setting": "both", "billing_class": "facility"}]}, {"description": "RISPERIDONE 1MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5310651", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 125.0, "discounted_cash": 93.75, "setting": "both", "billing_class": "facility"}]}, {"description": "RISPERIDONE 2MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5310652", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 142.0, "discounted_cash": 106.5, "setting": "both", "billing_class": "facility"}]}, {"description": "RISPERIDONE 2MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5310652", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 142.0, "discounted_cash": 106.5, "setting": "both", "billing_class": "facility"}]}, {"description": "RISPERIDONE 4MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5310654", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 243.0, "discounted_cash": 182.25, "setting": "both", "billing_class": "facility"}]}, {"description": "RISPERIDONE 4MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5310654", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 243.0, "discounted_cash": 182.25, "setting": "both", "billing_class": "facility"}]}, {"description": "RISPERIDONE PER.5MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J2794", "type": "HCPCS"}, {"code": "5324017", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 353.0, "discounted_cash": 264.75, "setting": "both", "billing_class": "facility"}]}, {"description": "RISPERIDONE PER.5MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J2794", "type": "HCPCS"}, {"code": "5324017", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 353.0, "discounted_cash": 264.75, "setting": "both", "billing_class": "facility"}]}, {"description": "RITONAVIR 100 MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5310670", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 242.0, "discounted_cash": 181.5, "setting": "both", "billing_class": "facility"}]}, {"description": "RITONAVIR 100 MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5310670", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 242.0, "discounted_cash": 181.5, "setting": "both", "billing_class": "facility"}]}, {"description": "RIVAROXABAN 10MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5310640", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 227.0, "discounted_cash": 170.25, "setting": "both", "billing_class": "facility"}]}, {"description": "RIVAROXABAN 10MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5310640", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 227.0, "discounted_cash": 170.25, "setting": "both", "billing_class": "facility"}]}, {"description": "RIVAROXABAN 15MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5310632", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 189.0, "discounted_cash": 141.75, "setting": "both", "billing_class": "facility"}]}, {"description": "RIVAROXABAN 15MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5310632", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 189.0, "discounted_cash": 141.75, "setting": "both", "billing_class": "facility"}]}, {"description": "RIVAROXABAN 20MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5310638", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 180.0, "discounted_cash": 135.0, "setting": "both", "billing_class": "facility"}]}, {"description": "RIVAROXABAN 20MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5310638", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 180.0, "discounted_cash": 135.0, "setting": "both", "billing_class": "facility"}]}, {"description": "RIVASTIGMINE 1.5MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5310665", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 95.0, "discounted_cash": 71.25, "setting": "both", "billing_class": "facility"}]}, {"description": "RIVASTIGMINE 1.5MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5310665", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 95.0, "discounted_cash": 71.25, "setting": "both", "billing_class": "facility"}]}, {"description": "RMV TUNLD CVAD W SQ PORT", "code_information": [{"code": "4916590", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 5576.0, "discounted_cash": 4182.0, "setting": "both", "billing_class": "facility"}]}, {"description": "RMVL SUBQ CAR RHYTHM MNTR", "code_information": [{"code": "4613273", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 2747.0, "discounted_cash": 2060.25, "setting": "both", "billing_class": "facility"}]}, {"description": "RNA POLYMERASE 3 AB", "code_information": [{"code": "83520", "type": "CPT"}, {"code": "7253578", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 152.0, "discounted_cash": 114.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ROCURONIUM10MG/1ML 5MLIJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5324025", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 930.0, "discounted_cash": 697.5, "setting": "both", "billing_class": "facility"}]}, {"description": "ROCURONIUM10MG/1ML10MLIJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5324024", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 937.0, "discounted_cash": 702.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ROPINIROLE 0.5MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5310676", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 61.0, "discounted_cash": 45.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ROPINIROLE 0.5MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5310676", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 61.0, "discounted_cash": 45.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ROPIVACAINE PER 1MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J2795", "type": "HCPCS"}, {"code": "5324052", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 3.0, "discounted_cash": 2.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ROPIVACAINE PER 1MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J2795", "type": "HCPCS"}, {"code": "5324052", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 3.0, "discounted_cash": 2.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ROPIVACAINE PER1MG PMXIJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J2795", "type": "HCPCS"}, {"code": "5324053", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 3.0, "discounted_cash": 2.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ROPIVACAINE PER1MG PMXIJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J2795", "type": "HCPCS"}, {"code": "5324053", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 3.0, "discounted_cash": 2.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ROSUVASTATIN 10MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5310693", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 191.0, "discounted_cash": 143.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ROSUVASTATIN 10MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5310693", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 191.0, "discounted_cash": 143.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ROTAVIRUS IA", "code_information": [{"code": "87425", "type": "CPT"}, {"code": "4104252", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 1061.0, "discounted_cash": 795.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ROTAVIRUS IA", "code_information": [{"code": "87425", "type": "CPT"}, {"code": "4177425", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 18.55, "discounted_cash": 13.91, "setting": "both", "billing_class": "facility"}]}, {"description": "RPLC PICC NO PRT/PMP W/IMG", "code_information": [{"code": "4916584", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 9298.0, "discounted_cash": 6973.5, "setting": "both", "billing_class": "facility"}]}, {"description": "RPLC TUNNL CVAD W PORT", "code_information": [{"code": "4916582", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 12355.0, "discounted_cash": 9266.25, "setting": "both", "billing_class": "facility"}]}, {"description": "RPLCE TUNL CVAD W SQ PMP", "code_information": [{"code": "4916583", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 24092.0, "discounted_cash": 18069.0, "setting": "both", "billing_class": "facility"}]}, {"description": "RSV AG DFA", "code_information": [{"code": "87280", "type": "CPT"}, {"code": "4107280", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 43.0, "discounted_cash": 32.25, "setting": "both", "billing_class": "facility"}]}, {"description": "RSV IA", "code_information": [{"code": "87420", "type": "CPT"}, {"code": "4106414", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 813.0, "discounted_cash": 609.75, "setting": "both", "billing_class": "facility"}]}, {"description": "RSV IA", "code_information": [{"code": "87420", "type": "CPT"}, {"code": "4176414", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 22.83, "discounted_cash": 17.12, "setting": "both", "billing_class": "facility"}]}, {"description": "RT VENTRICULAR RECORDING", "code_information": [{"code": "93603", "type": "CPT"}, {"code": "4613603", "type": "CDM"}, {"code": "480", "type": "RC"}], "standard_charges": [{"gross_charge": 37415.0, "discounted_cash": 28061.25, "setting": "both", "billing_class": "facility"}]}, {"description": "RUBELLA AB", "code_information": [{"code": "86762", "type": "CPT"}, {"code": "4106318", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 262.0, "discounted_cash": 196.5, "setting": "both", "billing_class": "facility"}]}, {"description": "RUBELLA AB/2", "code_information": [{"code": "86762", "type": "CPT"}, {"code": "4176317", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 7.14, "discounted_cash": 5.36, "setting": "both", "billing_class": "facility"}]}, {"description": "RUBELLA AB/2", "code_information": [{"code": "86762", "type": "CPT"}, {"code": "7256324", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 128.0, "discounted_cash": 96.0, "setting": "both", "billing_class": "facility"}]}, {"description": "RUBELLA AB/3", "code_information": [{"code": "86762", "type": "CPT"}, {"code": "4106762", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 265.0, "discounted_cash": 198.75, "setting": "both", "billing_class": "facility"}]}, {"description": "RUBELLA AB/3", "code_information": [{"code": "86762", "type": "CPT"}, {"code": "4126762", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 59.0, "discounted_cash": 44.25, "setting": "both", "billing_class": "facility"}]}, {"description": "RUBELLA AB/3", "code_information": [{"code": "86762", "type": "CPT"}, {"code": "4176762", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 54.23, "discounted_cash": 40.67, "setting": "both", "billing_class": "facility"}]}, {"description": "RUBELLA AB/3", "code_information": [{"code": "86762", "type": "CPT"}, {"code": "7256762", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 117.0, "discounted_cash": 87.75, "setting": "both", "billing_class": "facility"}]}, {"description": "RUBEOLA AB", "code_information": [{"code": "86765", "type": "CPT"}, {"code": "4106765", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 938.0, "discounted_cash": 703.5, "setting": "both", "billing_class": "facility"}]}, {"description": "RUBEOLA AB", "code_information": [{"code": "86765", "type": "CPT"}, {"code": "4126765", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 50.0, "discounted_cash": 37.5, "setting": "both", "billing_class": "facility"}]}, {"description": "RUBEOLA AB", "code_information": [{"code": "86765", "type": "CPT"}, {"code": "4176765", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 449.55, "discounted_cash": 337.16, "setting": "both", "billing_class": "facility"}]}, {"description": "RUBEOLA AB", "code_information": [{"code": "86765", "type": "CPT"}, {"code": "7256715", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 109.0, "discounted_cash": 81.75, "setting": "both", "billing_class": "facility"}]}, {"description": "RUBEOLA AB/2", "code_information": [{"code": "86765", "type": "CPT"}, {"code": "7256765", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 630.0, "discounted_cash": 472.5, "setting": "both", "billing_class": "facility"}]}, {"description": "RUSSL VIPR VEN TIME DIL", "code_information": [{"code": "85613", "type": "CPT"}, {"code": "4105613", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 135.0, "discounted_cash": 101.25, "setting": "both", "billing_class": "facility"}]}, {"description": "RUSSL VIPR VEN TIME DIL", "code_information": [{"code": "85613", "type": "CPT"}, {"code": "7255613", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 90.0, "discounted_cash": 67.5, "setting": "both", "billing_class": "facility"}]}, {"description": "RUSSL VIPR VEN TIME DIL/2", "code_information": [{"code": "85613", "type": "CPT"}, {"code": "7255615", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 156.0, "discounted_cash": 117.0, "setting": "both", "billing_class": "facility"}]}, {"description": "RUSSL VIPR VEN TIME DIL/5", "code_information": [{"code": "85613", "type": "CPT"}, {"code": "7255620", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 109.0, "discounted_cash": 81.75, "setting": "both", "billing_class": "facility"}]}, {"description": "SACROILIAC JOINTS 2 VWS", "code_information": [{"code": "72200", "type": "CPT"}, {"code": "4902200", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 982.0, "discounted_cash": 736.5, "setting": "both", "billing_class": "facility"}]}, {"description": "SACROILIAC JOINTS 2 VWS", "code_information": [{"code": "72200", "type": "CPT"}, {"code": "5112200", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 978.0, "discounted_cash": 733.5, "setting": "both", "billing_class": "facility"}]}, {"description": "SACROILIAC JOINTS 3 VWS", "code_information": [{"code": "72202", "type": "CPT"}, {"code": "4902202", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 1186.0, "discounted_cash": 889.5, "setting": "both", "billing_class": "facility"}]}, {"description": "SACROILIAC JOINTS 3 VWS", "code_information": [{"code": "72202", "type": "CPT"}, {"code": "5112202", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 1038.0, "discounted_cash": 778.5, "setting": "both", "billing_class": "facility"}]}, {"description": "SACRUM COCCYX 2 VWS", "code_information": [{"code": "72220", "type": "CPT"}, {"code": "4902220", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 1745.0, "discounted_cash": 1308.75, "setting": "both", "billing_class": "facility"}]}, {"description": "SACRUM COCCYX 2 VWS", "code_information": [{"code": "72220", "type": "CPT"}, {"code": "5112220", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 1362.0, "discounted_cash": 1021.5, "setting": "both", "billing_class": "facility"}]}, {"description": "SACUBIT/VALS 97-103MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5310709", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 136.0, "discounted_cash": 102.0, "setting": "both", "billing_class": "facility"}]}, {"description": "SACUBIT/VALS 97-103MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5310709", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 136.0, "discounted_cash": 102.0, "setting": "both", "billing_class": "facility"}]}, {"description": "SACUBIT/VALSAR 24-26MGTB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5310707", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 136.0, "discounted_cash": 102.0, "setting": "both", "billing_class": "facility"}]}, {"description": "SACUBIT/VALSAR 24-26MGTB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5310707", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 136.0, "discounted_cash": 102.0, "setting": "both", "billing_class": "facility"}]}, {"description": "SACUBIT/VALSAR 49-51MGTB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5310708", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 136.0, "discounted_cash": 102.0, "setting": "both", "billing_class": "facility"}]}, {"description": "SACUBIT/VALSAR 49-51MGTB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5310708", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 136.0, "discounted_cash": 102.0, "setting": "both", "billing_class": "facility"}]}, {"description": "SALIVA SUBST 60ML LQ", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5316263", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 125.0, "discounted_cash": 93.75, "setting": "both", "billing_class": "facility"}]}, {"description": "SALIVA SUBST 60ML LQ", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5316263", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 125.0, "discounted_cash": 93.75, "setting": "both", "billing_class": "facility"}]}, {"description": "SALMETEROL DK 50MCG PW", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3535", "type": "HCPCS"}, {"code": "5332282", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 2769.0, "discounted_cash": 2076.75, "setting": "both", "billing_class": "facility"}]}, {"description": "SALMETEROL DK 50MCG PW", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3535", "type": "HCPCS"}, {"code": "5332282", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 2769.0, "discounted_cash": 2076.75, "setting": "both", "billing_class": "facility"}]}, {"description": "SALMONELLA AB", "code_information": [{"code": "86768", "type": "CPT"}, {"code": "7256768", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 532.0, "discounted_cash": 399.0, "setting": "both", "billing_class": "facility"}]}, {"description": "SALSALATE 500MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5310683", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 85.0, "discounted_cash": 63.75, "setting": "both", "billing_class": "facility"}]}, {"description": "SALSALATE 500MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5310683", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 85.0, "discounted_cash": 63.75, "setting": "both", "billing_class": "facility"}]}, {"description": "SALSALATE 750MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5310686", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 93.0, "discounted_cash": 69.75, "setting": "both", "billing_class": "facility"}]}, {"description": "SALSALATE 750MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5310686", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 93.0, "discounted_cash": 69.75, "setting": "both", "billing_class": "facility"}]}, {"description": "SARSCOV IA ANTIGEN", "code_information": [{"code": "87426", "type": "CPT"}, {"code": "4100361", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 289.0, "discounted_cash": 216.75, "setting": "both", "billing_class": "facility"}]}, {"description": "SARSCOV2 COVID19 AMP PRB", "code_information": [{"code": "87635", "type": "CPT"}, {"code": "4100352", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 120.0, "discounted_cash": 90.0, "setting": "both", "billing_class": "facility"}]}, {"description": "SCAN HEMO COMP PREOP BI STDY", "code_information": [{"code": "93985", "type": "CPT"}, {"code": "5063985", "type": "CDM"}, {"code": "920", "type": "RC"}], "standard_charges": [{"gross_charge": 1868.0, "discounted_cash": 1401.0, "setting": "both", "billing_class": "facility"}]}, {"description": "SCAN HEMO COMP PREOP UNI STD", "code_information": [{"code": "93986", "type": "CPT"}, {"code": "5063986", "type": "CDM"}, {"code": "920", "type": "RC"}], "standard_charges": [{"gross_charge": 899.0, "discounted_cash": 674.25, "setting": "both", "billing_class": "facility"}]}, {"description": "SCAN HEMODIALYSIS ACCESS", "code_information": [{"code": "93990", "type": "CPT"}, {"code": "5067160", "type": "CDM"}, {"code": "921", "type": "RC"}], "standard_charges": [{"gross_charge": 1676.0, "discounted_cash": 1257.0, "setting": "both", "billing_class": "facility"}]}, {"description": "SCAPULA COMPLETE", "code_information": [{"code": "73010", "type": "CPT"}, {"code": "4903010", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 1624.0, "discounted_cash": 1218.0, "setting": "both", "billing_class": "facility"}]}, {"description": "SCAPULA COMPLETE", "code_information": [{"code": "73010", "type": "CPT"}, {"code": "5113010", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 3369.0, "discounted_cash": 2526.75, "setting": "both", "billing_class": "facility"}]}, {"description": "SCOPOLAMINE1.5MG72HR TD", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5337253", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 311.0, "discounted_cash": 233.25, "setting": "both", "billing_class": "facility"}]}, {"description": "SCOPOLAMINE1.5MG72HR TD", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5337253", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 311.0, "discounted_cash": 233.25, "setting": "both", "billing_class": "facility"}]}, {"description": "SCREEN TOMO BILAT", "code_information": [{"code": "77063", "type": "CPT"}, {"code": "3077063", "type": "CDM"}, {"code": "403", "type": "RC"}], "standard_charges": [{"gross_charge": 391.0, "discounted_cash": 293.25, "setting": "both", "billing_class": "facility"}]}, {"description": "SCREEN TOMO BILAT", "code_information": [{"code": "77063", "type": "CPT"}, {"code": "5117063", "type": "CDM"}, {"code": "403", "type": "RC"}], "standard_charges": [{"gross_charge": 391.0, "discounted_cash": 293.25, "setting": "both", "billing_class": "facility"}]}, {"description": "SCREW BIOABSORBABLE", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8136002", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 1906.0, "discounted_cash": 1429.5, "setting": "both", "billing_class": "facility"}]}, {"description": "SCREW CANN", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8136031", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 3306.0, "discounted_cash": 2479.5, "setting": "both", "billing_class": "facility"}]}, {"description": "SCREW HIP BONE STRYKER CL", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "4013105", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 892.0, "discounted_cash": 669.0, "setting": "both", "billing_class": "facility"}]}, {"description": "SCREW LOCKING NON LCKNG DJO CL", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "4013435", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 1235.0, "discounted_cash": 926.25, "setting": "both", "billing_class": "facility"}]}, {"description": "SCREW MALLEOLAR", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8136108", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 1436.0, "discounted_cash": 1077.0, "setting": "both", "billing_class": "facility"}]}, {"description": "SCREW SPECIALITY TYPEI", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8136266", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 2158.0, "discounted_cash": 1618.5, "setting": "both", "billing_class": "facility"}]}, {"description": "SCREW SPECIALITY TYPEII", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8136267", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 7754.0, "discounted_cash": 5815.5, "setting": "both", "billing_class": "facility"}]}, {"description": "SCREW TITANIUM", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8136003", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 15599.0, "discounted_cash": 11699.25, "setting": "both", "billing_class": "facility"}]}, {"description": "SCRN MAMMO+CAD BILAT", "code_information": [{"code": "77067", "type": "CPT"}, {"code": "3070202", "type": "CDM"}, {"code": "403", "type": "RC"}], "standard_charges": [{"gross_charge": 1182.0, "discounted_cash": 886.5, "setting": "both", "billing_class": "facility"}]}, {"description": "SCRN MAMMO+CAD BILAT", "code_information": [{"code": "77067", "type": "CPT"}, {"code": "5110202", "type": "CDM"}, {"code": "403", "type": "RC"}], "standard_charges": [{"gross_charge": 1182.0, "discounted_cash": 886.5, "setting": "both", "billing_class": "facility"}]}, {"description": "SCRW ANTI-ROTATION", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8135990", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 3950.0, "discounted_cash": 2962.5, "setting": "both", "billing_class": "facility"}]}, {"description": "SCRW ARTHRO", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8135150", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 1117.0, "discounted_cash": 837.75, "setting": "both", "billing_class": "facility"}]}, {"description": "SCRW BIOINTERFER ARTHREX", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8248410", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 4135.0, "discounted_cash": 3101.25, "setting": "both", "billing_class": "facility"}]}, {"description": "SCRW BN", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8136005", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 2278.0, "discounted_cash": 1708.5, "setting": "both", "billing_class": "facility"}]}, {"description": "SCRW BN", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8136006", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 1735.0, "discounted_cash": 1301.25, "setting": "both", "billing_class": "facility"}]}, {"description": "SCRW BN", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8136007", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 2292.0, "discounted_cash": 1719.0, "setting": "both", "billing_class": "facility"}]}, {"description": "SCRW CANC LCK", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8136022", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 5690.0, "discounted_cash": 4267.5, "setting": "both", "billing_class": "facility"}]}, {"description": "SCRW CANCL", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8136020", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 3114.0, "discounted_cash": 2335.5, "setting": "both", "billing_class": "facility"}]}, {"description": "SCRW CANCL", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8136021", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 2040.0, "discounted_cash": 1530.0, "setting": "both", "billing_class": "facility"}]}, {"description": "SCRW CANN", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8136030", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 4195.0, "discounted_cash": 3146.25, "setting": "both", "billing_class": "facility"}]}, {"description": "SCRW CANN F THREAD", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8136032", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 3787.0, "discounted_cash": 2840.25, "setting": "both", "billing_class": "facility"}]}, {"description": "SCRW COMPRESS", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8136050", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 1188.0, "discounted_cash": 891.0, "setting": "both", "billing_class": "facility"}]}, {"description": "SCRW COMPRESS", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8136055", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 3350.0, "discounted_cash": 2512.5, "setting": "both", "billing_class": "facility"}]}, {"description": "SCRW COMPRS/LAG", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8136060", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 5513.0, "discounted_cash": 4134.75, "setting": "both", "billing_class": "facility"}]}, {"description": "SCRW COMPRS/LAG", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8136065", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 8000.0, "discounted_cash": 6000.0, "setting": "both", "billing_class": "facility"}]}, {"description": "SCRW CORTICAL", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8136071", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 1930.0, "discounted_cash": 1447.5, "setting": "both", "billing_class": "facility"}]}, {"description": "SCRW CORTICAL 100X40 MM", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8136066", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 3196.0, "discounted_cash": 2397.0, "setting": "both", "billing_class": "facility"}]}, {"description": "SCRW CORTICAL II", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8135011", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 1987.0, "discounted_cash": 1490.25, "setting": "both", "billing_class": "facility"}]}, {"description": "SCRW CORTX", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8136067", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 1638.0, "discounted_cash": 1228.5, "setting": "both", "billing_class": "facility"}]}, {"description": "SCRW DISTRACTION", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8136076", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 978.0, "discounted_cash": 733.5, "setting": "both", "billing_class": "facility"}]}, {"description": "SCRW E CANCL4.0", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8136080", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 491.0, "discounted_cash": 368.25, "setting": "both", "billing_class": "facility"}]}, {"description": "SCRW E SCHANZ", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8136115", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 2114.0, "discounted_cash": 1585.5, "setting": "both", "billing_class": "facility"}]}, {"description": "SCRW E WASHER", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8136120", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 742.0, "discounted_cash": 556.5, "setting": "both", "billing_class": "facility"}]}, {"description": "SCRW FIXATION", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8136140", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 1948.0, "discounted_cash": 1461.0, "setting": "both", "billing_class": "facility"}]}, {"description": "SCRW HD/CRNI", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8136142", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 469.0, "discounted_cash": 351.75, "setting": "both", "billing_class": "facility"}]}, {"description": "SCRW HEADLESS", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8132806", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 6610.0, "discounted_cash": 4957.5, "setting": "both", "billing_class": "facility"}]}, {"description": "SCRW HI-TORQUE", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8136155", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 1068.0, "discounted_cash": 801.0, "setting": "both", "billing_class": "facility"}]}, {"description": "SCRW HIP CMP LAG", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8136170", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 3998.0, "discounted_cash": 2998.5, "setting": "both", "billing_class": "facility"}]}, {"description": "SCRW HIP COMP", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8136175", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 3995.0, "discounted_cash": 2996.25, "setting": "both", "billing_class": "facility"}]}, {"description": "SCRW HIP LAG", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8136180", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 5733.0, "discounted_cash": 4299.75, "setting": "both", "billing_class": "facility"}]}, {"description": "SCRW INTERFEREN", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8034015", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 1775.0, "discounted_cash": 1331.25, "setting": "both", "billing_class": "facility"}]}, {"description": "SCRW LCK CROSS DRIVE", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8136198", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 1432.0, "discounted_cash": 1074.0, "setting": "both", "billing_class": "facility"}]}, {"description": "SCRW LCK SLF TAP", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8136199", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 1558.0, "discounted_cash": 1168.5, "setting": "both", "billing_class": "facility"}]}, {"description": "SCRW LCK TIT", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8136194", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 3148.0, "discounted_cash": 2361.0, "setting": "both", "billing_class": "facility"}]}, {"description": "SCRW LOCKING", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8136196", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 3313.0, "discounted_cash": 2484.75, "setting": "both", "billing_class": "facility"}]}, {"description": "SCRW LOCKING CANN", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8136197", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 3334.0, "discounted_cash": 2500.5, "setting": "both", "billing_class": "facility"}]}, {"description": "SCRW MANDIBULAR", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8130274", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 1858.0, "discounted_cash": 1393.5, "setting": "both", "billing_class": "facility"}]}, {"description": "SCRW MAX FACIAL", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8136106", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 1453.0, "discounted_cash": 1089.75, "setting": "both", "billing_class": "facility"}]}, {"description": "SCRW METAPHYSEAL", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8136203", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 588.0, "discounted_cash": 441.0, "setting": "both", "billing_class": "facility"}]}, {"description": "SCRW MICRO BON", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8136207", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 8050.0, "discounted_cash": 6037.5, "setting": "both", "billing_class": "facility"}]}, {"description": "SCRW MULTIAXIAL", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8136206", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 13838.0, "discounted_cash": 10378.5, "setting": "both", "billing_class": "facility"}]}, {"description": "SCRW NEURO SLF-TAP", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8136208", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 992.0, "discounted_cash": 744.0, "setting": "both", "billing_class": "facility"}]}, {"description": "SCRW PLT HEAD NONLCK", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8136221", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 2421.0, "discounted_cash": 1815.75, "setting": "both", "billing_class": "facility"}]}, {"description": "SCRW PLT SHAFT NONLCK", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8136224", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 2421.0, "discounted_cash": 1815.75, "setting": "both", "billing_class": "facility"}]}, {"description": "SCRW POLYAXIAL", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8136223", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 14883.0, "discounted_cash": 11162.25, "setting": "both", "billing_class": "facility"}]}, {"description": "SCRW SET SPINAL", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8136245", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 1386.0, "discounted_cash": 1039.5, "setting": "both", "billing_class": "facility"}]}, {"description": "SCRW SHAFT", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8136251", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 1497.0, "discounted_cash": 1122.75, "setting": "both", "billing_class": "facility"}]}, {"description": "SCRW SHLDR PERIPHERAL", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8136253", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 1194.0, "discounted_cash": 895.5, "setting": "both", "billing_class": "facility"}]}, {"description": "SCRW SM FRAG AO", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8136255", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 1366.0, "discounted_cash": 1024.5, "setting": "both", "billing_class": "facility"}]}, {"description": "SCRW SOLID", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8136260", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 8468.0, "discounted_cash": 6351.0, "setting": "both", "billing_class": "facility"}]}, {"description": "SCRW TIBIAL FIXATION", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8136279", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 8300.0, "discounted_cash": 6225.0, "setting": "both", "billing_class": "facility"}]}, {"description": "SCRW TIT SLF DRILL", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8136281", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 3254.0, "discounted_cash": 2440.5, "setting": "both", "billing_class": "facility"}]}, {"description": "SCRW TITAN", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8136280", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 5696.0, "discounted_cash": 4272.0, "setting": "both", "billing_class": "facility"}]}, {"description": "SCRW WASHERLOC BIOMET", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8248480", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 13807.0, "discounted_cash": 10355.25, "setting": "both", "billing_class": "facility"}]}, {"description": "SED RATE AUTO", "code_information": [{"code": "85652", "type": "CPT"}, {"code": "4175653", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 2.86, "discounted_cash": 2.15, "setting": "both", "billing_class": "facility"}]}, {"description": "SED RATE AUTO", "code_information": [{"code": "85652", "type": "CPT"}, {"code": "7258565", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 6.0, "discounted_cash": 4.5, "setting": "both", "billing_class": "facility"}]}, {"description": "SEDIMENTN RATE-NON-AUTO", "code_information": [{"code": "85651", "type": "CPT"}, {"code": "4105651", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 570.0, "discounted_cash": 427.5, "setting": "both", "billing_class": "facility"}]}, {"description": "SEDIMENTN RATE-NON-AUTO", "code_information": [{"code": "85651", "type": "CPT"}, {"code": "4175651", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 5.71, "discounted_cash": 4.28, "setting": "both", "billing_class": "facility"}]}, {"description": "SEL DEB 1ST 20CM OR LESS", "code_information": [{"code": "97597", "type": "CPT"}, {"code": "6817597", "type": "CDM"}, {"code": "761", "type": "RC"}], "standard_charges": [{"gross_charge": 849.0, "discounted_cash": 636.75, "setting": "both", "billing_class": "facility"}]}, {"description": "SEL DEB 1ST 20CM OR LESS", "code_information": [{"code": "97597", "type": "CPT"}, {"code": "6907597", "type": "CDM"}, {"code": "761", "type": "RC"}], "standard_charges": [{"gross_charge": 1596.0, "discounted_cash": 1197.0, "setting": "both", "billing_class": "facility"}]}, {"description": "SEL DEB EAADD UPTO 20CM", "code_information": [{"code": "97598", "type": "CPT"}, {"code": "6907598", "type": "CDM"}, {"code": "761", "type": "RC"}], "standard_charges": [{"gross_charge": 1525.0, "discounted_cash": 1143.75, "setting": "both", "billing_class": "facility"}]}, {"description": "SELEGILINE 5MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5310719", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 85.0, "discounted_cash": 63.75, "setting": "both", "billing_class": "facility"}]}, {"description": "SELEGILINE 5MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5310719", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 85.0, "discounted_cash": 63.75, "setting": "both", "billing_class": "facility"}]}, {"description": "SELEGILINE 5MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5310720", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 92.0, "discounted_cash": 69.0, "setting": "both", "billing_class": "facility"}]}, {"description": "SELEGILINE 5MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5310720", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 92.0, "discounted_cash": 69.0, "setting": "both", "billing_class": "facility"}]}, {"description": "SELENIUM", "code_information": [{"code": "84255", "type": "CPT"}, {"code": "7254255", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 147.0, "discounted_cash": 110.25, "setting": "both", "billing_class": "facility"}]}, {"description": "SELENIUM SULF2.5%120MLLT", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5337246", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 449.0, "discounted_cash": 336.75, "setting": "both", "billing_class": "facility"}]}, {"description": "SELENIUM SULF2.5%120MLLT", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5337246", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 449.0, "discounted_cash": 336.75, "setting": "both", "billing_class": "facility"}]}, {"description": "SELENUM SU SHMP1%210MLLT", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5337245", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 113.0, "discounted_cash": 84.75, "setting": "both", "billing_class": "facility"}]}, {"description": "SELENUM SU SHMP1%210MLLT", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5337245", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 113.0, "discounted_cash": 84.75, "setting": "both", "billing_class": "facility"}]}, {"description": "SEMEN ANALYSIS PST VAS", "code_information": [{"code": "89321", "type": "CPT"}, {"code": "4109300", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 954.0, "discounted_cash": 715.5, "setting": "both", "billing_class": "facility"}]}, {"description": "SEMI-PRIVATE OBSTETRICS", "code_information": [{"code": "1990044", "type": "CDM"}, {"code": "122", "type": "RC"}], "standard_charges": [{"gross_charge": 3689.0, "discounted_cash": 2766.75, "setting": "both", "billing_class": "facility"}]}, {"description": "SEMI-PRIVATE OBSTETRICS", "code_information": [{"code": "2500044", "type": "CDM"}, {"code": "122", "type": "RC"}], "standard_charges": [{"gross_charge": 3689.0, "discounted_cash": 2766.75, "setting": "both", "billing_class": "facility"}]}, {"description": "SEMI-PRIVATE PEDIATRICS", "code_information": [{"code": "1990049", "type": "CDM"}, {"code": "123", "type": "RC"}], "standard_charges": [{"gross_charge": 3689.0, "discounted_cash": 2766.75, "setting": "both", "billing_class": "facility"}]}, {"description": "SEMI-PRIVATE PEDIATRICS", "code_information": [{"code": "2400049", "type": "CDM"}, {"code": "123", "type": "RC"}], "standard_charges": [{"gross_charge": 3689.0, "discounted_cash": 2766.75, "setting": "both", "billing_class": "facility"}]}, {"description": "SEMI-PRIVATE ROOM", "code_information": [{"code": "1990002", "type": "CDM"}, {"code": "120", "type": "RC"}], "standard_charges": [{"gross_charge": 3689.0, "discounted_cash": 2766.75, "setting": "both", "billing_class": "facility"}]}, {"description": "SEMI-PRIVATE ROOM", "code_information": [{"code": "2150002", "type": "CDM"}, {"code": "120", "type": "RC"}], "standard_charges": [{"gross_charge": 3689.0, "discounted_cash": 2766.75, "setting": "both", "billing_class": "facility"}]}, {"description": "SEMI-PRIVATE ROOM", "code_information": [{"code": "2300002", "type": "CDM"}, {"code": "120", "type": "RC"}], "standard_charges": [{"gross_charge": 3689.0, "discounted_cash": 2766.75, "setting": "both", "billing_class": "facility"}]}, {"description": "SEMI-PRIVATE ROOM", "code_information": [{"code": "2310002", "type": "CDM"}, {"code": "120", "type": "RC"}], "standard_charges": [{"gross_charge": 3689.0, "discounted_cash": 2766.75, "setting": "both", "billing_class": "facility"}]}, {"description": "SEMI-PRIVATE ROOM", "code_information": [{"code": "2400002", "type": "CDM"}, {"code": "120", "type": "RC"}], "standard_charges": [{"gross_charge": 3689.0, "discounted_cash": 2766.75, "setting": "both", "billing_class": "facility"}]}, {"description": "SENSITV 12 DISKS OR LESS", "code_information": [{"code": "87184", "type": "CPT"}, {"code": "4107184", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 398.0, "discounted_cash": 298.5, "setting": "both", "billing_class": "facility"}]}, {"description": "SEPARATOR INDIGO", "code_information": [{"code": "C1757", "type": "HCPCS"}, {"code": "8177024", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 29563.0, "discounted_cash": 22172.25, "setting": "both", "billing_class": "facility"}]}, {"description": "SEROTONIN", "code_information": [{"code": "84260", "type": "CPT"}, {"code": "7254260", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 1735.0, "discounted_cash": 1301.25, "setting": "both", "billing_class": "facility"}]}, {"description": "SEROTONIN/2", "code_information": [{"code": "84260", "type": "CPT"}, {"code": "7254261", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 1735.0, "discounted_cash": 1301.25, "setting": "both", "billing_class": "facility"}]}, {"description": "SERPINA1 COMMON VARIANTS", "code_information": [{"code": "81332", "type": "CPT"}, {"code": "7259212", "type": "CDM"}, {"code": "310", "type": "RC"}], "standard_charges": [{"gross_charge": 614.0, "discounted_cash": 460.5, "setting": "both", "billing_class": "facility"}]}, {"description": "SERTRALINE 12.5MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5310766", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 60.0, "discounted_cash": 45.0, "setting": "both", "billing_class": "facility"}]}, {"description": "SERTRALINE 12.5MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5310766", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 60.0, "discounted_cash": 45.0, "setting": "both", "billing_class": "facility"}]}, {"description": "SERTRALINE 25MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5310759", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 53.0, "discounted_cash": 39.75, "setting": "both", "billing_class": "facility"}]}, {"description": "SERTRALINE 25MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5310759", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 53.0, "discounted_cash": 39.75, "setting": "both", "billing_class": "facility"}]}, {"description": "SERTRALINE 50MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5310760", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 92.0, "discounted_cash": 69.0, "setting": "both", "billing_class": "facility"}]}, {"description": "SERTRALINE 50MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5310760", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 92.0, "discounted_cash": 69.0, "setting": "both", "billing_class": "facility"}]}, {"description": "SEVELAMER 800MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5310764", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 68.0, "discounted_cash": 51.0, "setting": "both", "billing_class": "facility"}]}, {"description": "SEVELAMER 800MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5310764", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 68.0, "discounted_cash": 51.0, "setting": "both", "billing_class": "facility"}]}, {"description": "SEVELAMER CARB 800MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5310765", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 76.0, "discounted_cash": 57.0, "setting": "both", "billing_class": "facility"}]}, {"description": "SEVELAMER CARB 800MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5310765", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 76.0, "discounted_cash": 57.0, "setting": "both", "billing_class": "facility"}]}, {"description": "SEX HORMONE BIND GLOBULN", "code_information": [{"code": "84270", "type": "CPT"}, {"code": "7254270", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 494.0, "discounted_cash": 370.5, "setting": "both", "billing_class": "facility"}]}, {"description": "SHEATH CLOTTRIEVER", "code_information": [{"code": "C1894", "type": "HCPCS"}, {"code": "8177028", "type": "CDM"}, {"code": "272", "type": "RC"}], "standard_charges": [{"gross_charge": 8819.0, "discounted_cash": 6614.25, "setting": "both", "billing_class": "facility"}]}, {"description": "SHEATH GUIDE", "code_information": [{"code": "C1894", "type": "HCPCS"}, {"code": "8177118", "type": "CDM"}, {"code": "272", "type": "RC"}], "standard_charges": [{"gross_charge": 2035.0, "discounted_cash": 1526.25, "setting": "both", "billing_class": "facility"}]}, {"description": "SHEATH URETERAL ACCESS", "code_information": [{"code": "C1894", "type": "HCPCS"}, {"code": "8041028", "type": "CDM"}, {"code": "272", "type": "RC"}], "standard_charges": [{"gross_charge": 1097.0, "discounted_cash": 822.75, "setting": "both", "billing_class": "facility"}]}, {"description": "SHIGA-TOXIN IA", "code_information": [{"code": "87427", "type": "CPT"}, {"code": "4106634", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 516.0, "discounted_cash": 387.0, "setting": "both", "billing_class": "facility"}]}, {"description": "SHIGA-TOXIN IA", "code_information": [{"code": "87427", "type": "CPT"}, {"code": "7256634", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 35.0, "discounted_cash": 26.25, "setting": "both", "billing_class": "facility"}]}, {"description": "SHNT CAROTD BYP", "code_information": [{"code": "C1889", "type": "HCPCS"}, {"code": "8177065", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 766.0, "discounted_cash": 574.5, "setting": "both", "billing_class": "facility"}]}, {"description": "SHNT CAROTID", "code_information": [{"code": "C1889", "type": "HCPCS"}, {"code": "8145010", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 3885.0, "discounted_cash": 2913.75, "setting": "both", "billing_class": "facility"}]}, {"description": "SHNT CATH LUMPR", "code_information": [{"code": "C1889", "type": "HCPCS"}, {"code": "8145030", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 11016.0, "discounted_cash": 8262.0, "setting": "both", "billing_class": "facility"}]}, {"description": "SHNT CATH PERT", "code_information": [{"code": "C1889", "type": "HCPCS"}, {"code": "8145035", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 64465.0, "discounted_cash": 48348.75, "setting": "both", "billing_class": "facility"}]}, {"description": "SHNT CONN", "code_information": [{"code": "C1889", "type": "HCPCS"}, {"code": "8145065", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 1548.0, "discounted_cash": 1161.0, "setting": "both", "billing_class": "facility"}]}, {"description": "SHNT CONN ST+Y", "code_information": [{"code": "C1889", "type": "HCPCS"}, {"code": "8145085", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 14682.0, "discounted_cash": 11011.5, "setting": "both", "billing_class": "facility"}]}, {"description": "SHNT CORONARY", "code_information": [{"code": "C1889", "type": "HCPCS"}, {"code": "8145086", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 1109.0, "discounted_cash": 831.75, "setting": "both", "billing_class": "facility"}]}, {"description": "SHNT PERITO-VEN", "code_information": [{"code": "C1889", "type": "HCPCS"}, {"code": "8145115", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 18795.0, "discounted_cash": 14096.25, "setting": "both", "billing_class": "facility"}]}, {"description": "SHNT RESV", "code_information": [{"code": "C1889", "type": "HCPCS"}, {"code": "8145120", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 46477.0, "discounted_cash": 34857.75, "setting": "both", "billing_class": "facility"}]}, {"description": "SHNT VALVE FL", "code_information": [{"code": "C1889", "type": "HCPCS"}, {"code": "8145135", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 10028.0, "discounted_cash": 7521.0, "setting": "both", "billing_class": "facility"}]}, {"description": "SHNT VALVE FL P", "code_information": [{"code": "C1889", "type": "HCPCS"}, {"code": "8145145", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 11894.0, "discounted_cash": 8920.5, "setting": "both", "billing_class": "facility"}]}, {"description": "SHOULDER 2 VWS MINIMUM", "code_information": [{"code": "73030", "type": "CPT"}, {"code": "4903030", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 2904.0, "discounted_cash": 2178.0, "setting": "both", "billing_class": "facility"}]}, {"description": "SHOULDER 2 VWS MINIMUM", "code_information": [{"code": "73030", "type": "CPT"}, {"code": "5113030", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 2046.0, "discounted_cash": 1534.5, "setting": "both", "billing_class": "facility"}]}, {"description": "SHOULDER ARTHROGRAPHY", "code_information": [{"code": "73040", "type": "CPT"}, {"code": "4903040", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 1578.0, "discounted_cash": 1183.5, "setting": "both", "billing_class": "facility"}]}, {"description": "SHOULDER SINGLE VIEW", "code_information": [{"code": "73020", "type": "CPT"}, {"code": "4903020", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 2324.0, "discounted_cash": 1743.0, "setting": "both", "billing_class": "facility"}]}, {"description": "SHOULDER SINGLE VIEW", "code_information": [{"code": "73020", "type": "CPT"}, {"code": "5113020", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 3091.0, "discounted_cash": 2318.25, "setting": "both", "billing_class": "facility"}]}, {"description": "SHTH DILATOR BYRD", "code_information": [{"code": "C1773", "type": "HCPCS"}, {"code": "8243094", "type": "CDM"}, {"code": "272", "type": "RC"}], "standard_charges": [{"gross_charge": 1707.0, "discounted_cash": 1280.25, "setting": "both", "billing_class": "facility"}]}, {"description": "SHTH INTRODUCER DRYSEAL", "code_information": [{"code": "C1894", "type": "HCPCS"}, {"code": "8177108", "type": "CDM"}, {"code": "272", "type": "RC"}], "standard_charges": [{"gross_charge": 3584.0, "discounted_cash": 2688.0, "setting": "both", "billing_class": "facility"}]}, {"description": "SHTH INTRODUCER MICRA", "code_information": [{"code": "C1894", "type": "HCPCS"}, {"code": "8177115", "type": "CDM"}, {"code": "272", "type": "RC"}], "standard_charges": [{"gross_charge": 57816.0, "discounted_cash": 43362.0, "setting": "both", "billing_class": "facility"}]}, {"description": "SHUNTOGRAM PREV NONVASC", "code_information": [{"code": "75809", "type": "CPT"}, {"code": "4905809", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 791.0, "discounted_cash": 593.25, "setting": "both", "billing_class": "facility"}]}, {"description": "SIALIC ACID", "code_information": [{"code": "84275", "type": "CPT"}, {"code": "7254275", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 83.0, "discounted_cash": 62.25, "setting": "both", "billing_class": "facility"}]}, {"description": "SIALOGRAPHY", "code_information": [{"code": "70390", "type": "CPT"}, {"code": "4900390", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 1971.0, "discounted_cash": 1478.25, "setting": "both", "billing_class": "facility"}]}, {"description": "SICKLING OF RBC", "code_information": [{"code": "85660", "type": "CPT"}, {"code": "4103052", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 352.0, "discounted_cash": 264.0, "setting": "both", "billing_class": "facility"}]}, {"description": "SICKLING OF RBC", "code_information": [{"code": "85660", "type": "CPT"}, {"code": "7255660", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 23.0, "discounted_cash": 17.25, "setting": "both", "billing_class": "facility"}]}, {"description": "SILDENAFIL 20MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5310777", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 645.0, "discounted_cash": 483.75, "setting": "both", "billing_class": "facility"}]}, {"description": "SILDENAFIL 20MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5310777", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 645.0, "discounted_cash": 483.75, "setting": "both", "billing_class": "facility"}]}, {"description": "SILVER NITRAT 1 STICK EA", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5337282", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 66.0, "discounted_cash": 49.5, "setting": "both", "billing_class": "facility"}]}, {"description": "SILVER NITRATE APPL 10PK", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5337271", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 41.0, "discounted_cash": 30.75, "setting": "both", "billing_class": "facility"}]}, {"description": "SILVER SULFADIA 1%50GMCR", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5337272", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 129.0, "discounted_cash": 96.75, "setting": "both", "billing_class": "facility"}]}, {"description": "SILVER SULFADIA 1%50GMCR", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5337272", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 129.0, "discounted_cash": 96.75, "setting": "both", "billing_class": "facility"}]}, {"description": "SILVER SULFADIA1%400GMCR", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5337274", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 722.0, "discounted_cash": 541.5, "setting": "both", "billing_class": "facility"}]}, {"description": "SILVER SULFADIA1%400GMCR", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5337274", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 722.0, "discounted_cash": 541.5, "setting": "both", "billing_class": "facility"}]}, {"description": "SIMETHICONE 80MG TB", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5310783", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 72.0, "discounted_cash": 54.0, "setting": "both", "billing_class": "facility"}]}, {"description": "SIMETHICONE 80MG TB", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5310783", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 72.0, "discounted_cash": 54.0, "setting": "both", "billing_class": "facility"}]}, {"description": "SIMETHICONE40/.6 15ML LQ", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5316333", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 88.0, "discounted_cash": 66.0, "setting": "both", "billing_class": "facility"}]}, {"description": "SIMETHICONE40/.6 15ML LQ", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5316333", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 88.0, "discounted_cash": 66.0, "setting": "both", "billing_class": "facility"}]}, {"description": "SIMETHICONE40/.6 30ML LQ", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5316334", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 95.0, "discounted_cash": 71.25, "setting": "both", "billing_class": "facility"}]}, {"description": "SIMETHICONE40/.6 30ML LQ", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5316334", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 95.0, "discounted_cash": 71.25, "setting": "both", "billing_class": "facility"}]}, {"description": "SIMVASTATIN 10MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5310791", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 90.0, "discounted_cash": 67.5, "setting": "both", "billing_class": "facility"}]}, {"description": "SIMVASTATIN 10MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5310791", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 90.0, "discounted_cash": 67.5, "setting": "both", "billing_class": "facility"}]}, {"description": "SIMVASTATIN 20MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5310792", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 135.0, "discounted_cash": 101.25, "setting": "both", "billing_class": "facility"}]}, {"description": "SIMVASTATIN 20MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5310792", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 135.0, "discounted_cash": 101.25, "setting": "both", "billing_class": "facility"}]}, {"description": "SIMVASTATIN 40MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5310793", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 135.0, "discounted_cash": 101.25, "setting": "both", "billing_class": "facility"}]}, {"description": "SIMVASTATIN 40MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5310793", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 135.0, "discounted_cash": 101.25, "setting": "both", "billing_class": "facility"}]}, {"description": "SINCALIDE 5MCG", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J2805", "type": "HCPCS"}, {"code": "5358290", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 2476.0, "discounted_cash": 1857.0, "setting": "both", "billing_class": "facility"}]}, {"description": "SINCALIDE 5MCG", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J2805", "type": "HCPCS"}, {"code": "5358290", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 2476.0, "discounted_cash": 1857.0, "setting": "both", "billing_class": "facility"}]}, {"description": "SINUSES 2VW MAX", "code_information": [{"code": "70210", "type": "CPT"}, {"code": "4900210", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 1757.0, "discounted_cash": 1317.75, "setting": "both", "billing_class": "facility"}]}, {"description": "SINUSES 2VW MAX", "code_information": [{"code": "70210", "type": "CPT"}, {"code": "5110210", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 1757.0, "discounted_cash": 1317.75, "setting": "both", "billing_class": "facility"}]}, {"description": "SINUSES 3VW MIN", "code_information": [{"code": "70220", "type": "CPT"}, {"code": "4900220", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 1948.0, "discounted_cash": 1461.0, "setting": "both", "billing_class": "facility"}]}, {"description": "SINUSES 3VW MIN", "code_information": [{"code": "70220", "type": "CPT"}, {"code": "5110220", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 1760.0, "discounted_cash": 1320.0, "setting": "both", "billing_class": "facility"}]}, {"description": "SIROLIMUS", "code_information": [{"code": "80195", "type": "CPT"}, {"code": "4100254", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 354.0, "discounted_cash": 265.5, "setting": "both", "billing_class": "facility"}]}, {"description": "SIROLIMUS", "code_information": [{"code": "80195", "type": "CPT"}, {"code": "7250254", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 238.0, "discounted_cash": 178.5, "setting": "both", "billing_class": "facility"}]}, {"description": "SIROLIMUS PER 1MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J7520", "type": "HCPCS"}, {"code": "5310800", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 173.0, "discounted_cash": 129.75, "setting": "both", "billing_class": "facility"}]}, {"description": "SIROLIMUS PER 1MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J7520", "type": "HCPCS"}, {"code": "5310800", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 173.0, "discounted_cash": 129.75, "setting": "both", "billing_class": "facility"}]}, {"description": "SITAGLIPTIN 100MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5310796", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 244.0, "discounted_cash": 183.0, "setting": "both", "billing_class": "facility"}]}, {"description": "SITAGLIPTIN 100MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5310796", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 244.0, "discounted_cash": 183.0, "setting": "both", "billing_class": "facility"}]}, {"description": "SITAGLIPTIN 25MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5310795", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 244.0, "discounted_cash": 183.0, "setting": "both", "billing_class": "facility"}]}, {"description": "SITAGLIPTIN 25MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5310795", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 244.0, "discounted_cash": 183.0, "setting": "both", "billing_class": "facility"}]}, {"description": "SITAGLIPTIN 50MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5310797", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 203.0, "discounted_cash": 152.25, "setting": "both", "billing_class": "facility"}]}, {"description": "SITAGLIPTIN 50MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5310797", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 203.0, "discounted_cash": 152.25, "setting": "both", "billing_class": "facility"}]}, {"description": "SKULL 4VW MIN", "code_information": [{"code": "70260", "type": "CPT"}, {"code": "4900260", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 1579.0, "discounted_cash": 1184.25, "setting": "both", "billing_class": "facility"}]}, {"description": "SKULL 4VW MIN", "code_information": [{"code": "70260", "type": "CPT"}, {"code": "5110260", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 1822.0, "discounted_cash": 1366.5, "setting": "both", "billing_class": "facility"}]}, {"description": "SKULL < 4 VIEWS", "code_information": [{"code": "70250", "type": "CPT"}, {"code": "4900250", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 1372.0, "discounted_cash": 1029.0, "setting": "both", "billing_class": "facility"}]}, {"description": "SKULL < 4 VIEWS", "code_information": [{"code": "70250", "type": "CPT"}, {"code": "5110251", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 1099.0, "discounted_cash": 824.25, "setting": "both", "billing_class": "facility"}]}, {"description": "SLING SHOULDER", "code_information": [{"code": "A4565", "type": "HCPCS"}, {"code": "8103026", "type": "CDM"}, {"code": "274", "type": "RC"}], "standard_charges": [{"gross_charge": 592.0, "discounted_cash": 444.0, "setting": "both", "billing_class": "facility"}]}, {"description": "SLNG URETH SUPPORT LYNX BLUE", "code_information": [{"code": "C1771", "type": "HCPCS"}, {"code": "4024702", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 19272.0, "discounted_cash": 14454.0, "setting": "both", "billing_class": "facility"}]}, {"description": "SM BOWEL SNGL CM STDY", "code_information": [{"code": "74250", "type": "CPT"}, {"code": "4904250", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 2462.0, "discounted_cash": 1846.5, "setting": "both", "billing_class": "facility"}]}, {"description": "SMEAR FLUORESCENT/AFS", "code_information": [{"code": "87206", "type": "CPT"}, {"code": "4107201", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 549.0, "discounted_cash": 411.75, "setting": "both", "billing_class": "facility"}]}, {"description": "SMEAR FLUORESCENT/AFS", "code_information": [{"code": "87206", "type": "CPT"}, {"code": "7257198", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 90.0, "discounted_cash": 67.5, "setting": "both", "billing_class": "facility"}]}, {"description": "SMEAR FLUORESCENT/AFS/3", "code_information": [{"code": "87206", "type": "CPT"}, {"code": "7257210", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 325.0, "discounted_cash": 243.75, "setting": "both", "billing_class": "facility"}]}, {"description": "SMEAR FLUORESCENT/AFS/4", "code_information": [{"code": "87206", "type": "CPT"}, {"code": "4107206", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 747.0, "discounted_cash": 560.25, "setting": "both", "billing_class": "facility"}]}, {"description": "SMEAR FLUORESCENT/AFS/4", "code_information": [{"code": "87206", "type": "CPT"}, {"code": "7257211", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 35.0, "discounted_cash": 26.25, "setting": "both", "billing_class": "facility"}]}, {"description": "SMEAR SALINE/INK/KOH", "code_information": [{"code": "87210", "type": "CPT"}, {"code": "4107215", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 334.0, "discounted_cash": 250.5, "setting": "both", "billing_class": "facility"}]}, {"description": "SMEAR SALINE/INK/KOH", "code_information": [{"code": "87210", "type": "CPT"}, {"code": "4177215", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 8.56, "discounted_cash": 6.42, "setting": "both", "billing_class": "facility"}]}, {"description": "SMEAR SALINE/INK/KOH/2", "code_information": [{"code": "87210", "type": "CPT"}, {"code": "4107220", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 367.0, "discounted_cash": 275.25, "setting": "both", "billing_class": "facility"}]}, {"description": "SMEAR SALINE/INK/KOH/3", "code_information": [{"code": "87210", "type": "CPT"}, {"code": "4177210", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 8.56, "discounted_cash": 6.42, "setting": "both", "billing_class": "facility"}]}, {"description": "SMEAR SALINE/INK/KOH/4", "code_information": [{"code": "87210", "type": "CPT"}, {"code": "4107210", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 267.0, "discounted_cash": 200.25, "setting": "both", "billing_class": "facility"}]}, {"description": "SMOOTH MUSCLE AB", "code_information": [{"code": "86015", "type": "CPT"}, {"code": "7256379", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 1219.0, "discounted_cash": 914.25, "setting": "both", "billing_class": "facility"}]}, {"description": "SMX-TMP 200-40/5 20MLLQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5314855", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 141.0, "discounted_cash": 105.75, "setting": "both", "billing_class": "facility"}]}, {"description": "SMX-TMP 200-40/5 20MLLQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5314855", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 141.0, "discounted_cash": 105.75, "setting": "both", "billing_class": "facility"}]}, {"description": "SMX-TMP 800/160MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5311092", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 77.0, "discounted_cash": 57.75, "setting": "both", "billing_class": "facility"}]}, {"description": "SMX-TMP 800/160MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5311092", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 77.0, "discounted_cash": 57.75, "setting": "both", "billing_class": "facility"}]}, {"description": "SNRPN/UBE3A METHYLATION/2", "code_information": [{"code": "81331", "type": "CPT"}, {"code": "7251333", "type": "CDM"}, {"code": "310", "type": "RC"}], "standard_charges": [{"gross_charge": 465.0, "discounted_cash": 348.75, "setting": "both", "billing_class": "facility"}]}, {"description": "SOD ZIRCONIUM CYCLOS 10GM PWLQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5316362", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 340.0, "discounted_cash": 255.0, "setting": "both", "billing_class": "facility"}]}, {"description": "SOD ZIRCONIUM CYCLOS 10GM PWLQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5316362", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 340.0, "discounted_cash": 255.0, "setting": "both", "billing_class": "facility"}]}, {"description": "SODIUM", "code_information": [{"code": "84295", "type": "CPT"}, {"code": "4104295", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 607.0, "discounted_cash": 455.25, "setting": "both", "billing_class": "facility"}]}, {"description": "SODIUM", "code_information": [{"code": "84295", "type": "CPT"}, {"code": "4174295", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 1.12, "discounted_cash": 0.84, "setting": "both", "billing_class": "facility"}]}, {"description": "SODIUM OTHER SOURCE", "code_information": [{"code": "84302", "type": "CPT"}, {"code": "4104297", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 361.0, "discounted_cash": 270.75, "setting": "both", "billing_class": "facility"}]}, {"description": "SODIUM OTHER SOURCE", "code_information": [{"code": "84302", "type": "CPT"}, {"code": "4174297", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 7.14, "discounted_cash": 5.36, "setting": "both", "billing_class": "facility"}]}, {"description": "SODIUM OTHER SOURCE/3", "code_information": [{"code": "84302", "type": "CPT"}, {"code": "7254302", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 319.0, "discounted_cash": 239.25, "setting": "both", "billing_class": "facility"}]}, {"description": "SODIUM TETRADECYL3%2MLIJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5324290", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 1369.0, "discounted_cash": 1026.75, "setting": "both", "billing_class": "facility"}]}, {"description": "SODIUM URINE", "code_information": [{"code": "84300", "type": "CPT"}, {"code": "4104296", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 450.0, "discounted_cash": 337.5, "setting": "both", "billing_class": "facility"}]}, {"description": "SODIUM URINE", "code_information": [{"code": "84300", "type": "CPT"}, {"code": "4174296", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 1.12, "discounted_cash": 0.84, "setting": "both", "billing_class": "facility"}]}, {"description": "SODIUM URINE/2", "code_information": [{"code": "84300", "type": "CPT"}, {"code": "4104300", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 452.0, "discounted_cash": 339.0, "setting": "both", "billing_class": "facility"}]}, {"description": "SODIUM URINE/2", "code_information": [{"code": "84300", "type": "CPT"}, {"code": "4174300", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 1.12, "discounted_cash": 0.84, "setting": "both", "billing_class": "facility"}]}, {"description": "SOLUABLE LIVER AG", "code_information": [{"code": "83516", "type": "CPT"}, {"code": "7253496", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 95.0, "discounted_cash": 71.25, "setting": "both", "billing_class": "facility"}]}, {"description": "SOMATOMEDIN", "code_information": [{"code": "84305", "type": "CPT"}, {"code": "7253543", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 238.0, "discounted_cash": 178.5, "setting": "both", "billing_class": "facility"}]}, {"description": "SORBITOL 70% 30ML LQ", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5316373", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 85.0, "discounted_cash": 63.75, "setting": "both", "billing_class": "facility"}]}, {"description": "SORBITOL 70% 30ML LQ", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5316373", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 85.0, "discounted_cash": 63.75, "setting": "both", "billing_class": "facility"}]}, {"description": "SOTALOL 80MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5310870", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 60.0, "discounted_cash": 45.0, "setting": "both", "billing_class": "facility"}]}, {"description": "SOTALOL 80MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5310870", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 60.0, "discounted_cash": 45.0, "setting": "both", "billing_class": "facility"}]}, {"description": "SP ANT CERVICAL PLT L1", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "4011214", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 18373.0, "discounted_cash": 13779.75, "setting": "both", "billing_class": "facility"}]}, {"description": "SP ANT CERVICAL PLT L2", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "4011215", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 22158.0, "discounted_cash": 16618.5, "setting": "both", "billing_class": "facility"}]}, {"description": "SP ANT CERVICAL PLT L3", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "4011216", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 26080.0, "discounted_cash": 19560.0, "setting": "both", "billing_class": "facility"}]}, {"description": "SP ANT CERVICAL PLT L4>", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "4011217", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 28908.0, "discounted_cash": 21681.0, "setting": "both", "billing_class": "facility"}]}, {"description": "SP ANTERIOR SCREW", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "4011218", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 8114.0, "discounted_cash": 6085.5, "setting": "both", "billing_class": "facility"}]}, {"description": "SP APHASIA EVAL PER HOUR", "code_information": [{"code": "96105", "type": "CPT"}, {"code": "5900810", "type": "CDM"}, {"code": "440", "type": "RC"}], "standard_charges": [{"gross_charge": 639.0, "discounted_cash": 479.25, "setting": "both", "billing_class": "facility"}], "modifiers": "GN"}, {"description": "SP BN GRAFT ALLOGRAFT", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "4011205", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 31465.0, "discounted_cash": 23598.75, "setting": "both", "billing_class": "facility"}]}, {"description": "SP BN GRFT EXT SYNTHETIC", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "4011204", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 34952.0, "discounted_cash": 26214.0, "setting": "both", "billing_class": "facility"}]}, {"description": "SP BUTTRESS SCREW", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "4011254", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 13924.0, "discounted_cash": 10443.0, "setting": "both", "billing_class": "facility"}]}, {"description": "SP CELLULAR BN MATRIX", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "4011273", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 75752.0, "discounted_cash": 56814.0, "setting": "both", "billing_class": "facility"}]}, {"description": "SP CERV INTERBODY DEV", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "4011206", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 37702.0, "discounted_cash": 28276.5, "setting": "both", "billing_class": "facility"}]}, {"description": "SP CLAMP", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "4011251", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 6758.0, "discounted_cash": 5068.5, "setting": "both", "billing_class": "facility"}]}, {"description": "SP CLAMP CONNECTOR", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "4011248", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 10682.0, "discounted_cash": 8011.5, "setting": "both", "billing_class": "facility"}]}, {"description": "SP COG FUNC ACTIVITY ADDL 15M", "code_information": [{"code": "97130", "type": "CPT"}, {"code": "5907130", "type": "CDM"}, {"code": "440", "type": "RC"}], "standard_charges": [{"gross_charge": 619.0, "discounted_cash": 464.25, "setting": "both", "billing_class": "facility"}], "modifiers": "GN"}, {"description": "SP COG FUNC ACTIVITY INIT 15M", "code_information": [{"code": "97129", "type": "CPT"}, {"code": "5907129", "type": "CDM"}, {"code": "440", "type": "RC"}], "standard_charges": [{"gross_charge": 619.0, "discounted_cash": 464.25, "setting": "both", "billing_class": "facility"}], "modifiers": "GN"}, {"description": "SP CROSSLINK ASSEMBLY", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "4011219", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 17697.0, "discounted_cash": 13272.75, "setting": "both", "billing_class": "facility"}]}, {"description": "SP EVAL BEH QUAL A V/RS BASIC", "code_information": [{"code": "92524", "type": "CPT"}, {"code": "5902524", "type": "CDM"}, {"code": "444", "type": "RC"}], "standard_charges": [{"gross_charge": 1167.0, "discounted_cash": 875.25, "setting": "both", "billing_class": "facility"}], "modifiers": "GN"}, {"description": "SP EVAL BEH QUAL A V/RS CMPLX", "code_information": [{"code": "92524", "type": "CPT"}, {"code": "5900531", "type": "CDM"}, {"code": "444", "type": "RC"}], "standard_charges": [{"gross_charge": 2333.0, "discounted_cash": 1749.75, "setting": "both", "billing_class": "facility"}], "modifiers": "GN"}, {"description": "SP EVAL BEH QUAL A V/RS EXTNSV", "code_information": [{"code": "92524", "type": "CPT"}, {"code": "5900532", "type": "CDM"}, {"code": "444", "type": "RC"}], "standard_charges": [{"gross_charge": 2691.0, "discounted_cash": 2018.25, "setting": "both", "billing_class": "facility"}], "modifiers": "GN"}, {"description": "SP EVAL BEH QUAL A W/RS INTERM", "code_information": [{"code": "92524", "type": "CPT"}, {"code": "5900530", "type": "CDM"}, {"code": "444", "type": "RC"}], "standard_charges": [{"gross_charge": 1751.0, "discounted_cash": 1313.25, "setting": "both", "billing_class": "facility"}], "modifiers": "GN"}, {"description": "SP EVAL CINE VIDEO", "code_information": [{"code": "92611", "type": "CPT"}, {"code": "5902611", "type": "CDM"}, {"code": "444", "type": "RC"}], "standard_charges": [{"gross_charge": 1610.0, "discounted_cash": 1207.5, "setting": "both", "billing_class": "facility"}], "modifiers": "GN"}, {"description": "SP EVAL CINE VIDEO EXTNSV", "code_information": [{"code": "92611", "type": "CPT"}, {"code": "5902637", "type": "CDM"}, {"code": "444", "type": "RC"}], "standard_charges": [{"gross_charge": 4125.0, "discounted_cash": 3093.75, "setting": "both", "billing_class": "facility"}], "modifiers": "GN"}, {"description": "SP EVAL FLUENCY BASIC", "code_information": [{"code": "92521", "type": "CPT"}, {"code": "5902521", "type": "CDM"}, {"code": "444", "type": "RC"}], "standard_charges": [{"gross_charge": 1763.0, "discounted_cash": 1322.25, "setting": "both", "billing_class": "facility"}], "modifiers": "GN"}, {"description": "SP EVAL FLUENCY COMPLEX", "code_information": [{"code": "92521", "type": "CPT"}, {"code": "5900522", "type": "CDM"}, {"code": "444", "type": "RC"}], "standard_charges": [{"gross_charge": 3528.0, "discounted_cash": 2646.0, "setting": "both", "billing_class": "facility"}], "modifiers": "GN"}, {"description": "SP EVAL FLUENCY EXTENSIVE", "code_information": [{"code": "92521", "type": "CPT"}, {"code": "5900523", "type": "CDM"}, {"code": "444", "type": "RC"}], "standard_charges": [{"gross_charge": 4410.0, "discounted_cash": 3307.5, "setting": "both", "billing_class": "facility"}], "modifiers": "GN"}, {"description": "SP EVAL FLUENCY INTERM", "code_information": [{"code": "92521", "type": "CPT"}, {"code": "5900521", "type": "CDM"}, {"code": "444", "type": "RC"}], "standard_charges": [{"gross_charge": 2647.0, "discounted_cash": 1985.25, "setting": "both", "billing_class": "facility"}], "modifiers": "GN"}, {"description": "SP EVAL LNG COM W/EXP BASIC", "code_information": [{"code": "92523", "type": "CPT"}, {"code": "5902523", "type": "CDM"}, {"code": "444", "type": "RC"}], "standard_charges": [{"gross_charge": 1788.0, "discounted_cash": 1341.0, "setting": "both", "billing_class": "facility"}], "modifiers": "GN"}, {"description": "SP EVAL LNG COM W/EXP COMPLEX", "code_information": [{"code": "92523", "type": "CPT"}, {"code": "5900528", "type": "CDM"}, {"code": "444", "type": "RC"}], "standard_charges": [{"gross_charge": 4515.0, "discounted_cash": 3386.25, "setting": "both", "billing_class": "facility"}], "modifiers": "GN"}, {"description": "SP EVAL LNG COM W/EXP EXTENSVE", "code_information": [{"code": "92523", "type": "CPT"}, {"code": "5900529", "type": "CDM"}, {"code": "444", "type": "RC"}], "standard_charges": [{"gross_charge": 4125.0, "discounted_cash": 3093.75, "setting": "both", "billing_class": "facility"}], "modifiers": "GN"}, {"description": "SP EVAL LNG COM W/EXP INTERM", "code_information": [{"code": "92523", "type": "CPT"}, {"code": "5900527", "type": "CDM"}, {"code": "444", "type": "RC"}], "standard_charges": [{"gross_charge": 2681.0, "discounted_cash": 2010.75, "setting": "both", "billing_class": "facility"}], "modifiers": "GN"}, {"description": "SP EVAL SOUND PROD BASIC", "code_information": [{"code": "92522", "type": "CPT"}, {"code": "5902522", "type": "CDM"}, {"code": "444", "type": "RC"}], "standard_charges": [{"gross_charge": 1408.0, "discounted_cash": 1056.0, "setting": "both", "billing_class": "facility"}], "modifiers": "GN"}, {"description": "SP EVAL/FIT VOICE PROSTH BASIC", "code_information": [{"code": "92597", "type": "CPT"}, {"code": "5901948", "type": "CDM"}, {"code": "444", "type": "RC"}], "standard_charges": [{"gross_charge": 770.0, "discounted_cash": 577.5, "setting": "both", "billing_class": "facility"}], "modifiers": "GN"}, {"description": "SP EXPAND/STACK DEVICES", "code_information": [{"code": "C1821", "type": "HCPCS"}, {"code": "4011220", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 96007.0, "discounted_cash": 72005.25, "setting": "both", "billing_class": "facility"}]}, {"description": "SP IBF BN ALLOGRAFT LUMB", "code_information": [{"code": "L8699", "type": "HCPCS"}, {"code": "4011223", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 82542.0, "discounted_cash": 61906.5, "setting": "both", "billing_class": "facility"}]}, {"description": "SP IBF DEV ARTICULATING", "code_information": [{"code": "C1889", "type": "HCPCS"}, {"code": "4011208", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 22881.0, "discounted_cash": 17160.75, "setting": "both", "billing_class": "facility"}]}, {"description": "SP LAMINAL HOOKS BLADE", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "4011224", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 13469.0, "discounted_cash": 10101.75, "setting": "both", "billing_class": "facility"}]}, {"description": "SP LUMB INTBODY DEV PLIF", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "4011226", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 66773.0, "discounted_cash": 50079.75, "setting": "both", "billing_class": "facility"}]}, {"description": "SP LUMB INTBODY DEV TLIF", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "4011227", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 37117.0, "discounted_cash": 27837.75, "setting": "both", "billing_class": "facility"}]}, {"description": "SP LUMBAR MIN 6 VWS", "code_information": [{"code": "72114", "type": "CPT"}, {"code": "4902114", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 2467.0, "discounted_cash": 1850.25, "setting": "both", "billing_class": "facility"}]}, {"description": "SP LUMBAR MIN 6 VWS", "code_information": [{"code": "72114", "type": "CPT"}, {"code": "5112114", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 3581.0, "discounted_cash": 2685.75, "setting": "both", "billing_class": "facility"}]}, {"description": "SP OCCIP BN SCRW", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "4011239", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 1585.0, "discounted_cash": 1188.75, "setting": "both", "billing_class": "facility"}]}, {"description": "SP OCCIP PLT", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "4011238", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 31487.0, "discounted_cash": 23615.25, "setting": "both", "billing_class": "facility"}]}, {"description": "SP OCCIPITAL ROD", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "4011209", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 3698.0, "discounted_cash": 2773.5, "setting": "both", "billing_class": "facility"}]}, {"description": "SP PEDICLE SCREW ADV", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "4011229", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 22623.0, "discounted_cash": 16967.25, "setting": "both", "billing_class": "facility"}]}, {"description": "SP PEDICLE SCREW STND", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "4011230", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 13744.0, "discounted_cash": 10308.0, "setting": "both", "billing_class": "facility"}]}, {"description": "SP ROD ADVANCED", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "4011231", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 4050.0, "discounted_cash": 3037.5, "setting": "both", "billing_class": "facility"}]}, {"description": "SP ROD STANDARD", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "4011211", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 9267.0, "discounted_cash": 6950.25, "setting": "both", "billing_class": "facility"}]}, {"description": "SP SET SCRW BOLT CAP NUT", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "4011202", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 4054.0, "discounted_cash": 3040.5, "setting": "both", "billing_class": "facility"}]}, {"description": "SP SPINOUS PROCESS DEV", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "4011244", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 69361.0, "discounted_cash": 52020.75, "setting": "both", "billing_class": "facility"}]}, {"description": "SP STAPLE", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "4011266", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 15544.0, "discounted_cash": 11658.0, "setting": "both", "billing_class": "facility"}]}, {"description": "SP STD COG PERF TEST BASIC", "code_information": [{"code": "96125", "type": "CPT"}, {"code": "5906125", "type": "CDM"}, {"code": "440", "type": "RC"}], "standard_charges": [{"gross_charge": 1231.0, "discounted_cash": 923.25, "setting": "both", "billing_class": "facility"}], "modifiers": "GN"}, {"description": "SP SWAL EVAL ORAL PHARYN BASIC", "code_information": [{"code": "92610", "type": "CPT"}, {"code": "5902610", "type": "CDM"}, {"code": "444", "type": "RC"}], "standard_charges": [{"gross_charge": 1784.0, "discounted_cash": 1338.0, "setting": "both", "billing_class": "facility"}], "modifiers": "GN"}, {"description": "SP SWAL EVAL ORAL PHARYN COMP", "code_information": [{"code": "92610", "type": "CPT"}, {"code": "5902618", "type": "CDM"}, {"code": "444", "type": "RC"}], "standard_charges": [{"gross_charge": 1610.0, "discounted_cash": 1207.5, "setting": "both", "billing_class": "facility"}], "modifiers": "GN"}, {"description": "SP SWAL EVAL ORAL PHARYN EXTNS", "code_information": [{"code": "92610", "type": "CPT"}, {"code": "5902630", "type": "CDM"}, {"code": "444", "type": "RC"}], "standard_charges": [{"gross_charge": 4861.0, "discounted_cash": 3645.75, "setting": "both", "billing_class": "facility"}], "modifiers": "GN"}, {"description": "SP SWAL EVAL ORAL PHARYN INTRM", "code_information": [{"code": "92610", "type": "CPT"}, {"code": "5902617", "type": "CDM"}, {"code": "444", "type": "RC"}], "standard_charges": [{"gross_charge": 2274.0, "discounted_cash": 1705.5, "setting": "both", "billing_class": "facility"}], "modifiers": "GN"}, {"description": "SP SWAL/ORAL TX BASIC", "code_information": [{"code": "92526", "type": "CPT"}, {"code": "5901090", "type": "CDM"}, {"code": "440", "type": "RC"}], "standard_charges": [{"gross_charge": 479.0, "discounted_cash": 359.25, "setting": "both", "billing_class": "facility"}], "modifiers": "GN"}, {"description": "SP SWAL/ORAL TX COMPLEX", "code_information": [{"code": "92526", "type": "CPT"}, {"code": "5901094", "type": "CDM"}, {"code": "440", "type": "RC"}], "standard_charges": [{"gross_charge": 966.0, "discounted_cash": 724.5, "setting": "both", "billing_class": "facility"}], "modifiers": "GN"}, {"description": "SP SWAL/ORAL TX EXTENSIVE", "code_information": [{"code": "92526", "type": "CPT"}, {"code": "5901096", "type": "CDM"}, {"code": "440", "type": "RC"}], "standard_charges": [{"gross_charge": 1207.0, "discounted_cash": 905.25, "setting": "both", "billing_class": "facility"}], "modifiers": "GN"}, {"description": "SP SWAL/ORAL TX INTERM", "code_information": [{"code": "92526", "type": "CPT"}, {"code": "5901092", "type": "CDM"}, {"code": "440", "type": "RC"}], "standard_charges": [{"gross_charge": 786.0, "discounted_cash": 589.5, "setting": "both", "billing_class": "facility"}], "modifiers": "GN"}, {"description": "SP THERAPEUTIC SP DEV BASIC", "code_information": [{"code": "92609", "type": "CPT"}, {"code": "5902609", "type": "CDM"}, {"code": "440", "type": "RC"}], "standard_charges": [{"gross_charge": 2070.0, "discounted_cash": 1552.5, "setting": "both", "billing_class": "facility"}], "modifiers": "GN"}, {"description": "SP THERAPEUTIC SP DEV COMPLEX", "code_information": [{"code": "92609", "type": "CPT"}, {"code": "5902620", "type": "CDM"}, {"code": "440", "type": "RC"}], "standard_charges": [{"gross_charge": 4142.0, "discounted_cash": 3106.5, "setting": "both", "billing_class": "facility"}], "modifiers": "GN"}, {"description": "SP THERAPEUTIC SP DEV INTERM", "code_information": [{"code": "92609", "type": "CPT"}, {"code": "5902613", "type": "CDM"}, {"code": "440", "type": "RC"}], "standard_charges": [{"gross_charge": 3108.0, "discounted_cash": 2331.0, "setting": "both", "billing_class": "facility"}], "modifiers": "GN"}, {"description": "SP THERPEUTIC SP DEV EXTENSIVE", "code_information": [{"code": "92609", "type": "CPT"}, {"code": "5902626", "type": "CDM"}, {"code": "440", "type": "RC"}], "standard_charges": [{"gross_charge": 5176.0, "discounted_cash": 3882.0, "setting": "both", "billing_class": "facility"}], "modifiers": "GN"}, {"description": "SP-GR EXCEPT URINE", "code_information": [{"code": "84315", "type": "CPT"}, {"code": "4104315", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 247.0, "discounted_cash": 185.25, "setting": "both", "billing_class": "facility"}]}, {"description": "SPEC PROC W/LITHO", "code_information": [{"code": "3083010", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 14602.0, "discounted_cash": 10951.5, "setting": "both", "billing_class": "facility"}]}, {"description": "SPEC STAIN TRICH OVA/PARA", "code_information": [{"code": "87209", "type": "CPT"}, {"code": "4108313", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 996.0, "discounted_cash": 747.0, "setting": "both", "billing_class": "facility"}]}, {"description": "SPEC STAIN TRICH OVA/PARA", "code_information": [{"code": "87209", "type": "CPT"}, {"code": "4177209", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 7.14, "discounted_cash": 5.36, "setting": "both", "billing_class": "facility"}]}, {"description": "SPEC STAINS GROUP I", "code_information": [{"code": "88312", "type": "CPT"}, {"code": "4308312", "type": "CDM"}, {"code": "310", "type": "RC"}], "standard_charges": [{"gross_charge": 639.0, "discounted_cash": 479.25, "setting": "both", "billing_class": "facility"}]}, {"description": "SPEC STAINS GROUP II", "code_information": [{"code": "88313", "type": "CPT"}, {"code": "4108314", "type": "CDM"}, {"code": "310", "type": "RC"}], "standard_charges": [{"gross_charge": 1667.0, "discounted_cash": 1250.25, "setting": "both", "billing_class": "facility"}]}, {"description": "SPEC STAINS GROUP II", "code_information": [{"code": "88313", "type": "CPT"}, {"code": "4308313", "type": "CDM"}, {"code": "310", "type": "RC"}], "standard_charges": [{"gross_charge": 1667.0, "discounted_cash": 1250.25, "setting": "both", "billing_class": "facility"}]}, {"description": "SPEC STAINS GROUP II", "code_information": [{"code": "88313", "type": "CPT"}, {"code": "7258831", "type": "CDM"}, {"code": "310", "type": "RC"}], "standard_charges": [{"gross_charge": 325.0, "discounted_cash": 243.75, "setting": "both", "billing_class": "facility"}]}, {"description": "SPECIAL STAIN SMEAR", "code_information": [{"code": "87207", "type": "CPT"}, {"code": "4177202", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 11.42, "discounted_cash": 8.57, "setting": "both", "billing_class": "facility"}]}, {"description": "SPECIAL STAIN SMEAR", "code_information": [{"code": "87207", "type": "CPT"}, {"code": "7257207", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 43.0, "discounted_cash": 32.25, "setting": "both", "billing_class": "facility"}]}, {"description": "SPECIAL STAIN SMEAR/2", "code_information": [{"code": "87207", "type": "CPT"}, {"code": "4107202", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 405.0, "discounted_cash": 303.75, "setting": "both", "billing_class": "facility"}]}, {"description": "SPECIAL STAIN SMEAR/2", "code_information": [{"code": "87207", "type": "CPT"}, {"code": "7257208", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 582.0, "discounted_cash": 436.5, "setting": "both", "billing_class": "facility"}]}, {"description": "SPECIMEN HANDLING", "code_information": [{"code": "99001", "type": "CPT"}, {"code": "4201300", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 129.0, "discounted_cash": 96.75, "setting": "both", "billing_class": "facility"}]}, {"description": "SPECIMEN HANDLING/2", "code_information": [{"code": "99001", "type": "CPT"}, {"code": "4201110", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 122.0, "discounted_cash": 91.5, "setting": "both", "billing_class": "facility"}]}, {"description": "SPECIMEN HANDLING/4", "code_information": [{"code": "99001", "type": "CPT"}, {"code": "4201125", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 122.0, "discounted_cash": 91.5, "setting": "both", "billing_class": "facility"}]}, {"description": "SPECIMEN HANDLING/5", "code_information": [{"code": "99001", "type": "CPT"}, {"code": "4209054", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 344.0, "discounted_cash": 258.0, "setting": "both", "billing_class": "facility"}]}, {"description": "SPEECH/LANG TX BASIC", "code_information": [{"code": "92507", "type": "CPT"}, {"code": "5901007", "type": "CDM"}, {"code": "440", "type": "RC"}], "standard_charges": [{"gross_charge": 813.0, "discounted_cash": 609.75, "setting": "both", "billing_class": "facility"}], "modifiers": "GN"}, {"description": "SPEECH/LANG TX CMPLX", "code_information": [{"code": "92507", "type": "CPT"}, {"code": "5901009", "type": "CDM"}, {"code": "440", "type": "RC"}], "standard_charges": [{"gross_charge": 1487.0, "discounted_cash": 1115.25, "setting": "both", "billing_class": "facility"}], "modifiers": "GN"}, {"description": "SPEECH/LANG TX EXTNSV", "code_information": [{"code": "92507", "type": "CPT"}, {"code": "5901005", "type": "CDM"}, {"code": "440", "type": "RC"}], "standard_charges": [{"gross_charge": 1713.0, "discounted_cash": 1284.75, "setting": "both", "billing_class": "facility"}], "modifiers": "GN"}, {"description": "SPEECH/LANG TX INTER", "code_information": [{"code": "92507", "type": "CPT"}, {"code": "5901008", "type": "CDM"}, {"code": "440", "type": "RC"}], "standard_charges": [{"gross_charge": 1154.0, "discounted_cash": 865.5, "setting": "both", "billing_class": "facility"}], "modifiers": "GN"}, {"description": "SPINAL CAGE", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8136504", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 76640.0, "discounted_cash": 57480.0, "setting": "both", "billing_class": "facility"}]}, {"description": "SPINAL PUNCT LUMB DX WFLUOR/CT", "code_information": [{"code": "4902321", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 4232.0, "discounted_cash": 3174.0, "setting": "both", "billing_class": "facility"}]}, {"description": "SPINAL PUNCT LUMB DX WFLUOR/CT", "code_information": [{"code": "4912328", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 3772.0, "discounted_cash": 2829.0, "setting": "both", "billing_class": "facility"}]}, {"description": "SPINAL PUNCTR LUMB DIAG", "code_information": [{"code": "4908900", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 4232.0, "discounted_cash": 3174.0, "setting": "both", "billing_class": "facility"}]}, {"description": "SPINAL PUNCTR LUMB DIAG", "code_information": [{"code": "4918900", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 3772.0, "discounted_cash": 2829.0, "setting": "both", "billing_class": "facility"}]}, {"description": "SPINE ANY LEVEL SNGL VW", "code_information": [{"code": "72020", "type": "CPT"}, {"code": "4902020", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 1352.0, "discounted_cash": 1014.0, "setting": "both", "billing_class": "facility"}]}, {"description": "SPINE CERV 6 > VWS", "code_information": [{"code": "72052", "type": "CPT"}, {"code": "4902052", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 2107.0, "discounted_cash": 1580.25, "setting": "both", "billing_class": "facility"}]}, {"description": "SPINE CERV 6 > VWS", "code_information": [{"code": "72052", "type": "CPT"}, {"code": "5112052", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 2891.0, "discounted_cash": 2168.25, "setting": "both", "billing_class": "facility"}]}, {"description": "SPINE CERVICAL 2 VIEWS", "code_information": [{"code": "72040", "type": "CPT"}, {"code": "4902040", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 1940.0, "discounted_cash": 1455.0, "setting": "both", "billing_class": "facility"}]}, {"description": "SPINE CERVICAL 2 VIEWS", "code_information": [{"code": "72040", "type": "CPT"}, {"code": "5112040", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 1309.0, "discounted_cash": 981.75, "setting": "both", "billing_class": "facility"}]}, {"description": "SPINE CERVICAL 3 VIEWS", "code_information": [{"code": "72040", "type": "CPT"}, {"code": "4902042", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 1309.0, "discounted_cash": 981.75, "setting": "both", "billing_class": "facility"}]}, {"description": "SPINE CERVICAL 3 VIEWS", "code_information": [{"code": "72040", "type": "CPT"}, {"code": "5112041", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 1739.0, "discounted_cash": 1304.25, "setting": "both", "billing_class": "facility"}]}, {"description": "SPINE CERVICAL 4 OR 5 VW", "code_information": [{"code": "72050", "type": "CPT"}, {"code": "4902050", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 3667.0, "discounted_cash": 2750.25, "setting": "both", "billing_class": "facility"}]}, {"description": "SPINE CERVICAL 4 OR 5 VW", "code_information": [{"code": "72050", "type": "CPT"}, {"code": "5112050", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 2633.0, "discounted_cash": 1974.75, "setting": "both", "billing_class": "facility"}]}, {"description": "SPINE LUMBAR 2 VIEWS", "code_information": [{"code": "72100", "type": "CPT"}, {"code": "4902100", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 2083.0, "discounted_cash": 1562.25, "setting": "both", "billing_class": "facility"}]}, {"description": "SPINE LUMBAR 2 VIEWS", "code_information": [{"code": "72100", "type": "CPT"}, {"code": "5117211", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 2152.0, "discounted_cash": 1614.0, "setting": "both", "billing_class": "facility"}]}, {"description": "SPINE LUMBAR 3 VIEWS", "code_information": [{"code": "72100", "type": "CPT"}, {"code": "4902101", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 2083.0, "discounted_cash": 1562.25, "setting": "both", "billing_class": "facility"}]}, {"description": "SPINE LUMBAR 3 VIEWS", "code_information": [{"code": "72100", "type": "CPT"}, {"code": "5112100", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 1708.0, "discounted_cash": 1281.0, "setting": "both", "billing_class": "facility"}]}, {"description": "SPINE LUMBAR MIN 4VWS", "code_information": [{"code": "72110", "type": "CPT"}, {"code": "4902110", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 3326.0, "discounted_cash": 2494.5, "setting": "both", "billing_class": "facility"}]}, {"description": "SPINE LUMBAR MIN 4VWS", "code_information": [{"code": "72110", "type": "CPT"}, {"code": "5112110", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 3326.0, "discounted_cash": 2494.5, "setting": "both", "billing_class": "facility"}]}, {"description": "SPINE THORACIC 2 VIEWS", "code_information": [{"code": "72070", "type": "CPT"}, {"code": "4902070", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 1751.0, "discounted_cash": 1313.25, "setting": "both", "billing_class": "facility"}]}, {"description": "SPINE THORACIC 2 VIEWS", "code_information": [{"code": "72070", "type": "CPT"}, {"code": "5112070", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 1472.0, "discounted_cash": 1104.0, "setting": "both", "billing_class": "facility"}]}, {"description": "SPINE THORACIC 3 VIEWS", "code_information": [{"code": "72072", "type": "CPT"}, {"code": "4902071", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 2207.0, "discounted_cash": 1655.25, "setting": "both", "billing_class": "facility"}]}, {"description": "SPINE THORACIC 3 VIEWS", "code_information": [{"code": "72072", "type": "CPT"}, {"code": "5112072", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 1487.0, "discounted_cash": 1115.25, "setting": "both", "billing_class": "facility"}]}, {"description": "SPINE THORACIC 4VW MIN", "code_information": [{"code": "72074", "type": "CPT"}, {"code": "4902072", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 1855.0, "discounted_cash": 1391.25, "setting": "both", "billing_class": "facility"}]}, {"description": "SPINE THORACIC 4VW MIN", "code_information": [{"code": "72074", "type": "CPT"}, {"code": "5112074", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 1855.0, "discounted_cash": 1391.25, "setting": "both", "billing_class": "facility"}]}, {"description": "SPINE THORACO-LUMBAR JCT", "code_information": [{"code": "72080", "type": "CPT"}, {"code": "4902080", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 610.0, "discounted_cash": 457.5, "setting": "both", "billing_class": "facility"}]}, {"description": "SPINE THORACOLMBR 1 VW", "code_information": [{"code": "72081", "type": "CPT"}, {"code": "4902081", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 339.0, "discounted_cash": 254.25, "setting": "both", "billing_class": "facility"}]}, {"description": "SPINE THORACOLMBR 2-3VW", "code_information": [{"code": "72082", "type": "CPT"}, {"code": "4902082", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 558.0, "discounted_cash": 418.5, "setting": "both", "billing_class": "facility"}]}, {"description": "SPIROMETRY", "code_information": [{"code": "94010", "type": "CPT"}, {"code": "5501192", "type": "CDM"}, {"code": "460", "type": "RC"}], "standard_charges": [{"gross_charge": 2655.0, "discounted_cash": 1991.25, "setting": "both", "billing_class": "facility"}]}, {"description": "SPIRONOLACTON NEO CMPDLQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5316384", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 5.0, "discounted_cash": 3.75, "setting": "both", "billing_class": "facility"}]}, {"description": "SPIRONOLACTON NEO CMPDLQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5316384", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 5.0, "discounted_cash": 3.75, "setting": "both", "billing_class": "facility"}]}, {"description": "SPIRONOLACTON PED CMPDLQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5316385", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 113.0, "discounted_cash": 84.75, "setting": "both", "billing_class": "facility"}]}, {"description": "SPIRONOLACTON PED CMPDLQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5316385", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 113.0, "discounted_cash": 84.75, "setting": "both", "billing_class": "facility"}]}, {"description": "SPIRONOLACTONE 100MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5310917", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 85.0, "discounted_cash": 63.75, "setting": "both", "billing_class": "facility"}]}, {"description": "SPIRONOLACTONE 100MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5310917", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 85.0, "discounted_cash": 63.75, "setting": "both", "billing_class": "facility"}]}, {"description": "SPIRONOLACTONE 25MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5310910", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 92.0, "discounted_cash": 69.0, "setting": "both", "billing_class": "facility"}]}, {"description": "SPIRONOLACTONE 25MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5310910", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 92.0, "discounted_cash": 69.0, "setting": "both", "billing_class": "facility"}]}, {"description": "SPIRONOLACTONE CMPD LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5316381", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 13.0, "discounted_cash": 9.75, "setting": "both", "billing_class": "facility"}]}, {"description": "SPIRONOLACTONE CMPD LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5316381", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 13.0, "discounted_cash": 9.75, "setting": "both", "billing_class": "facility"}]}, {"description": "SPLITTING BLD PROD EA UT", "code_information": [{"code": "86985", "type": "CPT"}, {"code": "4206985", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 280.0, "discounted_cash": 210.0, "setting": "both", "billing_class": "facility"}]}, {"description": "SPLITTING BLD PROD EA UT", "code_information": [{"code": "86985", "type": "CPT"}, {"code": "4506985", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 225.0, "discounted_cash": 168.75, "setting": "both", "billing_class": "facility"}]}, {"description": "SPOOL HUMERAL", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "8137900", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 37391.0, "discounted_cash": 28043.25, "setting": "both", "billing_class": "facility"}]}, {"description": "SPUTUM SPCMN", "code_information": [{"code": "89220", "type": "CPT"}, {"code": "5509220", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 508.0, "discounted_cash": 381.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ST ABDOMINAL EXTENSION ABRA", "code_information": [{"code": "A4649", "type": "HCPCS"}, {"code": "8084945", "type": "CDM"}, {"code": "272", "type": "RC"}], "standard_charges": [{"gross_charge": 50195.0, "discounted_cash": 37646.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ST ACCESS LIVER TRNSJUG", "code_information": [{"code": "C1894", "type": "HCPCS"}, {"code": "8034187", "type": "CDM"}, {"code": "272", "type": "RC"}], "standard_charges": [{"gross_charge": 2788.0, "discounted_cash": 2091.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ST CATH URET ILLUMINAT", "code_information": [{"code": "C1729", "type": "HCPCS"}, {"code": "8041321", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 3258.0, "discounted_cash": 2443.5, "setting": "both", "billing_class": "facility"}]}, {"description": "ST INTRO PEEL-AWAY", "code_information": [{"code": "C1892", "type": "HCPCS"}, {"code": "8248550", "type": "CDM"}, {"code": "272", "type": "RC"}], "standard_charges": [{"gross_charge": 1091.0, "discounted_cash": 818.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ST INTRO PEELAWAY W GW", "code_information": [{"code": "C1892", "type": "HCPCS"}, {"code": "8248551", "type": "CDM"}, {"code": "272", "type": "RC"}], "standard_charges": [{"gross_charge": 1103.0, "discounted_cash": 827.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ST PERCUTANEOUS INTROD", "code_information": [{"code": "C1894", "type": "HCPCS"}, {"code": "8034169", "type": "CDM"}, {"code": "272", "type": "RC"}], "standard_charges": [{"gross_charge": 1623.0, "discounted_cash": 1217.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ST PUMP IMPELLA CP CATH", "code_information": [{"code": "C1889", "type": "HCPCS"}, {"code": "8145166", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 462276.0, "discounted_cash": 346707.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ST RENAL DILAT", "code_information": [{"code": "C1726", "type": "HCPCS"}, {"code": "8177255", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 3334.0, "discounted_cash": 2500.5, "setting": "both", "billing_class": "facility"}]}, {"description": "ST SHTH DILT ROTAT CNTRL", "code_information": [{"code": "C1773", "type": "HCPCS"}, {"code": "8177256", "type": "CDM"}, {"code": "272", "type": "RC"}], "standard_charges": [{"gross_charge": 12521.0, "discounted_cash": 9390.75, "setting": "both", "billing_class": "facility"}]}, {"description": "STAPLE COMPRESSION", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8136624", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 23057.0, "discounted_cash": 17292.75, "setting": "both", "billing_class": "facility"}]}, {"description": "STAVUDINE 40MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5310950", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 209.0, "discounted_cash": 156.75, "setting": "both", "billing_class": "facility"}]}, {"description": "STAVUDINE 40MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5310950", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 209.0, "discounted_cash": 156.75, "setting": "both", "billing_class": "facility"}]}, {"description": "STEM CUP ALTIVATE HUM DJO CL", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "4013428", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 49408.0, "discounted_cash": 37056.0, "setting": "both", "billing_class": "facility"}]}, {"description": "STEM FEM CT HA ANT ACT DPY CL", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "4012813", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 30634.0, "discounted_cash": 22975.5, "setting": "both", "billing_class": "facility"}]}, {"description": "STEM FEM CT HA PA SCR STRY CL", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "4013056", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 29992.0, "discounted_cash": 22494.0, "setting": "both", "billing_class": "facility"}]}, {"description": "STEM FEM CTD CTD HA P2 DJO CL", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "4013398", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 29646.0, "discounted_cash": 22234.5, "setting": "both", "billing_class": "facility"}]}, {"description": "STEM FEM FRACTUR STEM DPY CL", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "4012814", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 20424.0, "discounted_cash": 15318.0, "setting": "both", "billing_class": "facility"}]}, {"description": "STEM FEM MOD SLV NCK DEPUY CL", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "4012815", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 5570.0, "discounted_cash": 4177.5, "setting": "both", "billing_class": "facility"}]}, {"description": "STEM FEM MODULAR STM DEPUY CL", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "4012816", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 25066.0, "discounted_cash": 18799.5, "setting": "both", "billing_class": "facility"}]}, {"description": "STEM FEMORAL FRACTURE DJO CL", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "4013399", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 14823.0, "discounted_cash": 11117.25, "setting": "both", "billing_class": "facility"}]}, {"description": "STEM FEMORAL UNCOAT DEPUY CL", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "4012817", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 24954.0, "discounted_cash": 18715.5, "setting": "both", "billing_class": "facility"}]}, {"description": "STEM FEMORAL UNCTD AESCULAP CL", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "4013337", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 25084.0, "discounted_cash": 18813.0, "setting": "both", "billing_class": "facility"}]}, {"description": "STEM FEMORAL UNCTD DJO CL", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "4013401", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 23057.0, "discounted_cash": 17292.75, "setting": "both", "billing_class": "facility"}]}, {"description": "STEM HIP MODULAR REVISN DJO CL", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "4013403", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 21410.0, "discounted_cash": 16057.5, "setting": "both", "billing_class": "facility"}]}, {"description": "STEM HUM FRACT REVSN STRYK CL", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "4013028", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 41666.0, "discounted_cash": 31249.5, "setting": "both", "billing_class": "facility"}]}, {"description": "STEM HUM SHRT P2 COATED DJO CL", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "4013433", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 23057.0, "discounted_cash": 17292.75, "setting": "both", "billing_class": "facility"}]}, {"description": "STEM HUMERAL NCK DJO CL", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "4013431", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 4941.0, "discounted_cash": 3705.75, "setting": "both", "billing_class": "facility"}]}, {"description": "STEM HUMERL CT UNCEM DEPUY CL", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "4013126", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 29397.0, "discounted_cash": 22047.75, "setting": "both", "billing_class": "facility"}]}, {"description": "STEM KNEE CEMENTED STRYKR CL", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "4013107", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 8106.0, "discounted_cash": 6079.5, "setting": "both", "billing_class": "facility"}]}, {"description": "STEM KNEE DEPU", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "8136585", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 19315.0, "discounted_cash": 14486.25, "setting": "both", "billing_class": "facility"}]}, {"description": "STEM KNEE EXTEN AS AESCULAP CL", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "4013346", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 21947.0, "discounted_cash": 16460.25, "setting": "both", "billing_class": "facility"}]}, {"description": "STEM KNEE EXTEN COATD DEPUY CL", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "4012819", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 20182.0, "discounted_cash": 15136.5, "setting": "both", "billing_class": "facility"}]}, {"description": "STEM KNEE EXTN UNCTED DEPUY CL", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "4012823", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 11140.0, "discounted_cash": 8355.0, "setting": "both", "billing_class": "facility"}]}, {"description": "STENT VENOUS WALLSTENT SLF-EXP", "code_information": [{"code": "C1876", "type": "HCPCS"}, {"code": "8067085", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 30077.0, "discounted_cash": 22557.75, "setting": "both", "billing_class": "facility"}]}, {"description": "STERNCLAVR JNTS 3VW MIN", "code_information": [{"code": "71130", "type": "CPT"}, {"code": "4901130", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 909.0, "discounted_cash": 681.75, "setting": "both", "billing_class": "facility"}]}, {"description": "STERNCLAVR JNTS 3VW MIN", "code_information": [{"code": "71130", "type": "CPT"}, {"code": "5111130", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 909.0, "discounted_cash": 681.75, "setting": "both", "billing_class": "facility"}]}, {"description": "STERNUM 2VW MIN", "code_information": [{"code": "71120", "type": "CPT"}, {"code": "4901120", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 1146.0, "discounted_cash": 859.5, "setting": "both", "billing_class": "facility"}]}, {"description": "STM SHLD MDSPCR ANTIB OSTEO CL", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "4013367", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 47556.0, "discounted_cash": 35667.0, "setting": "both", "billing_class": "facility"}]}, {"description": "STNT B ADVANX PRELD NAVF", "code_information": [{"code": "C2625", "type": "HCPCS"}, {"code": "8062212", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 1457.0, "discounted_cash": 1092.75, "setting": "both", "billing_class": "facility"}]}, {"description": "STNT B COTTN LEUNG WO DL", "code_information": [{"code": "C2617", "type": "HCPCS"}, {"code": "4024795", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 26262.0, "discounted_cash": 19696.5, "setting": "both", "billing_class": "facility"}]}, {"description": "STNT B EXPRESS LD", "code_information": [{"code": "C1876", "type": "HCPCS"}, {"code": "8243136", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 6499.0, "discounted_cash": 4874.25, "setting": "both", "billing_class": "facility"}]}, {"description": "STNT B FLEXIMA SYS SNGL", "code_information": [{"code": "C2625", "type": "HCPCS"}, {"code": "8243110", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 1562.0, "discounted_cash": 1171.5, "setting": "both", "billing_class": "facility"}]}, {"description": "STNT B INTRASTENT", "code_information": [{"code": "C1877", "type": "HCPCS"}, {"code": "8243135", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 6174.0, "discounted_cash": 4630.5, "setting": "both", "billing_class": "facility"}]}, {"description": "STNT B PALMAZ XL", "code_information": [{"code": "C1877", "type": "HCPCS"}, {"code": "8248618", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 6499.0, "discounted_cash": 4874.25, "setting": "both", "billing_class": "facility"}]}, {"description": "STNT B PROTEGE EVERFLEX", "code_information": [{"code": "C1876", "type": "HCPCS"}, {"code": "4024808", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 13220.0, "discounted_cash": 9915.0, "setting": "both", "billing_class": "facility"}]}, {"description": "STNT B PROTEGE GPS", "code_information": [{"code": "C1876", "type": "HCPCS"}, {"code": "4028735", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 7170.0, "discounted_cash": 5377.5, "setting": "both", "billing_class": "facility"}]}, {"description": "STNT B RENAL EXPRESS SD", "code_information": [{"code": "C1876", "type": "HCPCS"}, {"code": "4024815", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 7170.0, "discounted_cash": 5377.5, "setting": "both", "billing_class": "facility"}]}, {"description": "STNT B RX HERCULNK ELITE", "code_information": [{"code": "C1876", "type": "HCPCS"}, {"code": "4024804", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 14845.0, "discounted_cash": 11133.75, "setting": "both", "billing_class": "facility"}]}, {"description": "STNT B RX PLASTIC", "code_information": [{"code": "C2625", "type": "HCPCS"}, {"code": "4024807", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 1357.0, "discounted_cash": 1017.75, "setting": "both", "billing_class": "facility"}]}, {"description": "STNT B SLF-EXP SENTINOL", "code_information": [{"code": "C1876", "type": "HCPCS"}, {"code": "4024809", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 11648.0, "discounted_cash": 8736.0, "setting": "both", "billing_class": "facility"}]}, {"description": "STNT B TH SMART NITINOL6", "code_information": [{"code": "C1876", "type": "HCPCS"}, {"code": "8243119", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 18138.0, "discounted_cash": 13603.5, "setting": "both", "billing_class": "facility"}]}, {"description": "STNT B VISIPRO", "code_information": [{"code": "C1876", "type": "HCPCS"}, {"code": "4024817", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 13755.0, "discounted_cash": 10316.25, "setting": "both", "billing_class": "facility"}]}, {"description": "STNT B XPERT OTW", "code_information": [{"code": "C1876", "type": "HCPCS"}, {"code": "8243163", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 12341.0, "discounted_cash": 9255.75, "setting": "both", "billing_class": "facility"}]}, {"description": "STNT BILIARY RACER OTW", "code_information": [{"code": "C1876", "type": "HCPCS"}, {"code": "8062058", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 7396.0, "discounted_cash": 5547.0, "setting": "both", "billing_class": "facility"}]}, {"description": "STNT C ACS MULTILNK ULT", "code_information": [{"code": "C1876", "type": "HCPCS"}, {"code": "8243184", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 6708.0, "discounted_cash": 5031.0, "setting": "both", "billing_class": "facility"}]}, {"description": "STNT C LIBERTE MONORAIL", "code_information": [{"code": "C1876", "type": "HCPCS"}, {"code": "4024823", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 29964.0, "discounted_cash": 22473.0, "setting": "both", "billing_class": "facility"}]}, {"description": "STNT C PACLITAXEL", "code_information": [{"code": "C1874", "type": "HCPCS"}, {"code": "4025005", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 34252.0, "discounted_cash": 25689.0, "setting": "both", "billing_class": "facility"}]}, {"description": "STNT C PROMUS RX", "code_information": [{"code": "C1874", "type": "HCPCS"}, {"code": "4025001", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 25290.0, "discounted_cash": 18967.5, "setting": "both", "billing_class": "facility"}]}, {"description": "STNT C S660 RAPID EXCH12", "code_information": [{"code": "C1876", "type": "HCPCS"}, {"code": "8243242", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 6499.0, "discounted_cash": 4874.25, "setting": "both", "billing_class": "facility"}]}, {"description": "STNT C TAXUS LIBERTE", "code_information": [{"code": "C1874", "type": "HCPCS"}, {"code": "4025004", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 29180.0, "discounted_cash": 21885.0, "setting": "both", "billing_class": "facility"}]}, {"description": "STNT C VERIFLEX BARE MON", "code_information": [{"code": "C1876", "type": "HCPCS"}, {"code": "8062068", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 8570.0, "discounted_cash": 6427.5, "setting": "both", "billing_class": "facility"}]}, {"description": "STNT C XIENCE", "code_information": [{"code": "C1874", "type": "HCPCS"}, {"code": "4025009", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 18704.0, "discounted_cash": 14028.0, "setting": "both", "billing_class": "facility"}]}, {"description": "STNT C XIENCE PRIME RX", "code_information": [{"code": "C1874", "type": "HCPCS"}, {"code": "4025013", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 18704.0, "discounted_cash": 14028.0, "setting": "both", "billing_class": "facility"}]}, {"description": "STNT C/CV SYNERGY MR US", "code_information": [{"code": "C1874", "type": "HCPCS"}, {"code": "8062086", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 14699.0, "discounted_cash": 11024.25, "setting": "both", "billing_class": "facility"}]}, {"description": "STNT CAROTID RX ACCULINK", "code_information": [{"code": "C1876", "type": "HCPCS"}, {"code": "8062063", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 24087.0, "discounted_cash": 18065.25, "setting": "both", "billing_class": "facility"}]}, {"description": "STNT CAROTID RX XACT", "code_information": [{"code": "C1876", "type": "HCPCS"}, {"code": "8062079", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 24087.0, "discounted_cash": 18065.25, "setting": "both", "billing_class": "facility"}]}, {"description": "STNT CATH COVERED PAPYRUS", "code_information": [{"code": "C1874", "type": "HCPCS"}, {"code": "8062048", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 49408.0, "discounted_cash": 37056.0, "setting": "both", "billing_class": "facility"}]}, {"description": "STNT COLONIC WALLFLEX", "code_information": [{"code": "C1876", "type": "HCPCS"}, {"code": "4025020", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 38890.0, "discounted_cash": 29167.5, "setting": "both", "billing_class": "facility"}]}, {"description": "STNT COR RESOLUTE ONYX DES RX", "code_information": [{"code": "C1874", "type": "HCPCS"}, {"code": "8062083", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 12970.0, "discounted_cash": 9727.5, "setting": "both", "billing_class": "facility"}]}, {"description": "STNT COR XIENCE SIERRA EE RX", "code_information": [{"code": "C1874", "type": "HCPCS"}, {"code": "8062205", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 12047.0, "discounted_cash": 9035.25, "setting": "both", "billing_class": "facility"}]}, {"description": "STNT DBL PGTL", "code_information": [{"code": "C2617", "type": "HCPCS"}, {"code": "8062090", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 1919.0, "discounted_cash": 1439.25, "setting": "both", "billing_class": "facility"}]}, {"description": "STNT E POLYFLEX", "code_information": [{"code": "C1874", "type": "HCPCS"}, {"code": "4025099", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 11183.0, "discounted_cash": 8387.25, "setting": "both", "billing_class": "facility"}]}, {"description": "STNT ELUTNG BTK ESPIRIT NTAP", "code_information": [{"code": "C1874", "type": "HCPCS"}, {"code": "8062228", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 42846.0, "discounted_cash": 32134.5, "setting": "both", "billing_class": "facility"}]}, {"description": "STNT ENDOPROSTH COMFORM", "code_information": [{"code": "C1874", "type": "HCPCS"}, {"code": "4025104", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 82380.0, "discounted_cash": 61785.0, "setting": "both", "billing_class": "facility"}]}, {"description": "STNT ENDOPROSTH FEM ART", "code_information": [{"code": "C1874", "type": "HCPCS"}, {"code": "8062215", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 40683.0, "discounted_cash": 30512.25, "setting": "both", "billing_class": "facility"}]}, {"description": "STNT ENDOVAS GRFT FLAIR", "code_information": [{"code": "C1874", "type": "HCPCS"}, {"code": "8062104", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 38154.0, "discounted_cash": 28615.5, "setting": "both", "billing_class": "facility"}]}, {"description": "STNT ESOPHAGEAL AGILE", "code_information": [{"code": "C1874", "type": "HCPCS"}, {"code": "8062224", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 49701.0, "discounted_cash": 37275.75, "setting": "both", "billing_class": "facility"}]}, {"description": "STNT ESOPHAGEAL WALLFLEX", "code_information": [{"code": "C1874", "type": "HCPCS"}, {"code": "4025103", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 58570.0, "discounted_cash": 43927.5, "setting": "both", "billing_class": "facility"}]}, {"description": "STNT MULTLINK VISION OTW", "code_information": [{"code": "C1876", "type": "HCPCS"}, {"code": "4025201", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 7400.0, "discounted_cash": 5550.0, "setting": "both", "billing_class": "facility"}]}, {"description": "STNT MULTLNK MINI VISION", "code_information": [{"code": "C1876", "type": "HCPCS"}, {"code": "4025200", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 7400.0, "discounted_cash": 5550.0, "setting": "both", "billing_class": "facility"}]}, {"description": "STNT P GEENEN W DELV SYS", "code_information": [{"code": "C2625", "type": "HCPCS"}, {"code": "4025329", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 1053.0, "discounted_cash": 789.75, "setting": "both", "billing_class": "facility"}]}, {"description": "STNT P GEENEN WO DLV SYS", "code_information": [{"code": "C2617", "type": "HCPCS"}, {"code": "8248703", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 955.0, "discounted_cash": 716.25, "setting": "both", "billing_class": "facility"}]}, {"description": "STNT PERIPH PTX DRG ELUT", "code_information": [{"code": "C1874", "type": "HCPCS"}, {"code": "8062271", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 23059.0, "discounted_cash": 17294.25, "setting": "both", "billing_class": "facility"}]}, {"description": "STNT PERIPHERAL SUPERA", "code_information": [{"code": "C1876", "type": "HCPCS"}, {"code": "8062272", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 37016.0, "discounted_cash": 27762.0, "setting": "both", "billing_class": "facility"}]}, {"description": "STNT TBRNCH FLUENCY PLUS", "code_information": [{"code": "C1874", "type": "HCPCS"}, {"code": "4025400", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 11431.0, "discounted_cash": 8573.25, "setting": "both", "billing_class": "facility"}]}, {"description": "STNT U PERCUFLX PLUS", "code_information": [{"code": "C2617", "type": "HCPCS"}, {"code": "4025496", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 1892.0, "discounted_cash": 1419.0, "setting": "both", "billing_class": "facility"}]}, {"description": "STNT U PERCUFLX SFT", "code_information": [{"code": "C2617", "type": "HCPCS"}, {"code": "8243174", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 1356.0, "discounted_cash": 1017.0, "setting": "both", "billing_class": "facility"}]}, {"description": "STNT U POLARIS LOOP", "code_information": [{"code": "C2617", "type": "HCPCS"}, {"code": "4025497", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 2907.0, "discounted_cash": 2180.25, "setting": "both", "billing_class": "facility"}]}, {"description": "STNT U POLARIS ULTRA", "code_information": [{"code": "C2617", "type": "HCPCS"}, {"code": "4025498", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 2906.0, "discounted_cash": 2179.5, "setting": "both", "billing_class": "facility"}]}, {"description": "STNT ULTRAFLX ESOPH", "code_information": [{"code": "C1874", "type": "HCPCS"}, {"code": "8062143", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 31936.0, "discounted_cash": 23952.0, "setting": "both", "billing_class": "facility"}]}, {"description": "STNT URETERAL", "code_information": [{"code": "C2625", "type": "HCPCS"}, {"code": "8062145", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 2228.0, "discounted_cash": 1671.0, "setting": "both", "billing_class": "facility"}]}, {"description": "STNT URETERAL", "code_information": [{"code": "C2625", "type": "HCPCS"}, {"code": "8062155", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 1650.0, "discounted_cash": 1237.5, "setting": "both", "billing_class": "facility"}]}, {"description": "STNT URETERAL TRIA", "code_information": [{"code": "C2617", "type": "HCPCS"}, {"code": "8062161", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 3242.0, "discounted_cash": 2431.5, "setting": "both", "billing_class": "facility"}]}, {"description": "STNT VAS ABSOLUTE PRO SE", "code_information": [{"code": "C1876", "type": "HCPCS"}, {"code": "8062177", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 17096.0, "discounted_cash": 12822.0, "setting": "both", "billing_class": "facility"}]}, {"description": "STNT VASC BIL LIFESTAR", "code_information": [{"code": "C1876", "type": "HCPCS"}, {"code": "8062183", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 10968.0, "discounted_cash": 8226.0, "setting": "both", "billing_class": "facility"}]}, {"description": "STNT VASC COVERED LIFESTREAM", "code_information": [{"code": "C1874", "type": "HCPCS"}, {"code": "8062194", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 35409.0, "discounted_cash": 26556.75, "setting": "both", "billing_class": "facility"}]}, {"description": "STPL LINE REINFORCEMENT", "code_information": [{"code": "C1781", "type": "HCPCS"}, {"code": "8185138", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 3016.0, "discounted_cash": 2262.0, "setting": "both", "billing_class": "facility"}]}, {"description": "STRATTICE TM PER SQ CM SKINSUB", "code_information": [{"code": "Q4130", "type": "HCPCS"}, {"code": "4028740", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 400.0, "discounted_cash": 300.0, "setting": "both", "billing_class": "facility"}]}, {"description": "STRATTICE TM PER SQ CM SKINSUB", "code_information": [{"code": "Q4130", "type": "HCPCS"}, {"code": "4028740", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 400.0, "discounted_cash": 300.0, "setting": "both", "billing_class": "facility"}]}, {"description": "STRAVIX 2CM X 2CM PER SQ CM", "code_information": [{"code": "Q4133", "type": "HCPCS"}, {"code": "4028745", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 2197.0, "discounted_cash": 1647.75, "setting": "both", "billing_class": "facility"}]}, {"description": "STRAVIX 2CM X 2CM PER SQ CM", "code_information": [{"code": "Q4133", "type": "HCPCS"}, {"code": "4028745", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 2197.0, "discounted_cash": 1647.75, "setting": "both", "billing_class": "facility"}]}, {"description": "STRAVIX 2CMX4CM PER SQ CM", "code_information": [{"code": "Q4133", "type": "HCPCS"}, {"code": "4028746", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 2299.0, "discounted_cash": 1724.25, "setting": "both", "billing_class": "facility"}]}, {"description": "STRAVIX 2CMX4CM PER SQ CM", "code_information": [{"code": "Q4133", "type": "HCPCS"}, {"code": "4028746", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 2299.0, "discounted_cash": 1724.25, "setting": "both", "billing_class": "facility"}]}, {"description": "STRAVIX 3CMX6CM PER SQ CM", "code_information": [{"code": "Q4133", "type": "HCPCS"}, {"code": "4028747", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 1623.0, "discounted_cash": 1217.25, "setting": "both", "billing_class": "facility"}]}, {"description": "STRAVIX 3CMX6CM PER SQ CM", "code_information": [{"code": "Q4133", "type": "HCPCS"}, {"code": "4028747", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 1623.0, "discounted_cash": 1217.25, "setting": "both", "billing_class": "facility"}]}, {"description": "STREPTOCOCCUS A DIR OPT", "code_information": [{"code": "87880", "type": "CPT"}, {"code": "4106410", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 602.0, "discounted_cash": 451.5, "setting": "both", "billing_class": "facility"}]}, {"description": "STREPTOCOCCUS A IA", "code_information": [{"code": "87430", "type": "CPT"}, {"code": "4103526", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 1020.0, "discounted_cash": 765.0, "setting": "both", "billing_class": "facility"}]}, {"description": "STREPTOCOCCUS A IA/2", "code_information": [{"code": "87430", "type": "CPT"}, {"code": "4106411", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 1020.0, "discounted_cash": 765.0, "setting": "both", "billing_class": "facility"}]}, {"description": "STREPTOCOCCUS A IA/2", "code_information": [{"code": "87430", "type": "CPT"}, {"code": "4176411", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 22.83, "discounted_cash": 17.12, "setting": "both", "billing_class": "facility"}]}, {"description": "STRIATED AB SCR", "code_information": [{"code": "86255", "type": "CPT"}, {"code": "7251260", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 216.0, "discounted_cash": 162.0, "setting": "both", "billing_class": "facility"}]}, {"description": "STRP PERI", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8034258", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 3422.0, "discounted_cash": 2566.5, "setting": "both", "billing_class": "facility"}]}, {"description": "SUCCINYLCHOL UPTO 20MGIJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0330", "type": "HCPCS"}, {"code": "5324405", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 229.0, "discounted_cash": 171.75, "setting": "both", "billing_class": "facility"}]}, {"description": "SUCCINYLCHOL UPTO 20MGIJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0330", "type": "HCPCS"}, {"code": "5324405", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 229.0, "discounted_cash": 171.75, "setting": "both", "billing_class": "facility"}]}, {"description": "SUCRALFATE 1G/10ML LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5316390", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 108.0, "discounted_cash": 81.0, "setting": "both", "billing_class": "facility"}]}, {"description": "SUCRALFATE 1G/10ML LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5316390", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 108.0, "discounted_cash": 81.0, "setting": "both", "billing_class": "facility"}]}, {"description": "SUCRALFATE 1GM TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5311006", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 71.0, "discounted_cash": 53.25, "setting": "both", "billing_class": "facility"}]}, {"description": "SUCRALFATE 1GM TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5311006", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 71.0, "discounted_cash": 53.25, "setting": "both", "billing_class": "facility"}]}, {"description": "SUFENT/BUPIV 100ML IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J7999", "type": "HCPCS"}, {"code": "5324410", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 428.0, "discounted_cash": 321.0, "setting": "both", "billing_class": "facility"}]}, {"description": "SUFENT/BUPIV 100ML IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J7999", "type": "HCPCS"}, {"code": "5324410", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 428.0, "discounted_cash": 321.0, "setting": "both", "billing_class": "facility"}]}, {"description": "SUFENTANIL 50UG/ML1ML IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5327991", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 479.0, "discounted_cash": 359.25, "setting": "both", "billing_class": "facility"}]}, {"description": "SUGAMMADEX 200MG/2ML IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5324400", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 1611.0, "discounted_cash": 1208.25, "setting": "both", "billing_class": "facility"}]}, {"description": "SUGARS QUANT EA SPECIMEN", "code_information": [{"code": "84378", "type": "CPT"}, {"code": "7254393", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 140.0, "discounted_cash": 105.0, "setting": "both", "billing_class": "facility"}]}, {"description": "SUGARS SNGL QUAL EA SPEC", "code_information": [{"code": "84376", "type": "CPT"}, {"code": "7254376", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 488.0, "discounted_cash": 366.0, "setting": "both", "billing_class": "facility"}]}, {"description": "SULFACET/PRED.25% 5ML OS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5332151", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 1141.0, "discounted_cash": 855.75, "setting": "both", "billing_class": "facility"}]}, {"description": "SULFACET/PRED.25% 5ML OS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5332151", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 1141.0, "discounted_cash": 855.75, "setting": "both", "billing_class": "facility"}]}, {"description": "SULFACETAMID NA10%15MLOS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5332501", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 558.0, "discounted_cash": 418.5, "setting": "both", "billing_class": "facility"}]}, {"description": "SULFACETAMID NA10%15MLOS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5332501", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 558.0, "discounted_cash": 418.5, "setting": "both", "billing_class": "facility"}]}, {"description": "SULFADIAZINE 500MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5311052", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 146.0, "discounted_cash": 109.5, "setting": "both", "billing_class": "facility"}]}, {"description": "SULFADIAZINE 500MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5311052", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 146.0, "discounted_cash": 109.5, "setting": "both", "billing_class": "facility"}]}, {"description": "SULFAMETH/TRIM PER 5MG/1MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J2865", "type": "HCPCS"}, {"code": "5324408", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 2.0, "discounted_cash": 1.5, "setting": "both", "billing_class": "facility"}]}, {"description": "SULFAMETH/TRIM PER 5MG/1MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J2865", "type": "HCPCS"}, {"code": "5324408", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 2.0, "discounted_cash": 1.5, "setting": "both", "billing_class": "facility"}]}, {"description": "SULFASALAZINE 500MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5311110", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 61.0, "discounted_cash": 45.75, "setting": "both", "billing_class": "facility"}]}, {"description": "SULFASALAZINE 500MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5311110", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 61.0, "discounted_cash": 45.75, "setting": "both", "billing_class": "facility"}]}, {"description": "SULFATE URINE", "code_information": [{"code": "84392", "type": "CPT"}, {"code": "7254392", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 35.0, "discounted_cash": 26.25, "setting": "both", "billing_class": "facility"}]}, {"description": "SULINDAC 150MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5311183", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 85.0, "discounted_cash": 63.75, "setting": "both", "billing_class": "facility"}]}, {"description": "SULINDAC 150MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5311183", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 85.0, "discounted_cash": 63.75, "setting": "both", "billing_class": "facility"}]}, {"description": "SULINDAC 200MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5311187", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 85.0, "discounted_cash": 63.75, "setting": "both", "billing_class": "facility"}]}, {"description": "SULINDAC 200MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5311187", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 85.0, "discounted_cash": 63.75, "setting": "both", "billing_class": "facility"}]}, {"description": "SUMATRIPTAN 25MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5311190", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 512.0, "discounted_cash": 384.0, "setting": "both", "billing_class": "facility"}]}, {"description": "SUMATRIPTAN 25MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5311190", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 512.0, "discounted_cash": 384.0, "setting": "both", "billing_class": "facility"}]}, {"description": "SUMATRIPTAN PER 6MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3030", "type": "HCPCS"}, {"code": "5324420", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 1354.0, "discounted_cash": 1015.5, "setting": "both", "billing_class": "facility"}]}, {"description": "SUMATRIPTAN PER 6MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3030", "type": "HCPCS"}, {"code": "5324420", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 1354.0, "discounted_cash": 1015.5, "setting": "both", "billing_class": "facility"}]}, {"description": "SUMATRIPTAN PER6MG KT IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3030", "type": "HCPCS"}, {"code": "5324421", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 1837.0, "discounted_cash": 1377.75, "setting": "both", "billing_class": "facility"}]}, {"description": "SUMATRIPTAN PER6MG KT IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3030", "type": "HCPCS"}, {"code": "5324421", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 1837.0, "discounted_cash": 1377.75, "setting": "both", "billing_class": "facility"}]}, {"description": "SUPERIOR VENACAVAGRAM", "code_information": [{"code": "75827", "type": "CPT"}, {"code": "4915828", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 6053.0, "discounted_cash": 4539.75, "setting": "both", "billing_class": "facility"}]}, {"description": "SURFACTANT ADMIN TUBE", "code_information": [{"code": "94610", "type": "CPT"}, {"code": "3114610", "type": "CDM"}, {"code": "410", "type": "RC"}], "standard_charges": [{"gross_charge": 593.0, "discounted_cash": 444.75, "setting": "both", "billing_class": "facility"}]}, {"description": "SURG IRR BIOWASH", "code_information": [{"code": "A6260", "type": "HCPCS"}, {"code": "8034317", "type": "CDM"}, {"code": "272", "type": "RC"}], "standard_charges": [{"gross_charge": 3372.0, "discounted_cash": 2529.0, "setting": "both", "billing_class": "facility"}]}, {"description": "SURG LEVEL I EA ADD 15 MIN", "code_information": [{"code": "3203551", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 5851.0, "discounted_cash": 4388.25, "setting": "both", "billing_class": "facility"}]}, {"description": "SURG LEVEL I EA ADD 15 MIN", "code_information": [{"code": "3213551", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 5337.0, "discounted_cash": 4002.75, "setting": "both", "billing_class": "facility"}]}, {"description": "SURG LEVEL I INT 30 MIN", "code_information": [{"code": "3203550", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 8563.0, "discounted_cash": 6422.25, "setting": "both", "billing_class": "facility"}]}, {"description": "SURG LEVEL I INT 30 MIN", "code_information": [{"code": "3213550", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 12703.0, "discounted_cash": 9527.25, "setting": "both", "billing_class": "facility"}]}, {"description": "SURG LEVEL II EA ADD 15 MIN", "code_information": [{"code": "3203553", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 7478.0, "discounted_cash": 5608.5, "setting": "both", "billing_class": "facility"}]}, {"description": "SURG LEVEL II EA ADD 15 MIN", "code_information": [{"code": "3213553", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 5651.0, "discounted_cash": 4238.25, "setting": "both", "billing_class": "facility"}]}, {"description": "SURG LEVEL II INT 30 MIN", "code_information": [{"code": "3203552", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 10631.0, "discounted_cash": 7973.25, "setting": "both", "billing_class": "facility"}]}, {"description": "SURG LEVEL II INT 30 MIN", "code_information": [{"code": "3213552", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 14682.0, "discounted_cash": 11011.5, "setting": "both", "billing_class": "facility"}]}, {"description": "SURG LEVEL III EA ADD 15 MIN", "code_information": [{"code": "3203555", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 8384.0, "discounted_cash": 6288.0, "setting": "both", "billing_class": "facility"}]}, {"description": "SURG LEVEL III EA ADD 15 MIN", "code_information": [{"code": "3213555", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 6063.0, "discounted_cash": 4547.25, "setting": "both", "billing_class": "facility"}]}, {"description": "SURG LEVEL III INT 30 MIN", "code_information": [{"code": "3203554", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 12943.0, "discounted_cash": 9707.25, "setting": "both", "billing_class": "facility"}]}, {"description": "SURG LEVEL III INT 30 MIN", "code_information": [{"code": "3213554", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 14780.0, "discounted_cash": 11085.0, "setting": "both", "billing_class": "facility"}]}, {"description": "SURG LEVEL IV EA ADD 15 MIN", "code_information": [{"code": "3203557", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 9076.0, "discounted_cash": 6807.0, "setting": "both", "billing_class": "facility"}]}, {"description": "SURG LEVEL IV EA ADD 15 MIN", "code_information": [{"code": "3213557", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 6925.0, "discounted_cash": 5193.75, "setting": "both", "billing_class": "facility"}]}, {"description": "SURG LEVEL IV INT 30 MIN", "code_information": [{"code": "3203556", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 13634.0, "discounted_cash": 10225.5, "setting": "both", "billing_class": "facility"}]}, {"description": "SURG LEVEL IV INT 30 MIN", "code_information": [{"code": "3213556", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 15760.0, "discounted_cash": 11820.0, "setting": "both", "billing_class": "facility"}]}, {"description": "SURG PROC I", "code_information": [{"code": "6296000", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 1117.0, "discounted_cash": 837.75, "setting": "both", "billing_class": "facility"}]}, {"description": "SURG PROC II", "code_information": [{"code": "6296001", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 2236.0, "discounted_cash": 1677.0, "setting": "both", "billing_class": "facility"}]}, {"description": "SURG PROC III", "code_information": [{"code": "6296002", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 2899.0, "discounted_cash": 2174.25, "setting": "both", "billing_class": "facility"}]}, {"description": "SURG PROC LEVEL I", "code_information": [{"code": "6100400", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 1533.0, "discounted_cash": 1149.75, "setting": "both", "billing_class": "facility"}]}, {"description": "SURG PROC LEVEL I", "code_information": [{"code": "6166000", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 1533.0, "discounted_cash": 1149.75, "setting": "both", "billing_class": "facility"}]}, {"description": "SURG PROC LEVEL II", "code_information": [{"code": "6100402", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 3056.0, "discounted_cash": 2292.0, "setting": "both", "billing_class": "facility"}]}, {"description": "SURG PROC LEVEL II", "code_information": [{"code": "6166001", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 3056.0, "discounted_cash": 2292.0, "setting": "both", "billing_class": "facility"}]}, {"description": "SURG PROC LEVEL III", "code_information": [{"code": "6100404", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 3597.0, "discounted_cash": 2697.75, "setting": "both", "billing_class": "facility"}]}, {"description": "SURG PROC LEVEL III", "code_information": [{"code": "6166002", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 3597.0, "discounted_cash": 2697.75, "setting": "both", "billing_class": "facility"}]}, {"description": "SURGICAL PATH LEVEL I", "code_information": [{"code": "88300", "type": "CPT"}, {"code": "4308300", "type": "CDM"}, {"code": "310", "type": "RC"}], "standard_charges": [{"gross_charge": 593.0, "discounted_cash": 444.75, "setting": "both", "billing_class": "facility"}]}, {"description": "SURGICAL PATH LEVEL II", "code_information": [{"code": "88302", "type": "CPT"}, {"code": "4308302", "type": "CDM"}, {"code": "310", "type": "RC"}], "standard_charges": [{"gross_charge": 511.0, "discounted_cash": 383.25, "setting": "both", "billing_class": "facility"}]}, {"description": "SURGICAL PATH LEVEL III", "code_information": [{"code": "88304", "type": "CPT"}, {"code": "4308403", "type": "CDM"}, {"code": "310", "type": "RC"}], "standard_charges": [{"gross_charge": 1206.0, "discounted_cash": 904.5, "setting": "both", "billing_class": "facility"}]}, {"description": "SURGICAL PATH LEVEL IV", "code_information": [{"code": "88305", "type": "CPT"}, {"code": "4305103", "type": "CDM"}, {"code": "310", "type": "RC"}], "standard_charges": [{"gross_charge": 1431.0, "discounted_cash": 1073.25, "setting": "both", "billing_class": "facility"}]}, {"description": "SURGICAL PATH LEVEL V", "code_information": [{"code": "88307", "type": "CPT"}, {"code": "4308306", "type": "CDM"}, {"code": "310", "type": "RC"}], "standard_charges": [{"gross_charge": 1794.0, "discounted_cash": 1345.5, "setting": "both", "billing_class": "facility"}]}, {"description": "SURGICAL PATH LEVEL VI", "code_information": [{"code": "88309", "type": "CPT"}, {"code": "4308309", "type": "CDM"}, {"code": "310", "type": "RC"}], "standard_charges": [{"gross_charge": 1666.0, "discounted_cash": 1249.5, "setting": "both", "billing_class": "facility"}]}, {"description": "SURGICAL SPECIMEN", "code_information": [{"code": "76098", "type": "CPT"}, {"code": "3070013", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 639.0, "discounted_cash": 479.25, "setting": "both", "billing_class": "facility"}]}, {"description": "SURGICAL SPECIMEN", "code_information": [{"code": "76098", "type": "CPT"}, {"code": "4906095", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 849.0, "discounted_cash": 636.75, "setting": "both", "billing_class": "facility"}]}, {"description": "SURGIMEND 10X15 0.5CM2", "code_information": [{"code": "C9360", "type": "HCPCS"}, {"code": "4025511", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 83.0, "discounted_cash": 62.25, "setting": "both", "billing_class": "facility"}]}, {"description": "SURGIMEND 10X15 0.5CM2", "code_information": [{"code": "C9360", "type": "HCPCS"}, {"code": "4025511", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 83.0, "discounted_cash": 62.25, "setting": "both", "billing_class": "facility"}]}, {"description": "SURGIMEND 16X20 0.5CM2", "code_information": [{"code": "C9360", "type": "HCPCS"}, {"code": "4028802", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 113.0, "discounted_cash": 84.75, "setting": "both", "billing_class": "facility"}]}, {"description": "SURGIMEND 16X20 0.5CM2", "code_information": [{"code": "C9360", "type": "HCPCS"}, {"code": "4028802", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 113.0, "discounted_cash": 84.75, "setting": "both", "billing_class": "facility"}]}, {"description": "SURGIMEND 20X30 0.5CM2", "code_information": [{"code": "C9360", "type": "HCPCS"}, {"code": "4028803", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 120.0, "discounted_cash": 90.0, "setting": "both", "billing_class": "facility"}]}, {"description": "SURGIMEND 20X30 0.5CM2", "code_information": [{"code": "C9360", "type": "HCPCS"}, {"code": "4028803", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 120.0, "discounted_cash": 90.0, "setting": "both", "billing_class": "facility"}]}, {"description": "SURGIMEND MP 25X40 PER 0.5CM2", "code_information": [{"code": "C9360", "type": "HCPCS"}, {"code": "4025493", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 70.0, "discounted_cash": 52.5, "setting": "both", "billing_class": "facility"}]}, {"description": "SURGIMEND MP 25X40 PER 0.5CM2", "code_information": [{"code": "C9360", "type": "HCPCS"}, {"code": "4025493", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 70.0, "discounted_cash": 52.5, "setting": "both", "billing_class": "facility"}]}, {"description": "SURGIMEND THIN 4X7 PER 0.5CM2", "code_information": [{"code": "C9358", "type": "HCPCS"}, {"code": "4028784", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 89.0, "discounted_cash": 66.75, "setting": "both", "billing_class": "facility"}]}, {"description": "SURGIMEND THIN 4X7 PER 0.5CM2", "code_information": [{"code": "C9358", "type": "HCPCS"}, {"code": "4028784", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 89.0, "discounted_cash": 66.75, "setting": "both", "billing_class": "facility"}]}, {"description": "SUSCEPTBILTY STDY ENZYME", "code_information": [{"code": "87185", "type": "CPT"}, {"code": "4107036", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 424.0, "discounted_cash": 318.0, "setting": "both", "billing_class": "facility"}]}, {"description": "SUSCEPTBILTY STDY ENZYME", "code_information": [{"code": "87185", "type": "CPT"}, {"code": "4177036", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 7.14, "discounted_cash": 5.36, "setting": "both", "billing_class": "facility"}]}, {"description": "SUSCEPTIBLTY MACROBROTH/4", "code_information": [{"code": "87188", "type": "CPT"}, {"code": "7258724", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 1003.0, "discounted_cash": 752.25, "setting": "both", "billing_class": "facility"}]}, {"description": "SUSCEPTIBLTY MYCOBACTERIA", "code_information": [{"code": "87190", "type": "CPT"}, {"code": "7257190", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 543.0, "discounted_cash": 407.25, "setting": "both", "billing_class": "facility"}]}, {"description": "SUSCEPTIBLTY MYCOBACTERIA/3", "code_information": [{"code": "87190", "type": "CPT"}, {"code": "7257195", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 77.0, "discounted_cash": 57.75, "setting": "both", "billing_class": "facility"}]}, {"description": "SUSCEPTIBLTY STUDY MIC/2", "code_information": [{"code": "87186", "type": "CPT"}, {"code": "4177186", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 9.98, "discounted_cash": 7.49, "setting": "both", "billing_class": "facility"}]}, {"description": "SUSCEPTIBLTY STUDY MIC/3", "code_information": [{"code": "87186", "type": "CPT"}, {"code": "4107186", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 431.0, "discounted_cash": 323.25, "setting": "both", "billing_class": "facility"}]}, {"description": "SUSCEPTIBLTY STUDY MIC/4", "code_information": [{"code": "87186", "type": "CPT"}, {"code": "7257186", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 148.0, "discounted_cash": 111.0, "setting": "both", "billing_class": "facility"}]}, {"description": "SWAL FUNC W/CINE/VIDEO+CM STDY", "code_information": [{"code": "74230", "type": "CPT"}, {"code": "4904230", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 1704.0, "discounted_cash": 1278.0, "setting": "both", "billing_class": "facility"}]}, {"description": "SYPHILIS NONTREP QUAL", "code_information": [{"code": "86592", "type": "CPT"}, {"code": "4106592", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 716.0, "discounted_cash": 537.0, "setting": "both", "billing_class": "facility"}]}, {"description": "SYPHILIS NONTREP QUAL", "code_information": [{"code": "86592", "type": "CPT"}, {"code": "4176592", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 4.29, "discounted_cash": 3.22, "setting": "both", "billing_class": "facility"}]}, {"description": "SYPHILIS NONTREP QUAL/2", "code_information": [{"code": "86592", "type": "CPT"}, {"code": "4106594", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 776.0, "discounted_cash": 582.0, "setting": "both", "billing_class": "facility"}]}, {"description": "SYPHILIS NONTREP QUAL/2", "code_information": [{"code": "86592", "type": "CPT"}, {"code": "7256594", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 34.0, "discounted_cash": 25.5, "setting": "both", "billing_class": "facility"}]}, {"description": "SYPHILIS NONTREP QUAN", "code_information": [{"code": "86593", "type": "CPT"}, {"code": "4106593", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 429.0, "discounted_cash": 321.75, "setting": "both", "billing_class": "facility"}]}, {"description": "SYPHILIS NONTREP QUAN", "code_information": [{"code": "86593", "type": "CPT"}, {"code": "4176593", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 4.29, "discounted_cash": 3.22, "setting": "both", "billing_class": "facility"}]}, {"description": "SYRUP SIMPLE 1ML LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5316410", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 71.0, "discounted_cash": 53.25, "setting": "both", "billing_class": "facility"}]}, {"description": "SYRUP SIMPLE 1ML LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5316410", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 71.0, "discounted_cash": 53.25, "setting": "both", "billing_class": "facility"}]}, {"description": "SYRUP SIMPLE 30ML LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5316401", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 78.0, "discounted_cash": 58.5, "setting": "both", "billing_class": "facility"}]}, {"description": "SYRUP SIMPLE 30ML LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5316401", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 78.0, "discounted_cash": 58.5, "setting": "both", "billing_class": "facility"}]}, {"description": "SYS ACHILLES SPEEDBRIDGE", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "4018068", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 23264.0, "discounted_cash": 17448.0, "setting": "both", "billing_class": "facility"}]}, {"description": "SYS ACL REPAIR W IMPLNT", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "4018060", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 14470.0, "discounted_cash": 10852.5, "setting": "both", "billing_class": "facility"}]}, {"description": "SYS ANCHOR KNOTLESS", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "4018063", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 9081.0, "discounted_cash": 6810.75, "setting": "both", "billing_class": "facility"}]}, {"description": "SYS BICEP DSTL REPR IMPL", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "4018061", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 14182.0, "discounted_cash": 10636.5, "setting": "both", "billing_class": "facility"}]}, {"description": "SYS COMPL PLNTAR PLT RPR", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "4018069", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 22688.0, "discounted_cash": 17016.0, "setting": "both", "billing_class": "facility"}]}, {"description": "SYS COR ROTLNK CATH/BURR", "code_information": [{"code": "C1724", "type": "HCPCS"}, {"code": "8240374", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 15369.0, "discounted_cash": 11526.75, "setting": "both", "billing_class": "facility"}]}, {"description": "SYS ELBOW IMPLANT FIXATN", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8136679", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 25170.0, "discounted_cash": 18877.5, "setting": "both", "billing_class": "facility"}]}, {"description": "SYS EMBOLIC LIQUID", "code_information": [{"code": "C1889", "type": "HCPCS"}, {"code": "8034559", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 41635.0, "discounted_cash": 31226.25, "setting": "both", "billing_class": "facility"}]}, {"description": "SYS EMBOLIZATN PROTECT", "code_information": [{"code": "C1884", "type": "HCPCS"}, {"code": "8243530", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 6521.0, "discounted_cash": 4890.75, "setting": "both", "billing_class": "facility"}]}, {"description": "SYS EMBOLIZTN PROTECT2", "code_information": [{"code": "C1884", "type": "HCPCS"}, {"code": "8243531", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 5983.0, "discounted_cash": 4487.25, "setting": "both", "billing_class": "facility"}]}, {"description": "SYS FIXATION SM BN", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8243532", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 7615.0, "discounted_cash": 5711.25, "setting": "both", "billing_class": "facility"}]}, {"description": "SYS IMPL SPEEDBRGD SWVLK", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "4018070", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 59372.0, "discounted_cash": 44529.0, "setting": "both", "billing_class": "facility"}]}, {"description": "SYS INFUSION CV CATH", "code_information": [{"code": "C1887", "type": "HCPCS"}, {"code": "8145170", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 1543.0, "discounted_cash": 1157.25, "setting": "both", "billing_class": "facility"}]}, {"description": "SYS INTRAOSSEOUS FIX DRV", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "4011778", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 15023.0, "discounted_cash": 11267.25, "setting": "both", "billing_class": "facility"}]}, {"description": "SYS LAPIPLASTY ANATOM BIPLANAR", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8136677", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 75101.0, "discounted_cash": 56325.75, "setting": "both", "billing_class": "facility"}]}, {"description": "SYS MESH PHASIX ST W ECHO2", "code_information": [{"code": "C1781", "type": "HCPCS"}, {"code": "4028880", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 47762.0, "discounted_cash": 35821.5, "setting": "both", "billing_class": "facility"}]}, {"description": "SYS PERIPH INFUS MACH4", "code_information": [{"code": "C1751", "type": "HCPCS"}, {"code": "8178722", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 44386.0, "discounted_cash": 33289.5, "setting": "both", "billing_class": "facility"}]}, {"description": "SYS REP TRANSVAG W SLNG", "code_information": [{"code": "C1771", "type": "HCPCS"}, {"code": "4025514", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 19061.0, "discounted_cash": 14295.75, "setting": "both", "billing_class": "facility"}]}, {"description": "SYS REP VAG PROLAPS SLNG", "code_information": [{"code": "C1781", "type": "HCPCS"}, {"code": "4025524", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 26421.0, "discounted_cash": 19815.75, "setting": "both", "billing_class": "facility"}]}, {"description": "SYS SACROILC JOINT FUSN", "code_information": [{"code": "C1737", "type": "HCPCS"}, {"code": "4011785", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 46003.0, "discounted_cash": 34502.25, "setting": "both", "billing_class": "facility"}]}, {"description": "SYS SEALANT DURAL", "code_information": [{"code": "A4649", "type": "HCPCS"}, {"code": "4025519", "type": "CDM"}, {"code": "272", "type": "RC"}], "standard_charges": [{"gross_charge": 13644.0, "discounted_cash": 10233.0, "setting": "both", "billing_class": "facility"}]}, {"description": "SYS SLING MINIARC", "code_information": [{"code": "C1771", "type": "HCPCS"}, {"code": "4025516", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 16755.0, "discounted_cash": 12566.25, "setting": "both", "billing_class": "facility"}]}, {"description": "SYS SLING MONARC", "code_information": [{"code": "C1771", "type": "HCPCS"}, {"code": "8243667", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 15467.0, "discounted_cash": 11600.25, "setting": "both", "billing_class": "facility"}]}, {"description": "SYS SLING SGL INCISION", "code_information": [{"code": "C1771", "type": "HCPCS"}, {"code": "4028817", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 17623.0, "discounted_cash": 13217.25, "setting": "both", "billing_class": "facility"}]}, {"description": "SYS SLNG MIDURETHRL MSH", "code_information": [{"code": "C1771", "type": "HCPCS"}, {"code": "4028812", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 31452.0, "discounted_cash": 23589.0, "setting": "both", "billing_class": "facility"}]}, {"description": "SYS SNARE ENDOVASCULAR", "code_information": [{"code": "C1773", "type": "HCPCS"}, {"code": "8082988", "type": "CDM"}, {"code": "272", "type": "RC"}], "standard_charges": [{"gross_charge": 3604.0, "discounted_cash": 2703.0, "setting": "both", "billing_class": "facility"}]}, {"description": "SYS STNT VENOUS SLF EXP ABRE", "code_information": [{"code": "C1876", "type": "HCPCS"}, {"code": "8067503", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 23994.0, "discounted_cash": 17995.5, "setting": "both", "billing_class": "facility"}]}, {"description": "SYS TRANSCATH PACE MICRA", "code_information": [{"code": "C1786", "type": "HCPCS"}, {"code": "4005001", "type": "CDM"}, {"code": "275", "type": "RC"}], "standard_charges": [{"gross_charge": 185279.0, "discounted_cash": 138959.25, "setting": "both", "billing_class": "facility"}]}, {"description": "SYS TRANSCATH PACE MICRA AV", "code_information": [{"code": "C1786", "type": "HCPCS"}, {"code": "4005002", "type": "CDM"}, {"code": "275", "type": "RC"}], "standard_charges": [{"gross_charge": 185279.0, "discounted_cash": 138959.25, "setting": "both", "billing_class": "facility"}]}, {"description": "SYS VASCULR CLSR VASCADE", "code_information": [{"code": "C1760", "type": "HCPCS"}, {"code": "8178760", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 3457.0, "discounted_cash": 2592.75, "setting": "both", "billing_class": "facility"}]}, {"description": "T CELLS T4/T8 INC RATIO", "code_information": [{"code": "86360", "type": "CPT"}, {"code": "4106360", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 1425.0, "discounted_cash": 1068.75, "setting": "both", "billing_class": "facility"}]}, {"description": "T CELLS T4/T8 INC RATIO", "code_information": [{"code": "86360", "type": "CPT"}, {"code": "7256360", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 258.0, "discounted_cash": 193.5, "setting": "both", "billing_class": "facility"}]}, {"description": "T CELLS T4/T8 INC RATIO/2", "code_information": [{"code": "86360", "type": "CPT"}, {"code": "7258636", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 143.0, "discounted_cash": 107.25, "setting": "both", "billing_class": "facility"}]}, {"description": "T CELLS TOTAL COUNT", "code_information": [{"code": "86359", "type": "CPT"}, {"code": "4106359", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 355.0, "discounted_cash": 266.25, "setting": "both", "billing_class": "facility"}]}, {"description": "T CELLS TOTAL COUNT", "code_information": [{"code": "86359", "type": "CPT"}, {"code": "7256359", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 258.0, "discounted_cash": 193.5, "setting": "both", "billing_class": "facility"}]}, {"description": "T-CELLS ABSOLUTE CD4 CNT", "code_information": [{"code": "86361", "type": "CPT"}, {"code": "7256361", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 143.0, "discounted_cash": 107.25, "setting": "both", "billing_class": "facility"}]}, {"description": "T3 FREE", "code_information": [{"code": "84481", "type": "CPT"}, {"code": "4103554", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 2346.0, "discounted_cash": 1759.5, "setting": "both", "billing_class": "facility"}]}, {"description": "T3 FREE", "code_information": [{"code": "84481", "type": "CPT"}, {"code": "4173554", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 11.42, "discounted_cash": 8.57, "setting": "both", "billing_class": "facility"}]}, {"description": "T3 FREE", "code_information": [{"code": "84481", "type": "CPT"}, {"code": "7253554", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 20.0, "discounted_cash": 15.0, "setting": "both", "billing_class": "facility"}]}, {"description": "TACROLIMUS", "code_information": [{"code": "80197", "type": "CPT"}, {"code": "4102134", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 1167.0, "discounted_cash": 875.25, "setting": "both", "billing_class": "facility"}]}, {"description": "TACROLIMUS 0.5MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J7507", "type": "HCPCS"}, {"code": "5311206", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 72.0, "discounted_cash": 54.0, "setting": "both", "billing_class": "facility"}]}, {"description": "TACROLIMUS 0.5MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J7507", "type": "HCPCS"}, {"code": "5311206", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 72.0, "discounted_cash": 54.0, "setting": "both", "billing_class": "facility"}]}, {"description": "TACROLIMUS PER 1MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J7507", "type": "HCPCS"}, {"code": "5311204", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 124.0, "discounted_cash": 93.0, "setting": "both", "billing_class": "facility"}]}, {"description": "TACROLIMUS PER 1MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J7507", "type": "HCPCS"}, {"code": "5311204", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 124.0, "discounted_cash": 93.0, "setting": "both", "billing_class": "facility"}]}, {"description": "TACROLIMUS/2", "code_information": [{"code": "80197", "type": "CPT"}, {"code": "7250348", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 784.0, "discounted_cash": 588.0, "setting": "both", "billing_class": "facility"}]}, {"description": "TALC STERILE 4GM PW SP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5337313", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 2306.0, "discounted_cash": 1729.5, "setting": "both", "billing_class": "facility"}]}, {"description": "TAMOXIFEN 10MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8999", "type": "HCPCS"}, {"code": "5311210", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 78.0, "discounted_cash": 58.5, "setting": "both", "billing_class": "facility"}]}, {"description": "TAMOXIFEN 10MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8999", "type": "HCPCS"}, {"code": "5311210", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 78.0, "discounted_cash": 58.5, "setting": "both", "billing_class": "facility"}]}, {"description": "TAMSULOSIN .4MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5311215", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 128.0, "discounted_cash": 96.0, "setting": "both", "billing_class": "facility"}]}, {"description": "TAMSULOSIN .4MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5311215", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 128.0, "discounted_cash": 96.0, "setting": "both", "billing_class": "facility"}]}, {"description": "TARGETED GENOMIC SEQ ANALYS", "code_information": [{"code": "81445", "type": "CPT"}, {"code": "7061445", "type": "CDM"}, {"code": "310", "type": "RC"}], "standard_charges": [{"gross_charge": 7534.0, "discounted_cash": 5650.5, "setting": "both", "billing_class": "facility"}]}, {"description": "TB TEST CELL AG RESPONSE", "code_information": [{"code": "86480", "type": "CPT"}, {"code": "4106520", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 564.0, "discounted_cash": 423.0, "setting": "both", "billing_class": "facility"}]}, {"description": "TB TEST CELL AG RESPONSE", "code_information": [{"code": "86480", "type": "CPT"}, {"code": "4126480", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 179.0, "discounted_cash": 134.25, "setting": "both", "billing_class": "facility"}]}, {"description": "TB TEST CELL AG RESPONSE", "code_information": [{"code": "86480", "type": "CPT"}, {"code": "4176480", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 269.73, "discounted_cash": 202.3, "setting": "both", "billing_class": "facility"}]}, {"description": "TB TEST CELL AG RESPONSE", "code_information": [{"code": "86480", "type": "CPT"}, {"code": "7258648", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 476.0, "discounted_cash": 357.0, "setting": "both", "billing_class": "facility"}]}, {"description": "TB TEST CELL SUSPENSION", "code_information": [{"code": "86481", "type": "CPT"}, {"code": "4126481", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 129.0, "discounted_cash": 96.75, "setting": "both", "billing_class": "facility"}]}, {"description": "TB TEST CELL SUSPENSION", "code_information": [{"code": "86481", "type": "CPT"}, {"code": "7026482", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 233.0, "discounted_cash": 174.75, "setting": "both", "billing_class": "facility"}]}, {"description": "TB TRACH FEN WO CUFF", "code_information": [{"code": "A7520", "type": "HCPCS"}, {"code": "8207324", "type": "CDM"}, {"code": "274", "type": "RC"}], "standard_charges": [{"gross_charge": 473.0, "discounted_cash": 354.75, "setting": "both", "billing_class": "facility"}]}, {"description": "TBG-THYROXINE BND GLOBLN", "code_information": [{"code": "84442", "type": "CPT"}, {"code": "7254442", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 1153.0, "discounted_cash": 864.75, "setting": "both", "billing_class": "facility"}]}, {"description": "TBO-FILGRASTIM PER1MCGIJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J1447", "type": "HCPCS"}, {"code": "5324441", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 14.0, "discounted_cash": 10.5, "setting": "both", "billing_class": "facility"}]}, {"description": "TBO-FILGRASTIM PER1MCGIJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J1447", "type": "HCPCS"}, {"code": "5324441", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 14.0, "discounted_cash": 10.5, "setting": "both", "billing_class": "facility"}]}, {"description": "TC99 ALBUMIN MAA DOSE", "code_information": [{"code": "A9540", "type": "HCPCS"}, {"code": "5199540", "type": "CDM"}, {"code": "343", "type": "RC"}], "standard_charges": [{"gross_charge": 2653.0, "discounted_cash": 1989.75, "setting": "both", "billing_class": "facility"}]}, {"description": "TC99 DISOFENIN VIAL", "code_information": [{"code": "A9510", "type": "HCPCS"}, {"code": "5194050", "type": "CDM"}, {"code": "343", "type": "RC"}], "standard_charges": [{"gross_charge": 964.0, "discounted_cash": 723.0, "setting": "both", "billing_class": "facility"}]}, {"description": "TC99 MEBROFENIN DOSE", "code_information": [{"code": "A9537", "type": "HCPCS"}, {"code": "5199537", "type": "CDM"}, {"code": "343", "type": "RC"}], "standard_charges": [{"gross_charge": 1821.0, "discounted_cash": 1365.75, "setting": "both", "billing_class": "facility"}]}, {"description": "TC99 MEDRONAT UPTO 30MCI", "code_information": [{"code": "A9503", "type": "HCPCS"}, {"code": "5194010", "type": "CDM"}, {"code": "343", "type": "RC"}], "standard_charges": [{"gross_charge": 2193.0, "discounted_cash": 1644.75, "setting": "both", "billing_class": "facility"}]}, {"description": "TC99 MERTIATIDE DOSE", "code_information": [{"code": "A9562", "type": "HCPCS"}, {"code": "5199562", "type": "CDM"}, {"code": "343", "type": "RC"}], "standard_charges": [{"gross_charge": 14875.0, "discounted_cash": 11156.25, "setting": "both", "billing_class": "facility"}]}, {"description": "TC99 PENTET AEROSL DOS", "code_information": [{"code": "A9567", "type": "HCPCS"}, {"code": "5199567", "type": "CDM"}, {"code": "343", "type": "RC"}], "standard_charges": [{"gross_charge": 1124.0, "discounted_cash": 843.0, "setting": "both", "billing_class": "facility"}]}, {"description": "TC99 PENTETATE DOSE", "code_information": [{"code": "A9539", "type": "HCPCS"}, {"code": "5199539", "type": "CDM"}, {"code": "343", "type": "RC"}], "standard_charges": [{"gross_charge": 1038.0, "discounted_cash": 778.5, "setting": "both", "billing_class": "facility"}]}, {"description": "TC99 PERTECHN PER MCI", "code_information": [{"code": "A9512", "type": "HCPCS"}, {"code": "5199512", "type": "CDM"}, {"code": "343", "type": "RC"}], "standard_charges": [{"gross_charge": 2891.0, "discounted_cash": 2168.25, "setting": "both", "billing_class": "facility"}]}, {"description": "TC99 RBC DOSE", "code_information": [{"code": "A9560", "type": "HCPCS"}, {"code": "5199560", "type": "CDM"}, {"code": "343", "type": "RC"}], "standard_charges": [{"gross_charge": 2468.0, "discounted_cash": 1851.0, "setting": "both", "billing_class": "facility"}]}, {"description": "TC99 SESTAMIBI DOSE", "code_information": [{"code": "A9500", "type": "HCPCS"}, {"code": "5194170", "type": "CDM"}, {"code": "343", "type": "RC"}], "standard_charges": [{"gross_charge": 1688.0, "discounted_cash": 1266.0, "setting": "both", "billing_class": "facility"}]}, {"description": "TC99 SULFUR COLLOID DOSE", "code_information": [{"code": "A9541", "type": "HCPCS"}, {"code": "5199541", "type": "CDM"}, {"code": "343", "type": "RC"}], "standard_charges": [{"gross_charge": 3496.0, "discounted_cash": 2622.0, "setting": "both", "billing_class": "facility"}]}, {"description": "TC99 TETROFOSMIN DOSE", "code_information": [{"code": "A9502", "type": "HCPCS"}, {"code": "5194190", "type": "CDM"}, {"code": "343", "type": "RC"}], "standard_charges": [{"gross_charge": 816.0, "discounted_cash": 612.0, "setting": "both", "billing_class": "facility"}]}, {"description": "TCATH RETRV INTRAVASC FB+IMG", "code_information": [{"code": "4617197", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 22575.0, "discounted_cash": 16931.25, "setting": "both", "billing_class": "facility"}]}, {"description": "TCATH RETRV INTRAVASC FB+IMG", "code_information": [{"code": "4917197", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 22575.0, "discounted_cash": 16931.25, "setting": "both", "billing_class": "facility"}]}, {"description": "TCATH TX A/V NONCOR SUBS", "code_information": [{"code": "4617213", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 11016.0, "discounted_cash": 8262.0, "setting": "both", "billing_class": "facility"}]}, {"description": "TCATH TX CESSATION", "code_information": [{"code": "4617214", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 9528.0, "discounted_cash": 7146.0, "setting": "both", "billing_class": "facility"}]}, {"description": "TCATH TX INIT NONCOR ART", "code_information": [{"code": "4617211", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 9528.0, "discounted_cash": 7146.0, "setting": "both", "billing_class": "facility"}]}, {"description": "TCATH TX INIT NONCOR ART", "code_information": [{"code": "4917211", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 8069.0, "discounted_cash": 6051.75, "setting": "both", "billing_class": "facility"}]}, {"description": "TCATH TX INIT NONCOR VEN", "code_information": [{"code": "4617212", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 11016.0, "discounted_cash": 8262.0, "setting": "both", "billing_class": "facility"}]}, {"description": "TDAP > 7YR VAC IJ", "code_information": [{"code": "90715", "type": "CPT"}, {"code": "5320147", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 1547.0, "discounted_cash": 1160.25, "setting": "both", "billing_class": "facility"}]}, {"description": "TDAP > 7YR VAC IJ", "code_information": [{"code": "90715", "type": "CPT"}, {"code": "5320147", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 1547.0, "discounted_cash": 1160.25, "setting": "both", "billing_class": "facility"}]}, {"description": "TEETH COMPLETE EXAM", "code_information": [{"code": "70320", "type": "CPT"}, {"code": "4900320", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 313.0, "discounted_cash": 234.75, "setting": "both", "billing_class": "facility"}]}, {"description": "TELMISARTAN 40MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5311226", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 85.0, "discounted_cash": 63.75, "setting": "both", "billing_class": "facility"}]}, {"description": "TELMISARTAN 40MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5311226", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 85.0, "discounted_cash": 63.75, "setting": "both", "billing_class": "facility"}]}, {"description": "TEMAZEPAM 15MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5311233", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 63.0, "discounted_cash": 47.25, "setting": "both", "billing_class": "facility"}]}, {"description": "TEMAZEPAM 15MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5311233", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 63.0, "discounted_cash": 47.25, "setting": "both", "billing_class": "facility"}]}, {"description": "TENECTEPLASE PER 1MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3101", "type": "HCPCS"}, {"code": "5324431", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 450.0, "discounted_cash": 337.5, "setting": "both", "billing_class": "facility"}]}, {"description": "TENECTEPLASE PER 1MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3101", "type": "HCPCS"}, {"code": "5324431", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 450.0, "discounted_cash": 337.5, "setting": "both", "billing_class": "facility"}]}, {"description": "TENOFOVIR 300MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5311245", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 607.0, "discounted_cash": 455.25, "setting": "both", "billing_class": "facility"}]}, {"description": "TENOFOVIR 300MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5311245", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 607.0, "discounted_cash": 455.25, "setting": "both", "billing_class": "facility"}]}, {"description": "TERAZOSIN 1MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5311250", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 61.0, "discounted_cash": 45.75, "setting": "both", "billing_class": "facility"}]}, {"description": "TERAZOSIN 1MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5311250", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 61.0, "discounted_cash": 45.75, "setting": "both", "billing_class": "facility"}]}, {"description": "TERAZOSIN 2MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5311251", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 85.0, "discounted_cash": 63.75, "setting": "both", "billing_class": "facility"}]}, {"description": "TERAZOSIN 2MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5311251", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 85.0, "discounted_cash": 63.75, "setting": "both", "billing_class": "facility"}]}, {"description": "TERAZOSIN 5MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5311252", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 61.0, "discounted_cash": 45.75, "setting": "both", "billing_class": "facility"}]}, {"description": "TERAZOSIN 5MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5311252", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 61.0, "discounted_cash": 45.75, "setting": "both", "billing_class": "facility"}]}, {"description": "TERBINAFINE 1% 15GM CR", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5337429", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 117.0, "discounted_cash": 87.75, "setting": "both", "billing_class": "facility"}]}, {"description": "TERBINAFINE 1% 15GM CR", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5337429", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 117.0, "discounted_cash": 87.75, "setting": "both", "billing_class": "facility"}]}, {"description": "TERBINAFINE 250MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5311255", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 303.0, "discounted_cash": 227.25, "setting": "both", "billing_class": "facility"}]}, {"description": "TERBINAFINE 250MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5311255", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 303.0, "discounted_cash": 227.25, "setting": "both", "billing_class": "facility"}]}, {"description": "TERBUTALINE 2.5MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5311260", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 78.0, "discounted_cash": 58.5, "setting": "both", "billing_class": "facility"}]}, {"description": "TERBUTALINE 2.5MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5311260", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 78.0, "discounted_cash": 58.5, "setting": "both", "billing_class": "facility"}]}, {"description": "TERBUTALINE 5MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5311264", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 63.0, "discounted_cash": 47.25, "setting": "both", "billing_class": "facility"}]}, {"description": "TERBUTALINE 5MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5311264", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 63.0, "discounted_cash": 47.25, "setting": "both", "billing_class": "facility"}]}, {"description": "TERBUTALINE UPTO 1MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3105", "type": "HCPCS"}, {"code": "5324426", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 304.0, "discounted_cash": 228.0, "setting": "both", "billing_class": "facility"}]}, {"description": "TERBUTALINE UPTO 1MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3105", "type": "HCPCS"}, {"code": "5324426", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 304.0, "discounted_cash": 228.0, "setting": "both", "billing_class": "facility"}]}, {"description": "TERCONAZOLE 80MG BX3 VSU", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5337454", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 899.0, "discounted_cash": 674.25, "setting": "both", "billing_class": "facility"}]}, {"description": "TERCONAZOLE 80MG BX3 VSU", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5337454", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 899.0, "discounted_cash": 674.25, "setting": "both", "billing_class": "facility"}]}, {"description": "TERCONAZOLE 80MG VSU", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5337430", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 131.0, "discounted_cash": 98.25, "setting": "both", "billing_class": "facility"}]}, {"description": "TERCONAZOLE 80MG VSU", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5337430", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 131.0, "discounted_cash": 98.25, "setting": "both", "billing_class": "facility"}]}, {"description": "TERCONAZOLE.4%45GM VCR", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5337431", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 657.0, "discounted_cash": 492.75, "setting": "both", "billing_class": "facility"}]}, {"description": "TERCONAZOLE.4%45GM VCR", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5337431", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 657.0, "discounted_cash": 492.75, "setting": "both", "billing_class": "facility"}]}, {"description": "TERCONAZOLE.8%20GM VCR", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5337432", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 607.0, "discounted_cash": 455.25, "setting": "both", "billing_class": "facility"}]}, {"description": "TERCONAZOLE.8%20GM VCR", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5337432", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 607.0, "discounted_cash": 455.25, "setting": "both", "billing_class": "facility"}]}, {"description": "TESTOSTERONE FREE", "code_information": [{"code": "84402", "type": "CPT"}, {"code": "7254407", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 992.0, "discounted_cash": 744.0, "setting": "both", "billing_class": "facility"}]}, {"description": "TESTOSTERONE TOTAL", "code_information": [{"code": "84403", "type": "CPT"}, {"code": "4104403", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 1000.0, "discounted_cash": 750.0, "setting": "both", "billing_class": "facility"}]}, {"description": "TESTOSTERONE TOTAL", "code_information": [{"code": "84403", "type": "CPT"}, {"code": "4174403", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 5.71, "discounted_cash": 4.28, "setting": "both", "billing_class": "facility"}]}, {"description": "TESTOSTERONE TOTAL", "code_information": [{"code": "84403", "type": "CPT"}, {"code": "7254403", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 942.0, "discounted_cash": 706.5, "setting": "both", "billing_class": "facility"}]}, {"description": "TETANUS AB", "code_information": [{"code": "86774", "type": "CPT"}, {"code": "7256774", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 1662.0, "discounted_cash": 1246.5, "setting": "both", "billing_class": "facility"}]}, {"description": "TETANUS IG UPTO 250U IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J1670", "type": "HCPCS"}, {"code": "5324499", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 5716.0, "discounted_cash": 4287.0, "setting": "both", "billing_class": "facility"}]}, {"description": "TETANUS IG UPTO 250U IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J1670", "type": "HCPCS"}, {"code": "5324499", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 5716.0, "discounted_cash": 4287.0, "setting": "both", "billing_class": "facility"}]}, {"description": "TETRACAINE .5% 2ML OS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5332592", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 166.0, "discounted_cash": 124.5, "setting": "both", "billing_class": "facility"}]}, {"description": "TETRACAINE .5% 4ML OS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5332590", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 165.0, "discounted_cash": 123.75, "setting": "both", "billing_class": "facility"}]}, {"description": "TETRACAINE .5% 5ML OS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5332588", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 512.0, "discounted_cash": 384.0, "setting": "both", "billing_class": "facility"}]}, {"description": "TETRACAINE .5%15ML OS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5337441", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 191.0, "discounted_cash": 143.25, "setting": "both", "billing_class": "facility"}]}, {"description": "TETRACAINE 1% 2ML IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5324561", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 339.0, "discounted_cash": 254.25, "setting": "both", "billing_class": "facility"}]}, {"description": "TETRACAINE VISC.5%.6MLOS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5332600", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 108.0, "discounted_cash": 81.0, "setting": "both", "billing_class": "facility"}]}, {"description": "TETRAHYDRAZOL.05%15ML OS", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5332662", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 104.0, "discounted_cash": 78.0, "setting": "both", "billing_class": "facility"}]}, {"description": "TETRAHYDRAZOL.05%15ML OS", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5332662", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 104.0, "discounted_cash": 78.0, "setting": "both", "billing_class": "facility"}]}, {"description": "THEOPHYLLINE", "code_information": [{"code": "80198", "type": "CPT"}, {"code": "4102137", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 944.0, "discounted_cash": 708.0, "setting": "both", "billing_class": "facility"}]}, {"description": "THEOPHYLLINE", "code_information": [{"code": "80198", "type": "CPT"}, {"code": "4172137", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 8.56, "discounted_cash": 6.42, "setting": "both", "billing_class": "facility"}]}, {"description": "THEOPHYLLINE 100MG XR TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5311385", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 78.0, "discounted_cash": 58.5, "setting": "both", "billing_class": "facility"}]}, {"description": "THEOPHYLLINE 100MG XR TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5311385", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 78.0, "discounted_cash": 58.5, "setting": "both", "billing_class": "facility"}]}, {"description": "THEOPHYLLINE 200MG XR TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5311392", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 78.0, "discounted_cash": 58.5, "setting": "both", "billing_class": "facility"}]}, {"description": "THEOPHYLLINE 200MG XR TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5311392", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 78.0, "discounted_cash": 58.5, "setting": "both", "billing_class": "facility"}]}, {"description": "THEOPHYLLINE 300MG XR TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5311396", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 66.0, "discounted_cash": 49.5, "setting": "both", "billing_class": "facility"}]}, {"description": "THEOPHYLLINE 300MG XR TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5311396", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 66.0, "discounted_cash": 49.5, "setting": "both", "billing_class": "facility"}]}, {"description": "THEOPHYLLINE200MG XR24CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5311409", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 83.0, "discounted_cash": 62.25, "setting": "both", "billing_class": "facility"}]}, {"description": "THEOPHYLLINE200MG XR24CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5311409", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 83.0, "discounted_cash": 62.25, "setting": "both", "billing_class": "facility"}]}, {"description": "THEOPHYLLINE400MG XR24TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5311405", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 61.0, "discounted_cash": 45.75, "setting": "both", "billing_class": "facility"}]}, {"description": "THEOPHYLLINE400MG XR24TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5311405", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 61.0, "discounted_cash": 45.75, "setting": "both", "billing_class": "facility"}]}, {"description": "THEOPHYLLINE80MG/15ML LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5316433", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 76.0, "discounted_cash": 57.0, "setting": "both", "billing_class": "facility"}]}, {"description": "THEOPHYLLINE80MG/15ML LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5316433", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 76.0, "discounted_cash": 57.0, "setting": "both", "billing_class": "facility"}]}, {"description": "THERAGENESIS PER SQ CM", "code_information": [{"code": "A2008", "type": "HCPCS"}, {"code": "4025543", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 691.0, "discounted_cash": 518.25, "setting": "both", "billing_class": "facility"}]}, {"description": "THERAGENESIS PER SQ CM", "code_information": [{"code": "A2008", "type": "HCPCS"}, {"code": "4025543", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 691.0, "discounted_cash": 518.25, "setting": "both", "billing_class": "facility"}]}, {"description": "THERASKIN 6SQ CM XSML PR SQCM", "code_information": [{"code": "Q4121", "type": "HCPCS"}, {"code": "4025536", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 1066.0, "discounted_cash": 799.5, "setting": "both", "billing_class": "facility"}]}, {"description": "THERASKIN 6SQ CM XSML PR SQCM", "code_information": [{"code": "Q4121", "type": "HCPCS"}, {"code": "4025536", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 1066.0, "discounted_cash": 799.5, "setting": "both", "billing_class": "facility"}]}, {"description": "THERASKIN LRG 39SQ CM PR SQ CM", "code_information": [{"code": "Q4121", "type": "HCPCS"}, {"code": "4025535", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 449.0, "discounted_cash": 336.75, "setting": "both", "billing_class": "facility"}]}, {"description": "THERASKIN LRG 39SQ CM PR SQ CM", "code_information": [{"code": "Q4121", "type": "HCPCS"}, {"code": "4025535", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 449.0, "discounted_cash": 336.75, "setting": "both", "billing_class": "facility"}]}, {"description": "THERASKIN SM 13SQ CM PER SQ CM", "code_information": [{"code": "Q4121", "type": "HCPCS"}, {"code": "4025537", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 628.0, "discounted_cash": 471.0, "setting": "both", "billing_class": "facility"}]}, {"description": "THERASKIN SM 13SQ CM PER SQ CM", "code_information": [{"code": "Q4121", "type": "HCPCS"}, {"code": "4025537", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 628.0, "discounted_cash": 471.0, "setting": "both", "billing_class": "facility"}]}, {"description": "THERASKN XLG 7.6X15.2CM PRSQCM", "code_information": [{"code": "Q4121", "type": "HCPCS"}, {"code": "4025538", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 388.0, "discounted_cash": 291.0, "setting": "both", "billing_class": "facility"}]}, {"description": "THERASKN XLG 7.6X15.2CM PRSQCM", "code_information": [{"code": "Q4121", "type": "HCPCS"}, {"code": "4025538", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 388.0, "discounted_cash": 291.0, "setting": "both", "billing_class": "facility"}]}, {"description": "THIAMINE 100MG TB", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5311471", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 71.0, "discounted_cash": 53.25, "setting": "both", "billing_class": "facility"}]}, {"description": "THIAMINE 100MG TB", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5311471", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 71.0, "discounted_cash": 53.25, "setting": "both", "billing_class": "facility"}]}, {"description": "THIAMINE PER 100MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3411", "type": "HCPCS"}, {"code": "5324618", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 160.0, "discounted_cash": 120.0, "setting": "both", "billing_class": "facility"}]}, {"description": "THIAMINE PER 100MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3411", "type": "HCPCS"}, {"code": "5324618", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 160.0, "discounted_cash": 120.0, "setting": "both", "billing_class": "facility"}]}, {"description": "THIAMINE(VITAMIN B1)", "code_information": [{"code": "84425", "type": "CPT"}, {"code": "7254423", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 370.0, "discounted_cash": 277.5, "setting": "both", "billing_class": "facility"}]}, {"description": "THIAMINE(VITAMIN B1)/2", "code_information": [{"code": "84425", "type": "CPT"}, {"code": "7254429", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 744.0, "discounted_cash": 558.0, "setting": "both", "billing_class": "facility"}]}, {"description": "THIOCYANATE", "code_information": [{"code": "84430", "type": "CPT"}, {"code": "7254430", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 99.0, "discounted_cash": 74.25, "setting": "both", "billing_class": "facility"}]}, {"description": "THIOPURINE", "code_information": [{"code": "80299", "type": "CPT"}, {"code": "7251339", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 408.0, "discounted_cash": 306.0, "setting": "both", "billing_class": "facility"}]}, {"description": "THIORIDAZINE 10MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5311537", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 85.0, "discounted_cash": 63.75, "setting": "both", "billing_class": "facility"}]}, {"description": "THIORIDAZINE 10MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5311537", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 85.0, "discounted_cash": 63.75, "setting": "both", "billing_class": "facility"}]}, {"description": "THIORIDAZINE 25MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5311548", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 85.0, "discounted_cash": 63.75, "setting": "both", "billing_class": "facility"}]}, {"description": "THIORIDAZINE 25MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5311548", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 85.0, "discounted_cash": 63.75, "setting": "both", "billing_class": "facility"}]}, {"description": "THIOTHIXENE 10MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5311594", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 85.0, "discounted_cash": 63.75, "setting": "both", "billing_class": "facility"}]}, {"description": "THIOTHIXENE 10MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5311594", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 85.0, "discounted_cash": 63.75, "setting": "both", "billing_class": "facility"}]}, {"description": "THIOTHIXENE 1MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5311583", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 85.0, "discounted_cash": 63.75, "setting": "both", "billing_class": "facility"}]}, {"description": "THIOTHIXENE 1MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5311583", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 85.0, "discounted_cash": 63.75, "setting": "both", "billing_class": "facility"}]}, {"description": "THIOTHIXENE 5MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5311591", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 66.0, "discounted_cash": 49.5, "setting": "both", "billing_class": "facility"}]}, {"description": "THIOTHIXENE 5MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5311591", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 66.0, "discounted_cash": 49.5, "setting": "both", "billing_class": "facility"}]}, {"description": "THORACENTSIS W/IMAGING", "code_information": [{"code": "4912555", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 7209.0, "discounted_cash": 5406.75, "setting": "both", "billing_class": "facility"}]}, {"description": "THORACENTSIS W/IMAGING", "code_information": [{"code": "5052555", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 6509.0, "discounted_cash": 4881.75, "setting": "both", "billing_class": "facility"}]}, {"description": "THORACENTSIS W/IMAGING", "code_information": [{"code": "5062555", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 6392.0, "discounted_cash": 4794.0, "setting": "both", "billing_class": "facility"}]}, {"description": "THORACIC MYELO LUMB INJ", "code_information": [{"code": "4902302", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 3632.0, "discounted_cash": 2724.0, "setting": "both", "billing_class": "facility"}]}, {"description": "THORACIC MYELO LUMB INJ", "code_information": [{"code": "4912303", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 4699.0, "discounted_cash": 3524.25, "setting": "both", "billing_class": "facility"}]}, {"description": "THORACIC W/O SERL COMP", "code_information": [{"code": "75600", "type": "CPT"}, {"code": "4615601", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 9736.0, "discounted_cash": 7302.0, "setting": "both", "billing_class": "facility"}]}, {"description": "THORACIC W/SERL COMPLT", "code_information": [{"code": "75605", "type": "CPT"}, {"code": "4915606", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 9548.0, "discounted_cash": 7161.0, "setting": "both", "billing_class": "facility"}]}, {"description": "THROMB NONCOR ADD VESSLS", "code_information": [{"code": "4617185", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 20457.0, "discounted_cash": 15342.75, "setting": "both", "billing_class": "facility"}]}, {"description": "THROMB NONCOR INITL VSL", "code_information": [{"code": "4617184", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 22302.0, "discounted_cash": 16726.5, "setting": "both", "billing_class": "facility"}]}, {"description": "THROMB NONCOR INITL VSL", "code_information": [{"code": "4914100", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 33525.0, "discounted_cash": 25143.75, "setting": "both", "billing_class": "facility"}]}, {"description": "THROMBIN 20000U PW", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3590", "type": "HCPCS"}, {"code": "5337469", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 1506.3, "discounted_cash": 1129.73, "setting": "both", "billing_class": "facility"}]}, {"description": "THROMBIN 20000U RECOM KT", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3590", "type": "HCPCS"}, {"code": "5337478", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 3641.0, "discounted_cash": 2730.75, "setting": "both", "billing_class": "facility"}]}, {"description": "THROMBIN 5000U BOV SP KT", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3590", "type": "HCPCS"}, {"code": "5337479", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 957.0, "discounted_cash": 717.75, "setting": "both", "billing_class": "facility"}]}, {"description": "THROMBIN 5000U PW", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3590", "type": "HCPCS"}, {"code": "5337467", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 1093.0, "discounted_cash": 819.75, "setting": "both", "billing_class": "facility"}]}, {"description": "THROMBIN 5000U RECOM KT", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3590", "type": "HCPCS"}, {"code": "5337458", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 695.0, "discounted_cash": 521.25, "setting": "both", "billing_class": "facility"}]}, {"description": "THROMBIN TIME PLASMA", "code_information": [{"code": "85670", "type": "CPT"}, {"code": "4105670", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 111.0, "discounted_cash": 83.25, "setting": "both", "billing_class": "facility"}]}, {"description": "THROMBIN TIME PLASMA", "code_information": [{"code": "85670", "type": "CPT"}, {"code": "4175670", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 2.86, "discounted_cash": 2.15, "setting": "both", "billing_class": "facility"}]}, {"description": "THROMBIN TIME PLASMA", "code_information": [{"code": "85670", "type": "CPT"}, {"code": "7255616", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 104.0, "discounted_cash": 78.0, "setting": "both", "billing_class": "facility"}]}, {"description": "THROMBIN TIME PLASMA/2", "code_information": [{"code": "85670", "type": "CPT"}, {"code": "7255669", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 112.0, "discounted_cash": 84.0, "setting": "both", "billing_class": "facility"}]}, {"description": "THROMBIN TIME PLASMA/3", "code_information": [{"code": "85670", "type": "CPT"}, {"code": "7255670", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 90.0, "discounted_cash": 67.5, "setting": "both", "billing_class": "facility"}]}, {"description": "THROMBIN TIME PLASMA/4", "code_information": [{"code": "85670", "type": "CPT"}, {"code": "7258567", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 112.0, "discounted_cash": 84.0, "setting": "both", "billing_class": "facility"}]}, {"description": "THROMBOPLSTN INHIB TISS", "code_information": [{"code": "85705", "type": "CPT"}, {"code": "7255705", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 148.0, "discounted_cash": 111.0, "setting": "both", "billing_class": "facility"}]}, {"description": "THYROGLOBULIN", "code_information": [{"code": "84432", "type": "CPT"}, {"code": "7254432", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 95.0, "discounted_cash": 71.25, "setting": "both", "billing_class": "facility"}]}, {"description": "THYROGLOBULIN AB", "code_information": [{"code": "86800", "type": "CPT"}, {"code": "7256175", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 183.0, "discounted_cash": 137.25, "setting": "both", "billing_class": "facility"}]}, {"description": "THYROGLOBULIN/2", "code_information": [{"code": "84432", "type": "CPT"}, {"code": "7254433", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 171.0, "discounted_cash": 128.25, "setting": "both", "billing_class": "facility"}]}, {"description": "THYROGLOBULIN/4", "code_information": [{"code": "84432", "type": "CPT"}, {"code": "7254441", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 12.0, "discounted_cash": 9.0, "setting": "both", "billing_class": "facility"}]}, {"description": "THYROID C/M IMG NCK/CHST", "code_information": [{"code": "78015", "type": "CPT"}, {"code": "5208015", "type": "CDM"}, {"code": "341", "type": "RC"}], "standard_charges": [{"gross_charge": 2114.0, "discounted_cash": 1585.5, "setting": "both", "billing_class": "facility"}]}, {"description": "THYROID C/M IMG WHOL BDY", "code_information": [{"code": "78018", "type": "CPT"}, {"code": "5208018", "type": "CDM"}, {"code": "341", "type": "RC"}], "standard_charges": [{"gross_charge": 4668.0, "discounted_cash": 3501.0, "setting": "both", "billing_class": "facility"}]}, {"description": "THYROID DESICTED 30MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5311645", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 50.0, "discounted_cash": 37.5, "setting": "both", "billing_class": "facility"}]}, {"description": "THYROID DESICTED 30MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5311645", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 50.0, "discounted_cash": 37.5, "setting": "both", "billing_class": "facility"}]}, {"description": "THYROID IMG VSCFI SG/MLT", "code_information": [{"code": "78014", "type": "CPT"}, {"code": "5208014", "type": "CDM"}, {"code": "341", "type": "RC"}], "standard_charges": [{"gross_charge": 4949.0, "discounted_cash": 3711.75, "setting": "both", "billing_class": "facility"}]}, {"description": "THYROID IMG W/VASC FLOW", "code_information": [{"code": "78013", "type": "CPT"}, {"code": "5208013", "type": "CDM"}, {"code": "341", "type": "RC"}], "standard_charges": [{"gross_charge": 1207.0, "discounted_cash": 905.25, "setting": "both", "billing_class": "facility"}]}, {"description": "THYROID STIM IMMUNGLBN", "code_information": [{"code": "84445", "type": "CPT"}, {"code": "7254444", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 2563.0, "discounted_cash": 1922.25, "setting": "both", "billing_class": "facility"}]}, {"description": "THYROID UPTK SNG/MULT", "code_information": [{"code": "78012", "type": "CPT"}, {"code": "5208012", "type": "CDM"}, {"code": "341", "type": "RC"}], "standard_charges": [{"gross_charge": 4518.0, "discounted_cash": 3388.5, "setting": "both", "billing_class": "facility"}]}, {"description": "THYROTROPIN RECEPTOR AB", "code_information": [{"code": "83520", "type": "CPT"}, {"code": "7253528", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 96.0, "discounted_cash": 72.0, "setting": "both", "billing_class": "facility"}]}, {"description": "THYROXINE FREE", "code_information": [{"code": "84439", "type": "CPT"}, {"code": "4103531", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 794.0, "discounted_cash": 595.5, "setting": "both", "billing_class": "facility"}]}, {"description": "THYROXINE FREE", "code_information": [{"code": "84439", "type": "CPT"}, {"code": "4173531", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 5.71, "discounted_cash": 4.28, "setting": "both", "billing_class": "facility"}]}, {"description": "THYROXINE FREE", "code_information": [{"code": "84439", "type": "CPT"}, {"code": "7253534", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 11.0, "discounted_cash": 8.25, "setting": "both", "billing_class": "facility"}]}, {"description": "THYROXINE FREE/2", "code_information": [{"code": "84439", "type": "CPT"}, {"code": "7255310", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 80.0, "discounted_cash": 60.0, "setting": "both", "billing_class": "facility"}]}, {"description": "THYROXINE TOTAL", "code_information": [{"code": "84436", "type": "CPT"}, {"code": "4104436", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 883.0, "discounted_cash": 662.25, "setting": "both", "billing_class": "facility"}]}, {"description": "THYROXINE TOTAL", "code_information": [{"code": "84436", "type": "CPT"}, {"code": "4174436", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 8.56, "discounted_cash": 6.42, "setting": "both", "billing_class": "facility"}]}, {"description": "THYROXINE TOTAL", "code_information": [{"code": "84436", "type": "CPT"}, {"code": "7254436", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 10.0, "discounted_cash": 7.5, "setting": "both", "billing_class": "facility"}]}, {"description": "TIBIA/FIBULA 2 VIEWS", "code_information": [{"code": "73590", "type": "CPT"}, {"code": "4903590", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 1965.0, "discounted_cash": 1473.75, "setting": "both", "billing_class": "facility"}]}, {"description": "TIBIA/FIBULA 2 VIEWS", "code_information": [{"code": "73590", "type": "CPT"}, {"code": "5113590", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 1533.0, "discounted_cash": 1149.75, "setting": "both", "billing_class": "facility"}]}, {"description": "TICAGRELOR 60MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5311675", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 158.0, "discounted_cash": 118.5, "setting": "both", "billing_class": "facility"}]}, {"description": "TICAGRELOR 60MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5311675", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 158.0, "discounted_cash": 118.5, "setting": "both", "billing_class": "facility"}]}, {"description": "TICAGRELOR 90MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5311679", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 136.0, "discounted_cash": 102.0, "setting": "both", "billing_class": "facility"}]}, {"description": "TICAGRELOR 90MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5311679", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 136.0, "discounted_cash": 102.0, "setting": "both", "billing_class": "facility"}]}, {"description": "TIGECYCLINE PER 1MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3243", "type": "HCPCS"}, {"code": "5324739", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 53.0, "discounted_cash": 39.75, "setting": "both", "billing_class": "facility"}]}, {"description": "TIGECYCLINE PER 1MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3243", "type": "HCPCS"}, {"code": "5324739", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 53.0, "discounted_cash": 39.75, "setting": "both", "billing_class": "facility"}]}, {"description": "TIGHTROPE ABS NO BUTTON", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8137001", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 4436.0, "discounted_cash": 3327.0, "setting": "both", "billing_class": "facility"}]}, {"description": "TIMOLOL .25% 5ML OS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5332697", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 230.0, "discounted_cash": 172.5, "setting": "both", "billing_class": "facility"}]}, {"description": "TIMOLOL .25% 5ML OS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5332697", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 230.0, "discounted_cash": 172.5, "setting": "both", "billing_class": "facility"}]}, {"description": "TIMOLOL 0.5% 10ML OS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5332692", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 235.0, "discounted_cash": 176.25, "setting": "both", "billing_class": "facility"}]}, {"description": "TIMOLOL 0.5% 10ML OS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5332692", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 235.0, "discounted_cash": 176.25, "setting": "both", "billing_class": "facility"}]}, {"description": "TIMOLOL 0.5% 5ML OS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5332694", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 261.0, "discounted_cash": 195.75, "setting": "both", "billing_class": "facility"}]}, {"description": "TIMOLOL 0.5% 5ML OS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5332694", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 261.0, "discounted_cash": 195.75, "setting": "both", "billing_class": "facility"}]}, {"description": "TIOTROPIUM CP 18MCG IH", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3535", "type": "HCPCS"}, {"code": "5332713", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 1070.0, "discounted_cash": 802.5, "setting": "both", "billing_class": "facility"}]}, {"description": "TIOTROPIUM CP 18MCG IH", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3535", "type": "HCPCS"}, {"code": "5332713", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 1070.0, "discounted_cash": 802.5, "setting": "both", "billing_class": "facility"}]}, {"description": "TIOTROPIUM CP18MCG6DS IH", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3535", "type": "HCPCS"}, {"code": "5332711", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 400.0, "discounted_cash": 300.0, "setting": "both", "billing_class": "facility"}]}, {"description": "TIOTROPIUM CP18MCG6DS IH", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3535", "type": "HCPCS"}, {"code": "5332711", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 400.0, "discounted_cash": 300.0, "setting": "both", "billing_class": "facility"}]}, {"description": "TIROFIBAN PER .25MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3246", "type": "HCPCS"}, {"code": "5324763", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 130.0, "discounted_cash": 97.5, "setting": "both", "billing_class": "facility"}]}, {"description": "TIROFIBAN PER .25MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3246", "type": "HCPCS"}, {"code": "5324763", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 130.0, "discounted_cash": 97.5, "setting": "both", "billing_class": "facility"}]}, {"description": "TISS CONNECTIVE HUMAN", "code_information": [{"code": "C1762", "type": "HCPCS"}, {"code": "8240407", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 47590.0, "discounted_cash": 35692.5, "setting": "both", "billing_class": "facility"}]}, {"description": "TISS CONNECTIVE N-HUMAN", "code_information": [{"code": "C1763", "type": "HCPCS"}, {"code": "8240409", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 13625.0, "discounted_cash": 10218.75, "setting": "both", "billing_class": "facility"}]}, {"description": "TISS CULT ADD STUDIES", "code_information": [{"code": "87253", "type": "CPT"}, {"code": "7257257", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 230.0, "discounted_cash": 172.5, "setting": "both", "billing_class": "facility"}]}, {"description": "TISS CULT ADD STUDIES/4", "code_information": [{"code": "87253", "type": "CPT"}, {"code": "4107253", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 316.0, "discounted_cash": 237.0, "setting": "both", "billing_class": "facility"}]}, {"description": "TISS CULT INOC/OBSERV", "code_information": [{"code": "87252", "type": "CPT"}, {"code": "4109356", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 410.0, "discounted_cash": 307.5, "setting": "both", "billing_class": "facility"}]}, {"description": "TISS CULT INOC/OBSERV", "code_information": [{"code": "87252", "type": "CPT"}, {"code": "7257227", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 144.0, "discounted_cash": 108.0, "setting": "both", "billing_class": "facility"}]}, {"description": "TISS CULT INOC/OBSERV/5", "code_information": [{"code": "87252", "type": "CPT"}, {"code": "7257252", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 275.0, "discounted_cash": 206.25, "setting": "both", "billing_class": "facility"}]}, {"description": "TISS MTRX ACEL DERM SQCM", "code_information": [{"code": "Q4100", "type": "HCPCS"}, {"code": "8243791", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 262.0, "discounted_cash": 196.5, "setting": "both", "billing_class": "facility"}]}, {"description": "TISS MTRX ACEL DERM SQCM", "code_information": [{"code": "Q4100", "type": "HCPCS"}, {"code": "8243791", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 262.0, "discounted_cash": 196.5, "setting": "both", "billing_class": "facility"}]}, {"description": "TISS REINFORCEMENT BIO-A", "code_information": [{"code": "C1781", "type": "HCPCS"}, {"code": "8186099", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 12341.0, "discounted_cash": 9255.75, "setting": "both", "billing_class": "facility"}]}, {"description": "TISS TRANSGLUTAMINASE AB/2", "code_information": [{"code": "86364", "type": "CPT"}, {"code": "7253562", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 226.0, "discounted_cash": 169.5, "setting": "both", "billing_class": "facility"}]}, {"description": "TISS TRANSGLUTAMINASE AB/5", "code_information": [{"code": "86364", "type": "CPT"}, {"code": "7253979", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 226.0, "discounted_cash": 169.5, "setting": "both", "billing_class": "facility"}]}, {"description": "TISSUE CULT BONE MARROW", "code_information": [{"code": "88237", "type": "CPT"}, {"code": "7258238", "type": "CDM"}, {"code": "310", "type": "RC"}], "standard_charges": [{"gross_charge": 457.0, "discounted_cash": 342.75, "setting": "both", "billing_class": "facility"}]}, {"description": "TISSUE CULT BONE MARROW/2", "code_information": [{"code": "88237", "type": "CPT"}, {"code": "7038236", "type": "CDM"}, {"code": "310", "type": "RC"}], "standard_charges": [{"gross_charge": 429.0, "discounted_cash": 321.75, "setting": "both", "billing_class": "facility"}]}, {"description": "TISSUE CULTURE LYMPHOCYTE/4", "code_information": [{"code": "88230", "type": "CPT"}, {"code": "7258229", "type": "CDM"}, {"code": "310", "type": "RC"}], "standard_charges": [{"gross_charge": 1777.0, "discounted_cash": 1332.75, "setting": "both", "billing_class": "facility"}]}, {"description": "TISSUE CULTURE SKIN/BIOPSY/2", "code_information": [{"code": "88233", "type": "CPT"}, {"code": "7258232", "type": "CDM"}, {"code": "310", "type": "RC"}], "standard_charges": [{"gross_charge": 675.0, "discounted_cash": 506.25, "setting": "both", "billing_class": "facility"}]}, {"description": "TISSUE GRIND FOR CULTURE", "code_information": [{"code": "87176", "type": "CPT"}, {"code": "7257176", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 129.0, "discounted_cash": 96.75, "setting": "both", "billing_class": "facility"}]}, {"description": "TISSUEMEND", "code_information": [{"code": "Q4100", "type": "HCPCS"}, {"code": "4025530", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 16787.0, "discounted_cash": 12590.25, "setting": "both", "billing_class": "facility"}]}, {"description": "TISSUEMEND", "code_information": [{"code": "Q4100", "type": "HCPCS"}, {"code": "4025530", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 16787.0, "discounted_cash": 12590.25, "setting": "both", "billing_class": "facility"}]}, {"description": "TIZANIDINE 4MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5311692", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 63.0, "discounted_cash": 47.25, "setting": "both", "billing_class": "facility"}]}, {"description": "TIZANIDINE 4MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5311692", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 63.0, "discounted_cash": 47.25, "setting": "both", "billing_class": "facility"}]}, {"description": "TL201 CHLORIDE 1MCI", "code_information": [{"code": "A9505", "type": "HCPCS"}, {"code": "5194800", "type": "CDM"}, {"code": "343", "type": "RC"}], "standard_charges": [{"gross_charge": 431.0, "discounted_cash": 323.25, "setting": "both", "billing_class": "facility"}]}, {"description": "TLSO TRPLNR HYPEXT PREFB", "code_information": [{"code": "L0472", "type": "HCPCS"}, {"code": "8130980", "type": "CDM"}, {"code": "274", "type": "RC"}], "standard_charges": [{"gross_charge": 6768.0, "discounted_cash": 5076.0, "setting": "both", "billing_class": "facility"}]}, {"description": "TM JOINTS BILATERAL", "code_information": [{"code": "70330", "type": "CPT"}, {"code": "4900330", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 1918.0, "discounted_cash": 1438.5, "setting": "both", "billing_class": "facility"}]}, {"description": "TM JOINTS BILATERAL", "code_information": [{"code": "70330", "type": "CPT"}, {"code": "5110330", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 2104.0, "discounted_cash": 1578.0, "setting": "both", "billing_class": "facility"}]}, {"description": "TM JOINTS UNILATERAL", "code_information": [{"code": "70328", "type": "CPT"}, {"code": "4900328", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 452.0, "discounted_cash": 339.0, "setting": "both", "billing_class": "facility"}]}, {"description": "TOBRAMYC/DEXAMETH 5ML OS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5332733", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 1709.0, "discounted_cash": 1281.75, "setting": "both", "billing_class": "facility"}]}, {"description": "TOBRAMYC/DEXAMETH 5ML OS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5332733", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 1709.0, "discounted_cash": 1281.75, "setting": "both", "billing_class": "facility"}]}, {"description": "TOBRAMYC/DEXAMETH2.5MLOS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5332734", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 537.0, "discounted_cash": 402.75, "setting": "both", "billing_class": "facility"}]}, {"description": "TOBRAMYC/DEXAMETH2.5MLOS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5332734", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 537.0, "discounted_cash": 402.75, "setting": "both", "billing_class": "facility"}]}, {"description": "TOBRAMYC/DEXAMETH3.5GMOO", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5332731", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 1723.0, "discounted_cash": 1292.25, "setting": "both", "billing_class": "facility"}]}, {"description": "TOBRAMYC/DEXAMETH3.5GMOO", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5332731", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 1723.0, "discounted_cash": 1292.25, "setting": "both", "billing_class": "facility"}]}, {"description": "TOBRAMYCIN", "code_information": [{"code": "80200", "type": "CPT"}, {"code": "4104468", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 1076.0, "discounted_cash": 807.0, "setting": "both", "billing_class": "facility"}]}, {"description": "TOBRAMYCIN", "code_information": [{"code": "80200", "type": "CPT"}, {"code": "4174468", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 8.56, "discounted_cash": 6.42, "setting": "both", "billing_class": "facility"}]}, {"description": "TOBRAMYCIN .3% 3.5GM OO", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5332725", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 718.0, "discounted_cash": 538.5, "setting": "both", "billing_class": "facility"}]}, {"description": "TOBRAMYCIN .3% 3.5GM OO", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5332725", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 718.0, "discounted_cash": 538.5, "setting": "both", "billing_class": "facility"}]}, {"description": "TOBRAMYCIN .3% 5ML OS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5332726", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 541.0, "discounted_cash": 405.75, "setting": "both", "billing_class": "facility"}]}, {"description": "TOBRAMYCIN .3% 5ML OS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5332726", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 541.0, "discounted_cash": 405.75, "setting": "both", "billing_class": "facility"}]}, {"description": "TOBRAMYCIN 1.2GM PW", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5337470", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 4321.0, "discounted_cash": 3240.75, "setting": "both", "billing_class": "facility"}]}, {"description": "TOBRAMYCIN 300MG 5ML IS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5332732", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 1623.0, "discounted_cash": 1217.25, "setting": "both", "billing_class": "facility"}]}, {"description": "TOBRAMYCIN 300MG 5ML IS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5332732", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 1623.0, "discounted_cash": 1217.25, "setting": "both", "billing_class": "facility"}]}, {"description": "TOBRAMYCIN PER 1ML IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5324774", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 66.0, "discounted_cash": 49.5, "setting": "both", "billing_class": "facility"}]}, {"description": "TOBRAMYCIN UPTO 80MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3260", "type": "HCPCS"}, {"code": "5324780", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 111.0, "discounted_cash": 83.25, "setting": "both", "billing_class": "facility"}]}, {"description": "TOBRAMYCIN UPTO 80MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3260", "type": "HCPCS"}, {"code": "5324780", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 111.0, "discounted_cash": 83.25, "setting": "both", "billing_class": "facility"}]}, {"description": "TOBRAMYCIN/2", "code_information": [{"code": "80200", "type": "CPT"}, {"code": "4104469", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 1076.0, "discounted_cash": 807.0, "setting": "both", "billing_class": "facility"}]}, {"description": "TOBRAMYCIN/3", "code_information": [{"code": "80200", "type": "CPT"}, {"code": "4104471", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 1076.0, "discounted_cash": 807.0, "setting": "both", "billing_class": "facility"}]}, {"description": "TOCILIZUMAB (COVID) PER 1MG IJ", "code_information": [{"code": "Q0249", "type": "HCPCS"}, {"code": "5324793", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 21.0, "discounted_cash": 15.75, "setting": "both", "billing_class": "facility"}]}, {"description": "TOCILIZUMAB PER 1MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3262", "type": "HCPCS"}, {"code": "5324791", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 23.0, "discounted_cash": 17.25, "setting": "both", "billing_class": "facility"}]}, {"description": "TOCILIZUMAB PER 1MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3262", "type": "HCPCS"}, {"code": "5324791", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 23.0, "discounted_cash": 17.25, "setting": "both", "billing_class": "facility"}]}, {"description": "TOE(S) 2 VIEWS", "code_information": [{"code": "73660", "type": "CPT"}, {"code": "4903660", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 1787.0, "discounted_cash": 1340.25, "setting": "both", "billing_class": "facility"}]}, {"description": "TOE(S) 2 VIEWS", "code_information": [{"code": "73660", "type": "CPT"}, {"code": "5113660", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 1306.0, "discounted_cash": 979.5, "setting": "both", "billing_class": "facility"}]}, {"description": "TOLNAFTATE 1% 10ML TS", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5337488", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 102.0, "discounted_cash": 76.5, "setting": "both", "billing_class": "facility"}]}, {"description": "TOLNAFTATE 1% 10ML TS", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5337488", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 102.0, "discounted_cash": 76.5, "setting": "both", "billing_class": "facility"}]}, {"description": "TOLNAFTATE 1% 15GM CR", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5337493", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 160.0, "discounted_cash": 120.0, "setting": "both", "billing_class": "facility"}]}, {"description": "TOLNAFTATE 1% 15GM CR", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5337493", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 160.0, "discounted_cash": 120.0, "setting": "both", "billing_class": "facility"}]}, {"description": "TOLTERODINE 2MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5311752", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 95.0, "discounted_cash": 71.25, "setting": "both", "billing_class": "facility"}]}, {"description": "TOLTERODINE 2MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5311752", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 95.0, "discounted_cash": 71.25, "setting": "both", "billing_class": "facility"}]}, {"description": "TOLTERODINE 2MG XR CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5311747", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 165.0, "discounted_cash": 123.75, "setting": "both", "billing_class": "facility"}]}, {"description": "TOLTERODINE 2MG XR CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5311747", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 165.0, "discounted_cash": 123.75, "setting": "both", "billing_class": "facility"}]}, {"description": "TOLTERODINE 4MG XR CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5311748", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 165.0, "discounted_cash": 123.75, "setting": "both", "billing_class": "facility"}]}, {"description": "TOLTERODINE 4MG XR CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5311748", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 165.0, "discounted_cash": 123.75, "setting": "both", "billing_class": "facility"}]}, {"description": "TOMOGRAPHY SNGL PLANE", "code_information": [{"code": "76100", "type": "CPT"}, {"code": "4906100", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 1863.0, "discounted_cash": 1397.25, "setting": "both", "billing_class": "facility"}]}, {"description": "TOPIRAMATE 100MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5311755", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 126.0, "discounted_cash": 94.5, "setting": "both", "billing_class": "facility"}]}, {"description": "TOPIRAMATE 100MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5311755", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 126.0, "discounted_cash": 94.5, "setting": "both", "billing_class": "facility"}]}, {"description": "TOPIRAMATE 25MG SPRK CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5311746", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 111.0, "discounted_cash": 83.25, "setting": "both", "billing_class": "facility"}]}, {"description": "TOPIRAMATE 25MG SPRK CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5311746", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 111.0, "discounted_cash": 83.25, "setting": "both", "billing_class": "facility"}]}, {"description": "TOPIRAMATE 25MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5311754", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 64.0, "discounted_cash": 48.0, "setting": "both", "billing_class": "facility"}]}, {"description": "TOPIRAMATE 25MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5311754", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 64.0, "discounted_cash": 48.0, "setting": "both", "billing_class": "facility"}]}, {"description": "TOPIRAMATE LVL", "code_information": [{"code": "80201", "type": "CPT"}, {"code": "7254470", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 263.0, "discounted_cash": 197.25, "setting": "both", "billing_class": "facility"}]}, {"description": "TORSEMIDE 20MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5311762", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 66.0, "discounted_cash": 49.5, "setting": "both", "billing_class": "facility"}]}, {"description": "TORSEMIDE 20MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5311762", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 66.0, "discounted_cash": 49.5, "setting": "both", "billing_class": "facility"}]}, {"description": "TOXOPLASMA AB", "code_information": [{"code": "86777", "type": "CPT"}, {"code": "4106600", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 1080.0, "discounted_cash": 810.0, "setting": "both", "billing_class": "facility"}]}, {"description": "TOXOPLASMA AB IGM", "code_information": [{"code": "86778", "type": "CPT"}, {"code": "4106908", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 83.0, "discounted_cash": 62.25, "setting": "both", "billing_class": "facility"}]}, {"description": "TOXOPLASMA AB IGM", "code_information": [{"code": "86778", "type": "CPT"}, {"code": "7256923", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 53.0, "discounted_cash": 39.75, "setting": "both", "billing_class": "facility"}]}, {"description": "TOXOPLASMA AB/3", "code_information": [{"code": "86777", "type": "CPT"}, {"code": "7256777", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 727.0, "discounted_cash": 545.25, "setting": "both", "billing_class": "facility"}]}, {"description": "TOXOPLASMA AB/5", "code_information": [{"code": "86777", "type": "CPT"}, {"code": "7256922", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 181.0, "discounted_cash": 135.75, "setting": "both", "billing_class": "facility"}]}, {"description": "TPMT GENE ANALYSIS", "code_information": [{"code": "81335", "type": "CPT"}, {"code": "7251335", "type": "CDM"}, {"code": "310", "type": "RC"}], "standard_charges": [{"gross_charge": 402.0, "discounted_cash": 301.5, "setting": "both", "billing_class": "facility"}]}, {"description": "TRACE METAL 1ML IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5324844", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 374.0, "discounted_cash": 280.5, "setting": "both", "billing_class": "facility"}]}, {"description": "TRACE METAL NEO 2ML IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J7999", "type": "HCPCS"}, {"code": "5324845", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 499.0, "discounted_cash": 374.25, "setting": "both", "billing_class": "facility"}]}, {"description": "TRACE METAL NEO 2ML IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J7999", "type": "HCPCS"}, {"code": "5324845", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 499.0, "discounted_cash": 374.25, "setting": "both", "billing_class": "facility"}]}, {"description": "TRACE METAL PED 1ML IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5324837", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 530.0, "discounted_cash": 397.5, "setting": "both", "billing_class": "facility"}]}, {"description": "TRAMADOL 50MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5311770", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 78.0, "discounted_cash": 58.5, "setting": "both", "billing_class": "facility"}]}, {"description": "TRAMADOL 50MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5311770", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 78.0, "discounted_cash": 58.5, "setting": "both", "billing_class": "facility"}]}, {"description": "TRANDOLAPRIL 2MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5311765", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 85.0, "discounted_cash": 63.75, "setting": "both", "billing_class": "facility"}]}, {"description": "TRANDOLAPRIL 2MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5311765", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 85.0, "discounted_cash": 63.75, "setting": "both", "billing_class": "facility"}]}, {"description": "TRANEXAMIC ACID PER 5MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3290", "type": "HCPCS"}, {"code": "5324874", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 25.0, "discounted_cash": 18.75, "setting": "both", "billing_class": "facility"}]}, {"description": "TRANEXAMIC ACID PER 5MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3290", "type": "HCPCS"}, {"code": "5324874", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 25.0, "discounted_cash": 18.75, "setting": "both", "billing_class": "facility"}]}, {"description": "TRANS DEL FIX-DEVICE/GRFT+S&I", "code_information": [{"code": "4614712", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 76297.0, "discounted_cash": 57222.75, "setting": "both", "billing_class": "facility"}]}, {"description": "TRANSAMINASE-SGPT (ALT)", "code_information": [{"code": "84460", "type": "CPT"}, {"code": "4104460", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 501.0, "discounted_cash": 375.75, "setting": "both", "billing_class": "facility"}]}, {"description": "TRANSAMINASE-SGPT (ALT)", "code_information": [{"code": "84460", "type": "CPT"}, {"code": "4174460", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 1.12, "discounted_cash": 0.84, "setting": "both", "billing_class": "facility"}]}, {"description": "TRANSCATH INS/RPL PERM LDLS PM", "code_information": [{"code": "4610387", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 65961.0, "discounted_cash": 49470.75, "setting": "both", "billing_class": "facility"}]}, {"description": "TRANSCUTANEOUS PACING", "code_information": [{"code": "92953", "type": "CPT"}, {"code": "6100610", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 2220.0, "discounted_cash": 1665.0, "setting": "both", "billing_class": "facility"}]}, {"description": "TRANSESOPHAGEAL ECHO", "code_information": [{"code": "93312", "type": "CPT"}, {"code": "4611115", "type": "CDM"}, {"code": "483", "type": "RC"}], "standard_charges": [{"gross_charge": 6902.0, "discounted_cash": 5176.5, "setting": "both", "billing_class": "facility"}]}, {"description": "TRANSFERRIN", "code_information": [{"code": "84466", "type": "CPT"}, {"code": "4104462", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 538.0, "discounted_cash": 403.5, "setting": "both", "billing_class": "facility"}]}, {"description": "TRANSFERRIN", "code_information": [{"code": "84466", "type": "CPT"}, {"code": "7254462", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 95.0, "discounted_cash": 71.25, "setting": "both", "billing_class": "facility"}]}, {"description": "TRANSFUSION BLD/BLD COMP", "code_information": [{"code": "36430", "type": "CPT"}, {"code": "3603110", "type": "CDM"}, {"code": "391", "type": "RC"}], "standard_charges": [{"gross_charge": 2059.0, "discounted_cash": 1544.25, "setting": "both", "billing_class": "facility"}]}, {"description": "TRANSFUSN REACTN W RPT", "code_information": [{"code": "86078", "type": "CPT"}, {"code": "4306078", "type": "CDM"}, {"code": "310", "type": "RC"}], "standard_charges": [{"gross_charge": 313.0, "discounted_cash": 234.75, "setting": "both", "billing_class": "facility"}]}, {"description": "TRANSLUMBAR RENAL CYST", "code_information": [{"code": "74470", "type": "CPT"}, {"code": "4914470", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 4927.0, "discounted_cash": 3695.25, "setting": "both", "billing_class": "facility"}]}, {"description": "TRANSTERASE AST(SGOT)", "code_information": [{"code": "84450", "type": "CPT"}, {"code": "4104450", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 504.0, "discounted_cash": 378.0, "setting": "both", "billing_class": "facility"}]}, {"description": "TRANSTERASE AST(SGOT)", "code_information": [{"code": "84450", "type": "CPT"}, {"code": "4174450", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 7.14, "discounted_cash": 5.36, "setting": "both", "billing_class": "facility"}]}, {"description": "TRAUMA III-FULL TEAM", "code_information": [{"code": "G0390", "type": "HCPCS"}, {"code": "6109006", "type": "CDM"}, {"code": "683", "type": "RC"}], "standard_charges": [{"gross_charge": 14021.0, "discounted_cash": 10515.75, "setting": "both", "billing_class": "facility"}]}, {"description": "TRAUMA III-PARTIAL TEAM", "code_information": [{"code": "G0390", "type": "HCPCS"}, {"code": "6109007", "type": "CDM"}, {"code": "683", "type": "RC"}], "standard_charges": [{"gross_charge": 8795.0, "discounted_cash": 6596.25, "setting": "both", "billing_class": "facility"}]}, {"description": "TRAUMA PAD 12X12 1EA", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5337505", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 851.0, "discounted_cash": 638.25, "setting": "both", "billing_class": "facility"}]}, {"description": "TRAUMA PAD 12X12 1EA", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5337505", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 851.0, "discounted_cash": 638.25, "setting": "both", "billing_class": "facility"}]}, {"description": "TRAVOPROST.004% 2.5ML OS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5332745", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 1045.0, "discounted_cash": 783.75, "setting": "both", "billing_class": "facility"}]}, {"description": "TRAVOPROST.004% 2.5ML OS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5332745", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 1045.0, "discounted_cash": 783.75, "setting": "both", "billing_class": "facility"}]}, {"description": "TRAZADONE", "code_information": [{"code": "80338", "type": "CPT"}, {"code": "7250301", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 111.0, "discounted_cash": 83.25, "setting": "both", "billing_class": "facility"}]}, {"description": "TRAZODONE 100MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5311795", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 83.0, "discounted_cash": 62.25, "setting": "both", "billing_class": "facility"}]}, {"description": "TRAZODONE 100MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5311795", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 83.0, "discounted_cash": 62.25, "setting": "both", "billing_class": "facility"}]}, {"description": "TRAZODONE 150MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5311796", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 63.0, "discounted_cash": 47.25, "setting": "both", "billing_class": "facility"}]}, {"description": "TRAZODONE 150MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5311796", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 63.0, "discounted_cash": 47.25, "setting": "both", "billing_class": "facility"}]}, {"description": "TRAZODONE 50MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5311791", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 63.0, "discounted_cash": 47.25, "setting": "both", "billing_class": "facility"}]}, {"description": "TRAZODONE 50MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5311791", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 63.0, "discounted_cash": 47.25, "setting": "both", "billing_class": "facility"}]}, {"description": "TREPONEMA PALLIDUM AB", "code_information": [{"code": "86780", "type": "CPT"}, {"code": "7256650", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 47.0, "discounted_cash": 35.25, "setting": "both", "billing_class": "facility"}]}, {"description": "TREPONEMA PALLIDUM AB/2", "code_information": [{"code": "86780", "type": "CPT"}, {"code": "4106650", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 122.0, "discounted_cash": 91.5, "setting": "both", "billing_class": "facility"}]}, {"description": "TREPONEMA PALLIDUM AB/4", "code_information": [{"code": "86780", "type": "CPT"}, {"code": "7256781", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 33.0, "discounted_cash": 24.75, "setting": "both", "billing_class": "facility"}]}, {"description": "TRETINOIN 10MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5311800", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 425.0, "discounted_cash": 318.75, "setting": "both", "billing_class": "facility"}]}, {"description": "TRETINOIN 10MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5311800", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 425.0, "discounted_cash": 318.75, "setting": "both", "billing_class": "facility"}]}, {"description": "TRIAMCIN-A .1% 5GM PASTE", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5337620", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 574.0, "discounted_cash": 430.5, "setting": "both", "billing_class": "facility"}]}, {"description": "TRIAMCIN-A .1% 5GM PASTE", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5337620", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 574.0, "discounted_cash": 430.5, "setting": "both", "billing_class": "facility"}]}, {"description": "TRIAMCIN-A PF PER1MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3300", "type": "HCPCS"}, {"code": "5324072", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 47.0, "discounted_cash": 35.25, "setting": "both", "billing_class": "facility"}]}, {"description": "TRIAMCIN-A PF PER1MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3300", "type": "HCPCS"}, {"code": "5324072", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 47.0, "discounted_cash": 35.25, "setting": "both", "billing_class": "facility"}]}, {"description": "TRIAMCINOL-A .1%15GM CR", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5337615", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 141.0, "discounted_cash": 105.75, "setting": "both", "billing_class": "facility"}]}, {"description": "TRIAMCINOL-A .1%15GM CR", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5337615", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 141.0, "discounted_cash": 105.75, "setting": "both", "billing_class": "facility"}]}, {"description": "TRIAMCINOLON A PER10MGIJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3301", "type": "HCPCS"}, {"code": "5324865", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 99.0, "discounted_cash": 74.25, "setting": "both", "billing_class": "facility"}]}, {"description": "TRIAMCINOLON A PER10MGIJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3301", "type": "HCPCS"}, {"code": "5324865", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 99.0, "discounted_cash": 74.25, "setting": "both", "billing_class": "facility"}]}, {"description": "TRIAMCINOLONE .1%15GM OI", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5337575", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 125.0, "discounted_cash": 93.75, "setting": "both", "billing_class": "facility"}]}, {"description": "TRIAMCINOLONE .1%15GM OI", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5337575", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 125.0, "discounted_cash": 93.75, "setting": "both", "billing_class": "facility"}]}, {"description": "TRIAMCINOLONE .1%60ML LT", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5337580", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 729.0, "discounted_cash": 546.75, "setting": "both", "billing_class": "facility"}]}, {"description": "TRIAMCINOLONE .1%60ML LT", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5337580", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 729.0, "discounted_cash": 546.75, "setting": "both", "billing_class": "facility"}]}, {"description": "TRIAMCINOLONE .5%15GM CR", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5337595", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 142.0, "discounted_cash": 106.5, "setting": "both", "billing_class": "facility"}]}, {"description": "TRIAMCINOLONE .5%15GM CR", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5337595", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 142.0, "discounted_cash": 106.5, "setting": "both", "billing_class": "facility"}]}, {"description": "TRIAMCINOLONE.025%15GMCR", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5337545", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 141.0, "discounted_cash": 105.75, "setting": "both", "billing_class": "facility"}]}, {"description": "TRIAMCINOLONE.025%15GMCR", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5337545", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 141.0, "discounted_cash": 105.75, "setting": "both", "billing_class": "facility"}]}, {"description": "TRIAMTER-HCTZ 37.5/25 CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5311862", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 85.0, "discounted_cash": 63.75, "setting": "both", "billing_class": "facility"}]}, {"description": "TRIAMTER-HCTZ 37.5/25 CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5311862", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 85.0, "discounted_cash": 63.75, "setting": "both", "billing_class": "facility"}]}, {"description": "TRIAMTER-HCTZ 37.5/25 TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5311863", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 78.0, "discounted_cash": 58.5, "setting": "both", "billing_class": "facility"}]}, {"description": "TRIAMTER-HCTZ 37.5/25 TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5311863", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 78.0, "discounted_cash": 58.5, "setting": "both", "billing_class": "facility"}]}, {"description": "TRICHINELLA AB", "code_information": [{"code": "86784", "type": "CPT"}, {"code": "7256183", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 436.0, "discounted_cash": 327.0, "setting": "both", "billing_class": "facility"}]}, {"description": "TRICHOMONAS AMP PROBE", "code_information": [{"code": "87661", "type": "CPT"}, {"code": "7257661", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 85.0, "discounted_cash": 63.75, "setting": "both", "billing_class": "facility"}]}, {"description": "TRIGLYCERIDE MED CHN PED", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5340239", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 1.0, "discounted_cash": 0.75, "setting": "both", "billing_class": "facility"}]}, {"description": "TRIGLYCERIDE MED CHN PED", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5340239", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 1.0, "discounted_cash": 0.75, "setting": "both", "billing_class": "facility"}]}, {"description": "TRIGLYCERIDES", "code_information": [{"code": "84478", "type": "CPT"}, {"code": "4104475", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 416.0, "discounted_cash": 312.0, "setting": "both", "billing_class": "facility"}]}, {"description": "TRIGLYCERIDES", "code_information": [{"code": "84478", "type": "CPT"}, {"code": "4174475", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 1.12, "discounted_cash": 0.84, "setting": "both", "billing_class": "facility"}]}, {"description": "TRIGLYCERIDES MED PER1ML", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5340238", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 17.0, "discounted_cash": 12.75, "setting": "both", "billing_class": "facility"}]}, {"description": "TRIGLYCERIDES MED PER1ML", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5340238", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 17.0, "discounted_cash": 12.75, "setting": "both", "billing_class": "facility"}]}, {"description": "TRIGLYCERIDES/2", "code_information": [{"code": "84478", "type": "CPT"}, {"code": "4104478", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 526.0, "discounted_cash": 394.5, "setting": "both", "billing_class": "facility"}]}, {"description": "TRIGLYCERIDES/2", "code_information": [{"code": "84478", "type": "CPT"}, {"code": "7254475", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 131.0, "discounted_cash": 98.25, "setting": "both", "billing_class": "facility"}]}, {"description": "TRIGLYCERIDES/4", "code_information": [{"code": "84478", "type": "CPT"}, {"code": "7258447", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 12.0, "discounted_cash": 9.0, "setting": "both", "billing_class": "facility"}]}, {"description": "TRIHEXYPHENIDYL 2MGTB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5311942", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 63.0, "discounted_cash": 47.25, "setting": "both", "billing_class": "facility"}]}, {"description": "TRIHEXYPHENIDYL 2MGTB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5311942", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 63.0, "discounted_cash": 47.25, "setting": "both", "billing_class": "facility"}]}, {"description": "TRIIODTHYRN (T3/T4) UPTAKE", "code_information": [{"code": "84479", "type": "CPT"}, {"code": "4104250", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 942.0, "discounted_cash": 706.5, "setting": "both", "billing_class": "facility"}]}, {"description": "TRIIODTHYRN (T3/T4) UPTAKE", "code_information": [{"code": "84479", "type": "CPT"}, {"code": "4174250", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 11.42, "discounted_cash": 8.57, "setting": "both", "billing_class": "facility"}]}, {"description": "TRIIODTHYRN (T3/T4) UPTAKE", "code_information": [{"code": "84479", "type": "CPT"}, {"code": "7254250", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 11.0, "discounted_cash": 8.25, "setting": "both", "billing_class": "facility"}]}, {"description": "TRIIODTHYRNINE TOTAL T3", "code_information": [{"code": "84480", "type": "CPT"}, {"code": "4103538", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 1579.0, "discounted_cash": 1184.25, "setting": "both", "billing_class": "facility"}]}, {"description": "TRIIODTHYRNINE TOTAL T3", "code_information": [{"code": "84480", "type": "CPT"}, {"code": "4173538", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 11.42, "discounted_cash": 8.57, "setting": "both", "billing_class": "facility"}]}, {"description": "TRIIODTHYRNINE TOTAL T3", "code_information": [{"code": "84480", "type": "CPT"}, {"code": "7253539", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 16.0, "discounted_cash": 12.0, "setting": "both", "billing_class": "facility"}]}, {"description": "TRIM NAILS ANY NUMBER", "code_information": [{"code": "6810521", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 267.0, "discounted_cash": 200.25, "setting": "both", "billing_class": "facility"}]}, {"description": "TRIM NAILS ANY NUMBER", "code_information": [{"code": "6810521", "type": "CDM"}, {"code": "361", "type": "RC"}], "standard_charges": [{"gross_charge": 267.0, "discounted_cash": 200.25, "setting": "both", "billing_class": "facility"}]}, {"description": "TRIM NAILS ANY NUMBER", "code_information": [{"code": "6900035", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 267.0, "discounted_cash": 200.25, "setting": "both", "billing_class": "facility"}]}, {"description": "TRIM NAILS ANY NUMBER", "code_information": [{"code": "6900035", "type": "CDM"}, {"code": "361", "type": "RC"}], "standard_charges": [{"gross_charge": 267.0, "discounted_cash": 200.25, "setting": "both", "billing_class": "facility"}]}, {"description": "TRIM SKIN LESION 2-4", "code_information": [{"code": "6810510", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 752.0, "discounted_cash": 564.0, "setting": "both", "billing_class": "facility"}]}, {"description": "TRIM SKIN LESION 2-4", "code_information": [{"code": "6810510", "type": "CDM"}, {"code": "361", "type": "RC"}], "standard_charges": [{"gross_charge": 752.0, "discounted_cash": 564.0, "setting": "both", "billing_class": "facility"}]}, {"description": "TRIM SKIN LESION 2-4", "code_information": [{"code": "6900071", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 752.0, "discounted_cash": 564.0, "setting": "both", "billing_class": "facility"}]}, {"description": "TRIM SKIN LESION 2-4", "code_information": [{"code": "6900071", "type": "CDM"}, {"code": "361", "type": "RC"}], "standard_charges": [{"gross_charge": 752.0, "discounted_cash": 564.0, "setting": "both", "billing_class": "facility"}]}, {"description": "TRIM SKIN LESION >4", "code_information": [{"code": "6810509", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 752.0, "discounted_cash": 564.0, "setting": "both", "billing_class": "facility"}]}, {"description": "TRIM SKIN LESION >4", "code_information": [{"code": "6810509", "type": "CDM"}, {"code": "361", "type": "RC"}], "standard_charges": [{"gross_charge": 752.0, "discounted_cash": 564.0, "setting": "both", "billing_class": "facility"}]}, {"description": "TRIM SKIN LESION >4", "code_information": [{"code": "6900072", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 752.0, "discounted_cash": 564.0, "setting": "both", "billing_class": "facility"}]}, {"description": "TRIM SKIN LESION >4", "code_information": [{"code": "6900072", "type": "CDM"}, {"code": "361", "type": "RC"}], "standard_charges": [{"gross_charge": 752.0, "discounted_cash": 564.0, "setting": "both", "billing_class": "facility"}]}, {"description": "TRIM SKIN LESION SINGLE", "code_information": [{"code": "6810511", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 752.0, "discounted_cash": 564.0, "setting": "both", "billing_class": "facility"}]}, {"description": "TRIM SKIN LESION SINGLE", "code_information": [{"code": "6810511", "type": "CDM"}, {"code": "361", "type": "RC"}], "standard_charges": [{"gross_charge": 752.0, "discounted_cash": 564.0, "setting": "both", "billing_class": "facility"}]}, {"description": "TRIM SKIN LESION SINGLE", "code_information": [{"code": "6900070", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 712.0, "discounted_cash": 534.0, "setting": "both", "billing_class": "facility"}]}, {"description": "TRIM SKIN LESION SINGLE", "code_information": [{"code": "6900070", "type": "CDM"}, {"code": "361", "type": "RC"}], "standard_charges": [{"gross_charge": 712.0, "discounted_cash": 534.0, "setting": "both", "billing_class": "facility"}]}, {"description": "TRIMETHOBENZ TO 200MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3250", "type": "HCPCS"}, {"code": "5324953", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 162.0, "discounted_cash": 121.5, "setting": "both", "billing_class": "facility"}]}, {"description": "TRIMETHOBENZ TO 200MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3250", "type": "HCPCS"}, {"code": "5324953", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 162.0, "discounted_cash": 121.5, "setting": "both", "billing_class": "facility"}]}, {"description": "TRIMETHPRM/POLYMYX10MLOS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5332760", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 288.0, "discounted_cash": 216.0, "setting": "both", "billing_class": "facility"}]}, {"description": "TRIMETHPRM/POLYMYX10MLOS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5332760", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 288.0, "discounted_cash": 216.0, "setting": "both", "billing_class": "facility"}]}, {"description": "TRIPLE DYE .66ML TS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5335751", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 109.0, "discounted_cash": 81.75, "setting": "both", "billing_class": "facility"}]}, {"description": "TRIPLE DYE APPL SWAB EA", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5337645", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 71.0, "discounted_cash": 53.25, "setting": "both", "billing_class": "facility"}]}, {"description": "TRNSCTH BIOPSY", "code_information": [{"code": "4918005", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 8536.0, "discounted_cash": 6402.0, "setting": "both", "billing_class": "facility"}]}, {"description": "TRNSCTH BIOPSY S&I", "code_information": [{"code": "75970", "type": "CPT"}, {"code": "4915971", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 5092.0, "discounted_cash": 3819.0, "setting": "both", "billing_class": "facility"}]}, {"description": "TRNSCTH EMBOLIZATN", "code_information": [{"code": "75894", "type": "CPT"}, {"code": "4616005", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 4566.0, "discounted_cash": 3424.5, "setting": "both", "billing_class": "facility"}]}, {"description": "TRNSCTH EMBOLIZATN", "code_information": [{"code": "75894", "type": "CPT"}, {"code": "4915895", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 4566.0, "discounted_cash": 3424.5, "setting": "both", "billing_class": "facility"}]}, {"description": "TRNSVN INTRHEP PORT SHNT", "code_information": [{"code": "4917182", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 57345.0, "discounted_cash": 43008.75, "setting": "both", "billing_class": "facility"}]}, {"description": "TROFILE (TM) DNA", "code_information": [{"code": "87999", "type": "CPT"}, {"code": "7250029", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 4605.0, "discounted_cash": 3453.75, "setting": "both", "billing_class": "facility"}]}, {"description": "TROPICAMIDE .5% 15ML OS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5332774", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 398.0, "discounted_cash": 298.5, "setting": "both", "billing_class": "facility"}]}, {"description": "TROPICAMIDE 1% 15ML OS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5332781", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 530.0, "discounted_cash": 397.5, "setting": "both", "billing_class": "facility"}]}, {"description": "TROPICAMIDE 1% 2ML OS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5332780", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 177.0, "discounted_cash": 132.75, "setting": "both", "billing_class": "facility"}]}, {"description": "TROPICAMIDE 1% 3ML OS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5332782", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 269.0, "discounted_cash": 201.75, "setting": "both", "billing_class": "facility"}]}, {"description": "TROPONIN QUAN", "code_information": [{"code": "84484", "type": "CPT"}, {"code": "4104484", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 978.0, "discounted_cash": 733.5, "setting": "both", "billing_class": "facility"}]}, {"description": "TROPONIN QUAN/2", "code_information": [{"code": "84484", "type": "CPT"}, {"code": "4107235", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 947.0, "discounted_cash": 710.25, "setting": "both", "billing_class": "facility"}]}, {"description": "TROPONIN QUAN/2", "code_information": [{"code": "84484", "type": "CPT"}, {"code": "4177235", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 5.71, "discounted_cash": 4.28, "setting": "both", "billing_class": "facility"}]}, {"description": "TROPONIN QUAN/2", "code_information": [{"code": "84484", "type": "CPT"}, {"code": "7257238", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 175.0, "discounted_cash": 131.25, "setting": "both", "billing_class": "facility"}]}, {"description": "TRY CATH PICC DL MAXBAR", "code_information": [{"code": "C1751", "type": "HCPCS"}, {"code": "8057027", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 2995.0, "discounted_cash": 2246.25, "setting": "both", "billing_class": "facility"}]}, {"description": "TRY CATH PICC SGL MAXBAR", "code_information": [{"code": "C1751", "type": "HCPCS"}, {"code": "8057021", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 4108.0, "discounted_cash": 3081.0, "setting": "both", "billing_class": "facility"}]}, {"description": "TRY CVP TRI LUM", "code_information": [{"code": "C1751", "type": "HCPCS"}, {"code": "8083315", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 2013.0, "discounted_cash": 1509.75, "setting": "both", "billing_class": "facility"}]}, {"description": "TRY TIB MOD OSTEOREMEDIES CL", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "4013363", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 27669.0, "discounted_cash": 20751.75, "setting": "both", "billing_class": "facility"}]}, {"description": "TRYPS/BALS/CASTOIL30GMOI", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3590", "type": "HCPCS"}, {"code": "5337659", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 833.0, "discounted_cash": 624.75, "setting": "both", "billing_class": "facility"}]}, {"description": "TRYPS/BALS/CASTOIL30GMOI", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3590", "type": "HCPCS"}, {"code": "5337659", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 833.0, "discounted_cash": 624.75, "setting": "both", "billing_class": "facility"}]}, {"description": "TRYPS/BALS/CASTOIL60GMOI", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5337656", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 825.0, "discounted_cash": 618.75, "setting": "both", "billing_class": "facility"}]}, {"description": "TRYPS/BALS/CASTOIL60GMOI", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5337656", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 825.0, "discounted_cash": 618.75, "setting": "both", "billing_class": "facility"}]}, {"description": "TRYPS/BALS/CASTOIL60MLSP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5337655", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 761.0, "discounted_cash": 570.75, "setting": "both", "billing_class": "facility"}]}, {"description": "TRYPS/BALS/CASTOIL60MLSP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5337655", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 761.0, "discounted_cash": 570.75, "setting": "both", "billing_class": "facility"}]}, {"description": "TRYPSIN BLOOD TOTAL", "code_information": [{"code": "83519", "type": "CPT"}, {"code": "7254489", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 39.0, "discounted_cash": 29.25, "setting": "both", "billing_class": "facility"}]}, {"description": "TRYPSIN FECES QUAL", "code_information": [{"code": "84488", "type": "CPT"}, {"code": "7254488", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 617.0, "discounted_cash": 462.75, "setting": "both", "billing_class": "facility"}]}, {"description": "TRYPTASE LEVEL", "code_information": [{"code": "83520", "type": "CPT"}, {"code": "7253529", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 258.0, "discounted_cash": 193.5, "setting": "both", "billing_class": "facility"}]}, {"description": "TSH", "code_information": [{"code": "84443", "type": "CPT"}, {"code": "4104443", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 264.0, "discounted_cash": 198.0, "setting": "both", "billing_class": "facility"}]}, {"description": "TSH", "code_information": [{"code": "84443", "type": "CPT"}, {"code": "4174443", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 8.56, "discounted_cash": 6.42, "setting": "both", "billing_class": "facility"}]}, {"description": "TSH", "code_information": [{"code": "84443", "type": "CPT"}, {"code": "7254443", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 261.0, "discounted_cash": 195.75, "setting": "both", "billing_class": "facility"}]}, {"description": "TUBERCULIN PPD 5TU IJ", "code_information": [{"code": "86580", "type": "CPT"}, {"code": "5324989", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 131.0, "discounted_cash": 98.25, "setting": "both", "billing_class": "facility"}]}, {"description": "TUMOR IMM PER SPEC COMPT", "code_information": [{"code": "88361", "type": "CPT"}, {"code": "7038363", "type": "CDM"}, {"code": "310", "type": "RC"}], "standard_charges": [{"gross_charge": 393.0, "discounted_cash": 294.75, "setting": "both", "billing_class": "facility"}]}, {"description": "TUMOR IMM PER SPEC MAN", "code_information": [{"code": "88360", "type": "CPT"}, {"code": "4300083", "type": "CDM"}, {"code": "310", "type": "RC"}], "standard_charges": [{"gross_charge": 428.0, "discounted_cash": 321.0, "setting": "both", "billing_class": "facility"}]}, {"description": "TUMOR IMM PER SPEC MAN/3", "code_information": [{"code": "88360", "type": "CPT"}, {"code": "7048378", "type": "CDM"}, {"code": "310", "type": "RC"}], "standard_charges": [{"gross_charge": 422.0, "discounted_cash": 316.5, "setting": "both", "billing_class": "facility"}]}, {"description": "TUMOR LOC 2D WHOLE BDY 2+DAYS", "code_information": [{"code": "78804", "type": "CPT"}, {"code": "5208804", "type": "CDM"}, {"code": "341", "type": "RC"}], "standard_charges": [{"gross_charge": 6153.0, "discounted_cash": 4614.75, "setting": "both", "billing_class": "facility"}]}, {"description": "TUMOR LOCAL 2+ AREA 1+DAYS", "code_information": [{"code": "78801", "type": "CPT"}, {"code": "5202012", "type": "CDM"}, {"code": "341", "type": "RC"}], "standard_charges": [{"gross_charge": 7472.0, "discounted_cash": 5604.0, "setting": "both", "billing_class": "facility"}]}, {"description": "TUMOR LOCAL PLANAR SNGL AREA", "code_information": [{"code": "78800", "type": "CPT"}, {"code": "5202002", "type": "CDM"}, {"code": "341", "type": "RC"}], "standard_charges": [{"gross_charge": 4558.0, "discounted_cash": 3418.5, "setting": "both", "billing_class": "facility"}]}, {"description": "TUMOR LOCAL PLANAR WHOLEBDY", "code_information": [{"code": "78802", "type": "CPT"}, {"code": "5202022", "type": "CDM"}, {"code": "341", "type": "RC"}], "standard_charges": [{"gross_charge": 5256.0, "discounted_cash": 3942.0, "setting": "both", "billing_class": "facility"}]}, {"description": "TUMR LOC SPECT SGL AREA SGL DY", "code_information": [{"code": "78803", "type": "CPT"}, {"code": "5208803", "type": "CDM"}, {"code": "341", "type": "RC"}], "standard_charges": [{"gross_charge": 6237.0, "discounted_cash": 4677.75, "setting": "both", "billing_class": "facility"}]}, {"description": "TX I131 SOD CAP PER MCI", "code_information": [{"code": "A9517", "type": "HCPCS"}, {"code": "5199517", "type": "CDM"}, {"code": "344", "type": "RC"}], "standard_charges": [{"gross_charge": 770.0, "discounted_cash": 577.5, "setting": "both", "billing_class": "facility"}]}, {"description": "U1 RNP ANTIBODY", "code_information": [{"code": "83516", "type": "CPT"}, {"code": "7253659", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 129.0, "discounted_cash": 96.75, "setting": "both", "billing_class": "facility"}]}, {"description": "UA AUTO W/MICRO", "code_information": [{"code": "81001", "type": "CPT"}, {"code": "4101001", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 638.0, "discounted_cash": 478.5, "setting": "both", "billing_class": "facility"}]}, {"description": "UA AUTO W/MICRO", "code_information": [{"code": "81001", "type": "CPT"}, {"code": "4171001", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 5.71, "discounted_cash": 4.28, "setting": "both", "billing_class": "facility"}]}, {"description": "UA AUTO W/O MICRO", "code_information": [{"code": "81003", "type": "CPT"}, {"code": "4171004", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 5.71, "discounted_cash": 4.28, "setting": "both", "billing_class": "facility"}]}, {"description": "UA AUTO W/O MICRO", "code_information": [{"code": "81003", "type": "CPT"}, {"code": "7251003", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 60.0, "discounted_cash": 45.0, "setting": "both", "billing_class": "facility"}]}, {"description": "UA AUTO W/O MICRO/2", "code_information": [{"code": "81003", "type": "CPT"}, {"code": "4101004", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 502.0, "discounted_cash": 376.5, "setting": "both", "billing_class": "facility"}]}, {"description": "UA AUTO W/O MICRO/2", "code_information": [{"code": "81003", "type": "CPT"}, {"code": "7251004", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 10.0, "discounted_cash": 7.5, "setting": "both", "billing_class": "facility"}]}, {"description": "UA AUTO W/O MICRO/3", "code_information": [{"code": "81003", "type": "CPT"}, {"code": "4101006", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 438.0, "discounted_cash": 328.5, "setting": "both", "billing_class": "facility"}]}, {"description": "UA AUTO W/O MICRO/4", "code_information": [{"code": "81003", "type": "CPT"}, {"code": "4101008", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 438.0, "discounted_cash": 328.5, "setting": "both", "billing_class": "facility"}]}, {"description": "UA NON-AUTO W/MICRO", "code_information": [{"code": "81000", "type": "CPT"}, {"code": "4101000", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 413.0, "discounted_cash": 309.75, "setting": "both", "billing_class": "facility"}]}, {"description": "UA NON-AUTO W/O MICRO", "code_information": [{"code": "81002", "type": "CPT"}, {"code": "4171002", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 12.84, "discounted_cash": 9.63, "setting": "both", "billing_class": "facility"}]}, {"description": "UA NON-AUTO W/O MICRO/4", "code_information": [{"code": "81002", "type": "CPT"}, {"code": "4101098", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 272.0, "discounted_cash": 204.0, "setting": "both", "billing_class": "facility"}]}, {"description": "UA QUAL/SEMIQUANT", "code_information": [{"code": "81005", "type": "CPT"}, {"code": "4101005", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 377.0, "discounted_cash": 282.75, "setting": "both", "billing_class": "facility"}]}, {"description": "UA QUAL/SEMIQUANT", "code_information": [{"code": "81005", "type": "CPT"}, {"code": "4171005", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 19.98, "discounted_cash": 14.99, "setting": "both", "billing_class": "facility"}]}, {"description": "UE ART IMAGING COMP BILAT", "code_information": [{"code": "93930", "type": "CPT"}, {"code": "5062007", "type": "CDM"}, {"code": "921", "type": "RC"}], "standard_charges": [{"gross_charge": 2979.0, "discounted_cash": 2234.25, "setting": "both", "billing_class": "facility"}]}, {"description": "UE ART IMAGING COMP BILAT", "code_information": [{"code": "93930", "type": "CPT"}, {"code": "5112007", "type": "CDM"}, {"code": "921", "type": "RC"}], "standard_charges": [{"gross_charge": 2979.0, "discounted_cash": 2234.25, "setting": "both", "billing_class": "facility"}]}, {"description": "UE ART IMAGING UNI/LTD", "code_information": [{"code": "93931", "type": "CPT"}, {"code": "5067206", "type": "CDM"}, {"code": "921", "type": "RC"}], "standard_charges": [{"gross_charge": 2185.0, "discounted_cash": 1638.75, "setting": "both", "billing_class": "facility"}]}, {"description": "UE ART IMAGING UNI/LTD", "code_information": [{"code": "93931", "type": "CPT"}, {"code": "5117206", "type": "CDM"}, {"code": "921", "type": "RC"}], "standard_charges": [{"gross_charge": 2185.0, "discounted_cash": 1638.75, "setting": "both", "billing_class": "facility"}]}, {"description": "UE/LE ART STUD COMP 3+LVL", "code_information": [{"code": "93923", "type": "CPT"}, {"code": "6620802", "type": "CDM"}, {"code": "921", "type": "RC"}], "standard_charges": [{"gross_charge": 591.0, "discounted_cash": 443.25, "setting": "both", "billing_class": "facility"}]}, {"description": "UE/LE ART STUD LTD 1-2LV", "code_information": [{"code": "93922", "type": "CPT"}, {"code": "5503922", "type": "CDM"}, {"code": "921", "type": "RC"}], "standard_charges": [{"gross_charge": 1754.0, "discounted_cash": 1315.5, "setting": "both", "billing_class": "facility"}]}, {"description": "UE/LE ART STUD LTD 1-2LV", "code_information": [{"code": "93922", "type": "CPT"}, {"code": "6620804", "type": "CDM"}, {"code": "921", "type": "RC"}], "standard_charges": [{"gross_charge": 1177.0, "discounted_cash": 882.75, "setting": "both", "billing_class": "facility"}]}, {"description": "UE/LE ART STUD LTD 1-2LV", "code_information": [{"code": "93922", "type": "CPT"}, {"code": "6812010", "type": "CDM"}, {"code": "921", "type": "RC"}], "standard_charges": [{"gross_charge": 1754.0, "discounted_cash": 1315.5, "setting": "both", "billing_class": "facility"}]}, {"description": "UE/LE IMG VEINS COMP BILAT", "code_information": [{"code": "93970", "type": "CPT"}, {"code": "5062013", "type": "CDM"}, {"code": "921", "type": "RC"}], "standard_charges": [{"gross_charge": 4905.0, "discounted_cash": 3678.75, "setting": "both", "billing_class": "facility"}]}, {"description": "UE/LE IMG VEINS COMP BILAT", "code_information": [{"code": "93970", "type": "CPT"}, {"code": "5112013", "type": "CDM"}, {"code": "921", "type": "RC"}], "standard_charges": [{"gross_charge": 4905.0, "discounted_cash": 3678.75, "setting": "both", "billing_class": "facility"}]}, {"description": "UE/LE IMG VEINS UNI/LTD", "code_information": [{"code": "93971", "type": "CPT"}, {"code": "5067138", "type": "CDM"}, {"code": "921", "type": "RC"}], "standard_charges": [{"gross_charge": 3831.0, "discounted_cash": 2873.25, "setting": "both", "billing_class": "facility"}]}, {"description": "UE/LE IMG VEINS UNI/LTD", "code_information": [{"code": "93971", "type": "CPT"}, {"code": "5117138", "type": "CDM"}, {"code": "921", "type": "RC"}], "standard_charges": [{"gross_charge": 3831.0, "discounted_cash": 2873.25, "setting": "both", "billing_class": "facility"}]}, {"description": "UMBILICAL ART LINE NB", "code_information": [{"code": "3112120", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 380.0, "discounted_cash": 285.0, "setting": "both", "billing_class": "facility"}]}, {"description": "UMBILICAL ART LINE NB", "code_information": [{"code": "3112120", "type": "CDM"}, {"code": "361", "type": "RC"}], "standard_charges": [{"gross_charge": 380.0, "discounted_cash": 285.0, "setting": "both", "billing_class": "facility"}]}, {"description": "UMBILICAL VEIN LINE NB", "code_information": [{"code": "3112130", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 380.0, "discounted_cash": 285.0, "setting": "both", "billing_class": "facility"}]}, {"description": "UMBILICAL VEIN LINE NB", "code_information": [{"code": "3112130", "type": "CDM"}, {"code": "361", "type": "RC"}], "standard_charges": [{"gross_charge": 380.0, "discounted_cash": 285.0, "setting": "both", "billing_class": "facility"}]}, {"description": "UNIT HYDROCEPHALUS DIFF", "code_information": [{"code": "C1889", "type": "HCPCS"}, {"code": "8177804", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 48424.0, "discounted_cash": 36318.0, "setting": "both", "billing_class": "facility"}]}, {"description": "UNIVERSAL HEAD", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "8137050", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 13149.0, "discounted_cash": 9861.75, "setting": "both", "billing_class": "facility"}]}, {"description": "UNLISTED MOLEC PROC", "code_information": [{"code": "81479", "type": "CPT"}, {"code": "7251479", "type": "CDM"}, {"code": "310", "type": "RC"}], "standard_charges": [{"gross_charge": 96.0, "discounted_cash": 72.0, "setting": "both", "billing_class": "facility"}]}, {"description": "UNLISTED TRANSFUSION PROC", "code_information": [{"code": "86999", "type": "CPT"}, {"code": "7018699", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 674.0, "discounted_cash": 505.5, "setting": "both", "billing_class": "facility"}]}, {"description": "UNSCHED DIAL ESRD PT", "code_information": [{"code": "G0257", "type": "HCPCS"}, {"code": "5600257", "type": "CDM"}, {"code": "809", "type": "RC"}], "standard_charges": [{"gross_charge": 3920.0, "discounted_cash": 2940.0, "setting": "both", "billing_class": "facility"}]}, {"description": "UNSCHED DIAL ESRD PT", "code_information": [{"code": "G0257", "type": "HCPCS"}, {"code": "5600257", "type": "CDM"}, {"code": "829", "type": "RC"}], "standard_charges": [{"gross_charge": 3920.0, "discounted_cash": 2940.0, "setting": "both", "billing_class": "facility"}]}, {"description": "UNSCHED PERIT DIAL ESRD", "code_information": [{"code": "G0257", "type": "HCPCS"}, {"code": "5600258", "type": "CDM"}, {"code": "809", "type": "RC"}], "standard_charges": [{"gross_charge": 4345.0, "discounted_cash": 3258.75, "setting": "both", "billing_class": "facility"}]}, {"description": "UNSCHED PERIT DIAL ESRD", "code_information": [{"code": "G0257", "type": "HCPCS"}, {"code": "5600258", "type": "CDM"}, {"code": "829", "type": "RC"}], "standard_charges": [{"gross_charge": 4345.0, "discounted_cash": 3258.75, "setting": "both", "billing_class": "facility"}]}, {"description": "UPPER EXTREMITY INFANT", "code_information": [{"code": "73092", "type": "CPT"}, {"code": "4903092", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 1016.0, "discounted_cash": 762.0, "setting": "both", "billing_class": "facility"}]}, {"description": "UPPER EXTREMITY INFANT", "code_information": [{"code": "73092", "type": "CPT"}, {"code": "5113092", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 1494.0, "discounted_cash": 1120.5, "setting": "both", "billing_class": "facility"}]}, {"description": "UPPER GI DOUBLE CM STDY", "code_information": [{"code": "74246", "type": "CPT"}, {"code": "4904244", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 547.0, "discounted_cash": 410.25, "setting": "both", "billing_class": "facility"}]}, {"description": "UPPER GI SM INT F-THRU STD", "code_information": [{"code": "74248", "type": "CPT"}, {"code": "4904248", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 2462.0, "discounted_cash": 1846.5, "setting": "both", "billing_class": "facility"}]}, {"description": "UPPER GI W/SNGL CM STDY", "code_information": [{"code": "74240", "type": "CPT"}, {"code": "4904242", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 1546.0, "discounted_cash": 1159.5, "setting": "both", "billing_class": "facility"}]}, {"description": "UREA 10% 240ML LT", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5337690", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 164.0, "discounted_cash": 123.0, "setting": "both", "billing_class": "facility"}]}, {"description": "UREA 10% 240ML LT", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5337690", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 164.0, "discounted_cash": 123.0, "setting": "both", "billing_class": "facility"}]}, {"description": "UREA NITROGEN URINE", "code_information": [{"code": "84540", "type": "CPT"}, {"code": "4104540", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 129.0, "discounted_cash": 96.75, "setting": "both", "billing_class": "facility"}]}, {"description": "UREA NITROGEN URINE", "code_information": [{"code": "84540", "type": "CPT"}, {"code": "4174540", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 18.55, "discounted_cash": 13.91, "setting": "both", "billing_class": "facility"}]}, {"description": "UREA NITROGEN URINE/2", "code_information": [{"code": "84540", "type": "CPT"}, {"code": "4104541", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 136.0, "discounted_cash": 102.0, "setting": "both", "billing_class": "facility"}]}, {"description": "UREA NTRGN(BUN)CLEARANCE", "code_information": [{"code": "84545", "type": "CPT"}, {"code": "4104526", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 1008.0, "discounted_cash": 756.0, "setting": "both", "billing_class": "facility"}]}, {"description": "UREA NTRGN(BUN)CLEARANCE", "code_information": [{"code": "84545", "type": "CPT"}, {"code": "7254526", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 816.0, "discounted_cash": 612.0, "setting": "both", "billing_class": "facility"}]}, {"description": "URETHROCYSTOGRAPHY RETR", "code_information": [{"code": "74450", "type": "CPT"}, {"code": "4904450", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 3552.0, "discounted_cash": 2664.0, "setting": "both", "billing_class": "facility"}]}, {"description": "URETHROCYSTOGRAPHY VOID", "code_information": [{"code": "74455", "type": "CPT"}, {"code": "4904455", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 3575.0, "discounted_cash": 2681.25, "setting": "both", "billing_class": "facility"}]}, {"description": "URIC ACID BLOOD", "code_information": [{"code": "84550", "type": "CPT"}, {"code": "4104550", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 557.0, "discounted_cash": 417.75, "setting": "both", "billing_class": "facility"}]}, {"description": "URIC ACID BLOOD", "code_information": [{"code": "84550", "type": "CPT"}, {"code": "4174550", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 1.12, "discounted_cash": 0.84, "setting": "both", "billing_class": "facility"}]}, {"description": "URIC ACID OTHR SOURCE", "code_information": [{"code": "84560", "type": "CPT"}, {"code": "4104557", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 255.0, "discounted_cash": 191.25, "setting": "both", "billing_class": "facility"}]}, {"description": "URIC ACID OTHR SOURCE", "code_information": [{"code": "84560", "type": "CPT"}, {"code": "4174557", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 7.14, "discounted_cash": 5.36, "setting": "both", "billing_class": "facility"}]}, {"description": "URIC ACID OTHR SOURCE", "code_information": [{"code": "84560", "type": "CPT"}, {"code": "7254557", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 13.0, "discounted_cash": 9.75, "setting": "both", "billing_class": "facility"}]}, {"description": "URIC ACID OTHR SOURCE/2", "code_information": [{"code": "84560", "type": "CPT"}, {"code": "4104559", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 233.0, "discounted_cash": 174.75, "setting": "both", "billing_class": "facility"}]}, {"description": "URIC ACID OTHR SOURCE/2", "code_information": [{"code": "84560", "type": "CPT"}, {"code": "4174559", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 7.14, "discounted_cash": 5.36, "setting": "both", "billing_class": "facility"}]}, {"description": "URIC ACID OTHR SOURCE/3", "code_information": [{"code": "84560", "type": "CPT"}, {"code": "4104560", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 189.0, "discounted_cash": 141.75, "setting": "both", "billing_class": "facility"}]}, {"description": "URIC ACID OTHR SOURCE/3", "code_information": [{"code": "84560", "type": "CPT"}, {"code": "4174560", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 18.55, "discounted_cash": 13.91, "setting": "both", "billing_class": "facility"}]}, {"description": "URINALYSIS MICRO ONLY", "code_information": [{"code": "81015", "type": "CPT"}, {"code": "4171015", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 4.29, "discounted_cash": 3.22, "setting": "both", "billing_class": "facility"}]}, {"description": "URINE PREG TEST QUAL", "code_information": [{"code": "81025", "type": "CPT"}, {"code": "4101026", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 1247.0, "discounted_cash": 935.25, "setting": "both", "billing_class": "facility"}]}, {"description": "URINE PREG TEST QUAL", "code_information": [{"code": "81025", "type": "CPT"}, {"code": "4171026", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 21.41, "discounted_cash": 16.06, "setting": "both", "billing_class": "facility"}]}, {"description": "UROG/PYELOGRAPHY RETRO", "code_information": [{"code": "74420", "type": "CPT"}, {"code": "4904420", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 4699.0, "discounted_cash": 3524.25, "setting": "both", "billing_class": "facility"}]}, {"description": "UROGRAPHY EXCRETORY(IVP)", "code_information": [{"code": "74400", "type": "CPT"}, {"code": "4904400", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 4054.0, "discounted_cash": 3040.5, "setting": "both", "billing_class": "facility"}]}, {"description": "URSODIOL 300MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5312255", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 60.0, "discounted_cash": 45.0, "setting": "both", "billing_class": "facility"}]}, {"description": "URSODIOL 300MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5312255", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 60.0, "discounted_cash": 45.0, "setting": "both", "billing_class": "facility"}]}, {"description": "URSODIOL CMPD LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5316570", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 66.0, "discounted_cash": 49.5, "setting": "both", "billing_class": "facility"}]}, {"description": "URSODIOL CMPD LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5316570", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 66.0, "discounted_cash": 49.5, "setting": "both", "billing_class": "facility"}]}, {"description": "US ABD LTD SNGLE/QUAD/FU", "code_information": [{"code": "76705", "type": "CPT"}, {"code": "5066705", "type": "CDM"}, {"code": "402", "type": "RC"}], "standard_charges": [{"gross_charge": 7011.0, "discounted_cash": 5258.25, "setting": "both", "billing_class": "facility"}]}, {"description": "US ABDOMEN COMPLETE", "code_information": [{"code": "76700", "type": "CPT"}, {"code": "5066700", "type": "CDM"}, {"code": "402", "type": "RC"}], "standard_charges": [{"gross_charge": 5942.0, "discounted_cash": 4456.5, "setting": "both", "billing_class": "facility"}]}, {"description": "US ABDOMEN COMPLETE", "code_information": [{"code": "76700", "type": "CPT"}, {"code": "5116700", "type": "CDM"}, {"code": "402", "type": "RC"}], "standard_charges": [{"gross_charge": 5540.0, "discounted_cash": 4155.0, "setting": "both", "billing_class": "facility"}]}, {"description": "US ABDOMEN LTD/QUAD/FU", "code_information": [{"code": "76705", "type": "CPT"}, {"code": "5116705", "type": "CDM"}, {"code": "402", "type": "RC"}], "standard_charges": [{"gross_charge": 4336.0, "discounted_cash": 3252.0, "setting": "both", "billing_class": "facility"}]}, {"description": "US BREAST UNI COMPLETE", "code_information": [{"code": "76641", "type": "CPT"}, {"code": "3070016", "type": "CDM"}, {"code": "402", "type": "RC"}], "standard_charges": [{"gross_charge": 2379.0, "discounted_cash": 1784.25, "setting": "both", "billing_class": "facility"}]}, {"description": "US BREAST UNI COMPLETE", "code_information": [{"code": "76641", "type": "CPT"}, {"code": "5116645", "type": "CDM"}, {"code": "402", "type": "RC"}], "standard_charges": [{"gross_charge": 2379.0, "discounted_cash": 1784.25, "setting": "both", "billing_class": "facility"}]}, {"description": "US BREAST UNI LTD", "code_information": [{"code": "76642", "type": "CPT"}, {"code": "3076642", "type": "CDM"}, {"code": "402", "type": "RC"}], "standard_charges": [{"gross_charge": 713.0, "discounted_cash": 534.75, "setting": "both", "billing_class": "facility"}]}, {"description": "US CHEST INCLD MEDIASTNM", "code_information": [{"code": "76604", "type": "CPT"}, {"code": "5066604", "type": "CDM"}, {"code": "402", "type": "RC"}], "standard_charges": [{"gross_charge": 1509.0, "discounted_cash": 1131.75, "setting": "both", "billing_class": "facility"}]}, {"description": "US ELASTOGRAPHY 1ST TRGT LES", "code_information": [{"code": "76982", "type": "CPT"}, {"code": "5066982", "type": "CDM"}, {"code": "402", "type": "RC"}], "standard_charges": [{"gross_charge": 682.0, "discounted_cash": 511.5, "setting": "both", "billing_class": "facility"}]}, {"description": "US ELASTOGRAPHY ORGAN", "code_information": [{"code": "76981", "type": "CPT"}, {"code": "5060346", "type": "CDM"}, {"code": "402", "type": "RC"}], "standard_charges": [{"gross_charge": 736.0, "discounted_cash": 552.0, "setting": "both", "billing_class": "facility"}]}, {"description": "US ELASTOGRPHY EA ADL TRGT LES", "code_information": [{"code": "76983", "type": "CPT"}, {"code": "5066983", "type": "CDM"}, {"code": "402", "type": "RC"}], "standard_charges": [{"gross_charge": 428.0, "discounted_cash": 321.0, "setting": "both", "billing_class": "facility"}]}, {"description": "US GUIDANCE INTRAOPERATV", "code_information": [{"code": "76998", "type": "CPT"}, {"code": "5066986", "type": "CDM"}, {"code": "402", "type": "RC"}], "standard_charges": [{"gross_charge": 2078.0, "discounted_cash": 1558.5, "setting": "both", "billing_class": "facility"}]}, {"description": "US GUIDE AMNIOCENTESIS", "code_information": [{"code": "76946", "type": "CPT"}, {"code": "3100380", "type": "CDM"}, {"code": "402", "type": "RC"}], "standard_charges": [{"gross_charge": 2999.0, "discounted_cash": 2249.25, "setting": "both", "billing_class": "facility"}]}, {"description": "US GUIDE AMNIOCENTESIS", "code_information": [{"code": "76946", "type": "CPT"}, {"code": "5066862", "type": "CDM"}, {"code": "402", "type": "RC"}], "standard_charges": [{"gross_charge": 4515.0, "discounted_cash": 3386.25, "setting": "both", "billing_class": "facility"}]}, {"description": "US GUIDE NEEDLE PLACEMNT", "code_information": [{"code": "76942", "type": "CPT"}, {"code": "3070040", "type": "CDM"}, {"code": "402", "type": "RC"}], "standard_charges": [{"gross_charge": 4031.0, "discounted_cash": 3023.25, "setting": "both", "billing_class": "facility"}]}, {"description": "US GUIDE NEEDLE PLACEMNT", "code_information": [{"code": "76942", "type": "CPT"}, {"code": "4916942", "type": "CDM"}, {"code": "402", "type": "RC"}], "standard_charges": [{"gross_charge": 2649.0, "discounted_cash": 1986.75, "setting": "both", "billing_class": "facility"}]}, {"description": "US GUIDE NEEDLE PLACEMNT", "code_information": [{"code": "76942", "type": "CPT"}, {"code": "5066960", "type": "CDM"}, {"code": "402", "type": "RC"}], "standard_charges": [{"gross_charge": 2869.0, "discounted_cash": 2151.75, "setting": "both", "billing_class": "facility"}]}, {"description": "US GUIDE VASCULAR ACCESS", "code_information": [{"code": "76937", "type": "CPT"}, {"code": "4606937", "type": "CDM"}, {"code": "402", "type": "RC"}], "standard_charges": [{"gross_charge": 1263.0, "discounted_cash": 947.25, "setting": "both", "billing_class": "facility"}]}, {"description": "US GUIDE VASCULAR ACCESS", "code_information": [{"code": "76937", "type": "CPT"}, {"code": "4916937", "type": "CDM"}, {"code": "402", "type": "RC"}], "standard_charges": [{"gross_charge": 1263.0, "discounted_cash": 947.25, "setting": "both", "billing_class": "facility"}]}, {"description": "US GUIDE VASCULAR ACCESS", "code_information": [{"code": "76937", "type": "CPT"}, {"code": "5066937", "type": "CDM"}, {"code": "402", "type": "RC"}], "standard_charges": [{"gross_charge": 1036.0, "discounted_cash": 777.0, "setting": "both", "billing_class": "facility"}]}, {"description": "US GUIDE VASCULAR ACCESS", "code_information": [{"code": "76937", "type": "CPT"}, {"code": "5076937", "type": "CDM"}, {"code": "402", "type": "RC"}], "standard_charges": [{"gross_charge": 1036.0, "discounted_cash": 777.0, "setting": "both", "billing_class": "facility"}]}, {"description": "US INFANT HIPS DYNAMIC", "code_information": [{"code": "76885", "type": "CPT"}, {"code": "5066885", "type": "CDM"}, {"code": "402", "type": "RC"}], "standard_charges": [{"gross_charge": 1672.0, "discounted_cash": 1254.0, "setting": "both", "billing_class": "facility"}]}, {"description": "US INFANT HIPS LTD STATC", "code_information": [{"code": "76886", "type": "CPT"}, {"code": "5066886", "type": "CDM"}, {"code": "402", "type": "RC"}], "standard_charges": [{"gross_charge": 809.0, "discounted_cash": 606.75, "setting": "both", "billing_class": "facility"}]}, {"description": "US INFANT HIPS LTD STATC", "code_information": [{"code": "76886", "type": "CPT"}, {"code": "5116886", "type": "CDM"}, {"code": "402", "type": "RC"}], "standard_charges": [{"gross_charge": 809.0, "discounted_cash": 606.75, "setting": "both", "billing_class": "facility"}]}, {"description": "US OB COMP W FETL ANATMY", "code_information": [{"code": "76811", "type": "CPT"}, {"code": "5066811", "type": "CDM"}, {"code": "402", "type": "RC"}], "standard_charges": [{"gross_charge": 4589.0, "discounted_cash": 3441.75, "setting": "both", "billing_class": "facility"}]}, {"description": "US OB COMP<14WK ADD GEST", "code_information": [{"code": "76802", "type": "CPT"}, {"code": "5066802", "type": "CDM"}, {"code": "402", "type": "RC"}], "standard_charges": [{"gross_charge": 1694.0, "discounted_cash": 1270.5, "setting": "both", "billing_class": "facility"}]}, {"description": "US OB COMP<14WK ADD GEST", "code_information": [{"code": "76802", "type": "CPT"}, {"code": "5116802", "type": "CDM"}, {"code": "402", "type": "RC"}], "standard_charges": [{"gross_charge": 2311.0, "discounted_cash": 1733.25, "setting": "both", "billing_class": "facility"}]}, {"description": "US OB COMP<14WKS 1STGEST", "code_information": [{"code": "76801", "type": "CPT"}, {"code": "5066801", "type": "CDM"}, {"code": "402", "type": "RC"}], "standard_charges": [{"gross_charge": 3605.0, "discounted_cash": 2703.75, "setting": "both", "billing_class": "facility"}]}, {"description": "US OB COMP<14WKS 1STGEST", "code_information": [{"code": "76801", "type": "CPT"}, {"code": "5116801", "type": "CDM"}, {"code": "402", "type": "RC"}], "standard_charges": [{"gross_charge": 3605.0, "discounted_cash": 2703.75, "setting": "both", "billing_class": "facility"}]}, {"description": "US OB COMP>14WK ADD GEST", "code_information": [{"code": "76810", "type": "CPT"}, {"code": "5066843", "type": "CDM"}, {"code": "402", "type": "RC"}], "standard_charges": [{"gross_charge": 2484.0, "discounted_cash": 1863.0, "setting": "both", "billing_class": "facility"}]}, {"description": "US OB COMP>14WK ADD GEST", "code_information": [{"code": "76810", "type": "CPT"}, {"code": "5116810", "type": "CDM"}, {"code": "402", "type": "RC"}], "standard_charges": [{"gross_charge": 3410.0, "discounted_cash": 2557.5, "setting": "both", "billing_class": "facility"}]}, {"description": "US OB COMP>14WK SGL GEST", "code_information": [{"code": "76805", "type": "CPT"}, {"code": "3100510", "type": "CDM"}, {"code": "402", "type": "RC"}], "standard_charges": [{"gross_charge": 5355.0, "discounted_cash": 4016.25, "setting": "both", "billing_class": "facility"}]}, {"description": "US OB COMP>14WK SGL GEST", "code_information": [{"code": "76805", "type": "CPT"}, {"code": "5066825", "type": "CDM"}, {"code": "402", "type": "RC"}], "standard_charges": [{"gross_charge": 4108.0, "discounted_cash": 3081.0, "setting": "both", "billing_class": "facility"}]}, {"description": "US OB COMP>14WK SGL GEST", "code_information": [{"code": "76805", "type": "CPT"}, {"code": "5116805", "type": "CDM"}, {"code": "402", "type": "RC"}], "standard_charges": [{"gross_charge": 3148.0, "discounted_cash": 2361.0, "setting": "both", "billing_class": "facility"}]}, {"description": "US OB FETLANAT ADDL GEST", "code_information": [{"code": "76812", "type": "CPT"}, {"code": "5066812", "type": "CDM"}, {"code": "402", "type": "RC"}], "standard_charges": [{"gross_charge": 2311.0, "discounted_cash": 1733.25, "setting": "both", "billing_class": "facility"}]}, {"description": "US OB FTLNUC ABD SNG GES", "code_information": [{"code": "76813", "type": "CPT"}, {"code": "5066803", "type": "CDM"}, {"code": "402", "type": "RC"}], "standard_charges": [{"gross_charge": 3815.0, "discounted_cash": 2861.25, "setting": "both", "billing_class": "facility"}]}, {"description": "US OB LTD 1OR> FETUS", "code_information": [{"code": "76815", "type": "CPT"}, {"code": "3100500", "type": "CDM"}, {"code": "402", "type": "RC"}], "standard_charges": [{"gross_charge": 2623.0, "discounted_cash": 1967.25, "setting": "both", "billing_class": "facility"}]}, {"description": "US OB LTD 1OR> FETUS", "code_information": [{"code": "76815", "type": "CPT"}, {"code": "5066810", "type": "CDM"}, {"code": "402", "type": "RC"}], "standard_charges": [{"gross_charge": 2348.0, "discounted_cash": 1761.0, "setting": "both", "billing_class": "facility"}]}, {"description": "US OB TRANSVAGINAL", "code_information": [{"code": "76817", "type": "CPT"}, {"code": "5066816", "type": "CDM"}, {"code": "402", "type": "RC"}], "standard_charges": [{"gross_charge": 2237.0, "discounted_cash": 1677.75, "setting": "both", "billing_class": "facility"}]}, {"description": "US OB TRANSVAGINAL", "code_information": [{"code": "76817", "type": "CPT"}, {"code": "5116817", "type": "CDM"}, {"code": "402", "type": "RC"}], "standard_charges": [{"gross_charge": 2237.0, "discounted_cash": 1677.75, "setting": "both", "billing_class": "facility"}]}, {"description": "US PELVIC COMPLETE", "code_information": [{"code": "76856", "type": "CPT"}, {"code": "5066856", "type": "CDM"}, {"code": "402", "type": "RC"}], "standard_charges": [{"gross_charge": 5540.0, "discounted_cash": 4155.0, "setting": "both", "billing_class": "facility"}]}, {"description": "US PELVIC COMPLETE", "code_information": [{"code": "76856", "type": "CPT"}, {"code": "5116856", "type": "CDM"}, {"code": "402", "type": "RC"}], "standard_charges": [{"gross_charge": 3280.0, "discounted_cash": 2460.0, "setting": "both", "billing_class": "facility"}]}, {"description": "US PELVIC LTD/FU", "code_information": [{"code": "76857", "type": "CPT"}, {"code": "5066858", "type": "CDM"}, {"code": "402", "type": "RC"}], "standard_charges": [{"gross_charge": 2992.0, "discounted_cash": 2244.0, "setting": "both", "billing_class": "facility"}]}, {"description": "US PELVIC LTD/FU", "code_information": [{"code": "76857", "type": "CPT"}, {"code": "5116858", "type": "CDM"}, {"code": "402", "type": "RC"}], "standard_charges": [{"gross_charge": 2992.0, "discounted_cash": 2244.0, "setting": "both", "billing_class": "facility"}]}, {"description": "US POST URINARY BLADDER", "code_information": [{"code": "5061798", "type": "CDM"}, {"code": "402", "type": "RC"}], "standard_charges": [{"gross_charge": 1013.0, "discounted_cash": 759.75, "setting": "both", "billing_class": "facility"}]}, {"description": "US RETROPERITONEAL COMP", "code_information": [{"code": "76770", "type": "CPT"}, {"code": "5066770", "type": "CDM"}, {"code": "402", "type": "RC"}], "standard_charges": [{"gross_charge": 5080.0, "discounted_cash": 3810.0, "setting": "both", "billing_class": "facility"}]}, {"description": "US RETROPERITONEAL COMP", "code_information": [{"code": "76770", "type": "CPT"}, {"code": "5116770", "type": "CDM"}, {"code": "402", "type": "RC"}], "standard_charges": [{"gross_charge": 3171.0, "discounted_cash": 2378.25, "setting": "both", "billing_class": "facility"}]}, {"description": "US RETROPERITONEAL LTD", "code_information": [{"code": "76775", "type": "CPT"}, {"code": "5066775", "type": "CDM"}, {"code": "402", "type": "RC"}], "standard_charges": [{"gross_charge": 5303.0, "discounted_cash": 3977.25, "setting": "both", "billing_class": "facility"}]}, {"description": "US RETROPERITONEAL LTD", "code_information": [{"code": "76775", "type": "CPT"}, {"code": "5116775", "type": "CDM"}, {"code": "402", "type": "RC"}], "standard_charges": [{"gross_charge": 3171.0, "discounted_cash": 2378.25, "setting": "both", "billing_class": "facility"}]}, {"description": "US SCROTUM CONTENTS", "code_information": [{"code": "76870", "type": "CPT"}, {"code": "5066782", "type": "CDM"}, {"code": "402", "type": "RC"}], "standard_charges": [{"gross_charge": 5355.0, "discounted_cash": 4016.25, "setting": "both", "billing_class": "facility"}]}, {"description": "US SCROTUM CONTENTS", "code_information": [{"code": "76870", "type": "CPT"}, {"code": "5116780", "type": "CDM"}, {"code": "402", "type": "RC"}], "standard_charges": [{"gross_charge": 2931.0, "discounted_cash": 2198.25, "setting": "both", "billing_class": "facility"}]}, {"description": "US SOFT TISSUE HEAD/NECK", "code_information": [{"code": "76536", "type": "CPT"}, {"code": "5066536", "type": "CDM"}, {"code": "402", "type": "RC"}], "standard_charges": [{"gross_charge": 3934.0, "discounted_cash": 2950.5, "setting": "both", "billing_class": "facility"}]}, {"description": "US SOFT TISSUE HEAD/NECK", "code_information": [{"code": "76536", "type": "CPT"}, {"code": "5116536", "type": "CDM"}, {"code": "402", "type": "RC"}], "standard_charges": [{"gross_charge": 2560.0, "discounted_cash": 1920.0, "setting": "both", "billing_class": "facility"}]}, {"description": "US SPINAL CANAL", "code_information": [{"code": "76800", "type": "CPT"}, {"code": "5066800", "type": "CDM"}, {"code": "402", "type": "RC"}], "standard_charges": [{"gross_charge": 2063.0, "discounted_cash": 1547.25, "setting": "both", "billing_class": "facility"}]}, {"description": "US TRANSPLANT KIDNEY", "code_information": [{"code": "76776", "type": "CPT"}, {"code": "5066778", "type": "CDM"}, {"code": "402", "type": "RC"}], "standard_charges": [{"gross_charge": 4539.0, "discounted_cash": 3404.25, "setting": "both", "billing_class": "facility"}]}, {"description": "US TRANSPLANT KIDNEY", "code_information": [{"code": "76776", "type": "CPT"}, {"code": "5116778", "type": "CDM"}, {"code": "402", "type": "RC"}], "standard_charges": [{"gross_charge": 4539.0, "discounted_cash": 3404.25, "setting": "both", "billing_class": "facility"}]}, {"description": "US TRANSVAGINAL NOT OB", "code_information": [{"code": "76830", "type": "CPT"}, {"code": "5066830", "type": "CDM"}, {"code": "402", "type": "RC"}], "standard_charges": [{"gross_charge": 3491.0, "discounted_cash": 2618.25, "setting": "both", "billing_class": "facility"}]}, {"description": "US TRANSVAGINAL NOT OB", "code_information": [{"code": "76830", "type": "CPT"}, {"code": "5116830", "type": "CDM"}, {"code": "402", "type": "RC"}], "standard_charges": [{"gross_charge": 3491.0, "discounted_cash": 2618.25, "setting": "both", "billing_class": "facility"}]}, {"description": "US XTR JOINT COMPLETE", "code_information": [{"code": "76881", "type": "CPT"}, {"code": "5066861", "type": "CDM"}, {"code": "402", "type": "RC"}], "standard_charges": [{"gross_charge": 2688.0, "discounted_cash": 2016.0, "setting": "both", "billing_class": "facility"}]}, {"description": "US XTR JOINT COMPLETE", "code_information": [{"code": "76881", "type": "CPT"}, {"code": "5116860", "type": "CDM"}, {"code": "402", "type": "RC"}], "standard_charges": [{"gross_charge": 2688.0, "discounted_cash": 2016.0, "setting": "both", "billing_class": "facility"}]}, {"description": "US XTR SOFT TISSUE LMTD", "code_information": [{"code": "76882", "type": "CPT"}, {"code": "3076851", "type": "CDM"}, {"code": "402", "type": "RC"}], "standard_charges": [{"gross_charge": 1987.0, "discounted_cash": 1490.25, "setting": "both", "billing_class": "facility"}]}, {"description": "US XTR SOFT TISSUE LMTD", "code_information": [{"code": "76882", "type": "CPT"}, {"code": "5066864", "type": "CDM"}, {"code": "402", "type": "RC"}], "standard_charges": [{"gross_charge": 1987.0, "discounted_cash": 1490.25, "setting": "both", "billing_class": "facility"}]}, {"description": "US XTR SOFT TISSUE LMTD", "code_information": [{"code": "76882", "type": "CPT"}, {"code": "5116851", "type": "CDM"}, {"code": "402", "type": "RC"}], "standard_charges": [{"gross_charge": 1987.0, "discounted_cash": 1490.25, "setting": "both", "billing_class": "facility"}]}, {"description": "USE CONTRAST AGENT ECHO", "code_information": [{"code": "93352", "type": "CPT"}, {"code": "4603352", "type": "CDM"}, {"code": "483", "type": "RC"}], "standard_charges": [{"gross_charge": 565.0, "discounted_cash": 423.75, "setting": "both", "billing_class": "facility"}]}, {"description": "VALACYCLOVIR 500MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5312258", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 147.0, "discounted_cash": 110.25, "setting": "both", "billing_class": "facility"}]}, {"description": "VALACYCLOVIR 500MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5312258", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 147.0, "discounted_cash": 110.25, "setting": "both", "billing_class": "facility"}]}, {"description": "VALGANCICLOVIR 450MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5312263", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 803.0, "discounted_cash": 602.25, "setting": "both", "billing_class": "facility"}]}, {"description": "VALGANCICLOVIR 450MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5312263", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 803.0, "discounted_cash": 602.25, "setting": "both", "billing_class": "facility"}]}, {"description": "VALPROATE 250MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5312261", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 61.0, "discounted_cash": 45.75, "setting": "both", "billing_class": "facility"}]}, {"description": "VALPROATE 250MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5312261", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 61.0, "discounted_cash": 45.75, "setting": "both", "billing_class": "facility"}]}, {"description": "VALPROATE 250MG/5ML LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5316585", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 657.0, "discounted_cash": 492.75, "setting": "both", "billing_class": "facility"}]}, {"description": "VALPROATE 250MG/5ML LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5316585", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 657.0, "discounted_cash": 492.75, "setting": "both", "billing_class": "facility"}]}, {"description": "VALPROATE 500MG/5ML IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5325065", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 579.0, "discounted_cash": 434.25, "setting": "both", "billing_class": "facility"}]}, {"description": "VALPROIC ACID FREE", "code_information": [{"code": "80165", "type": "CPT"}, {"code": "7250165", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 81.0, "discounted_cash": 60.75, "setting": "both", "billing_class": "facility"}]}, {"description": "VALPROIC ACID TOTAL", "code_information": [{"code": "80164", "type": "CPT"}, {"code": "4104584", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 979.0, "discounted_cash": 734.25, "setting": "both", "billing_class": "facility"}]}, {"description": "VALPROIC ACID TOTAL", "code_information": [{"code": "80164", "type": "CPT"}, {"code": "4174584", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 5.71, "discounted_cash": 4.28, "setting": "both", "billing_class": "facility"}]}, {"description": "VALSARTAN 160MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5312266", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 84.0, "discounted_cash": 63.0, "setting": "both", "billing_class": "facility"}]}, {"description": "VALSARTAN 160MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5312266", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 84.0, "discounted_cash": 63.0, "setting": "both", "billing_class": "facility"}]}, {"description": "VALSARTAN 320MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5312269", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 52.0, "discounted_cash": 39.0, "setting": "both", "billing_class": "facility"}]}, {"description": "VALSARTAN 320MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5312269", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 52.0, "discounted_cash": 39.0, "setting": "both", "billing_class": "facility"}]}, {"description": "VALSARTAN 40MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5312262", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 61.0, "discounted_cash": 45.75, "setting": "both", "billing_class": "facility"}]}, {"description": "VALSARTAN 40MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5312262", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 61.0, "discounted_cash": 45.75, "setting": "both", "billing_class": "facility"}]}, {"description": "VALSARTAN 80MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5312265", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 72.0, "discounted_cash": 54.0, "setting": "both", "billing_class": "facility"}]}, {"description": "VALSARTAN 80MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5312265", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 72.0, "discounted_cash": 54.0, "setting": "both", "billing_class": "facility"}]}, {"description": "VALVULOPLASTY PULM", "code_information": [{"code": "92990", "type": "CPT"}, {"code": "4612990", "type": "CDM"}, {"code": "480", "type": "RC"}], "standard_charges": [{"gross_charge": 23982.0, "discounted_cash": 17986.5, "setting": "both", "billing_class": "facility"}]}, {"description": "VANCOMYCIN", "code_information": [{"code": "80202", "type": "CPT"}, {"code": "4100031", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 1638.0, "discounted_cash": 1228.5, "setting": "both", "billing_class": "facility"}]}, {"description": "VANCOMYCIN", "code_information": [{"code": "80202", "type": "CPT"}, {"code": "4170031", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 7.14, "discounted_cash": 5.36, "setting": "both", "billing_class": "facility"}]}, {"description": "VANCOMYCIN CMPD LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5316602", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 48.0, "discounted_cash": 36.0, "setting": "both", "billing_class": "facility"}]}, {"description": "VANCOMYCIN CMPD LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5316602", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 48.0, "discounted_cash": 36.0, "setting": "both", "billing_class": "facility"}]}, {"description": "VANCOMYCIN ENEMA CMPD RE", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J7999", "type": "HCPCS"}, {"code": "5338760", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 754.0, "discounted_cash": 565.5, "setting": "both", "billing_class": "facility"}]}, {"description": "VANCOMYCIN ENEMA CMPD RE", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J7999", "type": "HCPCS"}, {"code": "5338760", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 754.0, "discounted_cash": 565.5, "setting": "both", "billing_class": "facility"}]}, {"description": "VANCOMYCIN NEO CMPD IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J7999", "type": "HCPCS"}, {"code": "5325075", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 4.0, "discounted_cash": 3.0, "setting": "both", "billing_class": "facility"}]}, {"description": "VANCOMYCIN NEO CMPD IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J7999", "type": "HCPCS"}, {"code": "5325075", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 4.0, "discounted_cash": 3.0, "setting": "both", "billing_class": "facility"}]}, {"description": "VANCOMYCIN PER 10MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3373", "type": "HCPCS"}, {"code": "5325062", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 7.0, "discounted_cash": 5.25, "setting": "both", "billing_class": "facility"}]}, {"description": "VANCOMYCIN PER 10MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3373", "type": "HCPCS"}, {"code": "5325062", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 7.0, "discounted_cash": 5.25, "setting": "both", "billing_class": "facility"}]}, {"description": "VANCOMYCIN/2", "code_information": [{"code": "80202", "type": "CPT"}, {"code": "4100032", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 1706.0, "discounted_cash": 1279.5, "setting": "both", "billing_class": "facility"}]}, {"description": "VANCOMYCIN/2", "code_information": [{"code": "80202", "type": "CPT"}, {"code": "4170032", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 7.14, "discounted_cash": 5.36, "setting": "both", "billing_class": "facility"}]}, {"description": "VANCOMYCIN/3", "code_information": [{"code": "80202", "type": "CPT"}, {"code": "4100033", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 985.0, "discounted_cash": 738.75, "setting": "both", "billing_class": "facility"}]}, {"description": "VANCOMYCIN/3", "code_information": [{"code": "80202", "type": "CPT"}, {"code": "4170033", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 7.14, "discounted_cash": 5.36, "setting": "both", "billing_class": "facility"}]}, {"description": "VAPOTHERM MANAGEMENT DLY", "code_information": [{"code": "94799", "type": "CPT"}, {"code": "5504647", "type": "CDM"}, {"code": "460", "type": "RC"}], "standard_charges": [{"gross_charge": 3816.0, "discounted_cash": 2862.0, "setting": "both", "billing_class": "facility"}]}, {"description": "VARICELLA IMM GLOB125UIJ", "code_information": [{"code": "90396", "type": "CPT"}, {"code": "5325082", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 13225.0, "discounted_cash": 9918.75, "setting": "both", "billing_class": "facility"}]}, {"description": "VARICELLA IMM GLOB125UIJ", "code_information": [{"code": "90396", "type": "CPT"}, {"code": "5325082", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 13225.0, "discounted_cash": 9918.75, "setting": "both", "billing_class": "facility"}]}, {"description": "VARICELLA VIRUS VACC IJ", "code_information": [{"code": "90716", "type": "CPT"}, {"code": "5319190", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 2551.0, "discounted_cash": 1913.25, "setting": "both", "billing_class": "facility"}]}, {"description": "VARICELLA VIRUS VACC IJ", "code_information": [{"code": "90716", "type": "CPT"}, {"code": "5319190", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 2551.0, "discounted_cash": 1913.25, "setting": "both", "billing_class": "facility"}]}, {"description": "VARICELLA ZOSTER AB", "code_information": [{"code": "86787", "type": "CPT"}, {"code": "4106787", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 635.0, "discounted_cash": 476.25, "setting": "both", "billing_class": "facility"}]}, {"description": "VARICELLA ZOSTER AB/2", "code_information": [{"code": "86787", "type": "CPT"}, {"code": "4106786", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 635.0, "discounted_cash": 476.25, "setting": "both", "billing_class": "facility"}]}, {"description": "VARICELLA ZOSTER AB/2", "code_information": [{"code": "86787", "type": "CPT"}, {"code": "4126786", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 196.0, "discounted_cash": 147.0, "setting": "both", "billing_class": "facility"}]}, {"description": "VARICELLA ZOSTER AB/2", "code_information": [{"code": "86787", "type": "CPT"}, {"code": "4176786", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 303.98, "discounted_cash": 227.99, "setting": "both", "billing_class": "facility"}]}, {"description": "VARICELLA ZOSTER AB/2", "code_information": [{"code": "86787", "type": "CPT"}, {"code": "7256273", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 465.0, "discounted_cash": 348.75, "setting": "both", "billing_class": "facility"}]}, {"description": "VARICELLA ZOSTER AB/3", "code_information": [{"code": "86787", "type": "CPT"}, {"code": "7256786", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 465.0, "discounted_cash": 348.75, "setting": "both", "billing_class": "facility"}]}, {"description": "VARICELLA ZOSTER AB/5", "code_information": [{"code": "86787", "type": "CPT"}, {"code": "7250691", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 168.25, "discounted_cash": 126.19, "setting": "both", "billing_class": "facility"}]}, {"description": "VAS CLS ANGIOSEAL", "code_information": [{"code": "C1760", "type": "HCPCS"}, {"code": "8177901", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 2960.0, "discounted_cash": 2220.0, "setting": "both", "billing_class": "facility"}]}, {"description": "VAS CLS ART PERCLOSE", "code_information": [{"code": "C1760", "type": "HCPCS"}, {"code": "8240408", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 4135.0, "discounted_cash": 3101.25, "setting": "both", "billing_class": "facility"}]}, {"description": "VASC EMB/OCC ARTERY", "code_information": [{"code": "4617242", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 39751.0, "discounted_cash": 29813.25, "setting": "both", "billing_class": "facility"}]}, {"description": "VASC EMB/OCC ARTERY", "code_information": [{"code": "4917242", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 50707.0, "discounted_cash": 38030.25, "setting": "both", "billing_class": "facility"}]}, {"description": "VASC EMB/OCC BLEED", "code_information": [{"code": "4917244", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 29728.0, "discounted_cash": 22296.0, "setting": "both", "billing_class": "facility"}]}, {"description": "VASC EMB/OCC ORGAN", "code_information": [{"code": "4617243", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 39751.0, "discounted_cash": 29813.25, "setting": "both", "billing_class": "facility"}]}, {"description": "VASC EMB/OCC ORGAN", "code_information": [{"code": "4917243", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 40817.0, "discounted_cash": 30612.75, "setting": "both", "billing_class": "facility"}]}, {"description": "VASC EMB/OCC VENOUS", "code_information": [{"code": "4917241", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 44216.0, "discounted_cash": 33162.0, "setting": "both", "billing_class": "facility"}]}, {"description": "VASOACTIVE INTST POLYPEP", "code_information": [{"code": "84586", "type": "CPT"}, {"code": "7254238", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 385.0, "discounted_cash": 288.75, "setting": "both", "billing_class": "facility"}]}, {"description": "VASOPRESSIN (ADH)", "code_information": [{"code": "84588", "type": "CPT"}, {"code": "7254588", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 1923.0, "discounted_cash": 1442.25, "setting": "both", "billing_class": "facility"}]}, {"description": "VASOPRESSIN PER 1U IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J2598", "type": "HCPCS"}, {"code": "5325094", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 39.0, "discounted_cash": 29.25, "setting": "both", "billing_class": "facility"}]}, {"description": "VASOPRESSIN PER 1U IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J2598", "type": "HCPCS"}, {"code": "5325094", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 39.0, "discounted_cash": 29.25, "setting": "both", "billing_class": "facility"}]}, {"description": "VECURONIUM 10MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5325114", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 438.0, "discounted_cash": 328.5, "setting": "both", "billing_class": "facility"}]}, {"description": "VECURONIUM 20MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5325115", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 818.0, "discounted_cash": 613.5, "setting": "both", "billing_class": "facility"}]}, {"description": "VECURONIUM NEO IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J7999", "type": "HCPCS"}, {"code": "5325117", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 113.0, "discounted_cash": 84.75, "setting": "both", "billing_class": "facility"}]}, {"description": "VECURONIUM NEO IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J7999", "type": "HCPCS"}, {"code": "5325117", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 113.0, "discounted_cash": 84.75, "setting": "both", "billing_class": "facility"}]}, {"description": "VECURONIUM NEO PER1MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5325109", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 66.0, "discounted_cash": 49.5, "setting": "both", "billing_class": "facility"}]}, {"description": "VEEG 2-12 HR UNMNTR", "code_information": [{"code": "95711", "type": "CPT"}, {"code": "4805707", "type": "CDM"}, {"code": "740", "type": "RC"}], "standard_charges": [{"gross_charge": 8337.0, "discounted_cash": 6252.75, "setting": "both", "billing_class": "facility"}]}, {"description": "VEEG EA 12-26 HR UNMNTR", "code_information": [{"code": "95714", "type": "CPT"}, {"code": "4805710", "type": "CDM"}, {"code": "740", "type": "RC"}], "standard_charges": [{"gross_charge": 8337.0, "discounted_cash": 6252.75, "setting": "both", "billing_class": "facility"}]}, {"description": "VEIN VASCULAR GRAFT", "code_information": [{"code": "C1768", "type": "HCPCS"}, {"code": "4022328", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 51561.0, "discounted_cash": 38670.75, "setting": "both", "billing_class": "facility"}]}, {"description": "VENA CAVA FILT F", "code_information": [{"code": "C1880", "type": "HCPCS"}, {"code": "8145755", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 10889.0, "discounted_cash": 8166.75, "setting": "both", "billing_class": "facility"}]}, {"description": "VENA CAVA FILT J", "code_information": [{"code": "C1880", "type": "HCPCS"}, {"code": "8145760", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 6499.0, "discounted_cash": 4874.25, "setting": "both", "billing_class": "facility"}]}, {"description": "VENIPUNCTURE/2", "code_information": [{"code": "36415", "type": "CPT"}, {"code": "4209006", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 110.0, "discounted_cash": 82.5, "setting": "both", "billing_class": "facility"}]}, {"description": "VENLAFAXINE 37.5MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5312276", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 65.0, "discounted_cash": 48.75, "setting": "both", "billing_class": "facility"}]}, {"description": "VENLAFAXINE 37.5MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5312276", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 65.0, "discounted_cash": 48.75, "setting": "both", "billing_class": "facility"}]}, {"description": "VENLAFAXINE 37.5MG XR CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5312273", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 118.0, "discounted_cash": 88.5, "setting": "both", "billing_class": "facility"}]}, {"description": "VENLAFAXINE 37.5MG XR CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5312273", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 118.0, "discounted_cash": 88.5, "setting": "both", "billing_class": "facility"}]}, {"description": "VENLAFAXINE 75MG XR CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5312274", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 114.0, "discounted_cash": 85.5, "setting": "both", "billing_class": "facility"}]}, {"description": "VENLAFAXINE 75MG XR CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5312274", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 114.0, "discounted_cash": 85.5, "setting": "both", "billing_class": "facility"}]}, {"description": "VENOGRAM EXTREMITY BI", "code_information": [{"code": "75822", "type": "CPT"}, {"code": "4615823", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 9156.0, "discounted_cash": 6867.0, "setting": "both", "billing_class": "facility"}]}, {"description": "VENOGRAM EXTREMITY BI", "code_information": [{"code": "75822", "type": "CPT"}, {"code": "4915823", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 3448.0, "discounted_cash": 2586.0, "setting": "both", "billing_class": "facility"}]}, {"description": "VENOGRAM EXTREMITY UNI", "code_information": [{"code": "75820", "type": "CPT"}, {"code": "4615821", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 3921.0, "discounted_cash": 2940.75, "setting": "both", "billing_class": "facility"}]}, {"description": "VENOGRAM EXTREMITY UNI", "code_information": [{"code": "75820", "type": "CPT"}, {"code": "4905970", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 3885.0, "discounted_cash": 2913.75, "setting": "both", "billing_class": "facility"}]}, {"description": "VENOGRAM EXTREMITY UNI", "code_information": [{"code": "75820", "type": "CPT"}, {"code": "4915821", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 2612.0, "discounted_cash": 1959.0, "setting": "both", "billing_class": "facility"}]}, {"description": "VENOGRAPHY RENAL UNILAT", "code_information": [{"code": "75831", "type": "CPT"}, {"code": "4915832", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 7831.0, "discounted_cash": 5873.25, "setting": "both", "billing_class": "facility"}]}, {"description": "VENOGRM VNUS SINUS/JUGUL", "code_information": [{"code": "75860", "type": "CPT"}, {"code": "4915861", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 7467.0, "discounted_cash": 5600.25, "setting": "both", "billing_class": "facility"}]}, {"description": "VERAPAMIL 120MG XR TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5312291", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 61.0, "discounted_cash": 45.75, "setting": "both", "billing_class": "facility"}]}, {"description": "VERAPAMIL 120MG XR TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5312291", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 61.0, "discounted_cash": 45.75, "setting": "both", "billing_class": "facility"}]}, {"description": "VERAPAMIL 180MG XR TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5312290", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 61.0, "discounted_cash": 45.75, "setting": "both", "billing_class": "facility"}]}, {"description": "VERAPAMIL 180MG XR TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5312290", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 61.0, "discounted_cash": 45.75, "setting": "both", "billing_class": "facility"}]}, {"description": "VERAPAMIL 240 XR TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5312289", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 85.0, "discounted_cash": 63.75, "setting": "both", "billing_class": "facility"}]}, {"description": "VERAPAMIL 240 XR TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5312289", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 85.0, "discounted_cash": 63.75, "setting": "both", "billing_class": "facility"}]}, {"description": "VERAPAMIL 40MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5312283", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 53.0, "discounted_cash": 39.75, "setting": "both", "billing_class": "facility"}]}, {"description": "VERAPAMIL 40MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5312283", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 53.0, "discounted_cash": 39.75, "setting": "both", "billing_class": "facility"}]}, {"description": "VERAPAMIL 80MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5312284", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 71.0, "discounted_cash": 53.25, "setting": "both", "billing_class": "facility"}]}, {"description": "VERAPAMIL 80MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5312284", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 71.0, "discounted_cash": 53.25, "setting": "both", "billing_class": "facility"}]}, {"description": "VERAPAMIL2.5MG/ML 2ML IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5325125", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 201.0, "discounted_cash": 150.75, "setting": "both", "billing_class": "facility"}]}, {"description": "VERAPAMIL2.5MG/ML 4ML IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5325130", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 104.0, "discounted_cash": 78.0, "setting": "both", "billing_class": "facility"}]}, {"description": "VERY LNG CHN FATTY ACID", "code_information": [{"code": "82726", "type": "CPT"}, {"code": "7259920", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 691.0, "discounted_cash": 518.25, "setting": "both", "billing_class": "facility"}]}, {"description": "VFC IMM ADM EA ADDL VACCINE", "code_information": [{"code": "90472", "type": "CPT"}, {"code": "6290474", "type": "CDM"}, {"code": "771", "type": "RC"}], "standard_charges": [{"gross_charge": 13.75, "discounted_cash": 10.31, "setting": "both", "billing_class": "facility"}]}, {"description": "VFC IMM ADMIN SNGL/COMBO VAC", "code_information": [{"code": "90471", "type": "CPT"}, {"code": "6290473", "type": "CDM"}, {"code": "771", "type": "RC"}], "standard_charges": [{"gross_charge": 13.75, "discounted_cash": 10.31, "setting": "both", "billing_class": "facility"}]}, {"description": "VIGABATRIN", "code_information": [{"code": "80299", "type": "CPT"}, {"code": "7250432", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 265.0, "discounted_cash": 198.75, "setting": "both", "billing_class": "facility"}]}, {"description": "VIRUS INOC SHELL EACH", "code_information": [{"code": "87254", "type": "CPT"}, {"code": "4107256", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 306.0, "discounted_cash": 229.5, "setting": "both", "billing_class": "facility"}]}, {"description": "VIRUS INOC SHELL EACH/3", "code_information": [{"code": "87254", "type": "CPT"}, {"code": "7257255", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 226.0, "discounted_cash": 169.5, "setting": "both", "billing_class": "facility"}]}, {"description": "VIRUS INOC SHELL EACH/6", "code_information": [{"code": "87254", "type": "CPT"}, {"code": "7257250", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 259.0, "discounted_cash": 194.25, "setting": "both", "billing_class": "facility"}]}, {"description": "VIRUS INOC SHELL EACH/7", "code_information": [{"code": "87254", "type": "CPT"}, {"code": "7257258", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 17.0, "discounted_cash": 12.75, "setting": "both", "billing_class": "facility"}]}, {"description": "VISCOSITY", "code_information": [{"code": "85810", "type": "CPT"}, {"code": "4105810", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 252.0, "discounted_cash": 189.0, "setting": "both", "billing_class": "facility"}]}, {"description": "VISCOSITY", "code_information": [{"code": "85810", "type": "CPT"}, {"code": "7257192", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 181.0, "discounted_cash": 135.75, "setting": "both", "billing_class": "facility"}]}, {"description": "VIT D1 25-DIHYDROXY", "code_information": [{"code": "82652", "type": "CPT"}, {"code": "7254594", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 1179.0, "discounted_cash": 884.25, "setting": "both", "billing_class": "facility"}]}, {"description": "VITAL CAPACITY", "code_information": [{"code": "94150", "type": "CPT"}, {"code": "5501213", "type": "CDM"}, {"code": "460", "type": "RC"}], "standard_charges": [{"gross_charge": 494.0, "discounted_cash": 370.5, "setting": "both", "billing_class": "facility"}]}, {"description": "VITAMIN A", "code_information": [{"code": "84590", "type": "CPT"}, {"code": "7254590", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 83.0, "discounted_cash": 62.25, "setting": "both", "billing_class": "facility"}]}, {"description": "VITAMIN A 10MU CP", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5312335", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 85.0, "discounted_cash": 63.75, "setting": "both", "billing_class": "facility"}]}, {"description": "VITAMIN A 10MU CP", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5312335", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 85.0, "discounted_cash": 63.75, "setting": "both", "billing_class": "facility"}]}, {"description": "VITAMIN A&D 60GM OI", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5337735", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 78.0, "discounted_cash": 58.5, "setting": "both", "billing_class": "facility"}]}, {"description": "VITAMIN A&D 60GM OI", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5337735", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 78.0, "discounted_cash": 58.5, "setting": "both", "billing_class": "facility"}]}, {"description": "VITAMIN B-12 1000MCG TB", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5312364", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 71.0, "discounted_cash": 53.25, "setting": "both", "billing_class": "facility"}]}, {"description": "VITAMIN B-12 1000MCG TB", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5312364", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 71.0, "discounted_cash": 53.25, "setting": "both", "billing_class": "facility"}]}, {"description": "VITAMIN B-12 100MCG TB", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5312363", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 78.0, "discounted_cash": 58.5, "setting": "both", "billing_class": "facility"}]}, {"description": "VITAMIN B-12 100MCG TB", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5312363", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 78.0, "discounted_cash": 58.5, "setting": "both", "billing_class": "facility"}]}, {"description": "VITAMIN C 500MG/5ML LQ", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5316615", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 66.0, "discounted_cash": 49.5, "setting": "both", "billing_class": "facility"}]}, {"description": "VITAMIN C 500MG/5ML LQ", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5316615", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 66.0, "discounted_cash": 49.5, "setting": "both", "billing_class": "facility"}]}, {"description": "VITAMIN D 1000U TB", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5312375", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 65.0, "discounted_cash": 48.75, "setting": "both", "billing_class": "facility"}]}, {"description": "VITAMIN D 1000U TB", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5312375", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 65.0, "discounted_cash": 48.75, "setting": "both", "billing_class": "facility"}]}, {"description": "VITAMIN D/25 HYDROXY", "code_information": [{"code": "82306", "type": "CPT"}, {"code": "4104595", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 528.0, "discounted_cash": 396.0, "setting": "both", "billing_class": "facility"}]}, {"description": "VITAMIN D/25 HYDROXY", "code_information": [{"code": "82306", "type": "CPT"}, {"code": "7252306", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 181.0, "discounted_cash": 135.75, "setting": "both", "billing_class": "facility"}]}, {"description": "VITAMIN D/25 HYDROXY/2", "code_information": [{"code": "82306", "type": "CPT"}, {"code": "7254595", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 456.0, "discounted_cash": 342.0, "setting": "both", "billing_class": "facility"}]}, {"description": "VITAMIN D3 400U TB", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5312390", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 78.0, "discounted_cash": 58.5, "setting": "both", "billing_class": "facility"}]}, {"description": "VITAMIN D3 400U TB", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5312390", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 78.0, "discounted_cash": 58.5, "setting": "both", "billing_class": "facility"}]}, {"description": "VITAMIN E 200U CP", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5312405", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 85.0, "discounted_cash": 63.75, "setting": "both", "billing_class": "facility"}]}, {"description": "VITAMIN E 200U CP", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5312405", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 85.0, "discounted_cash": 63.75, "setting": "both", "billing_class": "facility"}]}, {"description": "VITAMIN E 400U CP", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5312407", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 61.0, "discounted_cash": 45.75, "setting": "both", "billing_class": "facility"}]}, {"description": "VITAMIN E 400U CP", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5312407", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 61.0, "discounted_cash": 45.75, "setting": "both", "billing_class": "facility"}]}, {"description": "VITAMIN K", "code_information": [{"code": "84597", "type": "CPT"}, {"code": "7254597", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 322.0, "discounted_cash": 241.5, "setting": "both", "billing_class": "facility"}]}, {"description": "VITAMIN NOS", "code_information": [{"code": "84591", "type": "CPT"}, {"code": "7254589", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 103.0, "discounted_cash": 77.25, "setting": "both", "billing_class": "facility"}]}, {"description": "VITAMN E(TOCOPHRL ALPHA)", "code_information": [{"code": "84446", "type": "CPT"}, {"code": "7254446", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 398.0, "discounted_cash": 298.5, "setting": "both", "billing_class": "facility"}]}, {"description": "VITB12 UNSAT", "code_information": [{"code": "82608", "type": "CPT"}, {"code": "7252608", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 60.0, "discounted_cash": 45.0, "setting": "both", "billing_class": "facility"}]}, {"description": "VLV AHMED GLAUCOMA", "code_information": [{"code": "C1783", "type": "HCPCS"}, {"code": "8177944", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 8940.0, "discounted_cash": 6705.0, "setting": "both", "billing_class": "facility"}]}, {"description": "VLV DELTA", "code_information": [{"code": "C1889", "type": "HCPCS"}, {"code": "8177939", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 6339.0, "discounted_cash": 4754.25, "setting": "both", "billing_class": "facility"}]}, {"description": "VLV HYDROCEPH", "code_information": [{"code": "C1729", "type": "HCPCS"}, {"code": "8177945", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 52414.0, "discounted_cash": 39310.5, "setting": "both", "billing_class": "facility"}]}, {"description": "VLV TRACH SPEAK", "code_information": [{"code": "L8501", "type": "HCPCS"}, {"code": "8207551", "type": "CDM"}, {"code": "274", "type": "RC"}], "standard_charges": [{"gross_charge": 1063.0, "discounted_cash": 797.25, "setting": "both", "billing_class": "facility"}]}, {"description": "VMA URINE", "code_information": [{"code": "84585", "type": "CPT"}, {"code": "7254585", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 536.0, "discounted_cash": 402.0, "setting": "both", "billing_class": "facility"}]}, {"description": "VMA URINE/2", "code_information": [{"code": "84585", "type": "CPT"}, {"code": "7258458", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 585.0, "discounted_cash": 438.75, "setting": "both", "billing_class": "facility"}]}, {"description": "VOLTAGE GATED CALCIUM/3", "code_information": [{"code": "86596", "type": "CPT"}, {"code": "7259625", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 304.0, "discounted_cash": 228.0, "setting": "both", "billing_class": "facility"}]}, {"description": "VOLTAGE GATED POTASSIUM", "code_information": [{"code": "83519", "type": "CPT"}, {"code": "7258335", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 1315.0, "discounted_cash": 986.25, "setting": "both", "billing_class": "facility"}]}, {"description": "VOLUME MEASURMNT URINE", "code_information": [{"code": "81050", "type": "CPT"}, {"code": "4101060", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 579.0, "discounted_cash": 434.25, "setting": "both", "billing_class": "facility"}]}, {"description": "VOLUME MEASURMNT URINE", "code_information": [{"code": "81050", "type": "CPT"}, {"code": "4201050", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 579.0, "discounted_cash": 434.25, "setting": "both", "billing_class": "facility"}]}, {"description": "VOLUME REDUC BLD EA UNIT", "code_information": [{"code": "86960", "type": "CPT"}, {"code": "4206960", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 966.0, "discounted_cash": 724.5, "setting": "both", "billing_class": "facility"}]}, {"description": "VOLUME VENT SUBSQ/DLY", "code_information": [{"code": "94003", "type": "CPT"}, {"code": "5500626", "type": "CDM"}, {"code": "410", "type": "RC"}], "standard_charges": [{"gross_charge": 7234.0, "discounted_cash": 5425.5, "setting": "both", "billing_class": "facility"}]}, {"description": "VOLUME VENTILATOR INTL", "code_information": [{"code": "94002", "type": "CPT"}, {"code": "5500620", "type": "CDM"}, {"code": "410", "type": "RC"}], "standard_charges": [{"gross_charge": 7234.0, "discounted_cash": 5425.5, "setting": "both", "billing_class": "facility"}]}, {"description": "VON WILLEBRANDFC PER1UIJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J7187", "type": "HCPCS"}, {"code": "5325246", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 102.0, "discounted_cash": 76.5, "setting": "both", "billing_class": "facility"}]}, {"description": "VONWILLEBRAND CB", "code_information": [{"code": "83520", "type": "CPT"}, {"code": "7253474", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 184.0, "discounted_cash": 138.0, "setting": "both", "billing_class": "facility"}]}, {"description": "VORICONAZOLE", "code_information": [{"code": "80299", "type": "CPT"}, {"code": "7251442", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 254.0, "discounted_cash": 190.5, "setting": "both", "billing_class": "facility"}]}, {"description": "VORICONAZOLE", "code_information": [{"code": "80375", "type": "CPT"}, {"code": "7258228", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 1178.0, "discounted_cash": 883.5, "setting": "both", "billing_class": "facility"}]}, {"description": "VORICONAZOLE 200MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5312451", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 552.0, "discounted_cash": 414.0, "setting": "both", "billing_class": "facility"}]}, {"description": "VORICONAZOLE 200MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5312451", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 552.0, "discounted_cash": 414.0, "setting": "both", "billing_class": "facility"}]}, {"description": "VORICONAZOLE 50MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5312450", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 296.0, "discounted_cash": 222.0, "setting": "both", "billing_class": "facility"}]}, {"description": "VORICONAZOLE 50MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5312450", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 296.0, "discounted_cash": 222.0, "setting": "both", "billing_class": "facility"}]}, {"description": "VORICONAZOLE PER 10MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3465", "type": "HCPCS"}, {"code": "5325239", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 128.0, "discounted_cash": 96.0, "setting": "both", "billing_class": "facility"}]}, {"description": "VORICONAZOLE PER 10MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3465", "type": "HCPCS"}, {"code": "5325239", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 128.0, "discounted_cash": 96.0, "setting": "both", "billing_class": "facility"}]}, {"description": "WARFARIN 10MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5312496", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 63.0, "discounted_cash": 47.25, "setting": "both", "billing_class": "facility"}]}, {"description": "WARFARIN 10MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5312496", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 63.0, "discounted_cash": 47.25, "setting": "both", "billing_class": "facility"}]}, {"description": "WARFARIN 1MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5312481", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 61.0, "discounted_cash": 45.75, "setting": "both", "billing_class": "facility"}]}, {"description": "WARFARIN 1MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5312481", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 61.0, "discounted_cash": 45.75, "setting": "both", "billing_class": "facility"}]}, {"description": "WARFARIN 2.5MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5312480", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 65.0, "discounted_cash": 48.75, "setting": "both", "billing_class": "facility"}]}, {"description": "WARFARIN 2.5MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5312480", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 65.0, "discounted_cash": 48.75, "setting": "both", "billing_class": "facility"}]}, {"description": "WARFARIN 2MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5312484", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 71.0, "discounted_cash": 53.25, "setting": "both", "billing_class": "facility"}]}, {"description": "WARFARIN 2MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5312484", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 71.0, "discounted_cash": 53.25, "setting": "both", "billing_class": "facility"}]}, {"description": "WARFARIN 5MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5312488", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 77.0, "discounted_cash": 57.75, "setting": "both", "billing_class": "facility"}]}, {"description": "WARFARIN 5MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5312488", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 77.0, "discounted_cash": 57.75, "setting": "both", "billing_class": "facility"}]}, {"description": "WARFARIN 7.5MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5312492", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 63.0, "discounted_cash": 47.25, "setting": "both", "billing_class": "facility"}]}, {"description": "WARFARIN 7.5MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5312492", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 63.0, "discounted_cash": 47.25, "setting": "both", "billing_class": "facility"}]}, {"description": "WASHER", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8137065", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 1421.0, "discounted_cash": 1065.75, "setting": "both", "billing_class": "facility"}]}, {"description": "WASHER CANCL", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8137070", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 325.0, "discounted_cash": 243.75, "setting": "both", "billing_class": "facility"}]}, {"description": "WASHER SPIKED", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8137080", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 1243.0, "discounted_cash": 932.25, "setting": "both", "billing_class": "facility"}]}, {"description": "WATER INJ BACST 30ML IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5325247", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 113.0, "discounted_cash": 84.75, "setting": "both", "billing_class": "facility"}]}, {"description": "WATER INJ STERL 10ML IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5325250", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 86.0, "discounted_cash": 64.5, "setting": "both", "billing_class": "facility"}]}, {"description": "WATER INJ STERL 20ML IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5325252", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 66.0, "discounted_cash": 49.5, "setting": "both", "billing_class": "facility"}]}, {"description": "WATER STERL 250ML IVF", "code_information": [{"code": "A4217", "type": "HCPCS"}, {"code": "5412780", "type": "CDM"}, {"code": "270", "type": "RC"}], "standard_charges": [{"gross_charge": 436.0, "discounted_cash": 327.0, "setting": "both", "billing_class": "facility"}]}, {"description": "WATER STERL INJ .5L IVF", "code_information": [{"code": "A4217", "type": "HCPCS"}, {"code": "5412785", "type": "CDM"}, {"code": "270", "type": "RC"}], "standard_charges": [{"gross_charge": 1222.0, "discounted_cash": 916.5, "setting": "both", "billing_class": "facility"}]}, {"description": "WATER STERL INJ 1L IVF", "code_information": [{"code": "A4217", "type": "HCPCS"}, {"code": "5412790", "type": "CDM"}, {"code": "270", "type": "RC"}], "standard_charges": [{"gross_charge": 424.0, "discounted_cash": 318.0, "setting": "both", "billing_class": "facility"}]}, {"description": "WATER STERL INJ 2L IVF", "code_information": [{"code": "A4217", "type": "HCPCS"}, {"code": "5412795", "type": "CDM"}, {"code": "270", "type": "RC"}], "standard_charges": [{"gross_charge": 605.0, "discounted_cash": 453.75, "setting": "both", "billing_class": "facility"}]}, {"description": "WBC AUTO", "code_information": [{"code": "85048", "type": "CPT"}, {"code": "4105013", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 352.0, "discounted_cash": 264.0, "setting": "both", "billing_class": "facility"}]}, {"description": "WEDGE ILIAC CREST TRICORTICAL", "code_information": [{"code": "C1762", "type": "HCPCS"}, {"code": "4027009", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 24704.0, "discounted_cash": 18528.0, "setting": "both", "billing_class": "facility"}]}, {"description": "WEDGE OSTEOTOMY", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "4018095", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 61760.0, "discounted_cash": 46320.0, "setting": "both", "billing_class": "facility"}]}, {"description": "WEST NILE VIRUS", "code_information": [{"code": "86789", "type": "CPT"}, {"code": "7256784", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 166.0, "discounted_cash": 124.5, "setting": "both", "billing_class": "facility"}]}, {"description": "WEST NILE VIRUS IGM", "code_information": [{"code": "86788", "type": "CPT"}, {"code": "7256783", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 166.0, "discounted_cash": 124.5, "setting": "both", "billing_class": "facility"}]}, {"description": "WEST NILE VIRUS IGM/2", "code_information": [{"code": "86788", "type": "CPT"}, {"code": "7256789", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 158.0, "discounted_cash": 118.5, "setting": "both", "billing_class": "facility"}]}, {"description": "WEST NILE VIRUS/2", "code_information": [{"code": "86789", "type": "CPT"}, {"code": "7256785", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 166.0, "discounted_cash": 124.5, "setting": "both", "billing_class": "facility"}]}, {"description": "WIRE CERCLAGE", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8177975", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 2527.0, "discounted_cash": 1895.25, "setting": "both", "billing_class": "facility"}]}, {"description": "WIRE GUIDEPINCAL", "code_information": [{"code": "C1769", "type": "HCPCS"}, {"code": "8137090", "type": "CDM"}, {"code": "272", "type": "RC"}], "standard_charges": [{"gross_charge": 610.0, "discounted_cash": 457.5, "setting": "both", "billing_class": "facility"}]}, {"description": "WIRE KIRCHNER PL", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8137095", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 429.0, "discounted_cash": 321.75, "setting": "both", "billing_class": "facility"}]}, {"description": "WIRE KIRCHNER TH", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8137100", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 1014.0, "discounted_cash": 760.5, "setting": "both", "billing_class": "facility"}]}, {"description": "WIRE KIRSCHNER W STOP", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8137102", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 1469.0, "discounted_cash": 1101.75, "setting": "both", "billing_class": "facility"}]}, {"description": "WIREGDE AMPLTZ", "code_information": [{"code": "C1769", "type": "HCPCS"}, {"code": "8177990", "type": "CDM"}, {"code": "272", "type": "RC"}], "standard_charges": [{"gross_charge": 1660.0, "discounted_cash": 1245.0, "setting": "both", "billing_class": "facility"}]}, {"description": "WND COLLAGEN PDR", "code_information": [{"code": "A6010", "type": "HCPCS"}, {"code": "8028003", "type": "CDM"}, {"code": "272", "type": "RC"}], "standard_charges": [{"gross_charge": 7828.0, "discounted_cash": 5871.0, "setting": "both", "billing_class": "facility"}]}, {"description": "WND MATRIX NANOFIBER RESTRATA", "code_information": [{"code": "A6460", "type": "HCPCS"}, {"code": "8028002", "type": "CDM"}, {"code": "272", "type": "RC"}], "standard_charges": [{"gross_charge": 28389.0, "discounted_cash": 21291.75, "setting": "both", "billing_class": "facility"}]}, {"description": "WND PREP ADDL 100SQCM", "code_information": [{"code": "6906900", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 4901.0, "discounted_cash": 3675.75, "setting": "both", "billing_class": "facility"}]}, {"description": "WND PREP ADDL 100SQCM", "code_information": [{"code": "6906900", "type": "CDM"}, {"code": "361", "type": "RC"}], "standard_charges": [{"gross_charge": 4901.0, "discounted_cash": 3675.75, "setting": "both", "billing_class": "facility"}]}, {"description": "WOUND DRESS HYDRFIB 2X2", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5337725", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 198.0, "discounted_cash": 148.5, "setting": "both", "billing_class": "facility"}]}, {"description": "WOUND DRESS HYDRFIB 2X2", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5337725", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 198.0, "discounted_cash": 148.5, "setting": "both", "billing_class": "facility"}]}, {"description": "WOUND DRESS HYDRFIB 4X4", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5337732", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 424.0, "discounted_cash": 318.0, "setting": "both", "billing_class": "facility"}]}, {"description": "WOUND DRESS HYDRFIB 4X4", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5337732", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 424.0, "discounted_cash": 318.0, "setting": "both", "billing_class": "facility"}]}, {"description": "WOUND PREP TRK/ARM/LEG", "code_information": [{"code": "6900140", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 6999.0, "discounted_cash": 5249.25, "setting": "both", "billing_class": "facility"}]}, {"description": "WOUND PREP TRK/ARM/LEG", "code_information": [{"code": "6900140", "type": "CDM"}, {"code": "361", "type": "RC"}], "standard_charges": [{"gross_charge": 6999.0, "discounted_cash": 5249.25, "setting": "both", "billing_class": "facility"}]}, {"description": "WRAP NRV PROTCT AXOGUARD", "code_information": [{"code": "C1763", "type": "HCPCS"}, {"code": "4027010", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 72150.0, "discounted_cash": 54112.5, "setting": "both", "billing_class": "facility"}]}, {"description": "WRIST 2 VIEWS", "code_information": [{"code": "73100", "type": "CPT"}, {"code": "4903100", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 1301.0, "discounted_cash": 975.75, "setting": "both", "billing_class": "facility"}]}, {"description": "WRIST 2 VIEWS", "code_information": [{"code": "73100", "type": "CPT"}, {"code": "5113100", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 1101.0, "discounted_cash": 825.75, "setting": "both", "billing_class": "facility"}]}, {"description": "WRIST 3 VIEWS MINIMUM", "code_information": [{"code": "73110", "type": "CPT"}, {"code": "4903110", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 1372.0, "discounted_cash": 1029.0, "setting": "both", "billing_class": "facility"}]}, {"description": "WRIST 3 VIEWS MINIMUM", "code_information": [{"code": "73110", "type": "CPT"}, {"code": "5113110", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 1038.0, "discounted_cash": 778.5, "setting": "both", "billing_class": "facility"}]}, {"description": "WSTNT B ENDOPROS VIABIL", "code_information": [{"code": "C1874", "type": "HCPCS"}, {"code": "8240421", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 44988.0, "discounted_cash": 33741.0, "setting": "both", "billing_class": "facility"}]}, {"description": "WSTNT B ENDOPROS VIATOR", "code_information": [{"code": "C1874", "type": "HCPCS"}, {"code": "8240423", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 59351.0, "discounted_cash": 44513.25, "setting": "both", "billing_class": "facility"}]}, {"description": "WSTNT B ENDPROS UNISTEP+", "code_information": [{"code": "C1876", "type": "HCPCS"}, {"code": "8240435", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 16590.0, "discounted_cash": 12442.5, "setting": "both", "billing_class": "facility"}]}, {"description": "X-RAY ESOPHAGUS SNGL CM STDY", "code_information": [{"code": "74220", "type": "CPT"}, {"code": "4904220", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 2052.0, "discounted_cash": 1539.0, "setting": "both", "billing_class": "facility"}]}, {"description": "XENON 133 10 MCI", "code_information": [{"code": "A9558", "type": "HCPCS"}, {"code": "5195100", "type": "CDM"}, {"code": "343", "type": "RC"}], "standard_charges": [{"gross_charge": 1761.0, "discounted_cash": 1320.75, "setting": "both", "billing_class": "facility"}]}, {"description": "XYLOSE ABSORPTION TEST", "code_information": [{"code": "84620", "type": "CPT"}, {"code": "7254620", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 795.0, "discounted_cash": 596.25, "setting": "both", "billing_class": "facility"}]}, {"description": "YO ANTIBODY SCRN", "code_information": [{"code": "86255", "type": "CPT"}, {"code": "7254192", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 235.0, "discounted_cash": 176.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ZIDOV/LAMI300MG/150MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5306344", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 175.0, "discounted_cash": 131.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ZIDOV/LAMI300MG/150MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5306344", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 175.0, "discounted_cash": 131.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ZIDOVUDINE 100MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5312510", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 85.0, "discounted_cash": 63.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ZIDOVUDINE 100MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5312510", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 85.0, "discounted_cash": 63.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ZIDOVUDINE 10MG/ML 5MLLQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5316660", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 85.0, "discounted_cash": 63.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ZIDOVUDINE 10MG/ML 5MLLQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5316660", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 85.0, "discounted_cash": 63.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ZIDOVUDINE 300MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5312511", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 184.0, "discounted_cash": 138.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ZIDOVUDINE 300MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5312511", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 184.0, "discounted_cash": 138.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ZIDOVUDINE PER 10MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3485", "type": "HCPCS"}, {"code": "5325269", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 72.0, "discounted_cash": 54.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ZIDOVUDINE PER 10MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3485", "type": "HCPCS"}, {"code": "5325269", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 72.0, "discounted_cash": 54.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ZIDOVUDINE10MG/ML 1ML LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5316664", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 71.0, "discounted_cash": 53.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ZIDOVUDINE10MG/ML 1ML LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5316664", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 71.0, "discounted_cash": 53.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ZIKA VIRUS AB IGM", "code_information": [{"code": "86794", "type": "CPT"}, {"code": "7256730", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 196.0, "discounted_cash": 147.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ZIKA VIRUS AMP PROBE", "code_information": [{"code": "87662", "type": "CPT"}, {"code": "7257781", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 504.0, "discounted_cash": 378.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ZINC CL 1MG/ML 10ML IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5325278", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 113.0, "discounted_cash": 84.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ZINC OX/MENTHOL 113GM OI", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5334688", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 124.0, "discounted_cash": 93.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ZINC OX/MENTHOL 113GM OI", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5334688", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 124.0, "discounted_cash": 93.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ZINC OX/MENTHOL 71GM OI", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5334686", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 125.0, "discounted_cash": 93.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ZINC OX/MENTHOL 71GM OI", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5334686", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 125.0, "discounted_cash": 93.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ZINC OXI/PERU BALS60GMOI", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5337757", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 126.0, "discounted_cash": 94.5, "setting": "both", "billing_class": "facility"}]}, {"description": "ZINC OXI/PERU BALS60GMOI", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5337757", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 126.0, "discounted_cash": 94.5, "setting": "both", "billing_class": "facility"}]}, {"description": "ZINC OXIDE 20% 30GM OI", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5337756", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 70.0, "discounted_cash": 52.5, "setting": "both", "billing_class": "facility"}]}, {"description": "ZINC OXIDE 20% 30GM OI", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5337756", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 70.0, "discounted_cash": 52.5, "setting": "both", "billing_class": "facility"}]}, {"description": "ZINC OXIDE 20% 60GM OI", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5337774", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 63.0, "discounted_cash": 47.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ZINC OXIDE 20% 60GM OI", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5337774", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 63.0, "discounted_cash": 47.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ZINC OXIDE 40% 60GM OI", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5337755", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 146.0, "discounted_cash": 109.5, "setting": "both", "billing_class": "facility"}]}, {"description": "ZINC OXIDE 40% 60GM OI", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5337755", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 146.0, "discounted_cash": 109.5, "setting": "both", "billing_class": "facility"}]}, {"description": "ZINC SULF 1MG/1ML IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5325285", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 113.0, "discounted_cash": 84.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ZINC SULF 5MG/ML 1ML IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5325286", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 113.0, "discounted_cash": 84.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ZINC SULFATE 220MG CP", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5312523", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 77.0, "discounted_cash": 57.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ZINC SULFATE 220MG CP", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5312523", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 77.0, "discounted_cash": 57.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ZINC/2", "code_information": [{"code": "84630", "type": "CPT"}, {"code": "7254631", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 630.0, "discounted_cash": 472.5, "setting": "both", "billing_class": "facility"}]}, {"description": "ZIPRASIDONE 20MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5312532", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 136.0, "discounted_cash": 102.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ZIPRASIDONE 20MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5312532", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 136.0, "discounted_cash": 102.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ZIPRASIDONE 60MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5312534", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 143.0, "discounted_cash": 107.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ZIPRASIDONE 60MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5312534", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 143.0, "discounted_cash": 107.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ZIPRASIDONE 80MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5312536", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 156.0, "discounted_cash": 117.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ZIPRASIDONE 80MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5312536", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 156.0, "discounted_cash": 117.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ZIPRASIDONE PER 10MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3486", "type": "HCPCS"}, {"code": "5325301", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 516.0, "discounted_cash": 387.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ZIPRASIDONE PER 10MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3486", "type": "HCPCS"}, {"code": "5325301", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 516.0, "discounted_cash": 387.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ZOLEDRONIC ACID PER1MGIJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3489", "type": "HCPCS"}, {"code": "5325293", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 1918.0, "discounted_cash": 1438.5, "setting": "both", "billing_class": "facility"}]}, {"description": "ZOLEDRONIC ACID PER1MGIJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3489", "type": "HCPCS"}, {"code": "5325293", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 1918.0, "discounted_cash": 1438.5, "setting": "both", "billing_class": "facility"}]}, {"description": "ZOLPIDEM 5MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5312529", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 171.0, "discounted_cash": 128.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ZOLPIDEM 5MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5312529", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 171.0, "discounted_cash": 128.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ZONISAMIDE 100MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5312535", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 66.0, "discounted_cash": 49.5, "setting": "both", "billing_class": "facility"}]}, {"description": "ZONISAMIDE 100MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5312535", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 66.0, "discounted_cash": 49.5, "setting": "both", "billing_class": "facility"}]}, {"description": "ZONISAMIDE/3", "code_information": [{"code": "80203", "type": "CPT"}, {"code": "7252561", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 43.0, "discounted_cash": 32.25, "setting": "both", "billing_class": "facility"}]}]}